Sijunzi decoction, a classical Chinese herbal formula, improves fatigue symptoms with changes in gut microbiota in chronic fatigue syndrome: A randomized, double-blind, placebo-controlled, multi-center clinical trial.

BACKGROUD: Chronic fatigue syndrome (CFS) severely impact patients' quality of life and lacks well-acknowledged drug therapy. Sijunzi decoction (SJZD), a classical Chinese herbal formula, has been widely used for spleen deficiency syndrome like fatigue in China. However, there is a lack of evidence on the efficacy of SJZD in treating CFS. PURPOSE: To evaluate the efficacy and safety of SJZD for CFS. STUDY DESIGN: A multi-center, double-blinded, randomized controlled trial. METHODS: Participants with definite diagnoses of CFS and spleen deficiency syndrome were randomly assigned in 1:1 ratio to receive SJZD or placebo granules for 2 months. The primary outcome was the change of Chalder fatigue questionnaire (CFQ) scoring after treatment. Other outcomes included changes in short form-36 physical function (SF36-PF) score, spleen deficiency scale score, Euroqol Questionnaire-Visual Analogue Scale (ED-VAS) score, and clinical global impression (CGI) evaluating by corresponding questionnaires. Fecal metagenome sequencing was conducted to explore the potential mechanism of SJZD effect. RESULTS: From June 2020 to July 2021, 105 of 127 participants completed the study at four hospitals in China. After a 2-month treatment, intention-to-treat (ITT) analysis found participants who received SJZD had larger reduction than placebo control (mean change 6.65 [standard deviation (SD) 6.11] points vs. 5.31 [SD 5.19] points; difference 1.34, 95 % confidence interval [CI] -0.65 to 3.33). Per-protocol (PP) analysis reported confirmative results with a significant difference between SJZD and placebo groups (2.24, 95 % CI 0.10 to 4.39). SJZD also significantly improved overall health status compared with placebo in per-protocol population (p = 0.009). No significant difference was found between groups in changes of SF36-PF, spleen deficiency scale scoring, and CGI. Fecal metagenome sequencing and correlation analyses indicated that the beneficial effect of SJZD may be related to the abundance change of Pediococcus acidilactici. No serious adverse event or abnormal laboratory test was found during the whole study. CONCLUSION: Our results indicated that SJZD can improve fatigue symptom and overall health status in patients with CFS under good medication adherence. Potential therapeutic effects may be related to the regulation of gut microbiota. Large-scale trials with longer intervention period are encouraged to further support SJZD's application. CLINICAL TRIAL REGISTRATION: (ID, ISRCTN23930966, URL = https://www.isrctn.com/ISRCTN23930966).

Galactagogue activity of poly-herbal decoction from Indonesia: a randomized open label controlled trial.

OBJECTIVES: Indonesia have several herbs empirically used as galactagogue. However there are limited clinical evidence regarding the efficacy and safety of this herbs especially poly-herb. The aim of this study was to assess the efficacy and safety of polyherbal galactagogue (PHG) consist of katuk leaves, torbangun leaves and papaya leaves compared to commercial galactagogue capsules (CGC) that contain a single plant extract, katuk leaves. METHODS: This study was an open label randomized controlled trial with 120 subjects that randomly assigned into two groups, PHG and CGC. This study was conducted at the herbal medicine research house (Rumah Riset Jamu/RRJ) Hortus Medicus and 30 subsites in Central Java and Jogjakarta provinces from July to November 2018. Duration of intervention 28 days. Parameter of efficacy breast milk volume, baby weight, prolactin level and parameter of safety ALT, AST, Urea, Creatinin were performed at baseline, day 14 and 28. The symptom of side effects also recorded every week. RESULTS: Breast milk volume and infant's weight increased at day-14 and 28 in both groups. However, prolactin level in both groups decreased. There were no significant differences of efficacy parameters at baseline in both groups. At three times measurement of ALT, AST, Urea and Ceratinin average levels were within the normal range. About 3-5% mothers experience higher ALT, AST and nausea that can tolerated well. No side effect was found in infants. CONCLUSIONS: PHG and CGC have the equal efficacy and safety as a galactagogue. The optimal used is for 14 days.

Efficacy, safety and cost-effectiveness of 5-fluorouracil versus interferon α-2b as adjuvant therapy after surgery in ocular surface squamous neoplasia in a southern European tertiary hospital.

PURPOSE: To analyze the efficacy, safety and cost-effectiveness of adjuvant therapy with 5-fluorouracil (5-FU) compared to interferon α-2b (IFNα-2b) after surgery in ocular surface squamous neoplasia (OSSN). METHODS: Retrospective study that included patients diagnosed with OSSN, who underwent surgical excision followed by adjuvant therapy with IFN α-2b (Group A) or 5-FU (Group B), in a tertial referral hospital. Clinical data collected included: demographics, risk factors, appearance, size and location of the lesions, slit-lamp examination, anterior segment optical coherence tomography, iconography and histological classification of subtypes of OSSN. Costs derived from surgery and adjuvant therapy were noted. Resolution of the lesion, recurrences and adverse events were studied. Cost-effectiveness analysis was performed with the incremental cost-effectiveness index (CEI). RESULTS: 54 cases of 54 patients were included, with a mean age of 74.4 years (range 28-109). 30 were male (55.6%), and predominantly Caucasian (79.6%). The main risk factor was prolonged sun exposure (79.6%). Leukoplakic appearance (48.1%), location in bulbar conjunctiva (48.2%) and T3 (46.3%) stage were the most common clinical features. Histologically, the percentage of CIN I, CIN II, CIN III and SCC were 25.9%, 29.6%, 40.7% and 3.7%, respectively. Complete resolution was obtained in 74.1% and tolerance was overall positive. The cost was significantly higher for IFNα (1025€ ± 130.68€) compared to 5-FU (165.57€ ± 45.85 €) (p 0.001). The CEI was - 247.14€. CONCLUSIONS: Both 5-FU and IFN α-2b are effective and present a good security profile as adjuvant therapies after surgery in OSSN. Although presenting slightly more ocular complications, 5-FU can be considered more cost-effective than IFN α-2b.

Relative biological efficacy of methionine hydroxy analogue-free acid compared to dl-methionine in the broiler chickens.

BACKGROUND: In the broiler's diets based on corn-soya bean meal, methionine (Met) and cystine (Cys), known as sulphur amino acids (SAAs), are the first limiting indispensable amino acids because of their limited presence, which are supplemented with different synthetic sources. Evaluation of the biological effectiveness of these sources can be important in their correct replacement, especially in the starter and growth diets. OBJECTIVES: The current study was done to assess the relative biological efficacy (RBE) of liquid Met hydroxy analogue-free acid (MHA-FA) in comparison with dl-Met (dl-Met) based on broiler performance traits at different levels of digestible SAA in the 1-11 (starter) and 11-25 (grower) days of age periods. METHODS: Two experiments were developed with treatments consisting of a basal diet without Met addition that met the nutrient and energy requirements of broilers with the exception of SAAs (Met + Cys) and five increasing Met doses for both sources (dl-Met and/or MHA-FA), resulting in digestible SAA concentrations from 0.62% to 1.02% of diet in the starter period (Trial 1) and 0.59% to 0.94% of diet in the grower period (Trial 2). The multi-linear regression model and slope ratio method were employed to calculate the RBE of MHA-FA compared with dl-Met for measured variables. RESULTS: In both experiments, the results obtained during the starter and grower periods with the different Met supplementations show significant growth responses to digestible SAAs levels. By increasing dietary dl-Met and/or MHA-FA levels, the growth performance traits and immune responses were improved (quadratic; p < 0.05). The RBE of MHA-FA compared to dl-Met on an equimolar basis was estimated 66%-89% (59%-79% on a weight-to-weight basis). CONCLUSIONS: It is concluded that the RBE of MHA-FA in comparison with dl-Met depends on broiler chicken age and what attribute is being evaluated.

[Methods for traditional Chinese medicine syndrome-based efficacy evaluation: a review].

Traditional Chinese medicine(TCM) syndrome-based efficacy is an evaluation index which is unique to TCM and can reflect the advantages of TCM. The development of the methods and measurement tools for evaluating TCM syndrome-based efficacy can provide objective and quantitative evidence for the clinical efficacy evaluation of TCM and the development of new Chinese medicine preparations, being the exploration direction of innovative methods and technologies for evaluating TCM efficacy. The conventional evaluation methods are subjective and limited to the mitigation of symptoms and the improvement of physical signs, which make it difficult to form a unified evaluation standard. In addition, the evaluation methods lack unity, objectivity, and quantitative research. The scientific connotation, evaluation ideas and methods, and key technologies of the evaluation for the therapeutic effect on syndromes remain unclear, which leads to diverse evaluation modes, methods, and indexes. The syndrome-based efficacy scale provides a new idea for the objective quantification and standardization of TCM syndromes. This review systematically summarizes the methods and problems, introduces the research progress in the evaluation scales, and puts forward some thoughts on the characteristics of TCM syndrome-based efficacy evaluation, aiming to provide insights for the research in this field.

[Analysis and prospect of correlation between relative molecular weight and efficacy of polysaccharides from medicinal plant resources].

Polysaccharides from medicinal plant resources are a kind of polymers extracted from medicinal plants. They are complex long chains formed by different monosaccharides connected via glucosidic bonds. These polysaccharides usually have straight chain and branched chain structures, and their relative molecular weight changes greatly. Modern studies have shown that the biological activi-ty of polysaccharides from medicinal plant resources is closely related to their relative molecular weight. This paper first reviewed the preparation and detection methods of polysaccharides from medicinal plant resources with different relative molecular weights. Then, the paper summarized and analyzed the general experience of the correlation between efficacy and relative molecular weight of polysaccharides from medicinal plant resources with different molecular weights. It was considered that polysaccharides with large relative molecular weights(>100 kDa) play a leading role in immune regulation. Polysaccharides with medium relative molecular weights(10-100 kDa) play a leading role in immune regulation and the protection of the liver. Polysaccharides with small relative molecular weights(<10 kDa) play a leading role in anti-oxidation, regulation of intestinal flora, regulation of blood glucose and lipids, anti-fatigue, and the protection of nerves. Therefore, precise development of polysaccharides from medicinal plant resources based on relative molecular weight is expected to improve their biological activity and application value.

Evidence for the efficacy of anti-inflammatory plants used in Brazilian traditional medicine with ethnopharmacological relevance.

ETHNOPHARMACOLOGICAL RELEVANCE: When exacerbated, inflammatory processes can culminate in physical and emotional disorders and, if not stopped, can be lethal. The high prevalence of inflammation has become a public health problem, and the need for new drugs to treat this pathology is imminent. The use of medicinal plants has emerged as an alternative, and a survey of data that corroborates its application in inflammatory diseases is the starting point. Furthermore, Brazil harbors a megadiversity, and the traditional use of plants is relevant and needs to be preserved and carefully explored for the discovery of new medicines. AIM OF THE STUDY: This review sought to survey the medicinal plants traditionally used in Brazil for the treatment of inflammatory processes and to perform, in an integrative way, a data survey of these species and analysis of their phytochemical, pharmacological, and molecular approaches. MATERIALS AND METHODS: Brazilian plants that are traditionally used for inflammation (ophthalmia, throat inflammation, orchitis, urinary tract inflammation, ear inflammation, and inflammation in general) are listed in the DATAPLAMT database. This database contains information on approximately 3400 native plants used by Brazilians, which were registered in specific documents produced until 1950. These inflammatory disorders were searched in scientific databases (PubMed/Medline, Scopus, Web of Science, Lilacs, Scielo, Virtual Health Library), with standardization of DECS/MESH descriptors for inflammation in English, Spanish, French, and Portuguese, without chronological limitations. For the inclusion criteria, all articles had to be of the evaluated plant species, without association of synthesized substances, and full articles free available in any of the four languages searched. Duplicated articles and those that were not freely available were excluded. RESULTS: A total of 126 species were identified, culminating in 6181 articles in the search. After evaluation of the inclusion criteria, 172 articles representing 40 different species and 38 families were included in the study. Comparison of reproducibility in intra-species results became difficult because of the large number of extraction solvents tested and the wide diversity of evaluation models used. Although the number of in vitro and in vivo evaluations was high, only one clinical study was found (Abrus precatorius). In the phytochemical analyses, more than 225 compounds, mostly phenolic compounds, were identified. CONCLUSION: This review allowed the grouping of preclinical and clinical studies of several Brazilian species traditionally used for the treatment of many types of inflammation, corroborating new searches for their pharmacological properties as a way to aid public health. Furthermore, the large number of plants that have not yet been studied has encouraged new research to revive traditional knowledge.

Efficacy and safety of solifenacin combined with biofeedback in children with overactive bladder.

BACKGROUND: Overactive bladder is a common chronic urological disorder in children, liable to impact normal social activities, disrupt sleep and even impair self-esteem. We aimed to evaluate the efficacy and safety of solifenacin combined with biofeedback for paediatric overactive bladder. METHOD: Forty-five children with overactive bladder were enrolled and divided into three groups: 15 patients in Group A were treated with solifenacin, 15 cases in Group B with biofeedback, and the other 15 patients in Group C with the combination of solifenacin plus biofeedback. Each group was subdivided into the non-urge incontinence (non-UI) and urge incontinence (UI) groups. The remission rates were compared among the three groups at 2, 4, 8 and 12 weeks from the beginning of treatment. The side effects of solifenacin were recorded and followed up. RESULT: After 2 weeks since initial treatment, the complete response rates were 33.3% (5/15), 20.0% (3/15), and 53.3% (8/15) in the three groups. At 4 weeks, the complete remission rates were 46.7% (7/15), 33.3% (5/15), and 60.0% (9/15) respectively. Moreover, the complete remission rates of the UI groups were higher than the non-UI groups (p < 0.05). At 8 weeks, the complete response rates were 53.3% (8/15), 40.0% (6/15), and 67.7% (10/15). At 12 weeks, the complete response rates were 67.8% (10/15), 60.0% (9/15), and 86.7% (13/15). The complete response rates were higher and urodynamic parameters were improved obviously in group C than the other two groups (p < 0.05) during the follow-ups. The median voiding frequency decreased and median functional bladder capacity increased obviously in Group C after 4 weeks (p < 0.05). Dry mouth was observed in 2 patients (4.4%). 2 patients experienced constipation (4.4%), and neither case was severe. The symptoms of these four patients had relieved by reducing the dose of solifenacin. CONCLUSION: Solifenacin combined with biofeedback had good efficacy and compliance for children experiencing overactive bladder. It took only 2 weeks to achieve the complete response rate over 50%, especially for the improvement of UI symptoms.

Therapeutic efficacy of acupuncture point stimulation for stomach cancer pain: a systematic review and meta-analysis.

Purpose: In recent years, traditional Chinese medicine has received widespread attention in the field of cancer pain treatment. This meta-analysis is the first to evaluate the effectiveness and safety of acupuncture point stimulation in the treatment of stomach cancer pain. Methods: For this systematic review and meta-analysis, we searched PubMed, Web of Science, Cochrane Library, Embase, WANFANG, China National Knowledge Infrastructure (CNKI), and Chinese Journal of Science and Technology (VIP) databases as well as forward and backward citations to studies published between database creation to July 27, 2023. All randomized controlled trials (RCTs) on acupuncture point stimulation for the treatment of patients with stomach cancer pain were included without language restrictions. We assessed all outcome indicators of the included trials. The evidence from the randomized controlled trials was synthesized as the standardized mean difference (SMD) of symptom change. The quality of the evidence was assessed using the Cochrane Risk of Bias tool. This study is registered on PROSPERO under the number CRD42023457341. Results: Eleven RCTs were included. The study included 768 patients, split into 2 groups: acupuncture point stimulation treatment group (n = 406), medication control group (n = 372). The results showed that treatment was more effective in the acupuncture point stimulation treatment group than in the medication control group (efficacy rate, RR = 1.63, 95% CI 1.37 to 1.94, p < 0.00001), decreasing in NRS score was greater in acupuncture point stimulation treatment group than in the medication control group (SMD = -1.30, 95% CI -1.96 to -0.63, p < 0.001). Systematic Review Registration: https://clinicaltrials.gov/, identifier CRD42023457341.

Evaluating the Impact of Practical Training: A Study on Satisfaction and Drug Knowledge among Pharmacy Students.

Practical training stands as a crucial component in shaping pharmacy students, bridging the gap between classroom-based theoretical knowledge and its application in real-world contexts. This study investigates the correlation between the satisfaction levels experienced during practical training and the acquisition of knowledge, particularly focusing on drug names. Drawing from the National DataBase (NDB) open data provided by Japan's Ministry of Health, Labour and Welfare, a survey centered on the top 100 dispensed drugs was crafted. A correlation analysis was conducted between the satisfaction scores gathered from students and their depth of knowledge on drug names. Intriguingly, despite observing a significantly high satisfaction level during the practical training, there was no marked correlation between this satisfaction and the proficiency in recalling drug names after the training. Furthermore, the volume of daily prescriptions handled did not significantly impact this knowledge. The findings underscore the notion that high satisfaction during training does not necessarily guarantee a thorough understanding of the subject matter. This sheds light on the importance of not solely relying on satisfaction metrics in training programs and ensuring a holistic, in-depth educational approach.

Chinese patent medicine combined with calcium channel blockers in the treatment of essential hypertension:a Bayes network meta-analysis and systematic review.

Backgroud: The co-administration of Chinese patent medicine with calcium channel blockers (CCBs) is a prevalent practice in China for treating essential hypertension (EH). However, robust evidence supporting the efficacy and safety of tailored combinations of different Chinese patent medicines with CCBs, according to individual patient conditions, is still limited. This study sought to elucidate the efficacy and safety of these combinations using a systematic review and network meta-analysis. Materials and methods: Relevant studies were sourced from established databases, incorporating randomized controlled trials published up to 1 February 2023. The ROB2 tool from the Cochrane Collaborative Network was employed to independently assess and cross-verify the quality of the included literature. A network meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 and PRISMA-Network Meta-Analyses (PRISMA-NMA) guidelines. A Bayesian network meta-analysis was utilized to gauge the efficacy and safety of distinct integrations of Chinese patent medicine and CCBs. Primary outcomes were interpreted using a paired fixed-effect meta-analysis. Publication bias was appraised through Egger's test and represented with funnel plots. All statistical analyses were executed within the R statistical framework. Results: Following rigorous selection, data extraction, and bias evaluation, 36 articles were incorporated. Tianma Gouteng Granule, when combined with CCBs, displayed superior efficacy in reducing systolic blood pressure (SBP). In terms of diastolic blood pressure (DBP) reduction, Songling Xuemaikang Capsule combined with CCBs emerged as the most effective. Regarding enhancement of antihypertensive effective rates, Qinggan Jiangya Capsule paired with CCBs demonstrated optimal results. For diminishing Traditional Chinese Medicine syndrome scores, the Qiangli Dingxuan Tablet and CCBs combination proved most beneficial. When aiming to reduce total cholesterol (TC), triglycerides (TG), and low-density lipoprotein cholesterol (LDL-C) levels, Tianma Gouteng Granule and CCBs showcased superior results. In contrast, the combination of Songling Xuemaikang Capsule and CCBs was more effective in reducing LDL-C, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Conclusion: This study underscores variability in outcomes from combining Chinese patent medicine and CCBs for hypertension, emphasizing the importance of personalized medicinal combinations, especially Tianma Gouteng Granule and Songling Xuemaikang Capsule. The results offer robust evidence to inform clinical guidelines for essential hypertention and significantly aid clinician in seleting appropriate Chinese patent medicines for treatment.

Mediating and Moderating Variables in the Relationship Between Emotional Demands and Teachers’ Emotional Exhaustion / [Variables mediadoras y moderadoras de la relación entre exigencias emocionales y agotamiento emocional en docentes]

Teachers tend to suffer high levels of emotional exhaustion, a variable that is associated with poor mental health and lower job performance. The present study analyzed how emotional demands, emotional dissonance, and self-efficacy to cope with stress interact in predicting teachers’ emotional exhaustion. To conduct this longitudinal research, 108 Andalusian teachers (57.3% women; mean age = 45.30, SD = 8.68) completed an online survey at three different time points. Moderated mediation analysis suggested that emotional dissonance mediated the relationship between emotional demands and emotional exhaustion, with self-efficacy acting as a moderator between the two. Teachers who perceived high emotional demands saw their levels of emotional dissonance increase, which in turn led to an increase in emotional exhaustion. In addition, self-efficacy acted as a protective factor against emotional exhaustion, buffering the negative effect of emotional dissonance. Strengthening these protective variables through interventions that increase levels of self-efficacy to cope with stress and reduce levels of emotional dissonance could help prevent teachers’ emotional exhaustion.(AU)

Los docentes tienden a sufrir un nivel elevado de agotamiento emocional, variable que se asocia con una mala salud mental y un bajo desempeño laboral. El estudio analiza cómo interactúan en la prevención del agotamiento emocional de los docentes las exigencias emocionales, la disonancia emocional y la autoeficacia para afrontar el estrés. Para llevar a cabo esta investigación de carácter longitudinal, 108 profesores andaluces (57.3% mujeres, edad media = 45.30, DT = 8.68) cumplimentaron una encuesta online en tres momentos distintos. El análisis de mediación moderada indicaba que la disonancia emocional mediaba la relación existente entre las exigencias emocionales y el agotamiento emocional, actuando como moderadora entre ambos la autoeficacia. Los profesores que percibieron exigencias emocionales elevadas vieron aumentar su grado de disonancia emocional, lo que a su vez aumentó el agotamiento emocional. Además, la autoeficacia actuó como factor protector del agotamiento emocional, amortiguando el efecto negativo de la disonancia emocional. Reforzar estas variables protectoras a través de intervenciones que aumenten el grado de autoeficacia para afrontar el estrés y reduzcan la disonancia emocional podría ayudar a prevenir el agotamiento emocional de los docentes.(AU)

Traditional Chinese medicine for gastric cancer: An evidence mapping.

As a complementary and alternative therapy, traditional Chinese medicine (TCM) has been playing a significant role in gastric cancer treatment. Data from individual systematic reviews have not been comprehensively summarized, and the relationship between certain interventions and outcomes are ill-defined. This study aimed to analyze the advantages of TCM interventions for gastric cancer by the method of evidence mapping. We searched PubMed, Embase, Web of Science, China National Knowledge Infrastructure, Chinese Scientific Journals Database, and Wanfang Database for systematic reviews of TCM treating gastric cancer up to December 31, 2023. We used Excel, Endnote 20, and Python software for the analysis of incorporated studies. We assessed the quality of included SRs by AMSTAR-2 and performed evidence mapping including 89 SRs, 1648 RCTs and 122,902 patients, identifying 47 types of interventions and 39 types of outcomes. From a visual overview, we displayed that most SRs reported beneficial effects in improving short- and long-term survival, myelosuppression, and immune function, even though the quality of evidence was generally low. The benefits of Brucea javanica Oil Emulsion Injection, ShenQiFuZheng Injection, XiaoAiPing, Astragalus-Containing TCM and Guben Xiaoji Therapy were found the most solid in corresponding aspects. Our findings suggest that although more rigorous clinical trials and SRs are needed to identify the precise effectiveness, integrating such evidence into clinical care of gastric cancer is expected to be beneficial.

[Estimation of gammaaminobutyric acid intake from the human diet].

Gamma-aminobutyric acid (GABA) is an endogenous bioactive compound with essential properties for the normal functioning of the human nervous system. As a potent neurotransmitter, it plays an important role in modulating synaptic transmission by exerting phasic inhibition of neurons. This and other effects of GABA provide the phenomenon of neural tissue plasticity underlying learning, memory, maturation and repair of neural tissue after damage. It also has a wide range of biological actions, including antihypertensive, anti-diabetic, antioxidant, and anti-inflammatory. In this regard, GABA is increasingly used in the composition of food for special dietary uses and dietary supplements. However, its adequate intake levels have not yet been assessed and its dietary intake has not been characterized. The aim of the review was to estimate the level of GABA intake under balanced consumption of foods, corresponding to rational norms that meet modern requirements of a healthy diet. Material and methods. The existing literature on the problem in recent years was reviewed using the databases RISC, CyberLeninka, Pubmed, and ResearchGate. Results. Based on the analysis of scientific literature, we evaluated the content of GABA in the average daily diet, compiled on the basis of the rational norms of food consumption that meet modern requirements for healthy nutrition (Order of the Ministry of Healthcare of the Russian Federation dated August 19, 2016. No. 614). The balanced diet can provide about 740 mg of GABA per day, mainly due to vegetables (potatoes - 419 mg/day, beet - 49 mg/day, pumpkin - 41 mg/day), fruits (apple - 15 mg/day, grapes - 3.8 mg/day), as well as low-fat dairy products (92 mg/day). Conclusion. The presented data may be useful in assessing the adequacy of enrichment of foods for special dietary uses and dietary supplements with GABA.

A systematic review of the efficacy and safety of turmeric in the treatment of digestive disorders.

Turmeric has been gaining popularity as a treatment option for digestive disorders, although a rigorous synthesis of efficacy has not been conducted. This study aimed to summarize the evidence for the efficacy and safety of turmeric in the treatment of digestive disorders, including inflammatory bowel diseases (IBD), irritable bowel syndrome (IBS), dyspepsia, gastroesophageal reflux disease, and peptic ulcers. Literature searches were conducted in Medline, EMBASE, AMED, the Cochrane Central Register of Control Trials, and Dissertation Abstracts from inception to November 15, 2021. Dual independent screening of citations and full texts was conducted and studies meeting inclusion criteria were retained: randomized controlled trials (RCT) and comparative observational studies evaluating turmeric use in people of any age with one of the digestive disorders of interest. Extraction of relevant data and risk of bias assessments were performed by two reviewers independently. Meta-analysis was not conducted due to high heterogeneity. From 1136 citations screened, 26 eligible studies were retained. Most studies were assessed to have a high risk of bias, and many had methodological limitations. Descriptive summaries suggest that turmeric is safe, with possible efficacy in patients with IBD or IBS, but its effects were inconsistent for other conditions. The efficacy of turmeric in digestive disorders remains unclear due to the high risk of bias and methodological limitations of the included studies. Future studies should be designed to include larger sample sizes, use rigorous statistical methods, employ core outcome sets, and adhere to reporting guidance for RCTs of herbal interventions to facilitate more meaningful comparisons and robust conclusions.

How can clinicians enhance self-efficacy beliefs in osteoarthritis? An overview of systematic reviews with meta-analysis.

This overview of reviews aimed to synthesize the effectiveness of non-pharmacological approaches to enhance self-efficacy in people with osteoarthritis. The CINAHL, Embase, PsycINFO, PubMed, SPORTDiscus, and the Cochrane Library databases were searched from inception to December 2023. We considered systematic reviews with meta-analysis of randomized clinical trials evaluating any non-pharmacological intervention. We used AMSTAR 2 to assess the methodological quality of reviews. The overlap between reviews was calculated. We included eight systematic reviews with meta-analysis evaluating 30 different clinical trials. Overall, mind-body exercises, psychological interventions, and self-management strategies may improve arthritis self-efficacy. Specifically, the meta-analyses showed tai chi exercises, coping skills training, and the arthritis self-management program are more effective than controls to enhance arthritis self-efficacy in people with hip and/or knee osteoarthritis. In addition, inconsistent results were detected across meta-analyses regarding the effectiveness of multidisciplinary interventions. Finally, the degree of overlap between all reviews was moderate (CCA = 6%) and many included reviews reported most of the items of AMSTAR 2. Tai chi exercises, coping skills training, and the arthritis self-management program may be beneficial for enhancing arthritis self-efficacy. Open Science Framework Registration: https://doi.org/10.17605/OSF.IO/VX2T6 .

Red/NIR-I-Fluorescence Carbon Dots Based on Rhein with Active Oxygen Scavenging and Colitis Targeting for UC Therapeutics.

Ulcerative colitis (UC) is a chronic inflammatory disease with uncontrolled inflammation and demage to the intestinal barrier. Rhein, a bioactive compound in traditional Chinese medicine, has anti-inflammatory and intestinal repair effect. However, their clinical application is limited by their hydrophobicity and poor bioavailability. L-arginine, as a complement to NO, has synergistic and attenuating effects. In this paper, red/NIR-I fluorescent carbon dots based on rhein and doped with L-arginine (RA-CDs), which are synthesized by a hydrothermal process without any organic solvents, are reported. RA-CDs preserve a portion of the functional group of the active precursor, increase rhein solubility, and emit red/NIR-I light for biological imaging. In vitro experiments show that RA-CDs scavenge excessive reactive oxygen species (ROS), protect cells from oxidative stress, and enable the fluorescence imaging of inflamed colons. In a DSS-induced UC mouse model, both delayed and prophylactic treatment with RA-CDs via intraperitoneal and tail vein injections alleviate UC severity by reducing intestinal inflammation and restoring the intestinal barrier. This study highlights a novel strategy for treating and imaging UC with poorly soluble small-molecule drugs.

Structural modeling of Chinese students' academic achievement identity and basic psychological needs: do academic self-efficacy, and mindfulness play a mediating role?

BACKGROUND: Mindfulness and academic self-efficacy were proposed as mediating variables, with successful academic identity as an exogenous variable. The backdrop for this research centers on the significance of psychological factors in shaping academic identity among first-grade high school students. OBJECTIVES: The primary aim of the research was to investigate the relationship between fundamental psychological needs, mindfulness, academic self-efficacy, and successful academic identity. Specifically, the study explored the direct and indirect impacts of basic psychological needs on successful academic identity mediated by mindfulness and academic self-efficacy. METHOD: The research employed a descriptive method, utilizing correlational studies and structural equation modeling. A sample of 355 undergraduate students at Henan Judicial Police Vocational College, Henan, China, was randomly selected through multistage cluster sampling. Data were collected using established scales, including the Basic Psychological Needs Scale, Baer Mindfulness Scale, Jenkins and Morgan Academic Self-Efficacy Scale, and Vas and Isakson Successful Academic Identity Scale. The data analysis was conducted using AMOS 22 software. FINDINGS: The research findings revealed that fundamental psychological needs directly and indirectly significantly impact successful academic identity. Mindfulness played a mediating role in this relationship. However, academic self-efficacy did not considerably mediate the influence of fundamental psychological needs on successful academic identity (p > 0.05). These results highlight the complex dynamics between psychological needs, mindfulness, academic self-efficacy, and successful academic identity among high school students in the specified academic year. CONCLUSIONS: The findings suggest targeted interventions, such as workshops for families and teachers to address basic needs and psychologist and school counselor interventions to increase mindfulness. Additionally, organizing educational classes is imperative for fostering a supportive environment conducive to successful academic identity among undergraduate students.

Herbal Nanoformulations for Diabetes: Mechanisms, Formulations, and Clinical Impact.

BACKGROUND: Diabetes mellitus remains a global health challenge, demanding innovative therapeutic strategies. Herbal remedies have garnered attention for their potential in diabetes management, and recent advancements in nanotechnology have enabled the development of herbal nanoformulations with enhanced efficacy and bioavailability. OBJECTIVE: This review aimed to comprehensively analyze the mechanisms, formulations, and clinical impact of herbal nanoformulations in managing diabetes mellitus. METHOD: A systematic literature search was conducted to identify relevant studies exploring the mechanisms of action, various formulations, and clinical outcomes of herbal nanoformulations in diabetes management. RESULT: Herbal nanoformulations exert their anti-diabetic effects through multiple mechanisms, including enhanced bioavailability, improved tissue targeting, and potentiation of insulin signaling pathways. Various herbal ingredients, such as bitter melon, fenugreek, and Gymnema sylvestre, have been encapsulated into nanocarriers, like liposomes, polymeric nanoparticles, and solid lipid nanoparticles, to enhance their therapeutic potential. Clinical studies have demonstrated promising results, showing improvements in glycemic control, lipid profile, and antioxidant status with minimal adverse effects. CONCLUSION: Herbal nanoformulations represent a promising avenue for the management of diabetes mellitus, offering improved therapeutic outcomes compared to conventional herbal preparations. Further research is warranted to optimize formulation strategies, elucidate long-term safety profiles, and explore the potential synergistic effects of herbal nanoformulations in combination therapies for diabetes management.

Antiparasitic efficacy of flavonoids identified from Psoralea corylifolia against Tetrahymena piriformis in guppy (Poecilia reticulate).

Tetrahymena piriformis belongs to the ciliated protists (ciliates), causing severe economic losses in aquaculture. Chemical drugs currently used usually have toxic side effects, and there is no specific drug against Tetrahymena. Therefore, it is an urgent need to identify new antiparasitic lead compounds. In the present study, the in vitro parasiticidal activity of ethyl acetate (EtOAc) extracts and water extracts from 22 selected traditional Chinese medicines (TCMs) were evaluated against T. piriformis. The EtOAc extract of P. corylifolia turned out to be the most active with the minimum parasiticidal concentration of 100 mg/L within 3 h. Thus, it was separated into 12 fractions by the first-dimensional (D1) normal phase liquid chromatography (NPLC), meanwhile combining with in vitro antiparasitic tests for activity tracking. Subsequently, 8 flavonoids were identified in the active fractions by the second-dimensional (D2) reverse phase liquid chromatography (RPLC) tandem high-resolution mass spectrometry. According to the results, 5 flavonoids were selected for in vitro antiparasitic test, of which isobavachalcone showed the minimum parasiticidal concentration of 3.125 mg/L in 2 h. Bathing treatment of infected guppies with isobavachalcone could significantly reduce the burden of T. piriformis, obtaining a 24-h median effective concentration (24-h EC50) value of 1.916 mg/L. And the concentration of isobavachalcone causing guppies to die within 24 h is 39 times than that of 24-h EC50. The results demonstrated that isobavachalcone has the potential to be developed into a novel commercial fish drug against T. piriformis.