Cerebellar transcranial magnetic stimulation for improving balance capacity and activity of daily living in stroke patients: a systematic review and meta-analysis.

BACKGROUND: The application of cerebellar transcranial magnetic stimulation (TMS) in stroke patients has received increasing attention due to its neuromodulation mechanisms. However, studies on the effect and safety of cerebellar TMS to improve balance capacity and activity of daily living (ADL) for stroke patients are limited. This systematic review and meta-analysis aimed to investigate the effect and safety of cerebellar TMS on balance capacity and ADL in stroke patients. METHOD: A systematic search of seven electronic databases (PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure, Wanfang and Chinese Scientific Journal) were conducted from their inception to October 20, 2023. The randomized controlled trials (RCTs) of cerebellar TMS on balance capacity and/or ADL in stroke patients were enrolled. The quality of included studies were assessed by Physiotherapy Evidence Database (PEDro) scale. RESULTS: A total of 13 studies involving 542 participants were eligible. The pooled results from 8 studies with 357 participants showed that cerebellar TMS could significantly improve the post-intervention Berg balance scale (BBS) score (MD = 4.24, 95%CI = 2.19 to 6.29, P < 0.00001; heterogeneity, I2 = 74%, P = 0.0003). The pooled results from 4 studies with 173 participants showed that cerebellar TMS could significantly improve the post-intervention Time Up and Go (TUG) (MD=-1.51, 95%CI=-2.8 to -0.22, P = 0.02; heterogeneity, I2 = 0%, P = 0.41). The pooled results from 6 studies with 280 participants showed that cerebellar TMS could significantly improve the post-intervention ADL (MD = 7.75, 95%CI = 4.33 to 11.17, P < 0.00001; heterogeneity, I2 = 56%, P = 0.04). The subgroup analysis showed that cerebellar TMS could improve BBS post-intervention and ADL post-intervention for both subacute and chronic stage stroke patients. Cerebellar high frequency TMS could improve BBS post-intervention and ADL post-intervention. Cerebellar TMS could still improve BBS post-intervention and ADL post-intervention despite of different cerebellar TMS sessions (less and more than 10 TMS sessions), different total cerebellar TMS pulse per week (less and more than 4500 pulse/week), and different cerebellar TMS modes (repetitive TMS and Theta Burst Stimulation). None of the studies reported severe adverse events except mild side effects in three studies. CONCLUSIONS: Cerebellar TMS is an effective and safe technique for improving balance capacity and ADL in stroke patients. Further larger-sample, higher-quality, and longer follow-up RCTs are needed to explore the more reliable evidence of cerebellar TMS in the balance capacity and ADL, and clarify potential mechanisms.

The Moonlighting Function of Soybean Disordered Methyl-CpG-Binding Domain 10c Protein.

Intrinsically disordered proteins (IDPs) are multifunctional due to their ability to adopt different structures depending on the local conditions. The intrinsically disordered regions of methyl-CpG-binding domain (MBD) proteins play important roles in regulating growth and development by interpreting DNA methylation patterns. However, whether MBDs have a stress-protective function is far from clear. In this paper, soybean GmMBD10c protein, which contains an MBD and is conserved in Leguminosae, was predicted to be located in the nucleus. It was found to be partially disordered by bioinformatic prediction, circular dichroism and a nuclear magnetic resonance spectral analysis. The enzyme activity assay and SDS-PAGE results showed that GmMBD10c can protect lactate dehydrogenase and a broad range of other proteins from misfolding and aggregation induced by the freeze-thaw process and heat stress, respectively. Furthermore, overexpression of GmMBD10c enhanced the salt tolerance of Escherichia coli. These data validate that GmMBD10c is a moonlighting protein with multiple functions.

Handelin extends lifespan and healthspan of Caenorhabditis elegans by reducing ROS generation and improving motor function.

Aging and aging-related disorders contribute to formidable socioeconomic and healthcare challenges. Several promising small molecules have been identified to target conserved genetic pathways delaying aging to extend lifespan and healthspan in many organisms. We previously found that extract from an edible and medicinal plant Chrysanthemum indicum L. (C. indicum L.) protect skin from UVB-induced photoaging, partially by reducing reactive oxygen species (ROS) generation. Thus, we hypothesized that C. indicum L. and its biological active compound may extend lifespan and health span in vivo. We find that both water and ethanol extracts from C. indicum L. extended lifespan of Caenorhabditis elegans, with better biological effect on life extending for ethanol extracts. As one of the major biological active compounds, handelin extended lifespan of C. elegans too. RNA-seq analysis revealed overall gene expression change of C. elegans post stimulation of handelin focus on several antioxidative proteins. Handelin significantly reduced ROS level and maintained the number and morphology of mitochondria. Moreover, handelin improveed many C. elegans behaviors related to healthspan, including increased pharyngeal pumping and body movement. Muscle fiber imaging analyses revealed that handelin maintains muscle architecture by stabilizing myofilaments. In conclusion, our present study finds a novel compound handelin, from C. indicum L., which bring about biologically beneficial effects by mild stress response, termed as hormetin, that can extend both lifespan and healthspan in vivo on C. elegans. Further study on mammal animal model of natural aging or sarcopenia will verify the potential clinical value of handelin.

Correlation between impaired hemodynamic response and cardiopulmonary fitness in middle-aged type 2 diabetes mellitus patients: a case-control study.

PURPOSE: Impaired cardiorespiratory fitness (CRF) is a predictor of mortality in patients with type 2 diabetes mellitus (T2DM). It is still not known how the exercise hemodynamic response correlates with CRF. The purpose was to assess the correlation between hemodynamic changes and CRF in middle-aged patients with T2DM. METHODS: After 1:1 matching by age and sex, 139 T2DM patients and 139 non-T2DM controls who completed the exercise treadmill test were included. Maximal aerobic capacity (VO2max), exercise-induced changes in heart rate (ΔHR), systolic blood pressure (ΔSBP), diastolic blood pressure (ΔDBP), and rate-pressure product (ΔRPP) were measured. HRR1 was calculated as the maximum heart rate minus the heart rate after 1 min of rest. RESULTS: Compared to the control population, T2DM patients had decreased ΔHR (87 (77, 97) v 93 (84, 104) bpm, p < 0.05), ΔRPP (3833.64 ± 1670.34 v 4381.16 ± 1587.78 bpm∙mmHg, p < 0.05), HRR1 (21 (14, 27) v 21 (17, 27) bpm, p < 0.05), and VO2max (32.76 ± 5.63 v 34.68 ± 5.70 ml/kg/min, p < 0.05). Multiple linear regression analysis showed that ΔHR and HRR1, yielded a positive correlation with VO2max in T2DM patients (ß = 0.325, P < 0.001; ß = 0.173, P = 0.01). CONCLUSION: The presence of impaired hemodynamic response and VO2max in middle-aged T2DM patients and the association of impaired ΔHR, HRR1, and VO2max may indicate a physiological pathway of impaired CRF, and our results support the need for cardiorespiratory screening and individualized treatment of middle-aged T2DM patients.

Performances of simultaneous enhanced removal of nitrogen and phosphorus via biological aerated filter with biochar as fillers under low dissolved oxygen for digested swine wastewater treatment.

This study aims to explore the feasibility of biochar as a carrier to improve the simultaneous removal of nitrogen and phosphorus in biological aerated filters (BAFs) for treating low C/N digested swine wastewater (DSW). Two similar BAFs (BAF-A with hydrophobic polypropylene resin as fillers and BAF-B with bamboo biochar as carrier) were developed for DSW treatment. Results showed that the NH4+-N, TN, and TP removal performances in BAF-B were higher than those in BAF-A. Carrier type had an obvious influence on the structures and diversity of the microbial population. The biochar carrier in BAF-B was conducive to the enrichment of the functional microorganisms and the increase of microbial diversity under high NH4+-N conditions. Microbial analysis showed that the genera Rhodanobacter (10.64%), JGI_0001001-h003 (14.24%), RBG-13-54-9 (8.87%), Chujaibacter (11.27%), and Ottowia were the predominant populations involved in nitrogen and phosphorus removal in the later stage of phase III in BAF-B. BAF with biochar as carrier was highly promising for TN and TP removal in low C/N and high NH4+-N DSW treatment.

Rapid start-up of partial nitritation in aerobic granular sludge bioreactor and the analysis of bacterial community dynamics.

The rapid start-up of the partial nitritation process in a laboratory-scale aerobic granular sludge-sequencing batch reactor was successful by controlling low dissolved oxygen and gradually increasing the influent ammonia levels. The microbial community dynamics were analyzed by high-throughput sequencing and quantitative polymerase chain reaction. The microbial communities were significantly affected by the different influent NH4+-N concentrations (77.84, 119.42, 170.31, and 252.21 mg/L) in Phases I, II, III, and IV. The sludge Shannon index in Phases I, II, III, and IV was 3.9, 4.39, 3.47, and 2.13, respectively, which was higher than that of the inoculated sludge (1.62). The dominant class transformed from Alphaproteobacteria and Gammaproteobacteria in Phase I to Betaproteobacteria in Phase IV. Furthermore, Sphingobacteria and Clostridia were the dominant bacteria in Phases III and IV. The quantitative polymerase chain reaction (qPCR) results suggested that Nitrosomonadaceae_uncultured belonging to ammonia-oxidizing bacterium was the dominant species, but the relative abundance of nitrite-oxidizing bacteria (mainly Nitrospira and Nitrobacter) was extremely rare in Phase IV. Furthermore, Thauera, Denitratisoma, and Planctomycetacia were the dominant functional nitrogen removal microbes in Phases III and IV. Some nitrogen removal pathways such as partial nitritation, denitrification, and anaerobic ammonium oxidation co-existed in the partial nitritation process.

Influence of age on static postural control in adults with type 2 diabetes mellitus: a cross-sectional study.

Aim: It was the aim of this study to assess static postural control characteristics in people with type 2 diabetes mellitus (T2D) of different ages using a force platform. A relationship was also established between static postural control parameters and age in this study. Methods: A total of 706 participants with T2D were included in this study. The participants were stratified into three age groups: Group 1 (<60 years old), Group 2 (60-70 years old), and Group 3 (>70 years old). Static postural control assessment during two-leg stance was performed on a force platform by all participants. The center of pressure (CoP)-related parameters were measured under two stance conditions (eyes open and closed). Kruskal-Wallis tests were applied to explore the difference among the different age groups. Multivariate regression analysis was performed to determine the relation between age and static postural control parameters. Results: Group 1 (<60 years old) had significantly less CoP total tracking length (TTL), sway area (SA), and CoP velocity along the Y direction (V-Y) under both eyes-open and eyes-closed conditions compared with Group 2 (60-70 years old) and Group 3 (>70 years old). Group 1 (<60 years old) had significantly less CoP maximum sway length along the X direction (MSL_X) and longer tracking length each area unit (TTL/SA) under the eyes-open condition compared with Group 2 (60-70 years old) and Group 3 (>70 years old). There was a significantly positive correlation between age and the most static postural parameters such as CoP TTL, SA, MSL-X, MSL-Y, and V-Y. There was a significantly negative correlation between age and TTL/SA. Conclusion: This study suggested that older T2D participants had worse static postural control ability than younger ones. Most static postural parameters presented a significant correlation with age; the higher the age, the worse the static postural control.

Efficacy of 3D-printed assisted percutaneous transhepatic one-step biliary fistulation combined with rigid choledochoscopy for intrahepatic bile duct stones.

This study evaluated the efficacy and safety of three-dimensional printing model-assisted percutaneous transhepatic one-step biliary fistulation (PTOBF) combined with rigid choledochoscopy for intrahepatic bile duct stones in patients with type I bile duct classification. The clinical data of 63 patients with a type I intrahepatic bile duct were reviewed from January 2019 to January 2023; 30 patients who underwent 3D printed model-assisted PTOBF combined with rigid choledochoscopy composed the experimental group and 33 patients who underwent simple PTOBF combined with rigid choledochoscopy composed the control group. Six indicators, including one-stage operation time and clearance rate, final removal rate, bleeding volume, channel size and complications, were observed and analyzed in the two groups. The one-stage and final removal rate in the experimental group was higher than that in the control group (P = 0.034, P = 0.014 versus control group). The time of one-stage operation, bleeding volume, and incidence of complications in the experimental group were significantly lower than those in the control group (P < 0.001, P = 0.039, P = 0.026 versus control group). Compared with simple PTOBF combined with rigid choledochoscopy, 3D printed model-assisted PTOBF combined with rigid choledochoscopy is a safer and more effective method for treating intrahepatic bile duct stones.

Effects of Tai Chi Chuan on Cognitive Function in Adults 60 Years or Older With Type 2 Diabetes and Mild Cognitive Impairment in China: A Randomized Clinical Trial.

Importance: Type 2 diabetes (T2D) is associated with the progression of cognitive dysfunction. Physical activity benefits cognition, but no evidence from randomized clinical trials has shown whether tai chi chuan has better long-term benefits than fitness walking in cognitive function for patients with T2D and mild cognitive impairment (MCI). Objective: To compare the effectiveness of tai chi chuan, a mind-body exercise, for improving cognitive function in older adults with T2D and MCI, with fitness walking. Design, Setting, and Participants: This randomized clinical trial was conducted between June 1, 2020, and February 28, 2022, at 4 sites in China. Participants included 328 adults (aged ≥60 years) with a clinical diagnosis of T2D and MCI. Interventions: Participants were randomized in a 1:1:1 ratio to a tai chi chuan group, a fitness walking group, or a control group. The tai chi chuan group received 24-form simplified tai chi chuan. The fitness walking group received fitness walking training. Both exercise groups took the training for 60 min/session, 3 times/wk, for 24 weeks in a supervised setting. All 3 groups were provided with a 30-minute diabetes self-management education session, once every 4 weeks for 24 weeks. The participants were followed up for 36 weeks. Main Outcomes and Measures: The primary outcome was the global cognitive function measured at 36 weeks by the Montreal Cognitive Assessment (MoCA). Secondary outcomes included MoCA at 24 weeks and other cognitive subdomain measures and blood metabolic indices at 24 and 36 weeks. Results: A total of 328 participants (mean [SD] age, 67.55 [5.02] years; mean [SD] T2D duration, 10.48 [6.81] years; 167 [50.9%] women) were randomized to the tai chi chuan group (n = 107), fitness walking group (n = 110), or control group (n = 111) and included in the intention-to-treat analysis. At 36 weeks, the tai chi chuan group showed improved MoCA scores compared with the fitness walking group (mean [SD], 24.67 [2.72] vs 23.84 [3.17]; between-group mean difference, 0.84 [95% CI, 0.02-1.66]; P = .046) in the intention-to-treat analysis. The per-protocol analysis data set and subgroup analysis at 36 weeks showed similar results. Based on the generalized linear models, the treatment effects were similar in each group after adjusting for self-reported dietary calories and physical activity. There were 37 nonserious adverse events (tai chi chuan group, 8; fitness walking group, 13; control group, 16) unrelated to the study with no statistically significant difference among the 3 groups (P = .26). Conclusions and Relevance: In this randomized clinical trial including older adults with T2D and MCI, tai chi chuan was more effective than fitness walking in improving global cognitive function. The findings support a long-term benefit, suggesting the potential clinical use of tai chi chuan as an exercise intervention to improve cognitive function for older adults with T2D and MCI. Trial Registration: ClinicalTrials.gov Identifier: NCT04416841.

Identification of five novel SCN1A variants.

Background: Epilepsy is characterized by recurrent unprovoked seizures. Mutations in the voltage-gated sodium channel alpha subunit 1 (SCN1A) gene are the main monogenic cause of epilepsy. Type and location of variants make a huge difference in the severity of SCN1A disorder, ranging from the mild phenotype (genetic epilepsy with febrile seizures plus, GEFS+) to the severe phenotype (developmental and epileptic encephalopathies, DEEs). Dravet Syndrome (DS) is an infantile-onset DEE, characterized by drug-resistant epilepsy and temperature sensitivity or febrile seizures. Genetic test results reveal SCN1A variants are positive in 80% DS patients and DS is mainly caused by de novo variants. Methods: Trio-whole exome sequencing (WES) was used to detect variants which were associated with clinical phenotype of five probands with epilepsy or twitching. Then, Sanger sequencing was performed to validate the five novel SCN1A variants and segregation analysis. After analyzing the location of five SCN1A variants, the pathogenic potential was assessed. Results: In this study, we identified five novel SCN1A variants (c.4224G > C, c.3744_3752del, c.209del, c.5727_5734delTTTAAAACinsCTTAAAAAG and c.5776delT) as the causative variants. In the five novel SCN1A variants, four were de novo and the remaining one was inherited. All novel variants would be classified as "pathogenic" or "likely pathogenic." Conclusion: The five novel SCN1A variants will enrich the SCN1A mutations database and provide the corresponding reference data for the further genetic counseling.

Application of three-dimensional visualization technology in the anatomical variations of hilar bile ducts in Chinese population.

This study aimed to establish three-dimensional models of the biliary tract of Chinese people using the Hisense computer-aided surgery (CAS) system and to explore the branching patterns and variation types of the biliary system under the study of 3D reconstruction of the biliary tract. Three-dimensional models of the biliary tract were reconstructed in 50 patients using the Hisense CAS system. The branching patterns of intrahepatic bile ducts were observed. The biliary tract was classified according to the confluence of the right posterior sectoral duct (RPSD), right anterior sectoral duct (RASD) and left hepatic duct (LHD), and the presence or absence of accessory hepatic ducts. The 3D models of the bile ducts were successfully reconstructed in 50 Chinese patients. The branching patterns of the bile ducts were classified into seven types. The anatomy of the bile ducts was typical in 54% of cases (n = 27), showed triple confluence in 10% (n = 5), and crossover anomaly in 14% (n = 7), which means anomalous drainage of the RPSD into the LHD, anomalous drainage of the RPSD into the common hepatic duct (CHD) in 10% (n = 5), anomalous drainage of the RPSD into the cystic duct (CD) in 2% (n = 1), absence of left main hepatic duct in 1% (n = 1), presence of accessory duct in 8% (n = 4). Among them, there were three cases of accessory hepatic ducts coexisting with other variation types. By using the Hisense CAS system to establish 3D models of the biliary tract of the Chinese people, we established the branching model of the second-order bile ducts, which has important value for the classification of the biliary system and its variation types.

Performance of expanded non-invasive prenatal testing for fetal aneuploidies and copy number variations: A prospective study from a single center in Jiangxi province, China.

To evaluate the performance of expanded non-invasive prenatal testing (expanded noninvasive prenatal testing, NIPT-Plus) in screening for fetal chromosomal abnormalities includes aneuploidies and copy number variations, a total of 23,116 pregnant women with a singleton pregnancy were recruited for NIPT-Plus. Screening positive results were verified by karyotype analysis and chromosomal microarray analysis after amniocentesis. A total of 264 pregnancies (1.14%) were positive results as predicted by NIPT-Plus, including 233 aneuploidies and 31 copy number variations. Following genetic counseling, 233 (88.26%) pregnant women underwent invasive prenatal diagnosis and 136 were verified as true positives, comprising 72 common trisomies (T21, T18, T13), 47 sex chromosomal abnormalities two rare autosomal aneuploidies (RATs) and 15 copy number variations The positive predictive value for common trisomies, SCAs, RATs and CNVs were 68.57%, 68.12%, 6.67% and 51.72%, respectively. Pregnant women with screen-positive results for common trisomies have higher rates of invasive prenatal diagnosis and pregnancy termination than those with positive results for SCAs, RATs, and CNVs. NIPT-Plus showed a good performance in detecting common trisomies, SCAs and also contributed to detecting pathogenic CNVs, but higher accuracy was required in the detection of RATs. In summary, this study provides a reference for the clinical application of NIPT-Plus for screening fetal chromosomal abnormalities in this region. Therefore, we suggest that NIPT-Plus could be widely used in clinical screening for fetal chromosomal abnormalities in combination with prenatal diagnosis and genetic counseling.

Prevalence of mild cognitive impairment in patients with hypertension: a systematic review and meta-analysis.

Mild cognitive impairment (MCI) is common in patients with hypertension. Prevalence estimates of MCI in hypertensive patients are needed to guide both public health and clinical decision making. A literature search was conducted in four databases, including PubMed, Embase, Cochrane Library, and Web of Science, from their inception to February 2021. The methodological quality assessment used the risk of bias tool. The pooled prevalence of MCI in hypertensive patients was determined by a random-effects model. Heterogeneity was explored using sensitivity analysis, subgroup analysis, and random effects meta-regression. Of 2314 references, 11 studies (47,179 participants) were included in the meta-analysis. The overall pooled prevalence of MCI in patients with hypertension was 30% (95% CI, 25-35), with significant heterogeneity present (I2 = 99.3%, p < 0.001). In subgroup analyses, Asian and European samples had a prevalence of 26% (95% CI, 20-31) and 40% (95% CI, 14-66), respectively; cross-sectional and cohort studies had a prevalence of 28% (95% CI, 24-32) and 38% (95% CI, -5-81); age older than 60 years had a prevalence of 28% (95% CI, 23-33); community-based and clinic-based samples had a prevalence of 17% (95% CI, 15-19) and 42% (95% CI, 23-62); and MCI diagnosis using the MoCA, NIA-AA, MMSE, and Peterson criteria had a prevalence of 64% (95% CI, 59-68), 18% (95% CI, 16-19), 19% (95% CI, 15-23), and 13% (95% CI, 9-17). Meta-regression analysis showed that different MCI diagnostic criteria could be the source of heterogeneity in the pooled results. MCI is common in patients with hypertension, with an overall prevalence of 30%. Earlier cognitive screening and management in hypertensive patients should be advocated.

CF2DSO2Na: An Effective Precursor Reagent for Deuteriodifluoromethylthiolation and Deuteriodifluoromethylation.

Deuteriodifluoromethythio (SCF2D) and deuteriodifluoromethyl (CF2D) are important functional groups in pharmaceutical and agrochemical compounds, and the introduction of these functional groups remains a challenging. We herein report a robust reagent for deuteriodifluoromethylthiolation and deuteriodifluoromethylation. Its potentials were successfully showcased by deuteriodifluoromethylation and deuteriodifluoromethylthiolation of indoles with high-level deuterium incorporation. The reagent also has potential for deuteriodifluoromethylation and deuteriodifluoromethylthiolation of wide range of other natural or synthetic bioactive molecules.

The prevalence of mild cognitive impairment in type 2 diabetes mellitus patients: a systematic review and meta-analysis.

AIMS: Mild Cognitive impairment (MCI) is common in type 2 diabetes mellitus (T2DM) patients. The impaired cognitive function had harmful effect on patients' diabetic conditions. This study aimed to estimate the prevalence of MCI in T2DM (T2DM-MCI) patients by conducting a systematic review and meta-analysis of observational studies. METHODS: We carried out a literature search until June 1, 2020, for all observational studies in the following databases: Medline (PubMed), Web of Science, and Embase. Two independent reviewers initially screened the eligible articles. Then, a meta-analysis (random effects model) was conducted to estimate the prevalence of MCI in people with T2DM with STATA 16. RESULTS: A total of 1808 articles were first considered after reading title and abstract, 12 of which remained after reviewing the full text. The combined prevalence of MCI in T2DM patients was estimated to be 45.0% (95% CI=36.0, 54.0). There was no significant heterogeneity through meta-regression and sensitivity analysis. Overall, Europe (n=2, r=36.6%, 95% CI=26.3, 46.9, I2=82.3%) had a lower prevalence than Asia (n=10, r=46.4%, 95% CI=36.2, 56.6, I2=98%). The overall prevalence in female patients (n=14, r=46.9%, 95% CI=34, 59.8, I2=98.3%) was higher than that in male patients (n=14, r=38.8%, 95% CI=27, 50.7, I2=98%). Subgroup analysis based on age demonstrated a lower prevalence in patients older than 60 years (n=9, r=44.3%, 95% CI=33.1, 55.6, I2=98.3%) than patients younger than 60 years (n=3, r=46.4%, 95% CI=33.3, 59.5, I2=91.2%). CONCLUSION: Our results demonstrate that the pooled estimated prevalence of mild cognitive impairment in type 2 diabetes mellitus patients is high worldwide, especially in China Asia. Primary care clinicians should pay more attention to the cognitive function of T2DM patients, as mild cognitive impairment is one of the risk factors for Alzheimer's disease.

Impact of Body Mass Index on Static Postural Control in Adults With and Without Diabetes: A Cross-Sectional Study.

Aim: The objective of this research was to determine the static postural control differences measured from a force platform in Type 2 diabetes mellitus (T2DM) and healthy control groups with different levels of body mass index (BMI), and detect the static postural control difference between T2DM and healthy control groups stratified by different BMI category. This research also explored the relationship of BMI and static postural performance. Methods: We recruited 706 participants with T2DM and 692 healthy controls who were sufficiently matched for age, gender, and BMI in this cross-sectional study. The participants were stratified into three groups by BMI: normal weight, overweight, and obesity. All participants performed two-legged static stance postural control assessment on a firm force platform. The Center of Pressure (CoP) parameters were collected under eyes-open and eyes-closed conditions. Mann-Whitney U test was used to compare the static postural control parameters within each BMI category in both groups. The static postural control parameters among different weight groups were compared by Kruskal-Wallis test, post hoc pair-wise comparison were conducted. Generalized linear model was conducted to examine the association between BMI and static postural control parameters while controlling for confounding factors. Results: Healthy control group had statistical difference in most CoP parameters compared to T2DM group based on all BMI categories. Normal weight participants presented significant difference compared with overweight and/or obesity for total track length (TTL) and velocity of CoP displacements in Y direction (V-Y) under eyes-open condition, and for most CoP parameters under eyes-closed condition in both groups. There were statistically significant correlations between BMI and most static postural control parameters under only eyes-closed condition according to the result of generalized linear model. Conclusion: T2DM patients had impaired static postural control performance compared to healthy controls at all BMI categories. The findings also indicated the association between BMI and static postural control, where higher BMI individuals showed more static postural instability in both T2DM and healthy controls.

Effect of tai chi on glycaemic control, lipid metabolism and body composition in adults with type 2 diabetes: A meta-analysis and systematic review.

OBJECTIVE: The aim of this systematic review was to evaluate the effects of tai chi on metabolic control and body composition indicators in patients with type 2 diabetes mellitus. DESIGN: Systematic review and meta-analysis of existing literature. METHODS: Electronic resource databases were searched to collect eligible studies. Two reviewers selected studies and independently evaluated method-ological quality. RESULTS: Twenty-three studies were included in this meta-analysis. The pooled results showed that tai chi had significant effects in improving metabolic indices, such as fasting blood glucose (mean differ-ence (MD) = -1.04; 95% confidence interval (95% CI) -1.42 to 0.66; p < 0.01) and total cholesterol (MD = -0.50; 95% CI -0.86 to -0.13; p < 0.01) compared with conventional clinical therapy. Most in-dices did not support the use of tai chi over aerobic exercise, except for glycated haemoglobin (HbA1c) (MD = -0.24; 95% CI -0.49 to 0.00; p < 0.01) and high-density lipoprotein (MD = 0.07; 95% CI 0.01 to 0.12; p < 0.01). CONCLUSION: Tai chi had better effects on metabolic control and body composition indicators than clinical conventional therapy, but only on HbA1c and HDL were superior than that of aerobic exercise. The best time-window for tai chi intervention may differ with different metabolic indices.

The Effects of Exercise Interventions on Balance Capacity in Patients with Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis.

The effect of exercise intervention on balance capacity among type 2 diabetes mellitus (T2DM) patients has not been evaluated. The objective of this systematic review and meta-analysis is to investigate the effect of exercise intervention on balance capacity among T2DM patients compared to the control group (usual care, waitlist, no-treatment, education). We conducted a comprehensive literature search through PubMed, EMBASE, Physiotherapy Evidence Database (PEDro), Cochrane library, Web of Science (WOS) from inception to August 2020. The literature language was limited to English. Randomized controlled trials (RCTs) or quasi-experimental (Q-E) trials that examined the effect of exercise intervention on balance capacity among T2DM patients were included. We used the standard methods of meta-analysis to evaluate the outcomes of exercise intervention for balance capacity of T2DM patients. A total of 14 trials (11 RCTs and 3 Q-E trials) involving 883 participants were eligible. The meta-analysis of some studies demonstrated that exercise intervention could significantly improve Berg Balance Scale (BBS) (MD = 2.56; 95%CI [0.35, 4.77]; P = .02), SLST (Single Leg Stance Test) under the eyes-open (EO) condition (MD = 3.63; 95%CI [1.79, 5.47]; P = .0001) and eyes-close (EC) condition (MD = 0.41; 95%CI [0.10, 0.72]; P = .01) compared to control group. There was no significant difference in Time Up and Go Test (TUGT) (MD = -0.75; 95%CI [-1.69, 0.19]; P = .12) and fall efficacy (SMD = -0.44; 95%CI [-0.86, -0.01]; P = .05). Narrative review of some studies indicated that exercise intervention could improve postural stability measured by Sensory Organization Test (SOT) and Center of Pressure (COP) variables, etc. This systematic review and meta-analysis summarized that exercise intervention could improve balance capacity in T2DM patients. However, further studies with high quality are required to evaluate its effect.

The efficacy of extracorporeal shock wave for chronic musculoskeletal pain conditions: A protocol of systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: This systematic review is the first one to assess the effectiveness and safety of extracorporeal shock-wave therapy (ESWT) for patients with chronic musculoskeletal pain conditions (CMPC). METHODS: Seven electronic databases were searched for all relevant literature from inception to December 2019, including PubMed, the Web of Science, EMBASE, Cochrane library, China National Knowledge Infrastructure Database (CNKI), Chinese Scientific Journal Database (VIP), and Wanfang database. Only randomized controlled trials (RCTs) of ESWT for chronic musculoskeletal pain will be included. Two reviewers will independently select eligible studies and collected the detailed information, assessed the methodological quality. A third reviewer will join in discussion to solve disagreements. The mean difference (MD) or standard mean difference (SMD) with 95% confidence intervals (CIs) will be presented to demonstrate the effectiveness of ESWT for patients with chronic MSK pain conditions. RevMan 5.4 software will be used for statistical analysis. RESULTS: This systematic review will explore the effectiveness and safety of ESWT for patients with CMPC. The primary outcome includes pain level, and secondary outcome includes function limitation and adverse events. CONCLUSION: It can provide the updated evidence which is of great importance for patients, clinical practice and health related policy maker in ESWT treating CMPC.

Intermolecular copigmentation between five common 3-O-monoglucosidic anthocyanins and three phenolics in red wine model solutions: The influence of substituent pattern of anthocyanin B ring.

In this study, intermolecular copigmentation between five primary wine monoglucosidic anthocyanins (cyanidin-3-O-glucoside, peonidin-3-O-glucoside, delphinidin-3-O-glucoside, petunidin-3-O-glucoside, and malvidin-3-O-glucoside) and three common wine phenolics (gallic acid, (-)-epicatechin, and quercetin-3-O-glucoside) were investigated through experimental and theoretical methods, and the influence of substituent pattern of anthocyanin B ring was studied emphatically. Chromatic and thermodynamic analysis showed there were great differences among these different pigment-copigment systems. Spatial conformations of the 15 copigmentation complexes were obtained through theoretical calculation, and diverse π-π stacking modes were observed. These results indicated that the substituent pattern of anthocyanin B ring had significant impact on its affinity to copigments, and more, the structures of pigments and copigments determined the color expression and stability of copigmentation together.