Differences of anticholinergic drug burden between older hospitalized patients with and without delirium: a systematic review and meta-analysis based on prospective cohort studies.

OBJECTIVES: This review aims to comprehensively summarize the differences in anticholinergic drug burden (ADB) scores between older hospitalized patients with and without delirium. METHODS: We searched PubMed, Embase, Web of Science, Cochrane Library and CINAHL EBSCOhost databases to identify prospective cohort studies exploring the relationship between ADB and the occurrence of delirium in older hospitalized patients. The primary outcome of the review was the mean ADB scores for the delirium and non-delirium groups, and the secondary outcome was the scores for the subsyndromal and non-delirium groups. The standardized mean difference (SMD) and corresponding 95% confidence intervals (95% CI) were incorporated using a fixed-effect method. Moreover, we performed subgroup analysis according to the admission type, age, the ADB scale type and the ADB classification. RESULTS: Nine prospective cohort studies involving 3791 older patients with a median age of 75.1 (71.6-83.9) were included. The ADB score was significantly higher in the delirium group than in the non-delirium group (SMD = 0.21, 95%CI 0.13-0.28). In subgroup analysis, the age subgroup was split into < 75 and ≥ 75 according to the median age of the older people. There were significant differences in ADB scores between older people with delirium and those without delirium in various subgroups: surgical (SMD = 0.20, 95%CI 0.12-0.28), internal medicine (SMD = 0.64, 95%CI 0.25-1.02), age < 75 (SMD = 0.17, 95%CI 0.08-0.26), age ≥ 75 (SMD = 0.27, 95%CI 0.15-0.39), ADS scale (SMD = 0.13, 95%CI 0.13-0.40), ARS scale (SMD = 0.15, 95%CI 0.03-0.26), ACB scale (SMD = 0.13, 95%CI 0.01-0.25), pre-admission ADB (SMD = 0.24, 95%CI 0.05-0.43) and ADB during hospitalization (SMD = 0.20, 95%CI 0.12-0.27). CONCLUSIONS: We found a quantitative relationship between ADB and delirium in older patients admitted for internal medicine and surgery. And this relationship remained significant in different age, ADB scale type and ADB classification subgroups. However, the actual difference in ADB scores between patients with delirium and without delirium was small. More high-quality observational studies should be conducted to explore the impact of ADB on delirium and subsyndromal delirium. CLINICAL TRIAL REGISTRATION: The protocol was published in the International Prospective Register of Systematic Reviews (PROSPERO) [Ref: CRD42022353649].

Evaluation of the texture characteristics and taste of shrimp surimi with partial replacement of NaCl by non­sodium metal salts.

Ionic strength plays a significant role in the aggregation behavior of myofibrillar proteins. The study investigated the effects of KCl or CaCl2 as substitutes for NaCl on the gel properties and taste of shrimp surimi at a constant ionic strength (IS = 0.51). Increased KCl substitution ratio resulted in a reduction in α-helix content and an increase in ß-sheet content of myofibrillar proteins, thereby enhancing water holding capacity. Optimal KCl substitutions (1.5% NaCl +1.94% KCl) contributed to maintaining the desired taste and improving gel properties. CaCl2 facilitates the extraction and dissolution of myofibrillar proteins, resulting in an organized and dense gel network with significant water-holding capacity. However, excessive additions (>1.27%) resulted in a notable decrease in taste and gel strength due to excessive aggregation and precipitation of myofibrillar proteins. These findings provide a solid theoretical foundation for production of high-quality, low-salt shrimp surimi.

Molecular mechanism of color deepening of ready-to-eat shrimp during storage.

Color deepening occurs during storage of ready-to-eat (RTE) shrimps, which seriously affects their marketing cycle. This study investigated the molecular mechanisms of color deterioration in RTE shrimps during accelerated storage, shedding light on the pattern of change in colored products and content. The findings revealed significant occurrences of phenolic oxidation, lipid oxidation, and Maillard browning reactions during accelerated storage. Qualitative and quantitative analyses were conducted on the colored products resulting from these chemical reactions. Multivariate mathematical models were employed to analyze the phenolic oxidation products (2-methylanthraquinone and p-benzoquinone), lipid oxidation products (lipofuscin-like pigments and hydrophobic pyrroles), and Maillard browning products (pyrazines and melanoidins). These products were identified as the main contributors to the deepening of the color of RTE shrimps during storage. The outcomes of this research could enhance our understanding of the color change mechanism in thermally processed marine foods, providing valuable insights for quality maintenance and industrial advancement.

Application of Patient-Reported Outcome Measurements in Clinical Trials in China.

Importance: Regulatory authorities, industry peers, and international health policies have emphasized the value of assessing patient-reported outcomes (PROs) in clinical studies. Despite the increase in the number of clinical studies in the last decade in China, little is known about the extent of the use of PROs. Objective: To evaluate the application and characteristics of PRO instruments as primary and secondary outcomes in randomized clinical trials in China. Design, Setting, and Participants: A cross-sectional study of interventional clinical trials conducted in China from January 1, 2010, to December 31, 2020, was performed. Data obtained from the Chinese Clinical Trial Registry and ClinicalTrials.gov databases were evaluated. Main Outcomes and Measures: Trials were categorized according to those that (1) precisely listed PRO tools as outcomes, (2) mentioned patient subjective feelings in outcomes but did not clarify which tools were used for assessment, and (3) did not mention any PRO measurements. Data on study phase, setting, participant age, and sex were extracted from trials that considered patient feelings, along with the target diseases and names of the PRO tools. Results: Among a total of 34 033 trials, 6915 (20.3%) listed the explicit PRO instruments used and 3178 (9.3%) included PRO in their outcomes but did not include the names of the assessment tools. From more than 32 million people included in the registered trials, data on 1.5 million (4.7%) patients were scientifically collected by PRO instruments, and subjective feelings were assessed for 693 867 (2.1%) participants. Pain (16.8%), cancer (15.6%), and musculoskeletal symptoms (13.3%) were the most common conditions for which PROs were precisely collected by tools. The most common tools for PRO measurements were the visual analog scale, Short-Form 36, and Hamilton Depression Scale. Conclusions and Relevance: In this cross-sectional study, the use of PROs increased during the study period in clinical trials conducted in China. However, patient opinion appears to still be rarely measured. The application of PRO is geographically unevenly distributed. Development of PRO instruments, especially those suitable for the Chinese population, may be useful. Further expansion of PROs with respect to the scope of diseases is needed to avoid missing important data.

Sleep Status and Menstrual Problems among Chinese Young Females.

BACKGROUND: The association between sleep disturbance and the menstruation in the young women population has been scarcely studied. The aim of this study is to assess the association between sleep status and phase of the menstrual cycle in healthy, young, ovulating women. METHODS: This cross-sectional study used the data collected from healthy young, ovulating Chinese females from September to December 2018. The association was analyzed by using linear regression and binary logistic analyses. RESULTS: 2260 women aged 17 to 30 were included in the analysis. The average sleep duration of the respondents was 7.24 hours (SD = 0.92). 61.7% of them admitted that they were accompanied by at least one of sleep symptoms including difficulty initiating sleep, difficulty maintaining sleep, dreaminess, early morning awakening, and somnolence. Sleep quality was significantly associated with dysmenorrhea (OR [95%CI] = 1.74 [1.40-2.17], P < 0.001) and self-awareness menstrual regularity (OR [95%CI] = 1.29 [1.06-1.56], P = 0.011). CONCLUSION: This study found that poor sleep quality is significantly associated with dysmenorrhea and self-awareness menstrual irregularity among healthy, young, ovulating, Chinese females.

Comprehensive analysis of differential circular RNA expression in a mouse model of colitis-induced colon carcinoma.

Circular RNAs (circRNAs) have received increasing attention for their involvement in the pathogenesis of cancer; however, the characterization and function of circRNAs in colitis-induced colon carcinoma remains largely unknown. A colitis-induced colon carcinoma model was established in mice treated with azoxymethane-dextran sodium sulfate (AOM-DSS), and the circRNA profile was screened by next generation sequencing. Bioinformatic tools, including Gene Ontology (GO) analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis, and network analysis were used to predict the functions of differentially expressed circRNAs and potentially coexpressed target genes. Among the detected candidate 3069 circRNA genes, 126 circRNAs were upregulated, and 108 circRNAs were down regulated in colon tissues from AOM/DSS mice compared to those from control mice. A total of six of these candidate circRNAs were validated by RT-PCR. GO analysis revealed that numerous target genes including most microRNAs were involved in the Ras-Raf-MAPK pathway, actin cytoskeleton, focal adhesion, and additional biological processes. Our study revealed a comprehensive expression and functional profile for differentially expressed circRNAs in AOM/DSS induced colon carcinogenesis, indicating possible involvement of these dysregulated circRNAs in the development of colitis-induced colon carcinoma. The mmu-circ-001226/mmu-circ-000287-miRNA-mRNA network may provide a potential mechanism for colitis-associated colorectal cancer.

Ambient fine particulate matter in China: Its negative impacts and possible countermeasures.

In recent decades, China has experienced rapid economic development accompanied by increasing concentrations of ambient PM2.5, particulate matter of less than 2.5 µm in diameter. PM2.5 is now believed to be a carcinogen, causing higher lung cancer risks and generating losses to the economy and society. This meta-analysis evaluates the losses generated by ambient PM2.5 in Suzhou from 2014 to 2016 and predicts losses at different concentrations. Estimations of total losses in Beijing, Shanghai, Hangzhou, Guangzhou, Dalian, and Xiamen are also presented, with a total national loss in 2015. The authors then demonstrate that lowering ambient PM2.5 concentrations would be a realistic way for China to reduce the evaluated social losses in the short term. Possible legal measures are listed for lowering ambient PM2.5 concentrations. IMPLICATIONS: The present findings quantify the economic effects of ambient PM2.5 due to the increased incidence rate and mortality rate of lung cancer. Lowering ambient PM2.5 concentrations would be the most realistic way for China to reduce tghe evaluated social losses in the short term. Possible legal measures for lowering ambient PM2.5 concentrations to reduce the total losses are identified.