Effectiveness and safety of photobiomodulation therapy in diabetic peripheral neuropathy: Protocol for a systematic review and meta-analysis.

INTRODUCTION: Diabetic peripheral neuropathy (DPN), a widely prevalent complication in patients with type 2 diabetes, exerts a significant influence on patients' overall health and financial circumstances. Photobiomodulation therapy is one of the means of physical therapy for DPN. Although preliminary findings suggest the efficacy of photobiomodulation therapy in alleviating peripheral neuropathy, the existing literature lacks substantial evidence regarding its safety and effectiveness specifically in the context of diabetes-related peripheral neuropathy. Therefore, we plan to arrive at more distinct findings through systematic evaluation and meta-analysis. METHODS: We will conduct a comprehensive search for studies published from the beginning until October 1, 2023, using various databases including Web of Science, Embase, Cochrane Library, PubMed, AMED, Wanfang database, VIP database, China National Knowledge Infrastructure, and the Chinese Biomedical Literature database. Simultaneously, we will also search for the WHO International Clinical Trial Registration Platform, China Clinical Trial Registration Platform, and Clinical Trials.gov. Gray literature will be retrieved using Google Scholar and opengrey.edu. Only randomized controlled trials in Chinese and English were included, with no restrictions on publication status. The primary outcomes will include change of symptom scores, change of nerve conduction velocity. Additional outcomes will encompass quality of life, change in pain, blood glucose levels after fasting and 2 hours after eating, levels of glycosylated hemoglobin, and any adverse events associated with photobiomodulation therapy. Reman V.5.4 and R language will be used for the meta-analysis. Assessment of potential bias will be conducted through Cochrane risk of bias 2 tool (RoB 2.0) and Physiotherapy Evidence Database (PEDro) scale. Registration: PROSPERO (registration number: CRD42023466586). DISCUSSION: This meta-analysis aims to assess the efficacy and safety of photobiomodulation therapy as a potential treatment for diabetic peripheral neuropathy (DPN), and providing a straightforward and convenient therapeutic for patients. Additionally, it expands the range of treatment alternatives available to healthcare professionals managing DPN.

Association Between Visceral Obesity Index and Diabetes: A Systematic Review and Meta-analysis.

CONTENT: The correlation between visceral obesity index (VAI) and diabetes and accuracy of early prediction of diabetes are still controversial. OBJECTIVE: This study aims to review the relationship between high level of VAI and diabetes and early predictive value of diabetes. DATA SOURCES: The databases of PubMed, Cochrane, Embase, and Web of Science were searched until October 17, 2023. STUDY SELECTION: After adjusting for confounding factors, the original study on the association between VAI and diabetes was analyzed. DATA EXTRACTION: We extracted odds ratio (OR) between VAI and diabetes management after controlling for mixed factors, and the sensitivity, specificity, and diagnostic 4-grid table for early prediction of diabetes. DATA SYNTHESIS: Fifty-three studies comprising 595 946 participants were included. The findings of the meta-analysis elucidated that in cohort studies, a high VAI significantly increased the risk of diabetes mellitus in males (OR = 2.83 [95% CI, 2.30-3.49]) and females (OR = 3.32 [95% CI, 2.48-4.45]). The receiver operating characteristic, sensitivity, and specificity of VAI for early prediction of diabetes in males were 0.64 (95% CI, .62-.66), 0.57 (95% CI, .53-.61), and 0.65 (95% CI, .61-.69), respectively, and 0.67 (95% CI, .65-.69), 0.66 (95% CI, .60-.71), and 0.61 (95% CI, .57-.66) in females, respectively. CONCLUSION: VAI is an independent predictor of the risk of diabetes, yet its predictive accuracy remains limited. In future studies, determine whether VAI can be used in conjunction with other related indicators to early predict the risk of diabetes, to enhance the accuracy of prediction of the risk of diabetes.

Total synthesis of linoxepin facilitated by a Ni-catalyzed tandem reductive cyclization.

A nickel-catalyzed reductive cyclization was developed to construct the tricyclic core embedded in linoxepin, a cyclolignan with a unique benzoxepin ring. The generated diastereodivergent acetals could be converted to the common unsaturated lactone, thus allowing a racemic synthesis of this molecule after incorporation of the remaining aromatic ring. This strategy with a late-stage installation of the D-ring led to the facile production of several linoxepin analogs as well.