Your preoperative rehabilitation assistant: A study protocol for the impact of a telemedicine-supported preoperative home rehabilitation program on the prognosis of patients undergoing thoracoscopic surgery.

Background: Reduced cardiorespiratory fitness levels are associated with increased short-term complications after surgery, and potentially exert long-lasting effects on the postoperative lives, work and educational pursuits of patients. Currently, research suggests that lifestyle interventions, such as preoperative physical exercise undertaken by patients themselves, may improve patients' cardiopulmonary fitness and reduce post-operative complications. This study aims to investigate the effectiveness and feasibility of a remote medical supervision model for prehabilitation exercise in patients undergoing thoracoscopic lung tumour resection surgery. Methods/Design: All enrolled patients will participate in a 4-week pre-operative exercise intervention to improve their cardiorespiratory fitness. During this period, patients will wear wearable devices and exercise at home based on exercise prescriptions. The exercise prescription comprises aerobic exercise (three times a week or more), muscle strengthening exercise (twice a week or more), and respiratory muscle exercise (once a day). The primary aim is to investigate whether baseline VO2max could be improved following a 4-week preoperative exercise program. Secondary objectives include changes in forced expiratory volume in 1 s and forced vital capacity, degree of acceptance of the technology, quality of life, handgrip strength, postoperative complication rate and length of hospital stay. Discussion: This study aims to evaluate the influence of preoperative prehabilitation exercises in a telemedicine active supervision mode in patients undergoing thoracoscopic lung tumour resection. As such, results of this trial might have some impact on future implementations of group- and home-based prehabilitation exercises in lung cancers. Trial registration: This study was approved by the Medical Ethics Committee of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology (approval number: TJ-IRB20220564) with registration at ClinicalTrials.gov (identifier: NCT05608759).

Enhancement of extraction efficiency and functional properties of chickpea protein isolate using pulsed electric field combined with ultrasound treatment.

Chickpea protein isolate (CPI) is a promising dietary protein with the advantages of low allergenicity, easy digestion and balanced composition of essential amino acids. However, due to the thick skin of chickpeas, the extraction of CPI is challenging, resulting in lower efficiency of the alkaline extraction-isoelectric precipitation (AE-IEP) method. Therefore, the present study investigated the effect of pulsed electric field combined with ultrasound (PEF-US) treatment on the extraction efficiency of CPI and the functional properties was characterized. Parameter optimization was carried out using response surface methodology (RSM), with the following optimized conditions: pulse duration of 87 s, electric field intensity of 0.9 kV/cm, ultrasonic time of 15 min, and ultrasonic power of 325 W. Under the optimized conditions, the yield of CPI after combined (PEF-US) treatment was 13.52 ± 0.13 %, which was a 47.28 % improvement over the AE-IEP method. This yield was better than that obtained with either individual PEF or US treatment. Additionally, the functional properties (solubility, emulsification, and foaming) of CPI were significantly enhanced compared to AE-IEP. However, the stability of emulsification and foaming did not show significant differences among the four methods. The PEF-US method efficiently extracts CPI with excellent functional properties, enabling the production of proteins as desired functional additives in the food industry.

Facilitators and barriers of adherence to rectal interventions by parents of young children with functional constipation: a qualitative study.

Background: Functional constipation in children is a worldwide problem that impacts both children's gastrointestinal function and the quality of family life. The treatment of this condition often depends on parental involvement to administer rectal interventions to their children to stimulate defecation. However, adherence to rectal interventions is currently suboptimal. We sought to explore the factors that facilitate and hinder parents from adherence to rectal interventions. Methods: A descriptive qualitative study was conducted involving semi-structured interviews with parents of infants and young children with functional constipation requiring rectal interventions from March to May 2023. The data were analyzed using content analysis. Results: Fourteen parents participated in the study. Parents reported the main facilitators of adherence to prescribed rectal interventions as recognition of illness severity, support from family and friends, and medical resource support and e-health literacy. Parents reported the primary barriers as information barriers, family conflict, cognitive misalignment, and difficulties in accessing healthcare services. Conclusion: Rectal interventions are often essential in managing constipation in young children, with parental compliance being crucial for effective treatment. Healthcare providers must consider the psychosocial aspects of parents' perceptions, adhere to guidelines to standardize communication, and ensure comprehensive education to improve medication literacy.

Allicin Ameliorated High-glucose Peritoneal Dialysis Solution-induced Peritoneal Fibrosis in Rats via the JAK2/STAT3 Signaling Pathway.

Peritoneal fibrosis (PF) is one of the most serious complications of peritoneal dialysis (PD) and is the greatest obstacle to the clinical application of PD. Chinese herbal monomers have been effective in the prevention and treatment of PF. The aim of this study was to observe the effect of allicin on PF in rats induced by high glucose and to investigate its molecular mechanism of action. A rat model of PF was established by using a 4.25% glucose-based standard peritoneal dialysis solution. The degree of peritoneal pathological damage was assessed by Hematoxylin and eosin (H&E) staining. Peritoneal collagen deposition was detected by Masson's trichrome staining. The levels of Interleukin-6 (IL-6), Tumor necrosis factor-α (TNF-α), Interleukin-1ß (IL-1ß) and monocyte chemoattractant protein-1 (MCP-1) in the serum were measured by Enzyme Linked Immunosorbent Assay (ELISA). The expression levels of TGF-ß, α-smooth muscle actin (α-SMA) and collagen I were examined by western blotting and immunohistochemistry. The protein expression levels and mRNA levels of E-cadherin, N-cadherin, vimentin, janus kinase 2 (JAK2) and signal transducer and activator of transcription 3 (STAT3) in peritoneal tissue were determined by western blotting and qRT-PCR. TGF-ß1 stimulated human peritoneal mesothelial cells (HPMCs), and the cells were treated with allicin and the JAK2/STAT3 pathway activator colivelin alone or in combination. A cell counting kit-8 (CCK-8) assay was used to measure cell viability. The role of JAK2/STAT3 in the effects of allicin was confirmed via in vitro mechanistic research by western blotting, wound healing assays and Transwell assays. Allicin relieves the inflammatory response by downregulating the levels of IL-1ß, IL-6, MCP-1 and TNF-α. Furthermore, allicin decreased the expression of TGF-ß, α-SMA and collagen I. Allicin also alleviated epithelial-to-mesenchymal transition (EMT), as specifically manifested by increased E-cadherin and reduced N-cadherin and vimentin. Further studies revealed that allicin reduced the protein levels of JAK2, STAT3, p-JAK2, and p-STAT3. The results of the cellular experiments verified the above results. The ability of allicin to inhibit fibrosis and the EMT process was significantly attenuated after HPMCs were treated with colivelin. Taken together, these findings suggest that allicin inhibits inflammation and EMT, thereby improving PF, and this protective effect may be achieved by inhibiting the JAK2/STAT3 signaling pathway.

Free fatty acids: independent predictors of long-term adverse cardiovascular outcomes in heart failure patients.

BACKGROUND: The association between plasma free fatty acid (FFA) and the outcomes in the heart failure (HF) patients remains unclear. METHODS: A cohort study among HF patients was performed. Plasma FFA was analyzed as both a continuous and a categorical variable (grouped by tertiles) to assess its association with composite cardiovascular (CV) death and HF hospitalization (CV death & HHP), CV death alone, and all-cause mortality (ACM) using Cox regression models. Subgroup analyses of HF patients with preserved ejection fraction (HFpEF) and mildly reduced/reduced ejection fraction (HFmrEF/HFrEF) were performed. This work also assessed the effectiveness of combining FFA and NT-pro BNP biomarkers for risk stratification by calculating the concordance index (C-index). RESULTS: Among the 4,109 HF patients, FFA levels exceeding 0.4-0.42 mmol/L were associated with increased risks of the three outcomes. Patients in the highest FFA tertile faced greater risks than those in the lowest tertile. Adjusted hazard ratios were 1.32 (95% CI: 1.11-1.58) for CV death & HHP, 1.45 (95% CI: 1.16-1.82) for CV death, and 1.39 (95% CI: 1.15-1.68) for ACM, with a maximum follow-up of 8 years (median: 25 months). Subgroup analyses revealed that elevated FFA levels consistently predicted worse outcomes in both HFmrEF/HFrEF and HFpEF patients. The C-index for predicting outcomes was significantly greater when NT-pro BNP and FFA were combined than when NT-pro BNP was used alone (P < 0.01). CONCLUSION: Increased plasma FFA concentrations were independently associated with greater risks of CV death & HHP, CV death, and ACM among HF patients, irrespective of the ejection fraction. The combination of FFA and NT-pro BNP biomarkers significantly improved risk stratification in HF patients.

Nomograms for predicting short-term mortality in acute-on-chronic liver disease caused by the combination of hepatitis B virus and alcohol.

This study aimed to identify predictive factors for the prognosis of acute-on-chronic liver disease (AoCLD) due to both hepatitis B virus (HBV) and alcohol and to develop prognostic models to improve treatment management. AoCLD patients with HBV and alcohol as etiological factors were selected from two multicenter prospective cohorts (NCT02457637,NCT03641872) and included in separate training and validation cohorts (n = 180 and n = 148). In the training cohort, the CATCH-LIFE A nomogram (based on age, bilirubin, international normalized ratio, serum sodium, and hepatic encephalopathy score) and CATCH-LIFE B nomogram (based on age, bilirubin, international normalized ratio, serum albumin, white blood cell, platelet count, and hepatic encephalopathy score) had discriminatory ability for predicting 28-day (c-indexes of 0.910 and 0.899) and 90-day mortality (c-indexes of 0.878 and 0.887, respectively). The area under the curve values for 28-day and 90-day mortality prediction by the CATCH-LIFE A nomogram were 0.922 (95% CI : 0.874, 0.971) and 0.905 (0.856, 0.956), respectively, while those for the CATCH-LIFE B nomogram were 0.916(0.861,0.972) and 0.915 (0.866,0.964), respectively. Similar performance results were observed in the validation cohort. Optimal cut-off scores for each nomogram could be used for patient stratification in high- and low-risk groups, and the high-risk groups showed shorter survival times than the low-risk groups in both the training and validation cohorts. Two nomograms constructed from the first short-term follow-up data from patients with AoCLD due to combined HBV infection and alcohol exposure showed good predictive performance for 28-day and 90-day mortality and might be used to guide clinical management.

Molecular subtypes and prognostic factors of lung large cell neuroendocrine carcinoma.

Background: Lung large cell neuroendocrine carcinoma (LCNEC) is an aggressive disease with poor prognosis and short-term survival, which lacks effective prognostic indicators. The study aims to investigate the molecular subtypes and prognostic markers of lung LCNEC. Methods: Patients diagnosed with lung LCNEC at Sun Yat-sen University Cancer Center (SYSUCC) between November 2007 and January 2021 were screened. Baseline clinical data were collected and routine blood indexes including lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR) and systemic immune-inflammation index (SII) were calculated. Immunohistochemistry (IHC) of ASCL1, NEUROD1, POU2F3, YAP1 were done to perform molecular subtyping, while CD56, Syn, CgA, CD3, CD8, CD20, CD68, and CD163 were also stained on tissue samples. Then prognostic factors of lung LCNEC were explored. Results: One hundred and fifty-one lung LCNEC patients were identified, 103 of whom had complete clinical information, available routine blood and biochemical indexes were eventually included in the present study. Tumor tissue specimens were available from 64 patients. Positive expression rates of ASCL1, NEUROD1, and YAP1 were 82.8%, 50.0%, and 28.1%, respectively. No POU2F3+ cases were detected. Forty (62.5%) patients co-expressed with two or three markers. High LMR (>3.3) was an independent predictor of favorable prognosis of disease-free survival (DFS) [hazard ratio (HR), 0.391; 95% confidence interval (CI): 0.161-0.948; P=0.04] and overall survival (OS) (HR, 0.201; 95% CI: 0.071-0.574; P=0.003). Notably, high LMR was correlated with higher intra-tumoral CD3+ (P=0.004), CD8+ (P=0.01), and CD68+ (P<0.001) immune cell infiltration compared to low LMR in lung LCNEC. Conclusions: Our study validated molecular subtypes by IHC in lung LCNEC, and co-expression was found among different subtypes, with no prognostic effect. High blood LMR level was associated with a favorable prognosis in lung LCNEC, which might partly reflect a hot tumor tissue immune microenvironment. Our findings may benefit clinical practice, and further studies are warranted.

The Effectiveness and Safety of Remdesivir Use in COVID-19 Patients with Neutropenia: A Retrospective Cohort Study.

BACKGROUND: The COVID-19 pandemic poses severe risks for immunocompromised patients, especially those with neutropenia due to chemotherapy. This study evaluates the safety and effectiveness of remdesivir use in COVID-19 patients with neutropenia. METHODS: This retrospective study used the Chang Gung Research Database (CGRD) and extracted data from 98,763 patients with COVID-19 diagnosed between April 2021 and September 2022. The patients were divided into groups based on their remdesivir use and the presence of neutropenia. The adverse effects of remdesivir and their outcomes were analyzed after propensity score matching. RESULTS: We compared common adverse effects of remdesivir in neutropenic patients before and after a 5-day regimen. A slight decrease in heart rate was observed but lacked clinical significance. There were no significant differences observed in hemoglobin, liver function tests, and blood glucose levels. After propensity score matching of COVID-19 patients with neutropenia according to gender, age, dexamethasone use, oxygen use, MASCC score, and WHO ordinal scale, no significant differences were found in length of stay, intubation rate, or ICU admission rate between the matched patients. CONCLUSIONS: Our study found remdesivir to be safe for COVID-19 patients with neutropenia, with no common adverse reactions observed. However, its effectiveness for these patients remains uncertain.

Investigation of the impact of diverse climate conditions on the cultivation suitability of Cinnamomum cassia using the MaxEnt model, HPLC and chemometric methods in China.

Cinnamomum cassia Presl. is a subtropical plant that is used for food and medicine. Climate change has changed the suitable habitats of medicinal plants, which might have repercussions for the efficacy of herbal remedies. In this study, the potential distribution in each period of Cinnamomum cassia was predicted and the quality in different suitable habitats was evaluated. According to the results, (1) precipitation, temperature, and soil are the primary environmental variables influencing C. cassia distribution. (2) The high-suitable habitats of current climate scenarios were predominantly located in the southern regions (Guangdong and Guangxi etc.) of China, with an area of 706,129.08 km2. Under future climate scenarios, suitable habitats will increasingly move northward, with a greater concentration south of the Yangtze River, particularly in the 2090s SSP585 scenario, the total area of newly extended suitable habitat reaches 312,963.53 km2. (3) HPLC and FTIR, combined with chemometrics, can be effective methods for identifying different suitable habitats of C. cassia. The content of trans-cinnamaldehyde (0.85%) is significantly higher in the high suitability habitat compared to the medium-low suitability habitat (0.30%). Our findings can offer valuable guidance for the identification of suitable C. cassia cultivation areas in China, as well as for the evaluation of C. cassia resource quality and the rational use of resources in different suitable habitats.

NIR-activatable nitric oxide generator based on nanoparticles loaded small-molecule photosensitizers for synergetic photodynamic/gas therapy.

BACKGROUND: Therapeutic approaches that combine conventional photodynamic therapy (PDT) with gas therapy (GT) to sensitize PDT are an attractive strategy, but the molecular structure design of the complex lacks effective guiding strategies. RESULTS: Herein, we have developed a nanoplatforms Cy-NMNO@SiO2 based on mesoporous silica materials loaded NIR-activatable small-molecule fluorescent probe Cy-NMNO for the synergistic treatment of photodynamic therapy/gas therapy (PDT/GT) in antibacterial and skin cancer. The theoretical calculation results showed that the low dissociation of N-NO in Cy-NMNO enabled it to dissociate effectively under NIR light irradiation, which is conducive to produce Cy and NO. Cy showed better 1O2 generation performance than Cy-NMNO. The cytotoxicity of Cy-NMNO obtained via the synergistic effect of GT and PDT synergistically enhances the effect of photodynamic therapy, thus achieving more effective tumor treatment and sterilization than conventional PDT. Moreover, the nanoplatforms Cy-NMNO@SiO2 realized efficient drug loading and drug delivery. CONCLUSIONS: This work not only offers a promising approach for PDT-GT synergistic drug delivery system, but also provides a valuable reference for the design of its drug molecules.

RNALocate v3.0: Advancing the Repository of RNA Subcellular Localization with Dynamic Analysis and Prediction.

Subcellular localization of RNA is a crucial mechanism for regulating diverse biological processes within cells. Dynamic RNA subcellular localizations are essential for maintaining cellular homeostasis; however, their distribution and changes during development and differentiation remain largely unexplored. To elucidate the dynamic patterns of RNA distribution within cells, we have upgraded RNALocate to version 3.0, a repository for RNA-subcellular localization (http://www.rnalocate.org/ or http://www.rna-society.org/rnalocate/). RNALocate v3.0 incorporates and analyzes RNA subcellular localization sequencing data from over 850 samples, with a specific focus on the dynamic changes in subcellular localizations under various conditions. The species coverage has also been expanded to encompass mammals, non-mammals, plants and microbes. Additionally, we provide an integrated prediction algorithm for the subcellular localization of seven RNA types across eleven subcellular compartments, utilizing convolutional neural networks (CNNs) and transformer models. Overall, RNALocate v3.0 contains a total of 1 844 013 RNA-localization entries covering 26 RNA types, 242 species and 177 subcellular localizations. It serves as a comprehensive and readily accessible data resource for RNA-subcellular localization, facilitating the elucidation of cellular function and disease pathogenesis.

Association between micronutrients and myopia in American adolescents: evidence from the 2003-2006 National Health and Nutrition Examination Survey.

Purpose: To investigate the associations between circulating micronutrients (vitamins A, C, D, E, and carotenoids) and the risk of myopia. Methods: A total of 1,620 adolescents from the 2003-2006 National Health and Nutrition Examination Survey (NHANES) were included. Logistic regression was used to analyze the associations of micronutrients with myopia and high myopia. Restricted cubic spline analysis was employed to assess the potential nonlinear relationships. Results: Among the 1,620 adolescents, 549 were diagnosed with myopia. After adjusting for multiple covariates, only cis-ß-carotene was significantly associated with the risk of myopia (OR 1.19, 95% CI 1.03-1.39) and high myopia (OR 1.44, 95% CI 1.03-2.03). No significant associations were found between vitamins A, D, E, C, α-carotene, trans-ß-carotene, lutein zeaxanthin, and myopia. No nonlinear relationships were observed between any of the micronutrients and myopia. Conclusion: Cis-ß-carotene is significantly associated with an increased risk of myopia and high myopia. Further research is needed to understand the underlying mechanisms and potential impact of cis-ß-carotene on ocular health.

Effects and safety of the traditional Chinese exercise baduanjin on depression and anxiety in COVID-19 patients: A systematic review and meta-analysis.

AIM: This systematic review and meta-analysis aimed to assess the safety and efficacy of Baduanjin, a traditional Chinese exercise (TCM), for reducing depression and anxiety in individuals suffering from coronavirus disease 2019 (COVID-19). METHODS: Nineteen databases were searched from their inception through August 2024 to gather data for this study. The focus of this study was randomized controlled trials (RCTs) in which Baduanjin was administered for the treatment of COVID-19 patients with depression and anxiety. The study included various types of Baduanjin exercise, whether used alone or in conjunction with other treatment modalities, for the control group. The comparators included a waitlist control, usual care, health education and supportive counseling, psychosocial support therapy, pharmacotherapies, and other common exercises. The exclusion criteria for trials were trials comparing different treatment durations, different treatment frequencies, and different types of Baduanjin exercise. Moreover, other traditional Chinese medicine (TCM) therapeutic methods applied in either the intervention or control group were also excluded. Throughout the entire study, the selection process, data extraction and quantitative analysis were carried out in strict adherence to all relevant guidelines. The Cochrane criteria for risk of bias were used to assess the methodological quality of the trials. In our review, a meta-analysis was performed using the software STATA MP14. RESULTS: After conducting a meta-analysis, eight RCTs were found to have satisfied the inclusion criteria. The effects of Baduanjin exercise on self-rating anxiety scale (SAS) scores were investigated in five RCTs comprising a total of 228 patients. Analysis of the results revealed that the combination of Baduanjin exercises and conventional therapies led to a statistically significant reduction in SAS scores [MD=-3.21 (95 % CI= -3.64, -2.79), P< 0.001] compared to conventional therapies alone. Moreover, this systematic review explored the effect of Baduanjin exercise on self-rating depression scale (SDS) scores (three RCTs involving 83 participants), Hamilton Anxiety Rating Scale (HAM-A) scores (one RCT involving 103 participants), Patient Health Questionnaire (PHQ-9) scores (one RCT involving 70 participants) and Generalized Anxiety Disorder-7 (GAD-7) scores (one RCT involving 59 participants) for patients with COVID-19. The results showed that, in addition to conventional therapies, Baduanjin exercise had a more favorable impact on reducing the SDS score [mean difference (MD) =-2.86 (95 % CI=4.11, -1.61), P=0.025], PHQ-9 score [MD=-5.31, 95 % CI=-8.73, -1.89), P=0.002] and HAM-A score [MD=-3.00, 95 % CI=-5.33, -0.67], P=0.010] in patients with COVID-19 than did the use of conventional therapies alone. Furthermore, the combination of Baduanjin exercise and conventional therapies effectively decreased the number of patients who experienced severe or moderate anxiety according to the GAD-7 score compared to that of patients who experienced severe or moderate anxiety according to conventional therapies alone [Relative Risk (RR) =0.03, 95 % CI=0.00, 0.51); P=0.020]. However, the included clinical trials lacked a detailed description of the randomization process, and only a small portion of the studies reported proper allocation concealment procedures, which may introduce selection bias. Moreover, owing to the nature of Baduanjin exercise, it is difficult to blind participants and practitioners, which may lead to performance bias. Furthermore, the lack of blinding may lead to subjective influences of assessors on the results, thereby causing detection bias. These methodological shortcomings and potential biases should be addressed in future studies. CONCLUSIONS: It is difficult to draw firm conclusions on whether Baduanjin exercise is an effective intervention for reducing depression and anxiety in COVID-19 patients because of the high risk of bias among the available RCTs. Further rigorous RCTs are warranted but need to overcome the methodological shortcomings of the existing evidence.

Precomputed low-frequency lighting in cinematic volume rendering.

Cinematic Rendering (CR) employs physical models such as ray tracing and global illumination to simulate real-world light phenomena, producing high-quality images with rich details. In the medical field, CR can significantly aid doctors in accurate diagnosis and preoperative planning. However, doctors require efficient real-time rendering when using CR, which presents a challenge due to the substantial computing resources demanded by CR's ray tracing and global illumination models. Precomputed lighting can enhance the efficiency of real-time rendering by freezing certain scene variables. Typically, precomputed methods freeze geometry and materials. However, since the physical rendering of medical images relies on volume data rendering of transfer functions, the CR algorithm cannot utilize precomputed methods directly. To improve the rendering efficiency of the CR algorithm, we propose a precomputed low-frequency lighting method. By simulating the lighting pattern of shadowless surgical lamps, we adopt a spherical distribution of multiple light sources, with each source capable of illuminating the entire volume of data. Under the influence of these large-area multi-light sources, the precomputed lighting adheres to physical principles, resulting in shadow-free and uniformly distributed illumination. We integrated this precomputed method into the ray-casting algorithm, creating an accelerated CR algorithm that achieves more than twice the rendering efficiency of traditional CR rendering.

Time trends in anxiety disorders incidence across the BRICS: an age-period-cohort analysis for the GBD 2021.

Background: Anxiety disorders are a significant global mental health concern, contributing to substantial disability-adjusted life years (DALYs) and imposing considerable social and economic burdens. Understanding the epidemiology of anxiety disorders within the BRICS nations (Brazil, Russian Federation, India, China, and South Africa) is essential due to their unique socio-economic landscapes and ongoing transformations. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 database to evaluate anxiety disorder incidence trends in BRICS countries from 1992 to 2021. The Age-Period-Cohort (APC) model with an intrinsic estimator (IE) algorithm was employed to disentangle the effects of age, period, and cohort on incidence rates. Data were categorized into 5-year age groups, and 95% uncertainty intervals (UIs) were calculated to account for data variability. Results: From 1992 to 2021, the global number of anxiety disorders cases increased by 73.44%, with age-standardized incidence rates rising by 21.17%. Among BRICS nations, India experienced the largest increase in cases (113.30%), while China had the smallest increase (2.79%). Globally, young (15-49 years) and oldest (80-94 years) age groups showed predominantly positive local drift values, indicating rising incidence rates. Brazil and India mirrored this trend, while China and South Africa mostly exhibited negative local drift values. Russia Federation had mixed trends with younger groups showing negative and older groups positive local drift values. The incidence of anxiety disorders exhibited an "M-shaped" age pattern with peaks at 10-14 and 35-39 years. Period effects were stable globally but varied in BRICS countries, with Brazil showing a decline and India an increase. Cohort effects were stable globally but showed increasing trends in Brazil and India post-1955-1959 cohort. Conclusion: This study highlights a significant increase in anxiety disorders incidence globally and within BRICS nations over the past three decades, with marked variations across countries. The distinct trends observed in age, period, and cohort effects call for age-specific and gender-sensitive mental health policies. Continuous monitoring, research, and tailored public health strategies are essential to address the rising burden of anxiety disorders and improve mental health outcomes in these rapidly evolving regions.

Effect and safety of aromatase inhibitors for the treatment of short stature in male children and adolescents: a meta-analysis of randomized controlled trials.

This study is to evaluate the efficacy and safety of aromatase inhibitors (AIs) in the treatment of short stature in male children and adolescents. Pooled estimates of final or near-final height, predicted adult height (PAH), bone age, and potential side effects were calculated using a random-effects model or fixed-effects model. Our search identified 11 studies with a total of 463 participants. AI was associated with a significant increase in final or near-final height (weight mean difference (WMD)=3.61 cm, 95 % CI: 0.96, 6.26; p<0.001) and PAH (WMD=2.52 cm, 95 % CI: 0.32, 4.72; p=0.025) compared to other treatment. The use of AI showed an increased risk of minor side effects (risk ratio (RR)=2.90, 95 % CI: 1.15, 7.33; p=0.025), but no severe adverse effects were reported. Subgroup analysis, stratified by patient disease, revealed that AI significantly enhanced final or near-final height in both patients with idiopathic short stature (ISS) and those with constitutional delay of growth and puberty (CDGP). AIs may contribute to height increase in male children and adolescents with short stature, without significantly advancing bone age. However, the increased risk of minor side effects indicates the need for careful monitoring during AI therapy.

MicroRNA expression profiles in plasma exosomes of late pregnant giant pandas.

BACKGROUND: MicroRNAs can regulate various biological functions including cell proliferation, differentiation, embryo formation, and implantation. The giant panda exhibits embryonic diapause, with embryo development resuming in late pregnancy. However, the changes in microRNAs during late pregnancy remain poorly understand. METHODS AND RESULTS: After mating, plasma samples were collected on day 40 of early pregnancy (EP; n = 3) and 30 days before delivery of late pregnancy (LP; n = 3). Following microRNAs screening, a total of 120 microRNAs were detected in the plasma exosomes of pregnant pandas. Nine differentially expressed microRNAs (DEmicroRNAs) were identified in LP compared to EP, including three that were upregulated and six that were downregulated. Notably, miR-25b and miR-47 were significantly downregulated in LP group. All DEmicroRNAs were predicted to target a total of 2,675 genes. Pathway enrichment analysis of these target genes revealed significant enrichment in the MAPK and Rap1 signaling pathways, which are closely related to cell proliferation, differentiation, and cell-cell and cell-matrix interactions. Analysis of protein-protein interaction networks showed that most of the hub genes (five out of eight), including Fgfr1, Fgf2, Fgf18, Erbb4, and Kras within the MAPK and Rap1 pathways are associated with the cell proliferation and differentiation. Significantly, Erbb4 was regulated by significantly differentially expressed miRNA-47. CONCLUSIONS: We suggest that plasma exosomal microRNAs are involved in cell proliferation and differentiation during embryonic development by regulating key hub genes within MAPK and Rap1 pathways. These findings provided new insights into the development of giant panda embryos.