Automated machine learning-based prediction of the progression of knee pain, functional decline, and incidence of knee osteoarthritis in individuals at high risk of knee osteoarthritis: Data from the osteoarthritis initiative study.

Objective: This study aimed to examine the performance of machine learning models in predicting the progression of knee pain, functional decline, and incidence of knee osteoarthritis (OA) in high-risk individuals, with automated machine learning (AutoML) being used to automate the prediction process. Design: There were four stages in the process of our AutoML-integrated prediction. Stage 1-Data preparation: The data of 3200 eligible individuals in the Osteoarthritis Initiative (OAI) study who were considered at high risk of knee OA at the baseline visit were extracted and used. Specifically, 1094 variables from the OAI study were used to predict the changes in knee pain, physical function, and incidence of knee OA (i.e. the first occurrence of frequent knee symptoms and definite tibial osteophytes (Kellgren and Lawrence grade ≥2)) over a 9-year period. Stage 2-Model training: The AutoML approach was used to automatically train nine widely used machine learning (ML) models. Stage 3-Model testing: The AutoML approach was used to automatically test the performance of the ML models. Stage 4-Selection of important input variables: The AutoML approach automated the process of computing the importance scores of all input variables and identifying the most important ones, using the technique of permutation feature importance. Results: Using the AutoML approach, the weighted ensemble model and the CatBoost model showed the best performance among all nine ML models. For the prediction of each outcome in each year, the five most important input variables were identified, most of which were obtained from self-reported questionnaire surveys and radiographic imaging reports. Conclusion: The AutoML approach has shown potential in automating the process of using ML models to predict long-term changes in knee OA-related outcomes. Its use could support the deployment of ML solutions, facilitating the provision of personalized interventions to prevent the deterioration of knee health and incident knee OA.

Feasibility of feeding cadmium accumulator maize (Zea mays L.) to beef cattle: Discovering a strategy for eliminating phytoremediation residues.

Eco-friendly and efficient strategies for eliminating cadmium (Cd) phytoremediation plant residues are needed. The present study investigated the feasibility of feeding Cd accumulator maize to beef cattle. In total, 20 cattle at 6 months of age were selected and randomly allocated into two groups fed with 85.82% (fresh basis) Cd accumulator maize (CAM) or normal maize (control [Con]) silage diets for 107 d. Feeding CAM did not affect the body weight (P = 0.24), while it decreased feed intake and increased feed efficiency of beef cattle (P < 0.01). Feeding CAM increased serum concentrations of immunoglobulin A and G, complement 3 and 4, blood urea nitrogen, and low-density lipoprotein cholesterol, decreased serum concentrations of interleukin-6 and lipopolysaccharide (P < 0.05), and caused wider lumens in the renal tubules. The Cd residue in meat was 7 µg/kg beyond the restriction for human food. In the muscle, the unsaturated fatty acids (t11C18:1 and C20:4), Lys, Arg, Pro, and Cys were decreased, while the saturated fatty acids (C10:0, C12:0, and C17:0) and Leu were increased (P < 0.05). Therefore, at the current feeding level, phytoremediation maize increased the feed efficiency of beef cattle, but did present risks to cattle health and production safety, and decreased the meat nutrition and flavor. Further research must be performed to determine whether a lower proper dose of phytoremediation maize and an appropriate feeding period may be possible to ensure no risk to cattle health and the supply of safe meat for humans.

Perceptions of a machine learning-based lower-limb exercise training system among older adults with knee pain.

Objective: To facilitate the older adults with knee pain to perform exercises and improve knee health, we proposed the design of a machine learning-based system for lower-limb exercise training that features three main components: video demonstration of exercises, real-time movement feedback, and tracking of exercise progress. At this early stage of design, we aimed to examine the perceptions of a paper-based prototype among older adults with knee pain and investigate the factors that may influence their perceptions of the system. Methods: A cross-sectional survey of the participants' (N = 94) perceptions of the system was conducted using a questionnaire, which assessed their perceived effects of the system, perceived ease of use of the system, attitude toward the system, and intention to use the system. Ordinal logistic regression was conducted to examine whether the participants' perceptions of the system were influenced by their demographic and clinical characteristics, physical activity level, and exercise experience. Results: The participants' responses to the perception statements exhibited consensus agreement (≥ 75%). Age, gender, duration of knee pain, knee pain intensity, experience with exercise therapy, and experience with technology-supported exercise programs were significantly associated with the participants' perceptions of the system. Conclusions: Our results demonstrate that the system appears promising for use by older adults to manage their knee pain. Therefore, it is needed to develop a computer-based system and further investigate its usability, acceptance, and clinical effectiveness.

Optimization of the extraction process and metabonomics analysis of uric acid-reducing active substances from Gymnadenia R.Br. and its protective effect on hyperuricemia zebrafish.

Background: As Gymnadenia R.Br. (Gym) has an obvious uric acid-lowering effect, but its specific bioactive substances and mechanism are still unclear. The key metabolites and pathways used by Gym to reduce uric acid (UA) were identify. Methods: An optimized extraction process for urate-lowering active substances from Gym was firstly been carried out based on the xanthine oxidase (XOD) inhibition model in vitro; then, the Ultra-high-performance liquid chromatography and Q-Exactive mass spectrometry (UHPLC-QE-MS) based on non-targeted metabolomics analysis of Traditional Chinese Medicine were performed for comparison of Gym with ethanol concentration of 95% (low extraction rate but high XOD inhibition rate) and 75% (high extraction rate but low XOD inhibition rate), respectively; finally, the protective effect of ethanolic extract of Gym on zebrafish with Hyperuricemia (referred to as HUA zebrafish) was explored. Results: We found that the inhibition rate of Gym extract with 95% ethanol concentration on XOD was 84.02%, and the extraction rate was 4.32%. Interestingly, when the other conditions were the same, the XOD inhibition rate of the Gym extract with 75% ethanol concentration was 76.84%, and the extraction rate was 14.68%. A total of 539 metabolites were identified, among them, 162 different metabolites were screened, of which 123 were up-regulated and 39 were down-regulated. Besides significantly reducing the contents of UA, BUN, CRE, ROS, MDA, and XOD activity in HUA zebrafish by Gym and acutely reduce the activity of SOD. Conclusion: Along with the flavonoids, polyphenols, alkaloids, terpenoids, and phenylpropanoids, the ethanolic extract of Gym may be related to reduce the UA level of Gym.

Effectiveness of Using Virtual Reality-Supported Exercise Therapy for Upper Extremity Motor Rehabilitation in Patients With Stroke: Systematic Review and Meta-analysis of Randomized Controlled Trials.

BACKGROUND: In recent years, efforts have been made to implement virtual reality (VR) to support the delivery of poststroke upper extremity motor rehabilitation exercises. Therefore, it is important to review and analyze the existing research evidence of its effectiveness. OBJECTIVE: Through a systematic review and meta-analysis of randomized controlled trials, this study examined the effectiveness of using VR-supported exercise therapy for upper extremity motor rehabilitation in patients with stroke. METHODS: This study followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The CINAHL Plus, MEDLINE, Web of Science, Embase, and Cochrane Library databases were searched on December 31, 2021. Changes in outcomes related to impairments in upper extremity functions and structures, activity limitations, and participation restrictions in life situations from baseline to after intervention, after intervention to follow-up assessment, and baseline to follow-up assessment were examined. Standardized mean differences (SMDs) were calculated using a random-effects model. Subgroup analyses were performed to determine whether the differences in treatment outcomes depended on age, stroke recovery stage, VR program type, therapy delivery format, similarities in intervention duration between study groups, intervention duration in VR groups, and trial length. RESULTS: A total of 42 publications representing 43 trials (aggregated sample size=1893) were analyzed. Compared with the control groups that used either conventional therapy or no therapy, the intervention groups that used VR to support exercise therapy showed significant improvements in upper extremity motor function (Fugl-Meyer Assessment-Upper Extremity; SMD 0.45, 95% CI 0.21-0.68; P<.001), range of motion (goniometer; SMD 1.01, 95% CI 0.50-1.52; P<.001), muscle strength (Manual Muscle Testing; SMD 0.79, 95% CI 0.28-1.30; P=.002), and independence in day-to-day activities (Functional Independence Measure; SMD 0.23, 95% CI 0.06-0.40; P=.01, and modified Rankin Scale; SMD 0.57, 95% CI 0.01-1.12; P=.046). Significant subgroup differences were observed in hand dexterity (Box and Block Test), spasticity (Ashworth Scale or modified Ashworth Scale), arm and hand motor ability (Wolf Motor Function Test and Manual Function Test), hand motor ability (Jebsen Hand Function Test), and quality of life (Stroke Impact Scale). There was no evidence that the benefits of VR-supported exercise therapy were maintained after the intervention ended. CONCLUSIONS: VR-supported upper extremity exercise therapy can be effective in improving motor rehabilitation results. Our review showed that of the 12 rehabilitation outcomes examined during the course of VR-based therapy, significant improvements were detected in 2 (upper extremity motor function and range of motion), and both significant and nonsignificant improvements were observed in another 2 (muscle strength and independence in day-to-day activities), depending on the measurement tools or methods used. TRIAL REGISTRATION: PROSPERO CRD42021256826; https://tinyurl.com/2uarftbh.

Circ_HECTD1 regulates cerebral ischemia injury via mechanisms involving the regulation of let-7c-5p/ROCK1 axis.

BACKGROUND: Ischemia is the main cause of cerebral ischemic stroke with a high mortality rate, and it is affected by the dysfunction of circular RNAs. The underlying molecular mechanisms of circ_HECTD1 were explored in cerebral ischemia stroke. METHODS: PC-12 cells were treated with oxygen-glucose deprivation/reoxygenation (OGD/R) as the cell model of cerebral ischemia model. The expression levels of circ_HECTD1, let-7c-5p, and Rho-associated coiled-coil-containing protein kinase 1 (ROCK1) were determined by quantitative real-time PCR in PC-12 cells. The proliferation ability of PC-12 cells was assessed by 5-ethynyl-2'-deoxyuridine and 3-(4,5-dimethylthizol-2-yl)-2,5-diphenyltetrazolium bromide assays. The protein expression levels were quantified by western blot analysis. Flow cytometry was performed to analyze cell apoptosis. Lactate dehydrogenase concentration was assessed by a commercialized kit. Dual-luciferase reporter assay was used to confirm the interaction relationships among circ_HECTD1, let-7c-5p and ROCK1. RESULTS: Circ_HECTD1 was upregulated in OGD/R-treated PC-12 cells. The results also showed that cell proliferation was decreased and apoptosis was increased in OGD/R-treated PC-12 cells, which was overturned by the inhibition of circ_HECTD1. Let-7c-5p was a target of circ_HECTD1, and the protective effects of circ_HECTD1 knockdown on OGD/R-treated PC-12 cells were canceled after co-transfection with let-7c-5p inhibitor. We found that ROCK1 was a potential target of let-7c-5p. Let-7c-5p -mediated the effects on the proliferation and apoptosis of OGD/R-treated PC-12 cells by targeting ROCK1. CONCLUSION: Circ_HECTD1 was implicated in the development of cerebral ischemia stroke. Knockdown of circ_HECTD1 protected against cerebral ischemia injury in OGD/R-treated PC-12 cells depending on the regulation of let-7c-5p/ROCK1 axis.

Effects of interventions to reduce the negative consequences of interruptions on task performance: A systematic review, meta-analysis, and narrative synthesis of laboratory studies.

A systematic review was conducted to examine the effects of interventions aimed at reducing the negative consequences of interruptions on task performance. Medline, PsycINFO, PsycARTICLES, and the ABI/INFORM Collection were searched for relevant publications. Thirty-three laboratory-based experiments, containing 49 interventions, were reviewed. Seven types of interventions were identified. Overall, the use of interventions significantly increased primary task accuracy (standardized mean difference (SMD) = 1.03, P = 0.001) and reduced resumption lag (SMD = -0.51, P < 0.001), whereas no significant difference was observed for interrupting task accuracy. Subgroup analyses indicated that intervention effects varied by (i) the type of intervention and (ii) the type of primary task (procedural, decision-making, or problem-solving tasks). The narrative synthesis provided additional evidence regarding interruption lag and time spent on a primary task. In sum, this review identified the types of interventions that were particularly effective and provided implications for application and further investigation.

Effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain: A systematic review and meta-analysis of randomized controlled trials.

OBJECTIVE: The study sought to examine the effects of technology-supported exercise programs on the knee pain, physical function, and quality of life of individuals with knee osteoarthritis and/or chronic knee pain by a systematic review and meta-analysis of randomized controlled trials. MATERIALS AND METHODS: We searched MEDLINE, EMBASE, CINAHL Plus, and the Cochrane Library from database inception to August 2020. A meta-analysis and subgroup analyses, stratified by technology type and program feature, were conducted. RESULTS: Twelve randomized controlled trials were reviewed, all of which implemented the programs for 4 weeks to 6 months. Telephone, Web, mobile app, computer, and virtual reality were used to deliver the programs. The meta-analysis showed that these programs were associated with significant improvements in knee pain (standardized mean difference [SMD] = -0.29; 95% confidence interval [CI], -0.48 to -0.10; P = .003) and quality of life (SMD = 0.25; 95% CI, 0.04 to 0.46; P = .02) but not with significant improvement in physical function (SMD = 0.22; 95% CI, 0 to 0.43; P = .053). Subgroup analyses showed that some technology types and program features were suggestive of potential benefits. CONCLUSIONS: Using technology to deliver the exercise programs appears to offer benefits. The technology types and program features that were associated with health values have been identified, based on which suggestions are discussed for the further research and development of such programs.

Rosmarinic acid protects against 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced dopaminergic neurotoxicity in zebrafish embryos.

Rosmarinic acid (RA) is an extract that can be obtained from Lamiaceae herbs and the Boraginaceae family. This study aimed to evaluate the effect of RA on 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-induced dopaminergic neurotoxicity in zebrafish embryos. Embryos were challenged with MPTP and then were treated with RA or brusatol (a Nrf2 inhibitor). Locomotor activity of zebrafish was recorded using a video camera. The swimming distance was analyzed with SMART 3.0 software. Tyrosine hydroxylase (TH) immunohistochemistry, reactive oxygen species (ROS), glutathione (GSH), and malondialdehyde (MDA) contents were evaluated. The expressions of proteins in the DJ-1/Akt/Nrf2 signaling pathway were measured. The results showed that RA not only prevented MPTP-induced dopaminergic neuron loss, but also attenuated the deficit in locomotor behavior. RA attenuated the increases of ROS and MDA induced by MPTP. Treatment with RA augmented expression of glutamate cysteine ligase catalytic subunit, glutamate cysteine ligase modifier subunit, and GSH. Furthermore, RA increased the expression of DJ-1, p-Akt, Nuclear-Nrf2, HO-1 and inhibited the expression of PTEN. Brusatol partially abolished the neuroprotective effect of RA in MPTP-induced Parkinson's disease (PD) model of zebrafish embryos. The results of this study indicate that RA exerts neuroprotective effects on MPTP-induced neurotoxicity in dopaminergic neurons of a zebrafish PD model. The mechanism underlying the effects of RA is associated with promotion of antioxidant gene expression via regulation of the DJ-1/Akt/Nrf2 signaling pathway.

Effect of electroacupuncture on the inflammatory response in patients with acute pancreatitis: an exploratory study.

OBJECTIVES: To examine the effects of electroacupuncture (EA) on inflammatory responses in patients with acute pancreatitis (AP). METHODS: Eighty patients with mild or severe AP were randomly allocated to a control group or an EA group. All patients were managed conservatively. In addition, the EA group received acupuncture for 30 min per day for 7 days at bilateral points ST36, LI4, TE6, ST37 and LR3. Interleukin (IL)-6, IL-10 and C-reactive protein (CRP) levels were measured on admission and on day 7. The time to re-feeding and length of stay in hospital were also recorded. RESULTS: A total of 58 patients provided complete data. The characteristics of the patients in the EA and control groups were similar. After 7 days the serum concentrations of IL-10 were higher in the EA group than in the control group (mild AP: 6.2±1.2 vs 5.2±0.9 pg/mL, p<0.05; severe AP: 14.9±7.8 vs 7.9±6.3 pg/mL, p<0.05). For patients with severe AP, the CRP level in the EA group was lower than in the control group (p<0.05). CONCLUSIONS: EA may reduce the severity of AP by inducing anti-inflammatory effects and reducing the time to re-feeding; however, it did not reduce the length of hospital stay. TRIAL REGISTRATION NUMBER: ChiCTR-TRC-13003572.