Telehealth-Supported Exercise or Physical Activity Programs for Knee Osteoarthritis: Systematic Review and Meta-Analysis.

BACKGROUND: The integration of telehealth-supported programs in chronic disease management has become increasingly common. However, its effectiveness for individuals with knee osteoarthritis (KOA) remains unclear. OBJECTIVE: This study aimed to assess the effectiveness of telehealth-supported exercise or physical activity programs for individuals with KOA. METHODS: A comprehensive literature search encompassing Embase, MEDLINE, CENTRAL, Web of Science, PubMed, Scopus, PEDro, GreyNet, and medRxiv from inception to September 2023 was conducted to identify randomized controlled trials comparing telehealth-supported exercise or physical activity programs to a control condition for KOA. Data were extracted and qualitatively synthesized across eligible studies, and a meta-analysis was performed to evaluate the effects. The study was reported according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020. RESULTS: In total, 23 studies met eligibility criteria, with 20 included in the meta-analysis. Results showed that telehealth-supported exercise or physical activity programs reduced pain (g=-0.39; 95% CI -0.67 to -0.11; P<.001), improved physical activity (g=0.13; 95% CI 0.03-0.23; P=.01), and enhanced physical function (g=-0.51; 95% CI -0.98 to -0.05; P=.03). Moreover, significant improvements in quality of life (g=0.25; 95% CI 0.14-0.36; P<.001), self-efficacy for pain (g=0.72; 95% CI 0.53-0.91; P<.001), and global improvement (odds ratio 2.69, 95% CI 1.41-5.15; P<.001) were observed. However, self-efficacy for physical function (g=0.14; 95% CI -0.26 to 0.53; P=.50) showed insignificant improvements. Subgroup analyses based on the World Health Organization classification of digital health (pain: χ22=6.5; P=.04 and physical function: χ22=6.4; P=.04), the type of teletechnology in the intervention group (pain: χ24=4.8; P=.31 and function: χ24=13.0; P=.01), and active or inactive controls (pain: χ21=5.3; P=.02 and physical function: χ21=3.4; P=.07) showed significant subgroup differences. CONCLUSIONS: Telehealth-supported exercise or physical activity programs might reduce knee pain and improve physical activity, physical function, quality of life, self-efficacy, and global improvement in individuals with KOA. Future research should consider longer implementation durations and assess the feasibility of incorporating wearables and standardized components into large-scale interventions to evaluate the effects. TRIAL REGISTRATION: PROSPERO CRD42022359658; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=359658.

The efficacy of exercise training for improving body composition in patients with breast cancer: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVES: To evaluate the efficacy of exercise in improving body composition in patients with breast cancer; the effects of exercise on weight and BMI were evaluated as secondary outcomes. DATA SOURCES: Cochrane Library, EMBASE, PubMed and Web of Science were searched for randomized controlled trials published in English from database inception to 29 November 2023. METHODS: The effects of exercise on body composition in patients with breast cancer were explored. After separately extracting the data, two reviewers assessed the overall quality of the evidence as well as the methodological quality of the included studies. RESULTS: Fourteen studies with 1241 participants were included, of which 12 studies were eligible for meta-analysis. Exercise significantly reduced body fat (mean difference [MD], -0.33; 95% CI, -0.37 to -0.29; P < 0.00001) and increased lean mass (MD, 0.42; 95% CI, 0.34 to 0.49; P < 0.00001) in patients with breast cancer. Further, exercise intervention was associated with increased BMI of patients with breast cancer (MD, 0.03; 95% CI, 0.01 to 0.06; P = 0.01), while no significant difference in weight was detected between the exercise and the non-exercise groups. Subgroup analysis results showed that only resistance exercise reduced fat mass (MD, -0.22; 95% CI, -0.27 to -0.16; P < 0.00001). CONCLUSIONS: Exercise effectively improves body composition in patients with breast cancer. Clinicians should encourage patients to engage in exercise and develop optimized exercise prescriptions.

Enhancing Stability and Efficiency of Inverted Inorganic Perovskite Solar Cells with In-Situ Interfacial Cross-Linked Modifier.

Inverted inorganic perovskite solar cells (PSCs) is potential as the top cells in tandem configurations, owing to the ideal bandgap, good thermal and light stability of inorganic perovskites. However, challenges such as mismatch of energy levels between charge transport layer and perovskite, significant non-radiative recombination caused by surface defects, and poor water stability have led to the urgent need for further improvement in the performance of inverted inorganic PSCs. Herein, the fabrication of efficient and stable CsPbI3-xBrx PSCs through surface treatment of (3-mercaptopropyl) trimethoxysilane (MPTS), is reported. The silane groups in MPTS can in situ crosslink in the presence of moisture to build a 3-dimensional (3D) network by Si-O-Si bonds, which forms a hydrophobic layer on perovskite surface to inhibit water invasion. Additionally, -SH can strongly interact with the undercoordinated Pb2+ at the perovskite surface, effectively minimizing interfacial charge recombination. Consequently, the efficiency of the inverted inorganic PSCs improves dramatically from 19.0% to 21.0% under 100 mW cm-2 illumination with MPTS treatment. Remarkably, perovskite films with crosslinked MPTS exhibit superior stability when soaking in water. The optimized PSC maintains 91% of its initial efficiency after aging 1000 h in ambient atmosphere, and 86% in 800 h of operational stability testing.

Defect Passivation and Lithium Ion Coordination Via Hole Transporting Layer Modification for High Performance Inorganic Perovskite Solar Cells.

Metal halide inorganic perovskite solar cells (PSCs) have great potential to achieve high efficiency with excellent thermal stability. However, the surface defect traps restrain the achievement of high open circuit voltage (VOC ) and power conversion efficiency (PCE) of the devices due to the severe nonradiative charge recombination. Moreover, the state-of-the-art hole transporting layer (HTL) significantly hampers device moisture stability, even though it renders the highest solar cell efficiency. Herein, a one-stone-two-birds strategy is proposed using a biocompatible material tryptamine (TA) as an additive in HTL. First, TA bearing electron rich moieties can favorably passivate the surface defects of inorganic perovskite films, significantly reducing trap density and prolonging charge lifetime. It results in a drastic improvement of VOC from 1.192 to 1.251 V, with a VOC loss of 0.48 V. The corresponding PSCs achieve a 21.8% PCE under 100 mW cm-2 illumination. Second, TA in HTL can coordinate with lithium cations, retarding their reaction with moisture and increasing the moisture stability of HTL. Consequently, the black phase of inorganic perovskite films is well preserved, and the corresponding PSCs maintain 90% of the initial PCE after 800 h storage at relative humidity of 25-35%, much higher than the control devices.

Effect of the telemedicine-supported multicomponent exercise therapy in patients with knee osteoarthritis: study protocol for a randomized controlled trial.

INTRODUCTION: The rising prevalence of knee osteoarthritis is placing a considerable strain on the global healthcare system. To address this issue, telemedicine-supported multicomponent exercise therapy has emerged as a promising approach. This therapy combines exercise, patient education, and health coaching to empower knee osteoarthritis patients to manage their condition from the comfort of their homes. Nevertheless, there are some existing limitations in the current research on this approach, including challenges related to patient compliance and the absence of objective evaluation methods. METHODS AND ANALYSIS: Patients diagnosed with knee osteoarthritis, who have not undergone knee surgery in the past year, will be recruited for a randomized controlled trial. The trial will include an intervention group and a control group. The intervention group will receive an mHealth app-based multicomponent exercise therapy, consisting of exercise therapy, patient education, and health coaching. Meanwhile, the control group will receive usual care, involving drug therapy and patient education. The primary outcome of the trial will be the measurement of pain intensity, assessed using a visual analog scale at baseline and at 4, 8, and 12 weeks of the post-intervention. To analyze the data, a two-factor, four-level repeated measures ANOVA will be used if the assumptions of homogeneity of variance and sphericity are met. If not, a mixed effects model will be employed. DISCUSSION: The aim of the study is to evaluate the effectiveness of multicomponent exercise therapy aimed at enhancing pain self-management for knee osteoarthritis patients in the comfort of their own homes. The intervention incorporate wearable devices equipped with advanced deep learning systems to monitor patients' adherence to the prescribed at-home exercise regimen, as well as to track changes in outcomes before and after the exercise sessions. The findings from this trial have the potential to enhance both the accessibility and quality of care provided to knee osteoarthritis patients, offering valuable insights for future improvements in their treatment and management. TRIAL REGISTRATION: Chinese Clinical Trials Registry, ChiCTR2300073688. Registered on 19 July 2023, https://www.chictr.org.cn/bin/project/edit?pid=199707 . World Health Organization International Clinical Trials Registry Platform, https://trialsearch.who.int/Trial2.aspx?TrialID=ChiCTR2300073688 .

Strengthened Surface Modification for High-Performance Inorganic Perovskite Solar Cells with 21.3% Efficiency.

Metal halide inorganic perovskites show excellent thermal stability compared to organic-inorganic perovskites. However, the performance of inorganic perovskite solar cells (PSCs) is far from theoretical values, together with unsatisfactory stability, mainly due to the poor interfacial properties. In this work, a facial but effective method is reported to realize high-performance inorganic PSCs by post-modifying the perovskite surface with 2-thiophene ethylamine (TEA). It is found that amine group from TEA can favorably interact with the undercoordinated Pb2+ via Lewis acid-based coordination, while thiophene ring with electron-rich sulfur assists such interaction by functioning as an electron donor. The synergetic interaction allows TEA to passivate perovskite film defects more efficiently, as compared to phenethylamine (PEA) with less electron-donating ability. Moreover, perovskite valence band is slightly upward shift to match with hole transport material and facilitate hole transfer. These combinations result in a reduced non-radiative charge recombination and improved charge carrier lifetime. Consequently, PSCs with TEA modification shows a drastic improvement of VOC by 54 mV, yielding a champion PCE of 21.3%, much higher than the control PSCs (19.3%), along with improved ambient stability. This work demonstrates that surface modifier with an electron-rich moiety is critical for achieving efficient and stable inorganic PSCs.