Effect of steviol glycosides as natural sweeteners on glucose metabolism in adult participants.

Steviol glycosides (SGs) are recognized as safe natural sweeteners; however, evidence from randomized controlled trials (RCTs) showed an inconclusive effect of SGs on glucose metabolism in adult participants. We aimed to conduct a systematic review and meta-analysis of RCTs to assess the effect of SGs on glucose metabolism. We systematically searched PubMed, Web of Science and EMBASE to include eligible RCTs. Our primary outcomes were differences between SGs and the control group with respect to changes in blood glucose from the baseline to the end of intervention (including fasting blood glucose [FBG], and HbA1c measurements). A random-effects meta-analysis was conducted for data synthesis to calculate the pooled mean difference (MD). There were twelve RCTs included for analyses with a total of 871 participants (48% females). A significant effect of SGs on FBG (MD = -4.10 mg dl-1, 95% CI -6.55 to -1.65) was found, while no significant difference in HbA1c (MD = 0.01%, 95% CI -0.12% to 0.13%) was observed between SGs and controls. The whole quality of evidence was rated as low. Subgroup analyses demonstrated favorable effects of SGs on FBG in participants aged ≤50 years, those without diabetes mellitus (DM) or hypertension at the baseline, and overweight and obese adults. Sensitivity analyses yielded results largely similar to the main findings. To conclude, SGs are found to produce significant improvement in glucose metabolism in adult participants when compared with the control. More evidence is required to further clarify and support the benefit of SGs as a sugar substitute for glucose metabolism.

Nicotinamide mononucleotide based hyaluronic acid methacryloyl hybrid hydrogel regulating stem cells fate for bone regeneration via SIRT1/RUNX2 signaling.

Efficient bone reconstruction, especially of the critical size after bone damage, remains a challenge in the clinic. Bone marrow mesenchymal stem cell (BMSC) osteogenic differentiation is considered as a promising strategy for bone repair. Nicotinamide adenine dinucleotide (NAD+) regulating BMSC fate and cellular function enhance osteogenesis, but is hardly delivered and lack of targeting. Herein, a novel and biocompatible scaffold was fabricated to locally deliver a precursor of NAD+, nicotinamide mononucleotide (NMN) to the bone defect site, and its bone repair capability and healing mechanism were clarified. NMN-based hyaluronic acid methacryloyl hybrid hydrogel scaffold (denoted as NMN/HAMA) was prepared via photopolymerization. In vitro RT-qPCR analysis, western blotting, Elisa and alizarin red S staining assays demonstrated that the NMN/HAMA hybrid hydrogel regulated BMSCs cellular function in favour of osteogenic differentiation and mineralization by upregulating the mRNA and proteins expression of the osteogenic genes type I pro-collagen (Col-1), bone morphogenic protein 4 (BMP4), and runt-related transcription factor 2 (RUNX2) via the SIRT1 pathway. Implantation of such hybrid hydrogels significantly enhanced bone regeneration in rodent critical calvarial defect models. Furthermore, restoration of the bone defect with NMN administration was inhibited in Prx1 Cre+; SIRT1flox/flox mice, confirming that the NMN/HAMA hybrid hydrogel scaffold promoted bone regeneration via the SIRT1-RUNX2 pathway. These results imply that NMN-based scaffold may be a promising and economic strategy for the treatment of bone defects.

Disassociation between fluctuation shift over frequency and glucose metabolism in motor cortex of Parkinson's disease: a hybrid PET/fMRI study.

Increased glucose metabolism and decreased low-frequency fluctuation have been consistently reported in the motor area of Parkinson's disease (PD). The reason for such seeming paradox is unclear. Here, we enrolled 34 PD patients and 25 healthy controls (HCs) for hybrid PET/fMRI scan (PET/fMRI(discovery) dataset). In addition, 2 replication datasets, namely fMRI(validation-1) and fMRI(validation-2) dataset, were also included. We computed ratio of standard uptake value (SUVr) to measure FDG-uptake. The amplitude of low-frequency fluctuations (ALFF) for the following 4 frequency bands was calculated: slow-5, slow-4, slow-3, and slow-2. We obtained a significant group-by-frequency interaction effect of ALFF in the paracentral lobule/supplementary motor area (PFWE = 0.003) and the right sensorimotor area (PFWE < 0.001) in the PET/fMRI(discovery) dataset, which could be replicated using fMRI(validation-1) and fMRI(validation-2) datasets (PFWE < 0.05). In detail, HCs exhibited power law-like fluctuation pattern, but PD patients did not. Correlation analyses further revealed significant associations between ALFF and FDG-uptake in HCs (P-values < 0.031), but not in PD (P-values > 0.28). Taken together, this study identified a fluctuation shift over frequency effect in PD patients, which further disassociated with glucose metabolism in the motor cortex.

Changes in blood pressure and related risk factors among nurses working in a negative pressure isolation ward.

Objective: To observe changes in blood pressure (ΔBP) and explore potential risk factors for high ΔBP among nurses working in a negative pressure isolation ward (NPIW). Methods: Data from the single-center prospective observational study were used. Based on a routine practice plan, female nurses working in NPIW were scheduled to work for 4 days/week in different shifts, with each day working continuously for either 5 or 6 h. BP was measured when they entered and left NPIW. Multivariable logistic regression was used to assess potential risk factors in relation to ΔBP ≥ 5 mm Hg. Results: A total of 84 nurses were included in the analysis. The ΔBP was found to fluctuate on different working days; no significant difference in ΔBP was observed between the schedules of 5 and 6 h/day. The standardized score from the self-rating anxiety scale (SAS) was significantly associated with an increased risk of ΔBP ≥ 5 mm Hg (odds ratio [OR] = 1.12, 95% CI: 1.00-1.24). Working 6 h/day (vs. 5 h/day) in NPIW was non-significantly related to decreased risk of ΔBP (OR = 0.70), while ≥ 2 consecutive working days (vs. 1 working day) was non-significantly associated with increased risk of ΔBP (OR = 1.50). Conclusion: This study revealed no significant trend for ΔBP by working days or working time. Anxiety was found to be significantly associated with increased ΔBP, while no <2 consecutive working days were non-significantly related to ΔBP. These findings may provide some preliminary evidence for BP control in nurses who are working in NPIW for Coronavirus Disease 2019 (COVID-19).

Trends in risk factor control in patients with gout: data from the National Health and Nutrition Examination Survey, 2007-2018.

OBJECTIVES: To explore trends in risk factor control (hypertension, diabetes mellitus, hyperlipidaemia) in patients with gout and medication use among those whose risk factor control targets were not achieved. METHODS: We used the data from National Health and Nutrition Examination Survey (NHANES) between 2007-2008 and 2017-2018 for analyses. The study samples were weighted so that they could be representative of the non-institutionalized US population. We conducted a cross-sectional analysis to assess trends in risk factor control and medication use, and employed logistic regression analyses to explore patient characteristics associated with risk factor control. RESULTS: The prevalence of participants in whom blood pressure control target was achieved decreased from 64.6% in 2007-2008 to 55.3% in 2017-2018 (P-value for trend = 0.03). The percentage of participants whose glycaemic, lipid or all three risk factor control targets were achieved remained stable temporally (P > 0.05). Some patient characteristics were significantly related to risk factor control, including age 45-64, age ≥65, Asian Americans, non-Hispanic Blacks, higher family income, and being overweight and obese. A trend towards increased use of glucose-lowering medication was found (from 71.0% in 2007-2008 to 94.7% in 2017-2018, P < 0.01), while the prevalence of taking blood pressure-lowering and lipid-lowering medications remained stable (P > 0.05). CONCLUSION: Based on NHANES data, a significant trend towards decreased blood pressure control was observed in patients with gout, while glycaemic and lipid control levelled off. These findings emphasize that more endeavours are needed to improve management of cardiovascular risk factors in patients with gout.

Association between serum uric acid and obesity in Chinese adults: a 9-year longitudinal data analysis.

OBJECTIVES: Hyperuricaemia has been reported to be significantly associated with risk of obesity. However, previous studies on the association between serum uric acid (SUA) and body mass index (BMI) yielded conflicting results. The present study examined the relationship between SUA and obesity among Chinese adults. METHODS: Data were collected at Guangdong Second Provincial General Hospital in Guangzhou City, China, between January 2010 and December 2018. Participants with ≥2 medical check-up times were included in our analyses. Physical examinations and laboratory measurement variables were obtained from the medical check-up system. The high SUA level group was classified as participants with hyperuricaemia, and obesity was defined as BMI ≥28 kg/m2. Logistic regression model was performed for data at baseline. For all participants, generalised estimation equation (GEE) model was used to assess the association between SUA and obesity, where the data were repeatedly measured over the 9-year study period. Subgroup analyses were performed by gender and age group. We calculated the cut-off values for SUA of obesity using the receiver operating characteristic curves (ROC) technique. RESULTS: A total of 15 959 participants (10 023 men and 5936 women) were included in this study, with an average age of 37.38 years (SD: 13.27) and average SUA of 367.05 µmol/L (SD: 97.97) at baseline, respectively. Finally, 1078 participants developed obesity over the 9-year period. The prevalence of obesity was approximately 14.2% for high SUA level. In logistic regression analysis at baseline, we observed a positive association between SUA and risk of obesity: OR=1.84 (95% CI: 1.77 to 1.90) for per-SD increase in SUA. Considering repeated measures over 9 year for all participants in the GEE model, the per-SD OR was 1.85 (95% CI: 1.77 to 1.91) for SUA and the increased risk of obesity were greater for men (OR=1.45) and elderly participants (OR=1.01). In subgroup analyses by gender and age, we observed significant associations between SUA and obesity with higher risk in women (OR=2.35) and young participants (OR=1.87) when compared with men (OR=1.70) and elderly participants (OR=1.48). The SUA cut-off points for risk of obesity using ROC curves were approximately consistent with the international standard. CONCLUSIONS: Our study observed higher SUA level was associated with increased risk of obesity. More high-quality research is needed to further support these findings.

Dual Energy Computed Tomography of Internal Carotid Artery: A Modified Dual-Energy Algorithm for Calcified Plaque Removal, Compared With Digital Subtraction Angiography.

Background: Atherosclerotic disease of the internal carotid artery (ICA) is a common reason for ischemic stroke. Computed tomography angiography (CTA) is a common tool for evaluation of internal carotid artery (ICA) stenosis. However, blooming artifacts caused by calcified plaques might lead to overestimation of the stenosis grade. Furthermore, the intracranial ICA is more vulnerable to calcification than other ICA segments. The proposed technique, dual-energy computed tomography (DECT) with a modified three-material decomposition algorithm may facilitate the removal of calcified plaques and thus increase diagnostic accuracy. Objectives: The objective of the study is to assess the accuracy of the modified three-material decomposition algorithm for grading intracranial ICA stenosis after calcified plaque removal, with digital subtraction angiography (DSA) used as a reference standard. Materials and Methods: In total, 41 patients underwent DECT angiography and DSA. The three-material decomposition DECT algorithm for calcium removal was applied. We evaluated 64 instances of calcified stenosis using conventional CTA, the previous non-modified calcium removal DECT technique, the modified DECT algorithm, and DSA. The correlation coefficient (r 2) between the results generated by the modified algorithm and DSA was also calculated. Results: The virtual non-calcium images (VNCa) produced by the previous non-modified calcium removal algorithm were named VNCa 1, and those produced by the modified algorithm were named VNCa 2. The assigned degree of stenosis of VNCa 1 (mean stenosis: 39.33 ± 19.76%) differed significantly from that of conventional CTA images (mean stenosis: 59.03 ± 25.96%; P = 0.001), DSA (13.19 ± 17.12%, P < 0.001). VNCa 1 also significantly differed from VNCa 2 (mean stenosis: 15.35 ± 18.70%, P < 0.001). In addition, there was a significant difference between the degree of stenosis of VNCa 2 and conventional CTA images (P < 0.001). No significant differences were observed between VNCa 2 and DSA (P = 0.076). The correlation coefficient (r 2) between the stenosis degree of the VNCa 2 and DSA images was 0.991. Conclusions: The proposed DECT with a modified three-material decomposition algorithm for calcium removal has high sensitivity for the detection of relevant stenoses, and its results were more strongly correlated with DSA than with those of conventional CTA or the previous non-modified algorithm. Further, it overcomes CTA's previous problem of overestimating the degree of stenosis because of blooming artifacts caused by calcified plaques. It is useful to account for calcified plaques while evaluating carotid stenosis.

The effect of extracorporeal shock wave therapy on the treatment of moderate to severe knee osteoarthritis and cartilage lesion.

BACKGROUND: Knee osteoarthritis (KOA) is a major cause leading to chronic bone and muscle pain. Extracorporeal shock wave therapy (ESWT) has been applied in treating KOA in recent years. METHODS: From April 2016 to April 2017, 82 patients were diagnosed with KOA that received ESWT were selected as the ESWT group. The treatment parameters were as follows, 2.0 bar, 0.25 mJ/mm, and 8 Hz/s for twice a week for 4 weeks continuously. In addition, 104 patients receiving oral administration of nonsteroidal anti-inflammatory drugs (NSAIDs) from April 2015 to April 2016 were also selected as the NSAIDs group. At 4, 8, 12, and 16 weeks upon the completion of treatment, the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities Arthritis Index (WOMAC) were adopted to evaluate the changes in pain and function of patients in both groups. For the ESWT group, the 50-m quick walk time and gait analysis were applied to observe the functional recovery at 4, 8, 12, and 16 weeks upon the completion of treatment; meanwhile, patients were followed up by magnetic resonance imaging (MRI) at 24 weeks upon the completion of treatment, so as to observe the cartilage changes. RESULTS: Differences in VAS, 4, 8, and 12 weeks after treatment were statistically significant compared with that before treatment (4.59 ±â€Š0.5, P < .05; 2.55 ±â€Š0.5, P < .05; 4.39 ±â€Š0.49, P < .05). Differences in 4, 8, and 12 weeks after treatment were statistically significant compared with that before treatment (90.41 ±â€Š6.64, P < .05; 59.94 ±â€Š3.19, P < .05; 90.49 ±â€Š6.87, P < .05). Gait analysis suggested differences in 50 m walk time, walking speed, swing phase, and stance phase 8 weeks after treatment were statistically significant compared with that before treatment (36.23 ±â€Š4.08, P < .05; 1.25 ±â€Š0.09, P < .05; 58.56 ±â€Š0.87, P < .05; 41.44 ±â€Š0.87, P < .05). Differences in the VAS and WOMAC at 4 and 8 weeks after treatment between ESWT group and NASIDs group were not statistically significant. CONCLUSIONS: The ESWT has potential in reducing pain and improving knee function, and the therapeutic effects may peak at 8 weeks after the completion of treatment. Further research is needed to arrive at a definitive conclusion.

Cold water immersion test (10 °C, 10 min) for diagnosing vibration-induced white finger among a group of polishers in a subtropical environment.

OBJECTIVE: This study aimed to investigate whether the finger skin temperature (FST) after cold provocation (10 °C, 10 min) is as a useful indicator for assisting in the diagnosis of vibration-induced white finger (VWF) in a group of polishers in a subtropical environment. METHOD: Ninety male vibration-exposed metal polishers (30 patients and 60 controls) from the Guangdong Province in Southern China were recruited. The FSTs at 30, 20, 10, and 0 min before cold water immersion (FSTpre-30, FSTpre-20, FSTpre-10, and FSTbaseline) and 0, 5, 10, 15, 20, 25, and 30 min after immersion (FST0, FST5, FST10, FST15, FST20, FST25, and FST30) were measured on the index, middle, and ring fingers of both hands. RESULTS: During the first 20-min adaptation period, there was a significant increase in FST in three fingers on both hands in the two groups. In contrast, there were no significant differences between FSTpre-10 and FSTbaseline. Furthermore, FSTpre-30, FSTpre-20, FSTpre-10, and FSTbaseline of the three fingers in both hands did not differ significantly. During recovery, the indicators FST5-0, FST10-0, R5, and R10 for the index finger of the left hand in patients were lower than for the controls. Among the various indicators, the absolute recovery rate, FST5-0, at 5 min after immersion was identified as the best diagnosis indicator with a sensitivity of 76.7% and specificity of 70.0% when applied to the index finger of the left hand. CONCLUSION: The cold water immersion test as applied in a subtropical environment can have a fair discriminating ability for diagnosing VWF.

Vibration characteristics of golf club heads in their handheld grinding process and potential approaches for reducing the vibration exposure.

To control vibration-induced white finger among workers performing the fine grinding of golf club heads, the aims of this study are to clarify the major vibration sources in the grinding process, to identify and understand the basic characteristics of the club head vibration, and to propose potential approaches for reducing the vibration exposure. The vibrations on two typical club heads and two belt grinding machines were measured at a workplace. A simulated test station was also constructed and used to help examine some influencing factors of the club head vibration. This study found that the club head vibration was the combination of the vibration transmitted from the grinding machines and that generated in the grinding process. As a result, any factor that affects the machine vibration, the grinding vibration, and/or the dynamic response of the club head can influence the vibration exposure of the fingers or hands holding the club head in the grinding process. The significant influencing factors identified in the study include testing subject, grinding machine, machine operation speed, drive wheel condition, club head model, mechanical constraints imposed on the club head during the grinding, and machine foot pad. These findings suggest that the vibration exposure can be controlled by reducing the grinding machine vibration, changing the workpiece dynamic properties, and mitigating the vibration transmission in its pathway. Many potential methods for the control are proposed and discussed. RELEVANCE TO INDUSTRY: Vibrations on handheld workpieces can be effectively transmitted to the hands, especially the fingers. As a result, a major component of the hand-arm vibration syndrome - vibration-induced white finger - has been observed among some workers performing the grinding and/or polishing tasks of the handheld workpieces such as golf club heads. The results of this study can be used to develop more effective methods and technologies to control the vibration exposure of these workers. This may help effectively control this occupational disease.

Nailfold capillary morphological characteristics of hand-arm vibration syndrome: a cross-sectional study.

OBJECTIVE: The purpose of this study was to investigate the characteristics of nailfold capillaroscopy associated with hand-arm vibration syndrome (HAVS). METHODS: In total, 113 male gold miners were recruited: 35 workers who were chronically exposed to vibration and developed vibration-induced white finger were defined as the HAVS group, 39 workers who were exposed to vibration but did not have HAVS were classified as the vibration-exposed controls (VEC) group, and 39 workers without vibration exposure were categorised as the non-VEC (NVEC) group. Video capillaroscopy was used to capture images of the 2nd, 3rd and 4th fingers of both hands. The following nailfold capillary characteristics were included: number of capillaries/mm, avascular areas, haemorrhages and enlarged capillaries. The experiments were carried out in the same winter. All characteristics were evaluated under blinded conditions. RESULTS: Significant differences in all morphological characteristics existed between the groups (p<0.05). Avascular areas in the HAVS, VEC and NVEC groups appeared in 74.3%, 43.6% and 25.0% of participants, respectively. A higher percentage of participants had haemorrhages in the HAVS group (65.7%) compared with the other groups (VEC: 7.7% and NVEC: 7.5%). The number of capillaries/mm, input limb width, output limb width, apical width, and ratio of output limb and input limb all had more than 70% sensitivity or specificity of their cut-off value. CONCLUSIONS: Nailfold capillary characteristics, especially the number of capillaries/mm, avascular areas, haemorrhages, output limb width, input limb width and apical width alterations, revealed significant associations with HAVS.

Epidemiology of herpes zoster among adults aged 50 and above in Guangdong, China.

Herpes zoster (HZ) exists widely in China and most cases occur among old people, but no epidemiology information of HZ was available. We aimed to investigate the epidemiology characteristics of HZ among adults aged 50 and over in Guangdong, China. A total of 34 counties/districts were randomly selected in Guangdong, and 7149 residents aged 50 and over were investigated by local CDC professionals using accidental sampling method. There were 247 respondents having had HZ before; the lifetime prevalence of HZ among people aged 50 and above in study area was 3.46%. The prevalence in females was higher than that in males. Pearl River Delta had the highest prevalence (5.29%), while Northern Guangdong had the lowest (1.87%). The annual incidence in the year 2013, 2012 and 2011 was 5.8, 3.4 and 4.1 per 1000 person-years, respectively. Detailed investigation of HZ cases showed that all cases meted the definition of HZ and had at least 1 typical symptom. 40% cases had suffered post-herpetic neuralgia. 75.9% cases had sought aid from hospital and 9.1% of them had been hospitalized. People who sought aid from hospital had more serious level of neuralgia. The epidemiology features of HZ in Guangdong were consistent with the current findings in other countries. The results of this study can provide baseline epidemiology information of HZ for further studies.

Alpha-enolase promotes cell glycolysis, growth, migration, and invasion in non-small cell lung cancer through FAK-mediated PI3K/AKT pathway.

BACKGROUND: During tumor formation and expansion, increasing glucose metabolism is necessary for unrestricted growth of tumor cells. Expression of key glycolytic enzyme alpha-enolase (ENO1) is controversial and its modulatory mechanisms are still unclear in non-small cell lung cancer (NSCLC). METHODS: The expression of ENO1 was examined in NSCLC and non-cancerous lung tissues, NSCLC cell lines, and immortalized human bronchial epithelial cell (HBE) by quantitative real-time reverse transcription PCR (qRT-PCR), immunohistochemistry, and Western blot, respectively. The effects and modulatory mechanisms of ENO1 on cell glycolysis, growth, migration, invasion, and in vivo tumorigenesis and metastasis in nude mice were also analyzed. RESULTS: ENO1 expression was increased in NSCLC tissues in comparison to non-cancerous lung tissues. Similarly, NSCLC cell lines A549 and SPCA-1 also express higher ENO1 than HBE cell line in both mRNA and protein levels. Overexpressed ENO1 significantly elevated NSCLC cell glycolysis, proliferation, clone formation, migration, and invasion in vitro, as well as tumorigenesis and metastasis in vivo by regulating the expression of glycolysis, cell cycle, and epithelial-mesenchymal transition (EMT)-associated genes. Conversely, ENO1 knockdown reversed these effects. More importantly, our further study revealed that stably upregulated ENO1 activated FAK/PI3K/AKT and its downstream signals to regulate the glycolysis, cell cycle, and EMT-associated genes. CONCLUSION: This study showed that ENO1 is responsible for NSCLC proliferation and metastasis; thus, ENO1 might serve as a potential molecular therapeutic target for NSCLC treatment.

Prognostic value of cancer stem cell marker CD133 expression in non-small cell lung cancer: a systematic review.

OBJECTIVE: To investigate the correlation between CD133-positive non-small cell lung cancer (NSCLC) and clinicopathological features and its impact on survival. METHODS: A search in the Pubmed, Embase and Wanfang databases (up to July 15, 2013) was performed. Only articles in which CD133 antigen was detected in situ localization by immunohistochemical staining were included. This meta-analysis was done using RevMan 5.2 software. Outcomes included overall survival and various clinicopathological features. RESULTS: A total of 1004 NSCLC patients from 11 studies were included. Meta-analysis showed that CD133 expression patients had a significant worse 5-year overall survival compared to the low expression ones (RR = 3.19, 95% CI: 2.05-4.98, P<0.0001 fixed random). With respect to clinicopathological features, CD133 expression by IHC method was closely correlated with tumor T stage (OR = 0.91, 95% CI: 0.59-1.39, P = 0.67 fixed-effect) and tumor grade (OR = 1.20, 95% CI: 0.80-1.79, P = 0.37 fixed-effect). CONCLUSION: CD133-positive NSCLC patients had worse prognosis, and was associated with common clinicopathological poor prognostic factors.

Comparative analysis of mitochondrial fragments transferred to the nucleus in vertebrate.

Mitochondrial DNA sequences transferred to the nucleus give rise to the socalled nuclear mitochondrial DNA (numt). In the GenBank database, 244 numts have been found in six orders of birds (Anseriformes, Columbiformes, Falconiformes, Charadriiformes, Galliformes and Passeriformes). Sequences alignment (NCBI-BLASTN) was carried out with mitochondrial and corresponding nuclear genome sequences in nine vertebrate species. The sequences with high homology were considered as numts. The number of numts ranged from 15 in chicken to 159 in chimpanzee. The sequences of numts in macaque, chimpanzee, and human spanned 100% of the entire mammalian mitochondrial genome. The reconstructed frequency of the mitochondrial gene transferred to the nucleus demonstrated that the rRNA genes had high frequencies than other mitochondrial genes. Using the RepeatMasker program, the transposable elements were detected in the flanking regions of each numt. The results showed that less than 5% of the flanking sequences were made up of repetitive elements in chicken. The GC content of 5'- and 3'-flanking regions of numts in nine species was less than 44%. The analysis of the flanking sequences provided a valuable understanding for future study on mechanism of mitochondrial gene transfer to the nucleus and the site of numt integration.