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Objective: Given the high incidence of sarcopenia among Asians, it is imperative to identify appropriate intervention methods. The International Clinical Practice Guidelines for Sarcopenia, developed by the International Conference on Sarcopenia and Frailty Research (ICFSR) task force, recommends resistance training (RT) as a primary treatment for managing sarcopenia. Inflammatory biomarkers serve as indicators of sarcopenia. However, there is currently insufficient conclusive evidence regarding the effectiveness of RT in modulating inflammatory biomarker levels among Asian participants with sarcopenia., Data Sources: Four databases were utilized for this study until October 9, 2023. This study focused on randomized controlled trials (RCTs) that examined the effects of RT on interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP), and interleukin-10 (IL-10) about sarcopenia. This study has been registered in the PROSPERO database (CRD42024501855)., Results: The meta-analysis included six studies from Asians involving 278 participants. The results showed a significant decrease in RT for IL-6 (weighted mean difference (WMD) = -0.73, 95% confidence interval (CI) = -1.02 to -0.44; n=5). However, no significant differences were found for TNF-α (WMD = -1.00, 95% CI = -2.47 to 0.46; n=5), CRP (WMD = -0.45, 95% CI = -1.14 to 0.23; n=3), and IL-10 (WMD = 0.13, 95% CI = -3.99 to 4.25; n=2). Subgroup analysis revealed that factors including gender selection, intervention methods, frequency, period, and duration could have a particular effect on the part of inflammatory biomarkers., Conclusion: RT has been shown to reduce part of the level of inflammatory markers, specifically IL-6, in Asian sarcopenia participants. However, other inflammatory factors, such as TNF-α, CRP, and IL-10, did not show significant changes. Further research should confirm the impact of RT on these indicators and explore the potential effects of various factors on different inflammatory markers, such as diet, body composition, and medications., Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=501855, identifier CRD42024501855., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Xue, Han, Zheng, Zhang and Kong.)

Background: Atherosclerotic coronary artery disease (CAD) often occurs concurrently with hypertrophic cardiomyopathy (HCM). However, the influence of concomitant CAD has not been fully assessed in patients with HCM., Methods: Invasive or computed tomography coronary angiography was performed in 461 patients with HCM at our hospital to determine the presence and severity of CAD from March 2010 to April 2022. The primary end points were all-cause, cardiovascular, and sudden cardiac deaths. The survival of HCM patients with severe CAD was compared with that of HCM patients without severe CAD., Results: Of 461 patients with HCM, 235 had concomitant CAD. During the median (interquartile range) follow-up of 49 (31-80) months, 75 patients (16.3%) died. The 5-year survival estimates were 64.3%, 82.5%, and 86.0% for the severe, mild-to-moderate, and no-CAD groups, respectively (log-rank, p = 0.010). Regarding the absence of cardiovascular death, the 5-year survival estimates were 68.5% for patients with severe CAD, 86.4% for patients with mild-to-moderate CAD, and 90.2% for HCM patients with no CAD (log-rank, p = 0.001). In multivariate analyses, severe CAD was associated with all-cause and cardiovascular death after adjusting for age, left ventricular ejection fraction, hypertension, and atrial fibrillation., Conclusions: This study showed a worse prognosis among HCM patients with severe CAD than among HCM patients without severe CAD. Therefore, timely recognition of severe CAD in HCM patients and appropriate treatment are important., (Copyright © 2023 Hellenic Society of Cardiology. Published by Elsevier Inc. All rights reserved.)

Background: Adverse psychosocial factors play an important role in cardio-cerebral vascular disease (CCVD). The aim of this study was to evaluate the impact of the cumulative burden of loneliness on the risk of CCVD in the Chinese older adult., Methods: A total of 6,181 Chinese older adult over the age of 62 in the monitoring survey of the fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) were included in this study. The loneliness cumulative burden (scored by cumulative degree) was weighted by the loneliness score for two consecutive years (2017-2018) and divided into low- and high-burden groups. The outcome was defined as the incidence of CCVD 1 year later (2018-2019). A multivariate logistic regression model was used to examine the relationship between the cumulative burden of loneliness and the new onset of CCVD., Results: Among participants, 18.9% had a higher cumulative burden of loneliness, and 11.5% had a CCVD incidence within 1 year. After multivariate adjustment, the risk of developing CCVD in the high-burden group was approximately 37% higher than that in the low-burden group (OR 1.373, 95%CI 1.096-1.721; p  = 0.006). Similar results were obtained when calculating the burden based on cumulative time. Longitudinal change in loneliness was not significantly associated with an increased risk of CCVD. A higher cumulative burden of loneliness may predict a higher risk of developing CCVD in older adult individuals aged 62-72 years or in those with diabetes., Conclusion: The cumulative burden of loneliness can be used to assess the risk of new-onset CCVD in the older adult in the short term., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Wu, Hu, Meng, Li, Xu, Zhang, Ma, Li, Zeng, Li, Zhang and Liu.)

Objective: To investigate the positivity rates and drug resistance characteristics of Mycobacterium tuberculosis (MTB) among suspected tuberculosis (TB) patients in Shandong Province, the second-largest population province in China., Methods: A prospective, multi-center study was conducted from April 2022 to June 2023. Pathogen and drug resistance were identified using nucleotide matrix-assisted laser desorption ionization time-of-flight mass spectrometry (nucleotide MALDI-TOF MS)., Results: Of 940 suspected TB patients included in this study, 552 cases were found to be infected with MTB giving an overall positivity rate of 58.72%. Total of 346 cases were resistant to arbitrary anti-TB drug (62.68%), with Zibo (76.47%), Liaocheng and Weihai (both 69.23%) ranking top three and TB treatment history might be a related factor. Monoresistance was the most common pattern (33.53%), with isoniazid the highest at 12.43%, followed by rifampicin at 9.54%. Further analysis of gene mutations conferring resistance revealed diverse types with high heteroresistance rate found in multiple anti-TB drugs., Conclusion: A relatively high rate of MTB positivity and drug resistance was found in Shandong Province during and after the COVID-19 pandemic, indicating the need for strengthening rapid identification of species and drug resistance among suspected TB patients to guide better medication and minimize the occurrence of drug resistance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Gao, Li, Han, Xiong, Xu, Ma, Wang, Zhang, Yang, Xie, Jiang, Wu, Lin, Liu, Ni, Wang, Li, Jiao, Ding and Zhang.)

Background: With the rapid population aging, healthy aging has become a concern for society as a whole. In this study, loneliness and its relationships with activity-related individual factors were examined among older Chinese individuals from the perspective of mental health and daily leisure activities., Methods: The data were from the fourth investigation of the Sample Survey of the Aged Population in Urban and Rural China, which had a total of 220,506 participants. Activity ability was assessed by the Barthel Activity of Daily Living Index, a self-designed activity type questionnaire was used to evaluate activity participation, and loneliness was measured with a single-item question., Results: The prevalence of varying degrees of loneliness among Chinese older individuals was 36.6%. The prevalence of loneliness among the older individuals differed significantly by age gender, age, physical health status, annual household income, education level, marital status, living status, ethnic minority status, religious faith and territory of residence. There were differences in activity participation among older Chinese adults in terms of all the demographic factors mentioned above, while there were no significant differences in living status or religious faith, and significant differences in several other demographic factors in terms of activity ability. Self-care ability, as a form of activity ability, and activity participation significantly predicted loneliness among the older participants., Conclusion: The topic of loneliness among Chinese older individuals is complex and requires greater attention. The buffering effect of activity-related factors on loneliness suggests that old people should improve their activity ability and participate more in daily activities., (© 2024. The Author(s).)

Introduction: Falls and fall-related injuries in young male adults with excess weight are closely related to an increased cognitive load. Previous research mainly focuses on analyzing the postural control status of these populations performing cognitive tasks while stabilized walking progress but overlooked a specific period of walking known as gait initiation (GI). It is yet unknown the influences of cognitive load on this population's postural control status during GI. Objective: This study aimed to determine the influences of cognitive load on the center of pressure (CoP) trajectory of young male adults with excess weight during GI. Design: A controlled laboratory study. Methods: Thirty-six male undergraduate students were recruited and divided into normal-weight, overweight, and obese groups based on their body mass index (BMI). Participants' CoP parameters during GI under single and dual-task conditions were collected by two force platforms. A mixed ANOVA was utilized to detect significant differences. Results: Compared with the normal-weight group, the obese group showed significant changes in the duration and CoP parameters during sub-phases of GI, mainly reflecting prolonged duration, increased CoP path length, higher mediolateral CoP displacement amplitude, and decreased velocity of anteroposterior CoP displacement. During GI with 1-back task, significantly increased mediolateral CoP displacement amplitude occurred in the obese group. During GI with 2-back task, the obese group had increased CoP path length, higher mediolateral CoP displacement amplitude, as well as a decreased velocity of CoP displacement. Conclusion: Based on the changes in CoP parameters during GI with cognitive tasks, young male adults with excess weight, mainly obese ones, have compromised postural stability. During GI with a difficult cognitive task, obese young male adults are more susceptible to deterioration in their lateral postural balance. These findings indicate that the increased cognitive load could exacerbate obese young male adults' postural control difficulty during GI under dual-task conditions, putting them at a higher risk of experiencing incidents of falls. Based on these findings, we offer suggestions for therapists to intervene with these young male adults to ensure their safety of GI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Kong, Zhang, Bao, Zhu, Tan, Xia, Zhang and Hao.)

Background: Despite the widespread adoption of the rapid response team (RRT) by many hospitals, questions remain regarding their effectiveness in improving several aspects of patient outcomes, such as hospital mortality, cardiopulmonary arrests, unplanned intensive care unit (ICU) admissions, and length of stay (LOS)., Objectives: To conduct a systematic review to understand the rapid response team's (RRT) effect on patient outcomes., Methods: A systematic search was conducted using PubMed, Cochrane, Embase, CINAHL, Web of Science, and two trial registers. The studies published up to May 6, 2022, from the inception date of the databases were included. Two researchers filtered the title, abstract and full text. The Version 2 of the Cochrane Risk of Bias tool and Bias in Non-Randomized Studies of Interventions (ROBINS-I) tool were used separately for randomized and non-randomized controlled trials for quality appraisal., Results: Sixty-one eligible studies were identified, four randomized controlled trials(RCTs), four non-randomized controlled trials, six interrupted time-series(ITS) design , and 47 pretest-posttest studies. A total of 52 studies reported hospital mortality, 51 studies reported cardiopulmonary arrests, 18 studies reported unplanned ICU admissions and ten studies reported LOS., Conclusion: This systematic review found the variation in context and the type of RRT interventions restricts direct comparisons. The evidence for improving several aspects of patient outcomes was inconsistent, with most studies demonstrating that RRT positively impacts patient outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023. Published by Elsevier Inc.)

The novel design of carbon materials with stable nanoarchitecture and optimized electrical properties featuring simultaneous intercalation of lithium ions (Li + ) and sodium ions (Na + ) is of great significance for the superb lithium - sodium storage capacities. Biomass-derived carbon materials with affluent porosity have been widely studied as anodes for lithium-ion batteries (LIBs) and sodium-ion batteries (SIBs). However, it remains unexplored to further enhance the stability and utilization of the porous carbon skeleton during cycles. Here, a lotus stems derived porous carbon (LPC) with graphene quantum dots (GQDs) and intrinsic carbon nanowires framework (CNF) is successfully fabricated by a self-template method. The LPC anodes show remarkable Li + and Na + storage performance with ultrahigh capacity (738 mA h g -1 for LIBs and 460 mA h g -1 for SIBs at 0.2 C after 300 cycles, 1C≈372 mA h g -1 ) and excellent long-term stability. Structural analysis indicates that the CNFs-supported porous structure and internal GQDs with excellent electrical conductivity contribute significantly to the dominant capacitive storage mechanism in LPC. This work provides new perspectives for developing advanced carbon-based materials for multifunctional batteries with improved stability and utilization of porous carbon frameworks during cycles., (© 2023 The Authors. Small Methods published by Wiley-VCH GmbH.)

Background: Visceral adiposity index (VAI) and lipid accumulation product (LAP) are comprehensive indicators to evaluate visceral fat and determine the metabolic health of individuals. Carotenoids are a group of naturally occurring antioxidants associated with several diseases. The purpose of this investigation was to explore the association between serum carotenoid concentration and VAI or LAP., Methods: The data were obtained from the National Health and Nutrition Examination Survey between 2001 and 2006. The levels of serum carotenoids were evaluated using high-performance liquid chromatography. Multivariate linear regression models were employed to investigate the relationship between levels of serum carotenoids and VAI or LAP. The potential non-linear relationship was determined using threshold effect analysis and fitted smoothing curves. Stratification analysis was performed to investigate the potential modifying factors., Results: In total, 5,084 participants were included in this population-based investigation. In the multivariate linear regressions, compared to the lowest quartiles of serum carotenoids, the highest quartiles were significantly associated with VAI, and the effect size (β) and 95% CI was - 0.98 (- 1.34, - 0.62) for α-carotene, - 1.39 (- 1.77, - 1.00) for β-carotene, - 0.79 (- 1.18, - 0.41) for β-cryptoxanthin, - 0.68 (- 0.96, - 0.39) for lutein/zeaxanthin, and - 0.88 (- 1.50, - 0.27) for trans-lycopene. Using piece-wise linear regression models, non-linear relationships were found between β-carotene and trans-lycopene and VAI with an inflection point of 2.44 (log2-transformed, ug/dL) and 3.80 (log2-transformed, ug/dL), respectively. The results indicated that α-carotene, β-cryptoxanthin, and lutein/zeaxanthin were linearly associated with VAI. An inverse association was also found between serum carotenoids and LAP after complete adjustments., Conclusion: This study revealed that several serum carotenoids were associated with VAI or LAP among the general American population. Further large prospective investigations are warranted to support this finding., (© 2023. The Author(s).)

Objective: The Klotho protein is a well-documented anti-aging protein known for its diverse biological functions. Hyperlipidemia is an established independent risk factor for various chronic diseases. However, there is limited understanding of the connection between Klotho and hyperlipidemia. The aim was to assess the association between serum Klotho levels and hyperlipidemia among adults., Methods: The study included 11,618 individuals from the NHANES database from 2006 to 2017. Hyperlipidemia was diagnosed following the National Cholesterol Education Program guidelines. Serum Klotho concentration was measured by an enzyme-linked immunosorbent assay kit, and the association between Klotho and hyperlipidemia was assessed by a multivariable logistic regression model. Fitted smoothing curves and threshold-effect analysis were employed to describe nonlinear relationships., Results: In our multiple logistic regression models, serum Klotho concentration was significantly associated with hyperlipidemia after adjusting for comprehensive confounders (per SD increment odds ratio (OR): 0.91; 95% confidence interval (CI): 0.86-0.97). Compared to individuals in the lowest Klotho quartile, those in the highest quartile exhibited a substantially decreased prevalence of hyperlipidemia (OR: 0.72; 95% CI: 0.58-0.90). Using a two-segment logistic regression model, we identified a U-shaped relationship between serum Klotho concentration and hyperlipidemia, with an inflection point at 1,365.5 pg/mL. Subgroup analysis did not reveal any potential moderating effects., Conclusion: This study revealed an inverse relationship between Klotho levels and hyperlipidemia. Further investigation is warranted to explore the underlying mechanism between serum Klotho and hyperlipidemia., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Yan, Luo, Lei, Zhang and Xiu.)

Objectives: Blood flow into the side branch affects the calculation of coronary angiography-derived fractional flow reserve (FFR), called Angio-FFR. Neglecting or improperly compensating for the side branch flow may decrease the diagnostic accuracy of Angio-FFR. This study aims to evaluate the diagnostic accuracy of a novel Angio-FFR analysis that considers the side branch flow based on the bifurcation fractal law., Methods: A one-dimensional reduced-order model based on the vessel segment was used to perform Angio-FFR analysis. The main epicardial coronary artery was divided into several segments according to the bifurcation nodes. Side branch flow was quantified using the bifurcation fractal law to correct the blood flow in each vessel segment. In order to verify the diagnostic performance of our Angio-FFR analysis, two other computational methods were taken as control groups: (i) FFR_s: FFR calculated by delineating the coronary artery tree to consider side branch flow, (ii) FFR_n: FFR calculated by just delineating the main epicardial coronary artery and neglecting the side branch flow., Results: The analysis of 159 vessels from 119 patients showed that our Anio-FFR calculation method had comparable diagnostic accuracy to FFR_s and provided significantly higher diagnostic accuracy than that of FFR_n. In addition, using invasive FFR as a reference, the Pearson correlation coefficients of Angio-FFR and FFRs were 0.92 and 0.91, respectively, while that of FFR_n was only 0.85., Conclusions: Our Angio-FFR analysis has demonstrated good diagnostic performance in assessing the hemodynamic significance of coronary stenosis by using the bifurcation fractal law to compensate for side branch flow., Clinical Relevance Statement: Bifurcation fractal law can be used to compensate for side branch flow during the Angio-FFR calculation of the main epicardial vessel. Compensating for side branch flow can improve the ability of Angio-FFR to diagnose stenosis functional severity., Key Points: • The bifurcation fractal law could accurately estimate the blood flow from the proximal main vessel into the main branch, thus compensating for the side branch flow. • Angiography-derived FFR based on the bifurcation fractal law is feasible to evaluate the target diseased coronary artery without delineating the side branch., (© 2023. The Author(s), under exclusive licence to European Society of Radiology.)

Background: Social frailty has not been comprehensively studied in China. Our objective is to investigate the prevalence of social frailty among the older population in China, as well as identify relevant factors and urban-rural differences., Methods: We obtained data from the Fourth Sample Survey of the Aged Population in Urban and Rural China (SSAPUR) database. The study employed a multistage, stratified, cluster-sampling method, recruiting a total of 224,142 adults aged 60 years or older. Participants were interviewed to gather demographic data and information on family, health and medical conditions, health care service status, living environment conditions, social participation, protected rights status, spiritual and cultural life, and health. Social frailty was assessed using the HALFE Social Frailty Index. A score of three or above indicated social frailty., Results: We analyzed a total of 222,179 cases, and the overall prevalence of social frailty was found to be 15.2%. The highest prevalence was observed among participants aged 75-79 years (18.0%). The prevalence of social frailty was higher in rural older populations compared to urban older populations (19.9% in rural vs. 10.9% in urban, P < 0.0001). In urban areas, women had a higher prevalence than men (11.7% in women vs. 9.9% in men, P < 0.0001), while in rural areas, men had a higher prevalence than women (20.6% in men vs. 19.2% in women, P < 0.0001). Multivariate regression analysis revealed that living in a rural/urban environment (OR 1.789, 95% CI 1.742-1.837), absence of a spouse/spousal presence (OR 4.874, 95% CI 4.743-5.009), self-assessed unhealthy/health status (OR 1.696, 95% CI 1.633-1.761), and housing dissatisfaction/satisfaction (OR 2.303, 95% CI 2.233-2.376) were all significantly associated with social frailty., Conclusions: Using the HALFE social frailty index, we found a prevalence of 15.2% among older people in China, with the highest prevalence observed in the 75-79 age group. Social frailty was more prevalent in rural areas than in urban areas. Various factors, including spousal presence, housing satisfaction, health status, and urban-rural residential differences, were significantly associated with social frailty. These findings highlight the modifiable and non-modifiable factors that contribute to social frailty among older individuals in China., (© 2023. BioMed Central Ltd., part of Springer Nature.)

This study employs the principles of computer science and statistics to evaluate the efficacy of the linear random effect model, utilizing Lasso variable selection techniques (including Lasso, Elastic-Net, Adaptive-Lasso, and SCAD) through numerical simulation and empirical research. The analysis focuses on the model's consistency in variable selection, prediction accuracy, stability, and efficiency. This study employs a novel approach to assess the consistency of variable selection across models. Specifically, the angle between the actual coefficient vector β and the estimated coefficient vector β ˆ is computed to determine the degree of consistency. Additionally, the boxplot tool of statistical analysis is utilized to visually represent the distribution of model prediction accuracy data and variable selection consistency. The comparative stability of each model is assessed based on the frequency of outliers. This study conducts comparative experiments of numerical simulation to evaluate a proposed model evaluation method against commonly used analysis methods. The results demonstrate the effectiveness and correctness of the proposed method, highlighting its ability to conveniently analyze the stability and efficiency of each fitting model., Competing Interests: The authors declare there are no competing interests., (©2023 Hou et al.)

Background: Social frailty is one type of frailty. Physical frailty with cardiovascular and cerebrovascular diseases (CCVD) have been studied a lot, but less research on social frailty., Objectives: To study the prevalence, related risk factors and regional differences of social frailty with CCVD in Chinese older adults., Methods: SSAPUR was a national cross-sectional survey. Participants aged 60 years or older were recruited in August 2015. Demographic data and information regarding family, health and medical conditions, living environment conditions, social participation, spiritual and cultural life, and health condition were obtained. Social frailty was assessed in five areas (HALFE Social Frailty Index) including inability to help others, limited social participation, loneliness, financial difficulty, and living alone. The prevalence of CCVD with social frailty, related risk factors and regional differences in CCVD with social frailty were studied., Results: A total of 222,179 participants were enrolled. 28.4% of them had CCVD history. The prevalence of social frailty in the CCVD group was 16.03%. In CCVD participants, compared with the group without social frailty, there were significant differences in gender, age, urban-rural distribution, ethnicity, marital status, and education levels in the social frailty group. Significant differences were also found in physical exercise participation, health status, cataract, hypertension, diabetes mellitus, hospitalization within 1 year, self-assessed health status, crutch or wheelchair usage, urinary and fecal incontinence, need for care from others, fall history, housing satisfaction, and self-assessed happiness in the social frailty group. Women with CCVD had a higher prevalence of social frailty than men. By age in CCVD with social frailty, the highest prevalence was found in participants 75-79 years old. The prevalence of CCVD was significant difference between social frailty in urban and rural group. The prevalence of social frailty with CCVD was significantly different in different regions. The highest prevalence was 20.4% in southwest area, and the lowest prevalence was 12.5% in northeast with area., Conclusion: The prevalence of social frailty among the CCVD older adults is high. Factors such as gender, age, region, urban-rural residence, and the state of the disease may be associated with social frailty., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Qi, Jia, Hu, Meng, Zeng, Liu, Shi, Zeng, Li, Zhang, Li and Liu.)

Background: Music Therapy (MT) is a unique treatment method for Persons with Multiple Sclerosis (PwMS) that can accelerate their functional recovery. MT has been proven to adjust the gait performance of PwMS in a short period. Its therapeutic effects in gait disorders of PwMS for long-term intervention are also starting to draw interest, but it has yet to be investigated., Aim: This review aimed to systematically examine the outcomes of PwMS with gait disorders after receiving MT intervention., Methods: A systematic review has been performed using several academic databases with keywords such as music therapy, multiple sclerosis, and gait. The study protocol was registered on PROSPERO (CRD42022365668)., Results: A total of 405 studies were initially identified. After applying the inclusion and exclusion criteria, twelve studies were finally included. The results showed that all PwMS received MT intervention with different strategies, and ten studies confirmed that gait disorders of PwMS were effectively improved by MT intervention., Conclusion: Most previous studies focused on the transient effects of MT on the gait performance of PwMS. This review bridges gaps in the long-term intervention of MT on gait disorders of PwMS and offers references for therapists to design treatment plans. According to this review, MT intervention has positive therapeutic effects on gait disorders in PwMS., Competing Interests: Declaration of Competing Interest All authors (Lingyu Kong, Xinwen Zhang, Lingyue Meng, Hao Xue, Wenlong Zhou, Xin Meng, Qiuxia Zhang, and Jianzhong Shen) declare no conflict of interest. All authors have read and approved the final version of the manuscript (Title: Effects of Music Therapy Intervention on Gait Disorder in Persons with Multiple Sclerosis: A Systematic Review of Clinical Trials)., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Atherosclerosis is one of the most common types of cardiovascular disease and is driven by lipid accumulation and chronic inflammation in the arteries, which leads to stenosis and thrombosis. Researchers have been working to design multifunctional nanomedicines with the ability to target, diagnose, and treat atherosclerosis, but recent studies have also identified that nanomaterials can cause atherosclerosis. Therefore, this review aims to outline the molecular mechanisms and physicochemical properties of nanomaterials that promote atherosclerosis. By analyzing the toxicological effects of nanomaterials on cells involved in the pathogenesis of atherosclerosis such as vascular endothelial cells, vascular smooth muscle cells and immune cells, we aim to provide new perspectives for the prevention and treatment of atherosclerosis, and raise awareness of nanotoxicology to advance the clinical translation and sustainable development of nanomaterials., (© 2023. The Author(s).)

Background: Functional ankle instability (FAI) is the primary classification of ankle injuries. Competitive activities have complicated movements that can result in ankle re-injury among patients with FAI. Unanticipated movement state (MS) and mental fatigue (MF) could also happen in these activities, which may further increase their joint injury risk. Objective: This study aimed to clarify the biomechanical characteristics difference of the lower extremity (LE) between the injured side and the uninjured side among patients with FAI when they perform unanticipated side-step cutting after MF. Methods: Fifteen males with unilateral FAI participated in this study (age: 20.7 ± 1.3 years, height: 173.6 ± 4.4 cm, weight: 70.1 ± 5.0 kg). They used the injured side and the uninjured side of LE to complete anticipated and unanticipated side-step cutting before and after MF. The kinematic and kinetics data were evaluated using three-way ANOVA with repeated measures. Results: During patients with FAI performed anticipated side-step cutting, the ankle stiffness of both sides showed no significant change after MF; During they performed unanticipated side-step cutting, their injured side presented significantly lower ankle stiffness after MF, while the uninjured side did not have such change. In addition, after MF, the injured side exhibited increased ankle inversion, knee valgus and LR, but the uninjured side did without these changes. Conclusion: Influenced by MF, when patients with FAI use their injured side of LE to perform side-step cutting, this side LE has a higher risk of musculoskeletal injuries such as lateral ankle sprains and anterior cruciate ligament injury. The ankle stiffness of the injured side will be further reduced when patients with FAI perform unanticipated side-step cutting, which increases ankle instability and the risk of re-injury., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Kong, Wu, Zhang, Meng, Kong, Zhang and Shen.)

Background: Losing postural control ability and related injuries are of particular concern for elders living in the nursing home (NH). The Otago Exercise Program (OEP) is a multimodal exercise training program initially designed as an individually tailored home exercise for community-dwelling elders, but whether its movement characteristics and exercise intensity meet NH elders' needs still needs to be clarified. This study aimed to determine the effects of the OEP in enhancing postural control ability among elders in the NH., Methods: A systematic literature search of English language databases (Cochrane Library, PubMed, EMBASE, CINAHL, and Web of Science) and Chinese language databases (China National Knowledge Infrastructure, Wanfang, and Chongqing VIP) until 15 April 2022 were performed by 2 reviewers on searching randomized controlled trial (RCT) and non-RCT. A meta-analysis was performed using Review Manager 5.3 software. Continuous data were expressed as mean difference (MD) with 95% confidence intervals (95% CI). Dichotomous data were presented as risk ratios (RRs) with 95% CI. Study methodological quality was assessed according to the Cochrane Handbook for Systematic Reviews of Interventions for RCTs and Risk Of Bias In Non-randomized Studies-of Interventions for non-RCTs by 3 reviewers., Results: Nine studies with 546 participants were included in this review. Two hundred and sixty-nine participants received OEP, and 277 only had conventional exercise training. Compared to the conventional exercise training group, the NH elders in the OEP group have considerably decreased in fall risk (MD = -0.84; 95% CI = -1.17, -0.51; P < .00001) and positively increased in postural balance (MD = 5.55; 95% CI = 3.60, 7.50; P < .00001), functional mobility in short-distance (MD = -6.39; 95% CI = -8.07, -4.70; P < .00001), lower-limb muscle strength (MD = 4.32; 95% CI = 3.71, 4.93; P < .00001), and health status (risk ratio = 0.35; 95% CI = 0.18, 0.66; P = .001)., Conclusions: Current evidence suggests that OEP is practical and feasible in NH. The nursing personnel can receive sufficient support for maintaining and enhancing these elders' postural control ability, especially during the COVID-19 pandemic., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Background: Chronic exertional compartment syndrome (CECS) causes exercise-induced leg pain. The diagnosis is confirmed by intramuscular pressure (IMP) measurements. Fasciotomy has been demonstrated to be a successful treatment for CECS; however, few studies have examined postoperative IMP and long-term outcomes., Purpose: To evaluate long-term outcomes and postoperative IMP in patients surgically treated for anterior CECS, and to identify possible preoperative or postoperative factors associated with overall satisfaction with treatment at follow-up., Study Design: Case-control study; Level of evidence, 3., Methods: A consecutive series of 209 patients who underwent fasciotomy of the anterior compartment for CECS between 2009 and 2019 and had at least 1 year of follow-up were approached for inclusion. A total of 144 patients (69%), with a follow-up time of 1 to 11.5 years, were ultimately included. All patients underwent preoperative and postoperative 1-minute postexercise IMP measurements of the anterior compartment and completed a questionnaire covering pain and activity parameters at both time points. The follow-up questionnaire included an additional question on overall satisfaction with treatment, and surgical details were collected from the patient's medical records., Results: The median IMP was significantly lower at follow-up than at baseline (17 mm Hg [range, 5-91 mm Hg] vs 49 mm Hg [range, 25-130 mm Hg]; P < .001). The overall satisfaction rate was 77%, and 83% reported a decreased pain level. The group of patients who were satisfied with the treatment included more men and had a higher ΔIMP and a lower revision rate ( P < .05). Among the 16 patients (11%) who had undergone revision fasciotomies before follow-up, the satisfaction rate was 56%, and 64% reported a decrease in pain level., Conclusion: Fasciotomy significantly reduced 1-minute postexercise IMP in patients with CECS and resulted in satisfaction and decreased pain in more than three-quarters of the patients at long-term follow-up. The male sex and a significant decrease in IMP were both positively associated with treatment satisfaction. Patients who underwent revision surgery before the follow-up had lower satisfaction rates and less pain reduction than the overall group., Competing Interests: The authors have declared that there are no conflicts of interest in the authorship and publication of this contribution. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2023.)

Houshiheisan (HSHS), a classic prescription in traditional Chinese medicine (TCM), has shown outstanding efficacy in treating stroke. This study investigated various therapeutic targets of HSHS for ischemic stroke using mRNA transcriptomics. Herein, rats were randomly separated into the sham, model, HSHS 5.25 g/kg (HSHS5.25), and HSHS 10.5 g/kg (HSHS10.5) groups. Rats suffering from stroke were induced by permanent middle cerebral artery occlusion (pMCAO). After seven days of HSHS treatment, behavioral tests were conducted, and histological damage was examined with hematoxylin-eosin (HE). The mRNA expression profiles were identified using microarray analysis and quantitative real-time PCR (qRT-PCR) validated gene expression changes. An analysis of gene ontology and pathway enrichment was conducted to analyze potential mechanisms confirmed using immunofluorescence and western blotting. HSHS5.25 and HSHS10.5 improved neurological deficits and pathological injury in pMCAO rats. The intersections of 666 differentially expressed genes (DEGs) were chosen using transcriptomics analysis in the sham, model, and HSHS10.5 groups. The enrichment analysis suggested that the therapeutic targets of HSHS might regulate the apoptotic process and ERK1/2 signaling pathway, which was related to neuronal survival. Moreover, TUNEL and immunofluorescence analysis indicated that HSHS inhibited apoptosis and enhanced neuronal survival in the ischemic lesion. Western blot and immunofluorescence assay indicated that HSHS10.5 decreased Bax/Bcl-2 ratio and suppressed caspase-3 activation, while the phosphorylation of ERK1/2 and CREB was upregulated in a stroke rat model after HSHS treatment. Effective inhibition of neuronal apoptosis by activating the ERK1/2-CREB signaling pathway may be a potential mechanism for HSHS in the treatment of ischemic stroke., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Hongfa Cheng et al.)

Aim: To evaluated the prevalence and potential risk factors of self-reported diabetes among the elderly in China, by demographic data, socioeconomic factors, and psychological factors., Methods: Descriptive analysis and Chi-square analysis were used to assess the prevalence and variation between self-reported diabetes and non-diabetes by demographic data, living habits, socioeconomic factors and comorbidities. Univariate and multivariate logistic regression were used to describe the odds ratios (OR) of diabetes prevalence in different groups, while stratification analysis was performed to describe prevalence based on gender, age, and urban/rural areas., Results: 215,041 elderly adults (102,692 males and 112,349 females) were eventually included in the analysis. The prevalence of self-reported diabetes among the elderly in China is about 8.7%, with the highest prevalence in Beijing (20.8%) and the lowest prevalence in Xizang (0.9%). Logistic regression analysis showed that urban area ( P < 0.001), older age (65-84 years old, P < 0.001), female ( P < 0.001), higher income( P < 0.001), poor sleep quality ( P = 0.01) and some other factors were potential risk factors for diabetes., Conclusions: This study illustrates the prevalence and potential risk factors of diabetes among the elderly in China Meanwhile, these results provide information to assist the government in controlling non-communicable diseases in the elderly., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Hu, Meng, Wei, Xu, Li, Li, Jia, Li, Qi, Zeng, Zhang, Li and Liu.)

Background: The ankle is prone to injury during drop landing with usual residual symptoms, and functional ankle instability (FAI) is the most common. Vision guarantees the postural stability of patients with FAI, and visual deprivation (VD) increases their risk of injury when completing various movements. This study explored injury risk during drop landing in patients with FAI under VD through the kinetics of lower extremities. Methods: A total of 12 males with FAI participated in the study (age, 23.0 ± 0.8 years; height, 1.68 ± 0.06 m; weight, and 62.2 ± 10.4 kg) completed single-leg drop landings under visual presence (VP) and VD conditions. Ground reaction force (GRF), time to peak GRF, joint torque, and vertical length variation (ΔL) were measured. Results: Significant effects were detected in the group for time to peak lateral GRF ( p = 0.004), hip extensor torque ( p = 0.022), ankle plantarflexion torque ( p < 0.001), ankle varus torque ( p = 0.021), lower extremity stiffness ( p = 0.035), and ankle stiffness ( p < 0.001). Significant effects of conditions were detected for vertical GRF, time to peak vertical and lateral GRF, loading rate, hip extensor torque, knee extensor torque, hip varus torque, knee varus torque, lower extremity stiffness, and ankle stiffness ( p < 0.05). ΔL was affected by VD with a significant difference ( p < 0.001). Conclusion: In patients with FAI, an unstable extremity has a higher injury risk than a stable extremity, and VD increases such risk. However, because the influence of the central nervous system on hip strategy is also affected, the effect on the unstable extremity is more significant and more likely to result in injury. Deepening the squat range may be an effective preventive measure for reducing injury risk of unstable extremities during drop landing., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Meng, Kong, Kong, Zhang, Shen and Hao.)

Background: Triglyceride-glucose (TyG) index is a simple marker of insulin resistance. However, insufficient data is available on whether the TyG index is associated with worsening renal function (WRF) in the elderly. Therefore, this study was designed to explore the association between the TyG index and WRF based on a community elderly cohort., Methods: In this study, 7,822 elderly (aged ≥ 65 years) adults from southern China were enrolled and divided into four groups according to the TyG index quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m 2 . Additional endpoints included a decline in eGFR of 30% and 40% during the follow-up period., Results: During the median 2.04 year follow-up period, 1,541 (19.7%) participants developed CKD. After adjusting for confounding factors, multivariable Cox regression models revealed significant associations between TyG index and incident CKD (HR per SD increase, 1.21; 95% CI: 1.14-1.29), a decline in eGFR of 30% (HR per SD increase, 1.38; 95% CI: 1.26-1.50), and decline in eGFR of 40% (HR per SD increase, 1.42; 95% CI: 1.24-1.63). Furthermore, compared with those in Q1, participants in Q4 demonstrated a higher risk of developing CKD (HR, 1.59; 95% CI: 1.35-1.88). These positive associations remained consistent across different subgroup populations., Conclusion: Our study suggests a positive and independent association between the TyG index and WRF in the elderly., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lei, Liang, Qu, Zhong, Zhang, Dai, Lu, Xiao, Zhao, Zhou, Li, Hu, Xiu and Zhang.)

Background: Aging is an essential national condition throughout China in the 21st century. Cardio-cerebral vascular disease (CCVD) is a common chronic vascular disease in the elderly. Despite aging becoming an increasingly pressing issue, there has been no comprehensive national investigation into the risk factors, prevalence, and management of CCVD among the elderly population in China., Materials and Methods: Through the 4th Survey of the Aged Population in Urban and Rural China (SSAPUR), a nationally representative sample of 224,142 adults aged more than 60 years was surveyed using a multistage, stratified sampling method. The 4th SSAPUR was used to investigate CCVD in the elderly. Univariate and multivariate logistic proportional regression analyses explored the risk factors. These risk factors were then entered into a multivariate linear regression model to identify independent predictive factors for CCVD. Disease management was assessed from the self-reported history of physician diagnosis, treatments, and hospital visits among individuals with CCVD., Results: After excluding samples with missing information, 215,041 individuals were included in the analysis. The overall prevalence of CCVD was 26%. Living in a rural area, being older, being female, having low literacy, smoking, getting little sleep, losing a spouse, being single, not getting enough exercise, having a bad financial situation, and not taking part in public welfare programs were the main risk factors for CCVD among the elderly in China ( P < 0.05). In the multivariate linear regression model, holding all other variables at any fixed value, CCVD remained associated with "urban and rural" (β = 0.012, P < 0.001), "age" (β = -0.003, P < 0.001), "sex" (β = -0.022, P < 0.001), "education level" (β = -0.017, P < 0.001), "marriage" (β = 0.004, P = 0.047), "smoking" (β = 0.012, P = 0.003), "drinking" (β = -0.015, P = 0.001), and "sleep" (β = 0.008, P = 0.005). There were no collinearity problems among these factors., Conclusion: Major risk factors for prevalent CCVD among the elderly in China include the following: rural residence, female, low literacy level, poor sleep quality, bereavement, non-marriage, living alone, lack of exercise, poor financial situation, and non-participation in public welfare activities. Chinese national policies for preventing, controlling, and managing risk factors for CCVD in the elderly must be urgently developed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Meng, Xu, Li, Hu, Xu, Wu, Hu, Zeng, Zhang, Li, Gong and Liu.)

Objective: To investigate the prevalence of frailty and pre-frailty and its associated factors in Chinese older adults with diabetes through a nationwide cross-sectional study., Research Design and Methods: The data were obtained from the Sample Survey of the Aged Population in Urban and Rural China (SSAPUR), conducted in 2015, which was a cross-sectional study involving a nationally representative sample of older adults aged 60 years or more from 31 provinces, autonomous regions, and municipalities in mainland China. Subjects with diabetes were included in this study. Frailty index (FI), based on 33 potential deficits, was used to categorize individuals as robust, pre-frail, or frail., Results: A total of 18,010 older adults with diabetes were included in this study. The weighted prevalence of frailty and pre-frailty in older adults with diabetes in China was 22.7% (95% CI 22.1-23.3%) and 58.5% (95% CI 57.8-59.2%), respectively. The prevalence of frailty and pre-frailty among older adults with diabetes from different provinces/municipalities/autonomous regions was significantly different. Multinomial logistic regression analysis showed living alone, poor economic status, ADL disability, and comorbidities were strongly correlated with frailty and pre-frailty in older adults with diabetes., Conclusion: Frailty and pre-frailty are common in older adults with diabetes in China, and exhibit sociodemographic and geographic differences. In the clinical setting of older adults with diabetes, there is a need to increase awareness of frailty and to advance the early diagnosis and intervention of frailty., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Zeng, Jia, Meng, Shi, Li, Hu, Hu, Xu, Li, Li, Qi, Wang, Zhang, Li and Liu.)

Music therapy is an effective way to treat the gait disorders caused by Parkinson's disease. Rhythm music stimulation, therapeutic singing, and therapeutic instrument performance are often used in clinical practice. The mechanisms of music therapy on the gait of patients with Parkinson's disease include the compensation mechanism of cerebellum recruitment, rhythm entrainment, acceleration of motor learning, stimulation of neural coherence, and increase of cortical activity. All mechanisms work together to complete the intervention of music therapy on patients' gait and help patients to recover better. In this paper, the effect of music therapy on gait disorders in Parkinson's disease patients was reviewed, and some suggestions were put forward.

Background: General health checks can help in controlling cardiovascular risk factors. However, few studies have investigated whether regular participation in annual health checks could further improve the control of cardiovascular risk factors compared with intermittent participation. Therefore, our study aimed to explore the association between the frequency of annual health check participation and the control of cardiovascular risk factors., Methods: Residents aged ≥ 65 years or having chronic diseases (hypertension or diabetes) from 37 communities of Guangzhou, Guangdong, who participated in the Basic Public Health Service project between January 2015 and December 2019, were enrolled and divided into 3 groups ("Sometimes," "Usually," and "Always") according to their frequencies of annual health check participation. Multivariable linear regression models were performed to assess the association between the frequency of annual health check participation and the control of cardiovascular risk factors. A subgroup analysis stratified by gender was also conducted., Results: In total, 9,102 participants were finally included. Significant differences were identified between groups in systolic blood pressure (SBP), diastolic blood pressure (DBP), weight, fasting glucose, total cholesterol, high-density lipoprotein cholesterol, and serum creatinine. After fully adjusting for confounding factors, residents who always participated in the annual health check tended to have lower SBP (β = -4.36, 95% CI : -5.46; -3.26, p < 0.001), fasting glucose (β = -0.27, 95% CI : -0.38; -0.15, p < 0.001), and total cholesterol (β = -0.19, 95% CI: -0.26; -0.13, p < 0.001), compared with those who attended sometimes. Furthermore, gender did not alter these associations., Conclusion: A higher frequency of annual health check participation was associated with lower SBP, fasting glucose, and total cholesterol., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lei, Tang, Zhang, Xiao, Dai, Lu, Lin, Lu, Luo, Pan, Xin, Qiu, Li, An and Xiu.)

Aims: To explore the relationship between the severity of coronary artery disease (CAD) and the occurrence of ventricular tachycardia/ventricular fibrillation (VT/VF) in patients with acute myocardial infarction (AMI)., Methods: We retrospectively enrolled 705 patients with AMI, who were hospitalized and underwent percutaneous coronary intervention (PCI), in Nanfang Hospital from July 2017 to July 2020. Logistic regression analysis and backward stepwise approach were taken to select the correlation factors. The left and the receiver operating characteristic curves (ROC) analysis were plotted to observe the discriminative power of the SYNTAX score (SS)/caFFR-guided functional SS (FSS caFFR ) on the incident VT/VF., Results: About 58 (8.2%) patients experienced life-threatening VT/VF. The FSS caFFR (OR: 1.155; 95% CI: 1.047 to 1.273; p = 0.004) was an independent predictor of VT/VF after AMI. The ROC analysis showed that the discriminative power of FSS caFFR on the incident VT/VF was significantly better than SS (0.759 vs.0.695, p < 0.0001). Patients with VT/VF were categorized into 2 groups according to the interval between the onset of AMI and the VT/VF. The logistic regression analysis revealed that FSS caFFR was a significant independent correlation of early- and late-VT/VF., Conclusion: The incident VT/VF in patients with AMI is closely associated with the severity of CAD evaluated by SS and FSS caFFR . Compared to SS, FSS caFFR has a higher correlation with VT/VF, and FSS caFFR was demonstrated to be an independent correlation factor of incident VT/VF after AMI., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Pan, Zhang, Lei, Chen, Li, Liang, Lu, Zhang, Tang, Pu, Yang, Mo and Xiu.)

Background: Visceral adiposity index (VAI) is an indicator of visceral fat accumulation and dysfunction. However, little is known about whether VAI is associated with worsening renal function (WRF) in the elderly. Therefore, our study aimed to explore the association between VAI and WRF among the elderly population., Methods: In total, 5,583 elderly participants (aged ≥ 65 years) who participated in the annual health checkups at least twice between January 2017 and July 2021 were enrolled and divided into four groups according to the VAI quartiles. The primary endpoint was incident chronic kidney disease (CKD), defined as incident estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m 2 . The secondary endpoint was rapid kidney function decline (RKFD), defined as decline in eGFR of 40%. To evaluate the association between VAI and WRF, three Cox regression models were conducted, where VAI was treated as a continuous variable and a categorical variable (Q1 as reference), respectively. Subgroup analysis in participants with different baseline characteristics was also performed., Results: During a median of 2.46 year follow-up, 931 (16.68%) participants developed CKD. After fully adjusting for confounding factors, VAI was significantly associated with incident CKD (HR, 1.052; 95% CI: 1.029-1.076, p < 0.001), and RKFD (HR, 1.077; 95% CI: 1.041-1.114, p < 0.001). Moreover, compared to those with the lowest VAI quartiles, subjects with the highest quartiles had a higher risk of incident CKD (HR, 1.286; 95% CI: 1.033-1.601, p = 0.024), and RKFD (HR, 1.895; 95% CI: 1.086-3.307, p = 0.025). The risk of incident CKD also tended to increase with elevated VAI quartiles (all p -values for trend <0.05). This positive association remained consistent among participants with different genders, baseline weights, or kidney functions., Conclusion: In our study, elevated VAI was associated with increased risk of incident CKD and RKFD in the elderly population., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Lei, Dai, Zhang, Lu, Tang, Xiao, Li, Yan, Li, Chen, Chen, Li, An and Xiu.)

Background: To develop a reliable model to predict rapid kidney function decline (RKFD) among population at risk of cardiovascular disease., Methods: In this retrospective study, key monitoring residents including the elderly, and patients with hypertension or diabetes of China National Basic Public Health Service who underwent community annual physical examinations from January 2015 to December 2020 were included. Healthy records were extracted from regional chronic disease management platform. RKFD was defined as the reduction of estimated glomerular filtration rate (eGFR) ≥ 40% during follow-up period. The entire cohort were randomly assigned to a development cohort and a validation cohort in a 2:1 ratio. Cox regression analysis was used to identify the independent predictors. A nomogram was established based on the development cohort. The concordance index (C-index) and calibration plots were calculated. Decision curve analysis was applied to evaluate the clinical utility., Results: A total of 8455 subjects were included. During the median follow-up period of 3.72 years, the incidence of RKFD was 11.96% (n = 1011), 11.98% (n = 676) and 11.92% (n = 335) in the entire cohort, development cohort and validation cohort, respectively. Age, eGFR, hemoglobin, systolic blood pressure, and diabetes were identified as predictors for RKFD. Good discriminating performance was observed in both the development (C-index, 0.73) and the validation (C-index, 0.71) cohorts, and the AUCs for predicting 5-years RKFD was 0.763 and 0.740 in the development and the validation cohort, respectively. Decision curve analysis further confirmed the clinical utility of the nomogram., Conclusions: Our nomogram based on five readily accessible variables (age, eGFR, hemoglobin, systolic blood pressure, and diabetes) is a useful tool to identify high risk patients for RKFD among population at risk of cardiovascular disease in primary care. Whereas, further external validations are needed before clinical generalization., (© 2022. The Author(s).)

Purpose: To investigate distributions and identify possible differences in intramuscular pressure (IMP) values at 1 min post-exercise between the four muscle compartments of the lower leg, in patients with exertional leg pain with or without chronic exertional compartment syndrome (CECS)., Methods: A consecutive series of patients seeking orthopaedic consultation for exertional leg pain underwent IMP measurements between 2009 and 2018. The diagnosis of CECS was confirmed (n = 442) or ruled out (n = 422), based on the patient's history, clinical examination, and IMP measurements., Results: The median (range) 1 min post-exercise IMP values in affected compartments in the patients diagnosed with CECS were 33 (25-53) mmHg (deep posterior), 35 (27-54) mmHg (superficial posterior), 40 (26-106) mmHg (lateral), and 47 (24-120) mmHg (anterior). In patients with no CECS, the median (range) 1 min post-exercise IMP values in the compartments were 12 (2-28) mmHg (deep posterior), 12 (2-27) mmHg (superficial posterior), 14 (2-26) mmHg (lateral), and 18 (4-34) mmHg (anterior). The IMP was significantly lower in the lateral and both posterior compartments than in the anterior compartment in both patients diagnosed with CECS and patients without CECS., Conclusion: The study demonstrates significantly lower IMP values in the posterior and lateral compartments compared to the anterior compartments. These findings suggest a lowering of the IMP 1 min post-exercise cut-off value for diagnosing CECS in the lateral and both posterior compartments, which may lead to improved treatment of patients with suspected CECS in the lower leg., Level of Evidence: Level II.

Background: Coronary artery fistula complicated with giant coronary artery ectasia (CAE) is a rare cardiac malformation, and its surgical indications and treatment strategies still need further discussion., Case Summary: In this case, a 41-year-old man had complained of occasional dizziness for 2 years, but he did not seek medical attention until he started to feel palpitations. A right coronary artery (RCA)-left ventricular (LV) fistula with giant RCA of diffuse ectasia was firstly revealed by transthoracic echocardiography. A widened left ventricle and significantly constricted right atrium and right ventricle were also detected by three-dimensional coronary artery computed tomography. Surgical treatment, including the repair of the RCA-LV fistula, the resection and reconstruction of the dilated RCA and coronary artery bypass grafting (CABG) under hypothermic cardiopulmonary bypass, were performed to correct the malformation. The patient presented a favourable health condition without any discomfort at the 1-year follow-up., Discussion: CAE can be caused by various congenital or acquired factors. Surgical treatment, such as transcatheter embolization excision, surgical ligation or resection for symptomatic patients with CAE three times or larger than the reference diameter, has been reported to have satisfactory results. Additionally, CABG can be selected if myocardial perfusion is compromised and the distal branch is of reasonable size. In this case, the giant ectasia of the RCA may have been a consequence of the congenital RCA-LV fistula. Atherosclerosis, with calcified plaques in the RCA, and the patient's long-term history of smoking may have contributed to the development of giant ectasia of the RCA., (© The Author(s) 2021. Published by Oxford University Press on behalf of the European Society of Cardiology.)

Catalpol hexapropionate (CP-6) was designed and synthesized as anti-aging drug. In order to investigate the behavior of CP-6 in simulated gastric juice, ultra-high performance liquid chromatography-electrospray ionization-high resolution mass spectrometry was used to determinate the components produced in simulated gastric conditions. Six metabolites were identified with the possible metabolic processes proposed. Hydrolysis may be the main metabolic pathways. The relative contents of CP-6 and its metabolites were determined using their extractive ion chromatograms. The results show that the relative content of CP-6 is rapidly decreased about 15% during the first 0.5 h and generally stable after 0.5 h. The mainly produced metabolites are catalpol penta-propionate (CP-5), catalpol and a spot of catalpol tetra-propionate (CP-4), catalpol tri-propionate (CP-3), catalpol dipropionate (CP-2) and catalpol propionate (CP-1). The metabolitic process of CP-6 may be an hydrolysis under acid conditions. The research results can provide useful information for development and utilization of CP-6 as a pharmaceutical preparation.

Background: Transcatheter aortic valve implantation (TAVI) has been a favored option for the patient who suffered from symptomatic aortic stenosis. However, the efficacy and safety outcomes in novel oral anticoagulants (NOACs) versus Vitamin-K antagonist (VKA) for post-TAVI patients are still controversial. This meta-analysis aims at comparing the clinical outcome and safety of NOACs and VKA in the patients after receiving TAVI., Method: We searched literature articles in all reachable databases, and observational study as well as randomized controlled trial would be included in order to perform a comprehensive analysis. All-cause mortality, major or life-threatening bleeding, disabling or nondisabling stroke were main pooled outcome measures. Subgroup analysis and meta-regression were adopted to explore heterogeneity. Assessment of bias was performed under the suggestion of Cochrane's Collaboration Tool., Results: We collected 3841 non-duplicate citations from PubMed, Embase, Cochrane and ClinicalTrials.gov, and eventually 7 studies were included for this meta-analysis. As a result, VKA showed priority against NOACs in the field of anti-thromboembolism (4435 participants, RR:1.44, 95% CI: 1.05 to 1.99, I 2  = 0%, P = 0.02)., Conclusion: With corroborative analysis of severe complications, VKA is shown to be more protective on post-TAVI patients in disabling or nondisabling stroke scenario but not in mortality or bleeding event.

Background: Simultaneous measurement of electromyography (EMG) and local muscle oxygenation is proposed in an isometric loading model adjusted for patients that have undergone spinal surgery., Methods: Twelve patients with degenerative lumbar spinal stenosis (DLSS) were included. They were subjected to a test protocol before and after surgery. The protocol consisted of two parts, a dynamic and an isometric Ito loading with a time frame of 60 s and accompanying rest of 120 s. The Ito test was repeated three times. EMG was measured bilaterally at the L4 level and L2 and was recorded using surface electrodes and collected (Biopac Systems Inc.). EMG signal was expressed as RMS and median frequency (MF). Muscle tissue oxygen saturation (MrSO 2 ) was monitored using a near-infrared spectroscopy (NIRS) device (INVOS® 5100C Oxymeter). Two NIRS sensors were positioned bilaterally at the L4 level. The intensity of the leg and back pain and perceived exertion before, during, and after the test was evaluated with a visual analogue scale (VAS) and Borg RPE-scale, respectively., Results: All patients were able to perform and complete the test protocol pre- and postoperatively. A consistency of lower median and range values was noted in the sensors of EMG1 (15.3 μV, range 4.5-30.7 μV) and EMG2 (13.6 μV, range 4.0-46.5 μV) that were positioned lateral to NIRS sensors at L4 compared with EMG3 (18.9 μV, range 6.5-50.0 μV) and EMG4 (20.4 μV, range 7.5-49.0 μV) at L2. Right and left side of the erector spinae exhibited a similar electrical activity behaviour over time during Ito test (60 s). Regional MrSO 2 decreased over time during loading and returned to the baseline level during recovery on both left and right side. Both low back and leg pain was significantly reduced postoperatively., Conclusion: Simultaneous measurement of surface EMG and NIRS seems to be a promising tool for objective assessment of paraspinal muscle function in terms of muscular activity and local muscle oxygenation changes in response to isometric trunk extension in patients that have undergone laminectomy for spinal stenosis.

Fluorescence quantum dots (QDs) are promising functional nanomaterials in chemical biology and environmental applications, where an analyte-induced responsive system is beneficial for detecting numerous life-related molecules and pollutants. Here, fluorescent Ti3C2 MXene quantum dots (MQDs) with the size of 1.75 nm were synthesized by a simple method of hydrofluoric acid etching and dimethyl sulfoxide exfoliation to form nanosheets followed by a one-step ultrasound method. The as-synthesized MQDs showed excitation-dependent behaviour along with a fluorescence quantum yield value of 7.7%. In addition, the fluorescence of the MQDs can be significantly suppressed by Fe3+. The mechanism for the fluorescence quenching of the MQDs was systematically investigated, which was attributed to the oxidation-reduction reaction between the MQDs and Fe3+ and the inner filter effect (IFE), different from the reported Förster resonant energy transfer (FRET) mechanism for MXene nanosheets. Based on this trait, a fluorescence method for Fe3+ detection based on MQDs was demonstrated with high sensitivity and selectivity, and the limit of detection was 310 nM. The proposed method was successfully used for the sensitive detection of Fe3+ in serum and sea water. This work will not only help to understand the selectivity mechanisms of MQDs as fluorescent probes for metal ions, but also provide a smart sensing platform in biological and environmental detection.

Background: Astroglioma, one major form of brain tumors, has remained principally tough to handle for decades, due to the complexity of tumor pathology and the poor response to chemo- and radio-therapies., Methods: Our previous study demonstrated that nifurtimox could regulate the signaling axis of AKT-GSK3β in various tumor types including the astroglioma U251 cells. Intriguingly, earlier case studies suggested that nifurtimox could possibly permeate the blood brain barrier and arrest neuroblastoma in the brain. These observations jointly encouraged us to explore whether nifurtimox would hinder the growth of astroglioma in vivo., Results: Our results exhibited that nifurtimox could competently hinder the development of astroglioma in the mouse brain as compared to temozolomide, the first line of drug for brain tumors. Meanwhile the surviving rate, as well as the body-weight was dramatically upregulated upon nifurtimox treatment, as compared to that of temozolomide. These findings offered nifurtimox as a better alternative drug in treating astroglioma in vivo., Conclusion: Persistently, the manipulation of the signaling axis of AKT-GSK3β in astroglioma was found in line with earlier findings in neuroblastoma when treated with nifurtimox., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Exosomes have been reported to play an important role in the anti-tumor immune response, tumor diagnosis and other processes, and are promising biomarkers for early cancer diagnosis. In this work, a sensitive electrogenerated chemiluminescence (ECL) biosensor was developed for detection of exosomes using aptamer modified two-dimensional material Ti 3 C 2 MXenes nanosheets as the ECL nanoprobe because of its large surface area, the excellent conductivity and catalytic properties. The exosomes can be high efficiently captured onto the electrode surface by an EpCAM protein recognized aptamer modified on the electrode surface. In addition, the ECL nanoprobe can also recognize the exosomes, and significantly enhanced the ECL signals of luminol. Based on this strategy, a highly sensitive ECL biosensor for MCF-7 exosomes detection was obtained. The detection limit is 125 particles μL -1 , which was over 100 times lower than that of conventional ELISA method. The as prepared ECL biosensor was performed successfully for MCF-7 exosomes detection in the serum. This strategy provided a feasible, sensitive and reliable tool for the exosomes detection in exosomes-related clinical diagnostics., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Exosomes, as novel noninvasive biomarkers for disease prediction and diagnosis, have shown fascinating prospects in monitoring cancer-linked public health issues. Herein, a unique Cy3 labeled CD63 aptamer (Cy3-CD63 aptamer)/Ti 3 C 2 MXenes nanocomplex was constructed as a self-standard ratiometric fluorescence resonance energy transfer (FRET) nanoprobe for quantitative detection of exosomes. The Cy3-CD63 aptamer can be selectively adsorbed onto the Ti 3 C 2 MXene nanosheets by hydrogen bond and metal chelate interaction between the aptamer and MXenes, and the fluorescence signal from Cy3-CD63 aptamer was quenched quickly owing to the FRET between the Cy3 and MXenes. The fluorescence of Cy3 greatly recovered after the addition of the exosomes which can specifically combine with the aptamer and release from the surface of Ti 3 C 2 MXenes due to the high affinity between the aptamer and CD63 protein on exosome surface. Meanwhile, the self-fluorescence signal of MXenes in the whole process showed little change, which can be used as a standard reference. Based on the self-standard turn-on FRET biosensing platform the detection limit of exosome was determined as 1.4 × 10 3 particles mL -1 , which was over 1000× lower than that of conventional ELISA method. This fluorescence sensor can also be used for the identification of multiple biomarkers on the exosome surface and different kinds of exosomes, combining with the fluorescent confocal scanning microscope image. The proposed strategy not only provides a universal nanoplatform for exosomes, but also can be extensively expanded to multiple biomarkers detection, which may promise the prospect of MXenes as robust candidates in biological fields.

Aim: We validated patientpain drawing (PPD) in establishing the diagnosis of chronic anterior compartment syndrome (CACS) in patients with exercise-induced leg pain., Methods: The study comprised 477 consecutive patients, all suspected of having CACS. The diagnosis was based on the patient's history, a thorough clinical examination and measurements of intramuscular pressure (IMP) following an exercise test. Patients completed a PPD before their hospital visit. Two independent orthopaedic surgeons diagnosed the causes of leg pain based only on the PPD at least 1 year after admission. Based on the results of diagnostic tests, the patients were divided into three groups: CACS (n=79), CACS with comorbidity (n=89) and non-CACS (n=306)., Results: The sensitivity of the PPD to identify CACS correctly was 67% (observer 1) and 75% (observer 2). The specificity was 65% and 54%, respectively. The interobserver agreement (n=477) was 80%, and the kappa value was 0.55. The interobserver agreement was 77%, and the kappa value was 0.48 among 168 CACS patients with or without comorbidity. The interobserver agreement was 85%, and the kappa value was 0.56 in 79 CACS, and CACS was correctly diagnosed in 79% (observer 1) and 82% (observer 2). The test-retest showed the same results for the two observers, with an intraobserver agreement of 84%, while the test-retest reliability coefficient was 0.7. Comorbidity was found in 53% of CACS patients., Conclusion: PPD might be a valuable instrument in diagnosing the causes of exercise-induced leg pain. It is useful in identifying CACS with and without comorbidity., Competing Interests: Competing interests: None declared.

Aim: Autophagy, a highly regulated process with a dual role (pro-survival or pro-death), has been implicated in adverse pregnancy outcomes. The aim of this study was to explore the mechanism whereby mammalian target of rapamycin (mTOR) signaling regulates autophagy by modulating protein O-GlcNAcylation in human trophoblasts., Methods: HTR8/SVneo cells were incubated in serum-free medium for different time intervals or treated with varying doses of Torin1. Protein expression and cell apoptosis were detected by immunoblotting and flow cytometry, respectively., Results: Short-term serum starvation or slight suppression of mTOR signaling promoted autophagy and decreased apoptosis in HTR8/SVneo cells. Conversely, prolonged serum starvation or excessive inhibition of mTOR reduced autophagy and enhanced cell apoptosis. Both serum starvation and mTOR signaling suppression reduced protein O-GlcNAcylation. Upregulation and downregulation of O-linked β-N-acetylglucosamine (O-GlcNAc) levels attenuated and augmented autophagy, respectively. Moderate mTOR inhibition-induced autophagy was blocked by upregulation of protein O-GlcNAcylation. Furthermore, immunoprecipitation studies revealed that Beclin1 and synaptosome associated protein 29 (SNAP29) could be O-GlcNAcylated, and that slight mTOR inhibition resulted in decreased O-GlcNAc modification of Beclin1 and SNAP29. Notably, we observed an inverse correlation between phosphorylation (Ser15) and O-GlcNAcylation of Beclin1., Conclusion: mTOR signaling inhibition played dual roles in regulating autophagy and apoptosis in HTR8/SVneo cells. Moderate mTOR suppression might induce autophagy via modulating O-GlcNAcylation of Beclin1 and SNAP29. Moreover, the negative interplay between Beclin1 O-GlcNAcylation and phosphorylation (Ser15) may be involved in autophagy regulation by mTOR signaling., (© 2017 Japan Society of Obstetrics and Gynecology.)

To evaluate a forward-sensing fiber-optic pressure technique for recording of intramuscular pressure (IMP) in the human leg and investigate factors that may influence IMP measurements used in diagnosing compartment syndromes. IMP in the tibialis anterior muscle was recorded simultaneously by a fiber-optic technique and needle-injection technique in 12 legs of 7 healthy subjects. Both measurement catheters were placed in parallel with the muscle fibers to the same depth, as verified by sonography. IMP recordings were performed at rest before, during and after applying a model of abnormally elevated IMP (simulated compartment syndrome). IMP was elevated by venous obstruction induced by a thigh tourniquet of a casted leg. IMP was also measured during injections of 0.1 ml of saline into the muscle through the catheters. IMP at baseline was 5.1 (SD = 2.6) mmHg measured with the fiber-optic technique and 7.1 (SD = 2.5) mmHg with the needle-injection technique (p < 0.001). It increased to 48.5 (SD = 6.9) mmHg and 47.6 (SD = 6.6) mmHg respectively, during simulated compartment syndrome. IMP increased significantly following injection of 0.1 ml of saline, measured by both techniques. It remained increased 1 min after injection. The fiber-optic technique was able to record pulse-synchronous IMP oscillations. The fiber-optic technique may be used for IMP measurements in a muscle with both normal and abnormally elevated IMP. It has good dynamic properties allowing for measurement of IMP oscillations. Saline injection used with needle-injection systems to ensure catheter patency compromises IMP readings at least one minute after injection.

Background: Patients with compartment syndromes have elevated intramuscular pressure (IMP) due to increased volume in the affected muscle. However, the accuracy of IMP as a parameter in diagnosing chronic compartment syndrome has been questioned. It has been observed that arterial pulsations create oscillations in the IMP in patients with abnormally elevated IMP. The amplitude of the IMP oscillations appears to be related to a pathogenic mechanism of elevated IMP. Therefore, the purpose of the present study was to investigate the relation between the amplitude of pulse-synchronous IMP oscillations and the absolute level of IMP with a high-end fiber-optic system in a human experimental model of abnormally elevated IMP (simulated compartment syndrome) of the leg. The hypothesis that the amplitude of the IMP oscillations is correlated to the absolute level of IMP was tested., Methods: IMP was measured at rest in the anterior tibial muscle in 12 legs of 7 healthy subjects (4 females and 3 males) with a mean age of 28 (range 23-38) years. The subject lay supine with his/her heel placed in a footrest. The foot was kept in a neutral position to avoid biased IMP readings. Measurements were performed at baseline and during 10 minutes with a model of abnormally elevated IMP (simulated compartment syndrome) applied. The abnormally elevated IMP was created by venous obstruction induced by a thigh tourniquet (65 mmHg) of a casted leg. Placement of the pressure-recording catheter was verified by sonography., Results: The IMP increased from 4.7 (SD = 1.8) mmHg at baseline to 48.6 (SD = 7.1) mmHg when the model of elevated IMP was applied. The amplitude of the pulse-synchronous oscillations was undetectable at baseline. It increased to 3.9 (SD = 1.4) mmHg with increasing IMP when the model was applied. The amplitude of the oscillations showed a positive correlation (r = 0.59) with the absolute level of IMP., Conclusions: The amplitude of the pulse-synchronous IMP oscillations is correlated with the absolute level of IMP during abnormally elevated IMP. The oscillations of IMP may therefore be an additional parameter assuring the abnormally elevated IMP in the diagnosis of compartment syndromes.