Time-Restricted Eating and Bone Health: A Systematic Review with Meta-Analysis.

Time-restricted eating (TRE) has emerged as a dietary strategy that restricts food consumption to a specific time window and is commonly applied to facilitate weight loss. The benefits of TRE on adipose tissue have been evidenced in human trials and animal models; however, its impact on bone tissue remains unclear. To systematically synthesize and examine the evidence on the impact of TRE on bone health (bone mineral content (BMC), bone mineral density (BMD), and bone turnover factors), PubMed, Scopus, Cochrane CENTRAL, and Web of Science databases were systematically explored from inception to 1 October 2023 searching for randomized controlled trials (RCTs) aimed at determining the effects of TRE on bone health in adults (≥18 years). The Cochrane Handbook and the PRISMA recommendations were followed. A total of seven RCTs involving 313 participants (19 to 68 years) were included, with an average length of 10.5 weeks (range: 4 to 24 weeks). Despite the significant weight loss reported in five out of seven studies when compared to the control, our meta-analysis showed no significant difference in BMD (g/cm2) between groups (MD = -0.009, 95% CI: -0.026 to 0.009, p = 0.328; I2 = 0%). BMC and bone turnover markers between TRE interventions and control conditions were not meta-analyzed because of scarcity of studies (less than five). Despite its short-term benefits on cardiometabolic health, TRE did not show detrimental effects on bone health outcomes compared to those in the control group. Nevertheless, caution should be taken when interpreting our results due to the scarcity of RCTs adequately powered to assess changes in bone outcomes.

Effect of different types of exercise on fitness in people with multiple sclerosis: A network meta-analysis.

BACKGROUND: It is assumed that people with multiple sclerosis (MS) who participate in programs of physical exercise improve their physical fitness. OBJECTIVE: The aim of this network meta-analysis (NMA) was to analyze the effect of different types of exercise on muscular fitness and cardiorespiratory fitness (CRF) among people with MS and to determine the best type of exercise according to disease severity. METHODS: MEDLINE, the Physiotherapy Evidence Database, the Cochrane Library, SPORTDiscus, Scopus, and Web of Science were searched from inception to April 2022 to identify randomized controlled trials (RCTs) concerning the effect of physical exercise on fitness in people with MS. We ranked the types of physical exercise by calculating the surface under the cumulative ranking (SUCRA). RESULTS: We included 72 RCTs involving 2543 MS patients in this NMA. A ranking of five types of physical exercise (aerobic, resistance, combined [aerobic and resistance], sensorimotor training, and mind-body exercises) was achieved. Combined and resistance training had the highest effect sizes (0.94, 95% CI 0.47, 1.41, and 0.93, 95% CI 0.57, 1.29, respectively) and the highest SUCRA (86.2% and 87.0%, respectively) for muscular fitness. The highest effect size (0.66, 95% CI 0.34, 0.99) and SUCRA (86.9%) for CRF was for aerobic exercise. CONCLUSIONS: Combined and resistance training seem to be the most effective exercises to improve muscular fitness and aerobic exercise for CRF in people with MS.

Sex and Time-of-Day Impact on Anxiety and Passive Avoidance Memory Strategies in Mice.

In humans, anxiety and cognitive processes are age, gender, and time of day dependent. The purpose of the present study was to assess whether the time of day and sex have an influence on anxiety and emotional memory in adult mice. Light-dark and passive avoidance (PA) tests were performed at the beginning and at the end of the light cycle, defined as Zeitgeber time (ZT) ZT0-2.5 and ZT9.5-12, respectively. A baseline difference in anxiety was not found, but on the 24 h retention trial of the PA test, females presented longer latencies to enter into the dark compartment at the ZT0-2.5 time point of the day. The data from the second test day (PA reversal trial) indicated that some animals associated the dark compartment with an aversive stimulus (shock), while others associated the aversive stimulus with crossing from one compartment to another. At the ZT9.5-12, female mice mainly related the aversive stimulus to transferring from one compartment to another, while male mice associated darkness with the aversive stimulus. There was a negative correlation between the frequency of light-dark transitions in the light-dark test and the PA latency on the 24 h retention trial in males tested at ZT0-2.5. The PA latency on the reversal and 24 h retention trials negatively correlated with a risk assessment behavior in male mice tested on ZT0-2.5 and ZT9.5-12, respectively. In conclusion, our data reveal that the impact of motor activity and risk assessment behavior on PA memory formation and applied behavioral strategies are time of day and sex dependent.

Characteristics that affect score reliability in the Berg Balance Scale: a meta-analytic reliability generalization study.

INTRODUCTION: The Berg Balance Scale is the most widely used clinical scale used to assess balance performance in neurological conditions. Reliability is not an unalterable value of a scale across different applications, but is a property referring to the results obtained with the scale, not the instrument in itself. The results of a scale can vary depending on the context where it is applied and the characteristics of the participants, therefore the reliability coefficient should be reported in each study. A systematic review and meta-analysis of the reliability coefficients obtained in different applications of the test with the data at hand is the best method to examine how the reliability of a test scores varies. The objectives of this systematic revision are: To determine the mean of internal consistency, intra and interrater reliability of the Berg balance scale in the clinical, nonclinical and mixed populations, to determine the methodological and substantive characteristics and to propose a predictive model enabling researchers and clinicians to use it in the future to estimate the expected reliability based on the characteristics of the most relevant studies. EVIDENCE ACQUISITION: The MEDLINE (Pubmed), EMBASE and CINAHL databases were searched from 1989 to 2015. Two reviewers independently selected empirical studies published in English or in Spanish that applied the Berg Balance Scale and reported any reliability coefficient. EVIDENCE SYNTHESIS: The 80 samples in the 65 studies reported any the Berg Balance Scale reliability estimate. Coefficient alpha ranged from 0.62 to .98, with a mean of 0.92. For intra-rater agreement, the mean intraclass correlation was ICC+=0.957, and for inter-rater agreement ICC+=0.97. The SD of the Berg Balance Scale scores presented statistically significant relationships with the coefficient alpha and with ICC (intra-rater). In addition, the clinical population and the institutionalized population presented statistically significant relationships with the coefficient alpha. The sample size and mean scale results were also statistically related to ICCs (intra-rater). CONCLUSIONS: The alpha coefficient and intra- and inter-rater agreement for Berg Balance Scale scores was very satisfactory. Several characteristics of the studies were statistically associated to the alpha coefficient and with intra-rater reliability.

Inter- and intra-rater reliability of the Modified Ashworth Scale: a systematic review and meta-analysis.

INTRODUCTION: The Modified Ashworth Scale is the most widely clinical scale used to measure the increase of muscle tone. Reliability is not an immutable property of a scale and can vary as a function of the variability and composition of the sample to which it is administered. The best method to examine how the reliability of a test scores varies is by conducting a systematic review and meta-analysis of the reliability coefficients obtained in different applications of the test with the data at hand. The objectives of this systematic revision are: what is the mean inter- and intra-rater reliability of the Modified Ashworth Scale's scores in upper and lower extremities? Which study characteristics affect the reliability of the scores in this scale? EVIDENCE ACQUISITION: The PubMed, Embase and CINAHL databases were searched from 1987 to February 2015. Two reviewers independently selected empirical studies published in English or in Spanish that applied the Modified Ashworth Scale and reported any reliability coefficient with the data at hand in children, adolescents or adults with spasticity. EVIDENCE SYNTHESIS: Thirty-three studies reported any reliability estimate of Modified Ashworth Scale scores (N.=1065 participants). For lower extremities and inter-rater agreement, the mean intraclass correlation was ICC+=0.686 (95% CI: 0.563 and 0.780) and for kappa coefficients, κ+=0.360 (95% CI: 0.241 and 0.468); for intra-rater agreement: ICC+=0.644 (95% CI: 0.543 and 0.726) and κ+=0.488 (95% CI: 0.370 and 0.591). For upper extremities and inter-rater agreement: ICC+=0.781 (95% CI: 0.679 and 0.853) and κ+=0.625 (95% CI: 0.350 and 0.801); for intra-rater agreement: ICC+=0.748 (95% CI: 0.671 and 0.809) and κ+=0.593 (95% CI: 0.467 and 0.696). The type of design, the study focus, and the number of raters presented statistically significant relationships with ICC both for lower and upper extremities. CONCLUSIONS: Inter- and intra-rater agreement for Modified Ashworth Scale scores was satisfactory. Modified Ashworth Scale' scores exhibited better reliability when measuring upper extremities than lower. Several characteristics of the studies were statistically associated to inter-rater reliability of the scores for lower and upper extremities.

Components of quality of life in a sample of patients with lupus: a confirmatory factor analysis and Rasch modeling of the LupusQoL.

The objective of this study was to test different exploratory solutions to the LupusQoL scale in a sample of Spanish patients with SLE using confirmatory factor analysis (CFA) and Rasch modeling, as well as to estimate the convergent validity. The χ 2 test, RMSEA, CFI, and TLI were used to test the fit of the different exploratory structures with CFA. To estimate the parameters in the dimensions found, a rating scale Rasch multidimensional random coefficient multinomial logit model was used. The reliability of the scores was obtained with coefficient alpha and coefficient omega. The convergent validity was calculated using Spearman's rho. Four hundred and fifty patients participated but complete data were available for 223 subjects. The original version (UK) and the French version obtained the best fit, showing that the proposed original structure was the best solution for the structure of the LupusQoL scale in the Spanish sample. The multidimensional solution of eight dimensions was adequate, but item 8 in physical health, item 16 in intimate relations, and items 29 and 30 obtained mean squares >1.6. Internal consistency and coefficient omega of the scores in the eight domains were higher. The Spanish version of LupusQoL correlated strongly with the corresponding SLAQ, EQ5D analogic scale, and EQ5D domain. This analysis confirmed the structure of eight dimensions of the original version in patients with SLE.

Measurement properties of the brief resilient coping scale in patients with systemic lupus erythematosus using rasch analysis.

BACGROUND: Resilience has been defined as the capacity or the ability to rebound from and positively adapt to significant stressors, despite experiences of significant adversity or trauma. To capture to what extent an individual copes with stress in a resilient fashion the Brief Resilient Coping Scale (BRCS) was developed. This tool was validated in people with chronic disease, such as rheumatoid arthritis using standard psychometric techniques of classical test theory, but not yet in patients with Systemic lupus erythematosus (SLE). The aim of this study was to explore the psychometric properties of the Brief Resilient Coping Scale in patients with SLE using Rasch analysis. METHOD: This study used cross-sectional data. The BRCS was administered to 232 patients with systemic lupus erythematosus. The aspects analyzed were unidimensionality, local independence and differential item functioning (DIF) to construct an interpretative scale of scores with the Rasch model. RESULTS: Rating scale mode (RSM) showed that the four categories used in the items of the BRCS are properly ordered. The four items provided a good fit to the polytomous Rasch model. Moreover, the parameters were sufficiently separated to measure resilience in patients with SLE. BRCS is a unidimensional scale (eigenvalue = 1.843) of resilience and the items were locally independent. There was no DIF between males and females in the sample. Only marginally significant differences depending on the level of education were found. The BRCS showed adequate discriminant validity between groups of scores. CONCLUSIONS: BRCS is a suitable scale for measuring resilience in patients with SLE. This scale might be useful for clinicians to obtain information concerning the degree of resilience that each patient has, allowing individuals with low resilience to be identified who need interventions aimed at developing coping skills.

Mesenchymal dental stem cells in regenerative dentistry

In the last decade, tissue engineering is a field that has been suffering an enormous expansion in the regenerative medicine and dentistry. The use of cells as mesenchymal dental stem cells of easy access for dentist and oral surgeon, immunosuppressive properties, high proliferation and capacity to differentiate into odontoblasts, cementoblasts, osteoblasts and other cells implicated in the teeth, suppose a good perspective of future in the clinical dentistry. However, is necessary advance in the known of growth factors and signalling molecules implicated in tooth development and regeneration of different structures of teeth. Furthermore, these cells need a fabulous scaffold that facility their integration, differentiation, matrix synthesis and promote multiple specific interactions between cells. In this review, we give a brief description of tooth development and anatomy, definition and classification of stem cells, with special attention of mesenchymal stem cells, commonly used in the cellular therapy for their trasdifferentiation ability, non ethical problems and acceptable results in preliminary clinical trials. In terms of tissue engineering, we provide an overview of different types of mesenchymal stem cells that have been isolated from teeth, including dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDs), periodontal ligament stem cells (PDLSCs), dental follicle progenitor stem cells (DFPCs), and stem cells from apical papilla (SCAPs), growth factors implicated in regeneration teeth and types of scaffolds for dental tissue regeneration (AU)

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Mesenchymal dental stem cells in regenerative dentistry.

In the last decade, tissue engineering is a field that has been suffering an enormous expansion in the regenerative medicine and dentistry. The use of cells as mesenchymal dental stem cells of easy access for dentist and oral surgeon, immunosuppressive properties, high proliferation and capacity to differentiate into odontoblasts, cementoblasts, osteoblasts and other cells implicated in the teeth, suppose a good perspective of future in the clinical dentistry. However, is necessary advance in the known of growth factors and signalling molecules implicated in tooth development and regeneration of different structures of teeth. Furthermore, these cells need a fabulous scaffold that facility their integration, differentiation, matrix synthesis and promote multiple specific interactions between cells. In this review, we give a brief description of tooth development and anatomy, definition and classification of stem cells, with special attention of mesenchymal stem cells, commonly used in the cellular therapy for their trasdifferentiation ability, non ethical problems and acceptable results in preliminary clinical trials. In terms of tissue engineering, we provide an overview of different types of mesenchymal stem cells that have been isolated from teeth, including dental pulp stem cells (DPSCs), stem cells from human exfoliated deciduous teeth (SHEDs), periodontal ligament stem cells (PDLSCs), dental follicle progenitor stem cells (DFPCs), and stem cells from apical papilla (SCAPs), growth factors implicated in regeneration teeth and types of scaffolds for dental tissue regeneration.

Calidad percibida en la fisioterapia de atención primaria: situación y oportunidades de mejora en la atención a la cervicalgia / Quality perceived in physical therapy in Primary Care: situation and opportunities to improve neck pain care

Objetivos: Describir y comparar la frecuencia en la quelos pacientes con cervicalgia perciben diferentesaspectos relacionados con la calidad percibida en laatención fisioterápica, ofrecida en diversos centros desalud.Material y método: Se realizó un estudio descriptivotransversal analítico. Se incluyó a pacientes concervicalgia mecánica no traumática. La recogida deinformación se llevó a cabo mediante un cuestionariotipo autoinforme sobre calidad percibida previamentevalidado. Se analizó la tasa de respuesta y el sesgo de norespuesta. Se realizó un análisis descriptivo ajustadomediante indicadores y se comparó la calidad percibidaentre centros según cada uno de los indicadorescompuestos en cada centro, así como el valor promedioy los percentiles respecto al conjunto de los centros.Resultados: Se entregó un total de 162 cuestionarios yse recogieron 111. No se han detectado diferenciassignificativas entre los que han respondido y los que noal cuestionario, en relación con el sexo y el nivel de estudios, y sí para la edad y el previo uso defisioterapia. Las dimensiones “Tiempo de espera” y“Competencia profesional” son las que presentanmayor porcentaje de problemas de calidad percibida,61,4 % (52,4-70,4) y 51,7 % (42,4-61,0)respectivamente. La dimensión “Organización” es laque presenta menor porcentaje de problemas (24,4%)(16,4-32,4). Hay diferencias en los niveles de calidadpercibida entre la mayoría de los centros respecto a lasdimensiones “Información” y “Competenciaprofesional”, y sólo entre algunos en relación con“Tiempo de espera” y “Organización”.Conclusiones: Las áreas de información y competenciaprofesional son las que acumulan más problemas decalidad percibida. Entre los centros de saludparticipantes hay variabilidad en los niveles de calidadpercibida

Objectives: To describe and compare how frequentlypatients with neck pain perceive different aspects relatedwith the quality of physical therapy care of several healthcare centers.Material and Methods: A descriptive, cross-sectional andanalytic study was conducted. Patients with mechanicaland non-traumatic neck pain were included. Informationwas collected using a self-report and previously validatedquestionnaire. Rate of answer and non- answer bias wereanalyzed. An adjusted descriptive analysis was performed,using indicators and the perceived quality was comparedamong centers based on indicators in each center, and thevalue average and percentiles of all centers.Results: A total of 111 out of 162 questionnaires werecollected. No significant differences were detected amongthose who responded and those who did respond to thequestionnaire in relationship to gender and study level,but there were significant differences for age and previousphysical therapy use. The dimensions of Waiting Timeand Professional Competence are those that present the higher percentage of problems of perceived quality, 61.4%(52.4-70.4) and 51.7% (42.4-61.0), respectively. Thedimension Organization has the lowest percentage ofproblems, 24.4 % (16.4-32.4). There are differences inthe levels of quality perceived between most of the centersregarding the dimensions of Information and ProfessionalCompetence, and only between some centers regardingTime of wait and Organization.Conclusions: The areas of Information and ProfessionalCompetence are those that accumulate the most problemsof perceived quality. There is variability in the levels ofperceived quality among the participant centers of healthcare(AU)