Physical therapy for acute and sub-acute low back pain: A systematic review and expert consensus.

OBJECTIVE: To review the effectiveness of different physical therapies for acute and sub-acute low back pain supported by evidence, and create clinical recommendations and expert consensus for physiotherapists on clinical prescriptions. DATA SOURCES: A systematic search was conducted in PubMed and the Cochrane Library for studies published within the previous 15 years. REVIEW METHODS: Systematic review and meta-analysis, randomized controlled trials assessing patients with acute and sub-acute low back pain were included. Two reviewers independently screened relevant studies using the same inclusion criteria. The Physiotherapy Evidence Database and the Assessment of Multiple Systematic Reviews tool were used to grade the quality assessment of randomized controlled trials and systematic reviews, respectively. The final recommendation grades were based on the consensus discussion results of the Delphi of 22 international experts. RESULTS: Twenty-one systematic reviews and 21 randomized controlled trials were included. Spinal manipulative therapy and low-level laser therapy are recommended for acute low back pain. Core stability exercise/motor control, spinal manipulative therapy, and massage can be used to treat sub-acute low back pain. CONCLUSIONS: The consensus statements provided medical staff with appliable recommendations of physical therapy for acute and sub-acute low back pain. This consensus statement will require regular updates after 5-10 years.

Advances in Traditional Chinese Medicine research in diabetic kidney disease treatment.

CONTEXT: Diabetic kidney disease (DKD) is a prominent complication arising from diabetic microangiopathy, and its prevalence and renal impact have placed it as the primary cause of end-stage renal disease. Traditional Chinese Medicine (TCM) has the distinct advantage of multifaceted and multilevel therapeutic attributes that show efficacy in improving clinical symptoms, reducing proteinuria, protecting renal function, and slowing DKD progression. Over recent decades, extensive research has explored the mechanisms of TCM for preventing and managing DKD, with substantial studies that endorse the therapeutic benefits of TCM compounds and single agents in the medical intervention of DKD. OBJECTIVE: This review lays the foundation for future evidence-based research efforts and provide a reference point for DKD investigation. METHODS: The relevant literature published in Chinese and English up to 30 June 2023, was sourced from PubMed, Cochrane Library, VIP Database for Chinese Technical Periodicals (VIP), Wanfang Data, CNKI, and China Biology Medicine disc (CBM). The process involved examining and summarizing research on TCM laboratory tests and clinical randomized controlled trials for DKD treatment. RESULTS AND CONCLUSIONS: The TCM intervention has shown the potential to inhibit the expression of inflammatory cytokines and various growth factors, lower blood glucose levels, and significantly affect insulin resistance, lipid metabolism, and improved renal function. Furthermore, the efficacy of TCM can be optimized by tailoring personalized treatment regimens based on the unique profiles of individual patients. We anticipate further rigorous and comprehensive clinical and foundational investigations into the mechanisms underlying the role of TCM in treating DKD.

Highly pH-Responsive Sensor Based on a EuIII Metal-Organic Framework with Efficient Recognition of Arginine and Lysine in Living Cells.

A lanthanide-based three-dimensional metal-organic framework with excellent water, acid/base, and solvent stability, namely {[(CH3)2NH2]0.7[Eu2(BTDBA)1.5(lac)0.7(H2O)2]·2H2O·2DMF·2CH3CN}n (JXUST-29, H4BTDBA = 4',4‴-(benzo[c][1,2,5]thiadiazole-4,7-diyl)bis([1,1'-biphenyl]-3,5-dicarboxylic acid), Hlac = lactic acid), has been synthesized and characterized. Since the N atoms of the thiadiazole group will not coordinate with lanthanide ions, JXUST-29 has a free basic N-site accessible to small H+ ions, which allows it to be used as a promising pH fluorescence sensor. Interestingly, the luminescence signal was significantly enhanced, with an approximately 54-fold enhancement in the emission intensity when the pH value was increased from 2 to 5, which is the typical behavior of pH probes. In addition, JXUST-29 can also be used as a luminescence sensor to detect l-arginine (Arg) and l-lysine (Lys) in an aqueous solution through fluorescence enhancement and the blue-shift effect. The detection limits were 0.023 and 0.077 µM, respectively. In addition, JXUST-29-based devices were designed and developed to facilitate detection. Importantly, JXUST-29 is also capable of detecting and sensing Arg and Lys in living cells.

The Effect of Cerebellar rTMS on Modulating Motor Dysfunction in Neurological Disorders: a Systematic Review.

The effectiveness of cerebellar repetitive transcranial magnetic stimulation (rTMS) on motor dysfunction in patients with neurological disorders has received increasing attention because of its potential for neuromodulation. However, studies on the neuromodulatory effects, parameters, and safety of rTMS implementation in the cerebellum to alleviate motor dysfunction are limited. This systematic review aimed to evaluate the effectiveness and safety of cerebellar rTMS treatment for motor dysfunction caused by neurological disorders and to review popular stimulation parameters. Five electronic databases-Medline, Web of Science, Scopus, Cochrane Library, and Embase-were searched for relevant research published from inception to July 2022. All randomized controlled trials (RCTs) that reported the effects of cerebellar rTMS combined with behavioral rating scales on motor dysfunction were eligible for enrollment. Additionally, reference lists of the enrolled studies were manually checked. Among 1156 articles screened, 21 RCTs with 666 subjects were included. rTMS conducted on the cerebellum showed an improvement in stroke (spasticity, balance, and gait), cervical dystonia, Parkinson's disease (tremor), cerebellar ataxia, and essential tremor but not in multiple sclerosis. The 8-shaped coil with a diameter of 70 mm was determined as the most common therapeutic choice. None of the studies reported severe adverse events except mild side effects in three. Therefore, rTMS appears to be a promising and safe technique for the treatment of motor dysfunction, targeting the cerebellum to induce motor behavioral improvement. Further rigorous RCTs, including more samples and longer follow-up periods, are required to precisely explore the effective stimulation parameters and possible mechanisms.

Rare earth upconversion luminescent composite based on energy transfer for specific and sensitive detection of cysteine.

Abnormal levels of thiols in cysteine (Cys) have been shown to be associated with growth retardation, skin lesions, and neurotoxicity in humans. Herein, we designed and synthesized a rare earth upconversion luminescent (UCL) nanocomposite probe UCNP-PEG-NOF1 for the UCL detection of Cys using NOF1 developed by our group as a Cys probe. The core structure of rare earth nanoparticles can absorb light at 980 nm and convert it into visible light. The detection principle of Cys was based on the change in absorption peak before and after the reaction between NOF1 and Cys, as well as the change in UCL intensity. The rare earth nanocomposite in the probe could be excited by near-infrared light and had low background fluorescence and strong penetration ability; thus, the probe was successfully employed to specifically and sensitively detect Cys with a low background signal. Overall, the developed UCNP-PEG-NOF1 probe had good selectivity and high sensitivity for Cys; its detection limit was as low as 83 nM.

Association between Respiratory Function and Motor Function in Different Stages of Parkinson's Disease.

INTRODUCTION: Respiratory dysfunction in patients with Parkinson's disease (PD) could present in the early stage and worsen in the late stages. These changes could be a factor affecting the ability of daily living and quality of life of patients with PD. The primary objective of this study was to assess the respiratory function and its association with motor function in patients with different stages of PD. METHODS: This was a cross-sectional study conducted at the Huashan Hospital of Fudan University in Shanghai, China. The study included 65 patients diagnosed with PD (the Hoehn and Yahr scale between 1 and 4) and 20 healthy individuals of similar age, gender, weight, and height. The ventilatory function was assessed using the spirometry. Motor function was evaluated using subscale III of the United Parkinson's disease rating scale (UPDRS-III). After confirming the normality of data distribution, we performed one-way ANOVA with a Tukey's post hoc test. RESULTS: Compared with the healthy individuals, there was no statistical significance in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and forced expiratory volume in 1 s/forced vital capacity (FEV1/FVC) in the H&Y 1 group and H&Y 2 group (p > 0.05) but reduced peak expiratory flow (PEF) in the H&Y 2 group (p = 0.002). Reduced FVC, FEV1, and PEF was seen in the H&Y 3 group (p = 0.002, p = 0.001, and p = 0.0001, respectively). Reduced FVC, FEV1, PEF, and FEF25-75% was seen in the H&Y 4 group (p = 0.001, p = 0.0001, p = 0.0001, and p = 0.025, respectively). The correlation analysis revealed that there was a significant negative correlation between FVC and UPDRS-III scores (r = -0.248, p = 0.046), disease duration (r = -0.276, p = 0.026), H&Y scale (r = -0.415, p = 0.001). FEV1 was negatively correlated with UPDRS-III scores (r = -0.277, p = 0.025), disease duration (r = -0.291, p = 0.019), H&Y scale (r = -0.434, p = 0.0001). FEF25-75% was negatively correlated with disease duration (r = -0.247, p = 0.047), H&Y scale (r = -0.278, p = 0.025). CONCLUSION: Our findings revealed that respiratory impairment is present in moderate and advanced PD patients, and directly related to the severity of the disease. It is important to conduct respiratory function test in the clinical practice.

A Benzothiadiazole-Based Eu3+ Metal-Organic Framework as the Turn-On Luminescent Sensor toward Al3+ and Ga3+ with Potential Bioimaging Application.

The design and preparation of novel multifunctional lanthanide metal-organic frameworks (Ln-MOFs) have been arisen widespread attention. In particular, Ln-MOFs have shown great luminescence potential in chemical sensing. Herein, a new benzothiadiazole-based Eu-MOF {[(CH3)2NH2][Eu(BTDB)2]·2H2O}n (JXUST-11) was obtained based on 4,4'-(benzo[c][1,2,5]thiadiazole-4,7-diyl)dibenzoic acid (H2BTDB), which exhibits a chain-based three-dimensional framework. Moreover, JXUST-11 is considered as a photoluminescent sensor to identify Al3+ and Ga3+ ions by fluorescence enhancement with the detection limits of 2.9 and 10.2 ppm, severally. Importantly, Al3+ and Ga3+ can be discerned with the naked eye by color change under a natural lamp. In addition, a portable MOF film based on JXUST-11 was developed for Al3+ and Ga3+ detection. This is the first Ln-MOF that can be employed as a naked-eye fluorescent probe to identify Ga3+. Interestingly, JXUST-11 is also capable of detecting Al3+ and Ga3+ in living cells.

Optimization of Alkali Extraction and Properties of Polysaccharides from Ziziphus jujuba cv. Residue.

Ziziphus jujuba cv. Muzao is a plant widely cultivated in the Yellow River Basin of China. It has nutritional and healthcare functions, in which polysaccharides are the main components of its bio-functions. In order to make effective use of Ziziphus jujuba cv. Muzao residue resources and explore new functional food ingredients, the polysaccharide (ZJRP) from Ziziphus jujuba cv. Muzao residues were extracted by sodium hydroxide, and the optimal extraction conditions of ZJRP were obtained by the response surface method. The basic composition and antioxidant effects of ZJRP were determined. The results showed that ZJRP has significant antioxidant activity, mainly reflected in the high DPPH radical scavenging rate, which may be related to their high content of galacturonic acid and the extraction method. In addition, the rheological and thermal properties of ZJRP were respectively determined by a rheometer and differential scanning calorimetry (DSC), indicating that they have shear thinning properties and good thermal stability. Results showed that the alkaline extraction method can be used as a potential technique for extracting ZJRP with high antioxidant activity, and ZJRP can be further explored as a functional food ingredient.

[Preparation Technology of Huayu Xiaozhong Spray Films].

OBJECTIVE: The extraction process and film-forming preparation technology of Huayu Xiaozhong spray film was optimized respectively by orthogonal design and central composite design/response surface method (CCD-RSM). METHODS: With the extraction rate of amygdalin as the index, the orthogonal experiment was adopted for the optimization of extraction process. With the film-forming time, spraying effect, thickness and maintain time of spray film as the indexes, the dosages of PVA 1788, PVP k30 and glycerin as factors, the prescription was optimized by CCD-RSM. RESULTS: The optimal extract processing was: immersing rude powder with 12 times of 60% ethanol for 24 hours. The optimal formula of Huayu Xiaozhong spray film was 5% of PVA 1788, 4.5% of glycerin and 5% of PVP-k30. CONCLUSION: Under the optimum condition, the extraction efficiency of amygdalin is 96.7%. Under the optimum technological condition of preparation, the spray film meets the demand of quality.

Pickering emulsions stabilized by starch nanocrystals prepared from various crystalline starches by ultrasonic assisted acetic acid: Stability and delivery of curcumin.

Ultrasonic assisted acetic acid hydrolysis was applied to prepare starch nanocrystals (SNCs) from native starches with different crystalline structures (A, B, and C types). The structure properties, morphology, Pickering emulsion stability and curcumin deliver capacity of both SNCs and native starches were investigated and compared. Compared with native starches, SNCs showed smaller size and higher crystallinity. The size of SNCs varied with different crystalline types, with C-type starch exhibiting the smallest SNCs (107.4 nm), followed by A-type (113.8 nm), and B-type displaying the largest particle size (149.0 nm). SNCs-Pickering emulsion showed enhanced stability with smaller emulsion droplets, higher static stability, and denser oil/water interface. SNCs-Pickering emulsions displayed higher curcumin loading efficiency (53.53 %-61.41 %) compared with native starch-Pickering emulsions (13.93 %-19.73 %). During in vitro digestion, SNCs-Pickering emulsions proved to be more proficient in protecting and prolonging the biological activity of curcumin due to their smaller size and better interfacial properties. These findings demonstrated the potential of SNCs for application in Pickering emulsion and delivery of bioactive components.

High-efficiency preparation of starch nanocrystals with small size and high crystallinity by ethanol-acid penetration and dry-heating pretreatment.

Ethanol-acid penetration and drying-heating treatment was developed to shorten the preparation time and improve the quality of starch nanocrystals (SNCs). After treatment by optimized parameters, including 40 % ethanol solution, 10.6 mM chloric acid, and heating time of 1.5 h or 2.0 h, the starches exhibited weakened internal structure and relatively complete crystalline structure. Compared with the regular preparation of only acid hydrolysis, the regular final yield (8.5 % after 5 days) was reached in 48 h and 12 h of the starch heated at 1.5 h and 2.0 h, respectively. The micromorphology, molecular weight, and crystalline structure evaluation demonstrated that the collected nanoparticles were indeed SNCs with smaller size and higher relative crystallinity than regular SNCs. Further analysis found that the SNCs had better crystalline lamellae, higher thermal stability, and lower proportion of phosphorus and sulfur atoms than regular SNCs. This provided a potential method for the high-efficiency preparation of SNCs.

Associations of bisphenol A exposure with metabolic syndrome and its components: A systematic review and meta-analysis.

Mounting evidence shows that bisphenol A (BPA) is associated with metabolic risk factors. The aim of this study was to review related epidemiologic studies and conduct a meta-analysis to quantitatively estimate the association between BPA and metabolic syndrome. Four electronic databases were systematically searched to identify suitable articles. A total of 47 published studies were finally included. Two studies involved metabolic syndrome. Of the 17, 17, 14, and 13 studies on the relationship between BPA with abdominal obesity, blood pressure, fasting plasma glucose, and dyslipidemia, 10, 6, 3, and 4 studies were included in the meta-analysis, respectively. The results showed that the risk of abdominal obesity increased with the increase of BPA exposure, especially in the group with higher BPA exposure levels (Quartile 2 vs. Quartile 1, pooled OR = 1.16, 95%CI: 1.01, 1.33; Q3 vs. Q1, pooled OR = 1.31, 95%CI: 1.13, 1.51; Q4 vs. Q1, pooled OR = 1.40, 95%CI: 1.21, 1.61). However, there was no significant correlation between BPA exposure and metabolic syndrome components including hypertension, abnormal fasting plasma glucose, and dyslipidemia. The present study found that BPA exposure is significantly associated with a higher risk of abdominal obesity. However, the relationship between BPA with metabolic syndrome and its other components needs further longitudinal studies to verify.

Repetitive peripheral magnetic stimulation combined with transcranial magnetic stimulation in rehabilitation of upper extremity hemiparesis following stroke: a pilot study.

OBJECTIVE: To investigate the effect of combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation on upper extremity function in subacute stroke patients. DESIGN: Pilot study. SUBJECTS: Subacute stroke patients. METHODS: Included patients were randomized into 3 groups: a central-associated peripheral stimulation (CPS) group, a central-stimulation-only (CS) group, and a control (C) group. The CPS group underwent a new paired associative stimulation (combined repetitive peripheral magnetic stimulation and transcranial magnetic stimulation), the CS group underwent repetitive transcranial magnetic stimulation, and the C group underwent sham stimulation. All 3 groups received physiotherapy after the stimulation or sham stimulation. The treatment comprised 20 once-daily sessions. Primary outcome was the Fugl-Meyer Assessment Upper Extremity (FMA-UE) score, and secondary outcomes were the Barthel Index and Comprehensive Functional Assessment scores, and neurophysiological assessments were mainly short-interval intracortical inhibition. A 3-group (CPS, CS, C) × 2-time (before, after intervention) repeated measures analysis of variance was conducted to determine whether changes in scores were significantly different between the 3 groups. RESULTS: A total of 45 patients were included in the analysis. Between-group comparisons on the FMA-UE demonstrated a significant improvement (group × time interaction, F2,42 = 4.86; p = 0.013; C vs CS, p = 0.020; C vs CPS, p = 0.016; CS vs CPS, p = 0.955). Correlation analysis did not find any substantial positive correlation between changes in FMA-UE and short-interval intracortical inhibition variables (C, r = -0.196, p = 0.483; CS, r = -0.169, p = 0.546; CPS, r = -0.424, p = 0.115). CONCLUSION: This study suggests that the real-stimulus (CS and CPS) groups had better outcomes than the control (C) group. In addition, the CPS group showed a better trend in clinical and neurophysiological assessments compared with the CS group.

Cortical reorganization after motor imagery training in chronic stroke patients with severe motor impairment: a longitudinal fMRI study.

INTRODUCTION: Despite its clinical efficacy, few studies have examined the neural mechanisms of motor imagery training (MIT) in stroke. Our objective was to find the cortical reorganization patterns after MIT in chronic stroke patients. METHODS: Twenty stroke patients with severe motor deficits were randomly assigned to the MIT or conventional rehabilitation therapy (CRT) group, but two lost in the follow-up. All 18 patients received CRT 5 days/week for 4 weeks. Nine subjects in the MIT group received 30-min MIT 5 days/week for 4 weeks. Before and after the interventions, the upper limb section of the Fugl-Meyer Scale (FM-UL) was blindly evaluated, and functional magnetic resonance imaging was administered while the patients executed a passive fist clutch task. RESULTS: Two cortical reorganization patterns were found. One pattern consisted of the growth in activation in the contralateral sensorimotor cortex (cSMC) for most patients (six in the MIT group, five in the CRT group), and the other consisted of focusing of the activation in the cSMC with increasing of the laterality index of the SMC for a small portion of patients (three in the MIT group, one in the CRT group). When we applied correlation analyses to the variables of relative ΔcSMC and ΔFM-UL in the 11 patients who experienced the first pattern, a positive relationship was detected. CONCLUSIONS: Our results indicate that different cortical reorganization patterns (increases in or focusing of recruitment to the cSMC region) exist in chronic stroke patients after interventions, and patients may choose efficient patterns to improve their motor function.

Early exercise protects the blood-brain barrier from ischemic brain injury via the regulation of MMP-9 and occludin in rats.

Early exercise within 24 h after stroke can reduce neurological deficits after ischemic brain injury. However, the mechanisms underlying this neuroprotection remain poorly understood. Ischemic brain injury disrupts the blood-brain barrier (BBB) and then triggers a cascade of events, leading to secondary brain injury and poor long-term outcomes. This study verified the hypothesis that early exercise protected the BBB after ischemia. Adult rats were randomly assigned to sham, early exercise (EE) or non-exercise (NE) groups. The EE and NE groups were subjected to ischemia induced by middle cerebral artery occlusion (MCAO). The EE group ran on a treadmill beginning 24 h after ischemia, 30 min per day for three days. After three-days' exercise, EB extravasation and electron microscopy were used to evaluate the integrity of the BBB. Neurological deficits, cerebral infarct volume and the expression of MMP-9, the tissue inhibitors of metalloproteinase-1 (TIMP-1), and occludin were determined. The data indicated that early exercise significantly inhibited the ischemia-induced reduction of occludin, and an increase in MMP-9 promoted TIMP-1 expression (p < 0.01), attenuated the BBB disruption (p < 0.05) and neurological deficits (p < 0.01) and diminished the infarct volume (p < 0.01). Our results suggest that the neuroprotection conferred by early exercise was likely achieved by improving the function of the BBB via the regulation of MMP-9 and occludin.

Shear stress inhibits apoptosis of ischemic brain microvascular endothelial cells.

As a therapeutic strategy for ischemic stroke, to restore or increase cerebral blood flow (CBF) is the most fundamental option. Laminar shear stress (LS), as an important force generated by CBF, mainly acts on brain microvascular endothelial cells (BMECs). In order to study whether LS was a protective factor in stroke, we investigated LS-intervented ischemic apoptosis of rat BMECs (rBMECs) through PE Annexin V/7-AAD, JC-1 and Hoechst 33258 staining to observe the membranous, mitochondrial and nuclear dysfunction. Real-time PCR and western blot were also used to test the gene and protein expressions of Tie-2, Bcl-2 and Akt, which were respectively related to maintain membranous, mitochondrial and nuclear norm. The results showed that LS could be a helpful stimulus for ischemic rBMECs survival. Simultaneously, membranous, mitochondrial and nuclear regulation played an important role in this process.

Education Changes Child Health Behavior in China: A Mediating Role of Information Technology.

Objectives: In this study, we aimed to explore the impact of education in changing child health behavior in China and mediating role of information technology. Methods: The theoretical framework of this study incorporated variables including mental health literacy, health education, information technology, and health behavior. This is a quantitative study that has utilized secondary data for determining the results. Based on the cross-sectional data collection method, 778 responses were considered for structural equation modeling. Smart PLS 3 was used to validate the research hypotheses. Results: We found that health education and mental health literacy have a substantial impact on Chinese child health behavior. Furthermore, our data also revealed that the mediating role of information technology is useful for children's health behavior enhancement. Conclusions: The health behavior of children is influenced by education and information technology mediates the health education-health behavior relationship.

Monolayer AsC5 as the Promising Hydrogen Storage Material for Clean Energy Applications.

One of the critical techniques for developing hydrogen storage applications is the advanced research to build novel two-dimensional materials with significant capacity and effective reversibility. In this work, we perform first-principles unbiased structure search simulations to find a novel AsC5 monolayer with a variety of functionally advantageous characteristics. Based on theoretical simulations, the proposed AsC5 has been found to be energetically, dynamically, and thermally stable, supporting the viability of experiment. Since the coupling between H2 molecules and the AsC5 monolayer is quite weak due to physisorption, it is crucial to be enhanced by thoughtful material design. Hydrogen storage capacity can be greatly enhanced by decorating the AsC5 monolayer with Li atoms. Each Li atom on the AsC5 substrate is shown to be capable of adsorbing up to four H2 molecules with an advantageous average adsorption energy (Ead) of 0.19 eV/H2. The gravimetric density for hydrogen storage adsorption with 16Li and 64 H2 of a Li-decorated AsC5 monolayer is about 9.7 wt%, which is helpful for the possible application in hydrogen storage. It is discovered that the desorption temperature (TD) is much greater than the hydrogen critical point. Therefore, such crucial characteristics make AsC5-Li be a promising candidate for the experimental setup of hydrogen storage.

Structural analysis, nutritional evaluation, and flavor characterization of parched rice made from proso millet.

This study investigated the structure and quality characteristics of hard and crispy parched rice obtained from raw proso millet through steaming, roasting, and milling. Results showed that thermal treatment disrupted the structure of samples and transformed the crystal from A-type in raw proso to V-type in parched rice. Rheological and thermodynamic analyses revealed that thermal treatment reduced the stability of parched rice. Gelatinization tests demonstrated that the parched rice was easier to gelatinize and had a lower viscosity. The digestibility of hard parched rice and crispy parched rice improved, with rapidly digestible starch content increasing by 73.62% and 76.95%, respectively, compared with that of raw proso millet. Headspace solid-phase microextraction/gas chromatography-mass spectrometry results further indicated that thermal treatment enhanced the flavor substances of parched rice. These findings demonstrated the unique properties of parched rice and supported its production and processing as a whole grain.