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Background: Irritable bowel syndrome (IBS) is a common disorder with abdominal pain and bowel habits changes. Herbal medicines (HMs) are frequently used in the treatment of IBS. Therefore, several systematic reviews (SRs) have been conducted to assess the efficacy and safety of HM in IBS patients. This study aimed to investigate the methodology and quality of evidence of SRs, and to describe the current state of research and evidence for the treatment of IBS with HM.Methods: SRs published up to January 2022 were searched using six electronic databases. SRs and/or meta-analyses on the use of HMs for IBS were included. The effects of placebo, conventional medicine (CM), and probiotics were compared with those of HMs. Two investigators independently extracted the data and assessed methodological quality using the Measure Tool to Assessment System Reviews 2 (AMSTAR 2). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each main finding.Results: Eighteen SRs were included in this overview. Among them, eight SRs reported only specific subtypes of IBS: six SRs reported patients with diarrhea-predominant IBS, and two SRs reported patients with constipation-predominant IBS. In terms of total efficacy, HM was more effective than placebo, CM, or probiotics. HM showed a more significant effect than CM in relieving independent IBS symptom score (abdominal pain score, diarrhea score, abdominal distension score, stool frequency score, etc.) and recurrence rate. The rate of adverse events was significantly lower with HM compared to CM, and no serious adverse events were reported with HM treatment. According to AMSTAR 2, the methodological quality of the included SRs was extremely low. Furthermore, the quality of evidence for total efficacy was considered low or very low according to the GRADE tool.Conclusion: HM can be considered as an effective and safe treatment for IBS. However, the methodological quality of the included SRs and the quality of evidence was generally low. Therefore, well-designed randomized controlled trials are needed in the future so that a high-quality SR can be used to better assess the safety and efficacy of HM in the treatment of IBS.Systematic Review Registration:https://osf.io/nt6wz, identifier 10.17605/OSF.IO/NT6WZ.

Social changes are reshaping play affordance patterns and redefining the concept of play space fences. This study explores this shift by examining four “childcare support bases” in Setagaya ward, Japan. We provided a historical overview of play affordances and explored how fences reflect the contemporary understanding of new play affordances. We categorized the play environment into new designated play spaces (NDPS) and carved-out play spaces (CPS). These were observed from the perspectives of both operators and users. We conducted four unstructured interviews to understand the operator’s viewpoint. From the user’s perspective, we interpreted fences perceived through social media phenomenologically, drawing on Merleau-Ponty’s concept of “perception through embodied experience.” The study sites in Setagaya ward encompass NDPS created and operated through new play affordances. Each NDPS forms a flexible cluster of play spaces by generating temporary CPS around it. Institutionalized play assistants facilitate an alliance between NDPS and CPS, acting as a non-physical fence permeable to the city and expandable through CPS. By reinterpreting fences in the context of new play affordances, we envision the integrated use of DPS and CPS in urban space planning, transcending the traditional conflict between them. This study offers a comprehensive examination of these concepts together.

Objectives Previous studies on the differences in the mechanism and complications of diabetes between men and women have indicated potential sex differences in cardiovascular health, which affect health-related quality of life (HRQoL).Design A cross-sectional cohort study.Setting To determine how sex differences can be noticed, acknowledged and applied in clinical practice, we aimed to determine the cardiovascular (CV) health status of men and women with diabetes and its effects on HRQoL.Participants In total, 2829 individuals with diabetes (1518 men and 1311 women) aged ≥40 years who participated in the Korean National Health and Nutrition Examination Survey from 2013 to 2018 were enrolled.Outcome measures Individuals with diabetes were categorised into poor, intermediate and ideal groups based on CV health indicators recommended by the American Heart Association. We used EQ-5D-3L to compare HRQoL scores between the sexes. Multivariable ordinal logistic regression and analysis of covariance were used to analyse the outcome variables.Results In the poor CV health score group, female sex was associated with mobility problems (OR 1.93, 95% CI 1.46 to 2.54), problems with usual activities (OR1.71, 95% CI 1.24 to 2.35), pain/discomfort (OR 1.69, 95% CI 1.32 to 2.16) and anxiety/depression (OR 1.66 95% CI 1.16 to 2.38). In the intermediate and ideal CV health score groups, female sex was associated with pain/discomfort (OR 1.57, 95% CI 1.15 to 2.15). Men had higher EQ-5D index scores in the poor and intermediate CV health score groups than did women.Conclusions Although women tended to have high health-related CV health scores, HRQoL was lower in women than in men, especially in the poor CV health score group and in the pain/discomfort domain.

Objectives This study aimed to compare the mental health status of patients with diabetes before and after the COVID-19 pandemic and to determine the effect of COVID-19 on their mental health status. This study was the first to investigate the relationship between diabetes and mental health in the Korean population during the COVID-19 pandemic.Design This retrospective cross-sectional study investigated the prevalence of mental health problems before (2018–2019) and during (2020–2021) the COVID-19 pandemic in individuals with diabetes aged 40 years or older who participated in the Korea National Health and Nutrition Examination Survey. Mental health problems were assessed using self-reported experiences of depression diagnosis, stress perception and suicide ideation. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Clinically significant depression requiring treatment was determined using an optimal cut-off score of 10 out of a total of 27 points.Participants There were 824 men and 763 women in the 2018–2019 survey and 882 men and 887 women in 2020–2021.Results In the unadjusted analysis, women had a statistically significantly higher prevalence of suicide ideation in 2020–2021 (2.9, 95% CI: 1.5 to 4.2) than in 2018–2019 (1.0, 95% CI: 0.4 to 1.7, but p

Pavilions are flexible, open architectural structures, usually erected in parks and gardens. And they played a significant role in the political and cultural propaganda through international exhibitions in the 19th century, as well as in the presentations of new technologies and materials. By focusing on the concept of temporality, this study takes a novel approach and examines the role of the pavilion from the perspective of nomadic, wandering cultures through a case of Serpentine Pavilion Project. This study is based on the interpretive and critical approach which relies on gathering cases and references about the phenomenon or literature in hand. We provide a history overview and trace the changes in the concept of place at the dawn of the modern era, investigating how the Serpentine Pavilion reflects a modern understanding of placeness. Essentially, it argues that the pavilion, as a special temporary architectural form, can be used as the foundation of modern discourse on placeness. As a material and spatial alternative to such placeness, the pavilion constitutes an important architectural type.

Abstract Background Although the cardiovascular health and quality of life (QoL) of stroke survivors have been previously studied, no study has investigated the correlation between cardiovascular health and QoL. This study aimed to investigate whether there would be a difference in the quality of life (QoL) in this population depending on the degree of cardiovascular health. Methods Overall, 577 people aged > 40 years who participated in the Korea National Health and Nutrition Examination Survey from 2013 to 2018 were included and were divided into three groups according to the survey period (2013–2014, n = 145; 2015–2016, n = 198; and 2017–2018, n = 234). Participants were further divided into the following groups based on their cardiovascular health score, as defined by the American Heart Association: poor, intermediate, and ideal groups. We examined how the health-related QoL score was expressed through the five-dimensional European Quality of Life Questionnaire (EQ-5D-3L). Results The ideal (cardiovascular health scores 11–14) and intermediate (cardiovascular health scores 8–10) groups had the lowest (7.72–8.14%) and highest (46.39–57.70%) number of participants, respectively. The total EQ-5D index score was highest in the ideal group, followed by the intermediate and poor groups across all three periods (2013–2014, p = 0.0015; 2015–2016, p = 0.0040; 2017–2018, p

Recent case reports in medical literatures suggest that more and more second-generation atypical antipsychotics (AAs) have been prescribed for off-label use; quetiapine (Brand name: Seroquel®) showed increase in its trend for off-label use. Little is known about the reasons behind this trend, although historical sedative and hypnotic prescription patterns suggest that despite relatively superior safety profiles of quetiapine (especially for movement disorders), it may be used for treating substance abuse disorder. In addition, recent studies have shown a strong potential for misuse and abuse (MUA) of quetiapine beyond Food and Drug Administration-approved indications. This includes drug-seeking behaviors, such as feigning symptoms, motivated by quetiapine and use of quetiapine in conjunction with alcohol. Quetiapine appears to be the most documented AA with street values bartered illicitly on the street. A recent report from the Drug Abuse Warning Network has shown a high prevalence of quetiapine-related emergency department visits involving MUA. Several other case studies have found that quetiapine causes seeking behaviors observed in substance use disorder. In fact, the majority of quetiapine MUA involved patients diagnosed with substance use disorder. In the absence of a definitive mechanism of action of quetiapine's reinforcing properties, it is imperative to gather robust evidence to support or refute increasing off-label use of AAs.

Graviola is one of the most accomplished natural anticancer therapists gaining popularity in recent times. Harnessing the full benefit from tapping all of its rich bioactive reservoirs is absolutely worthy and mandatory. It is in this regard that a well optimized extraction methodology gains paramount importance. In case of Graviola, no sophistication in terms of extraction methods is reported. A neoteric sonication cum microwave combined extraction technology was introduced that maximized the extraction process and minimized (7 min) the extraction time. The extraction efficiency was validated based on the significant enrichment of bioactive ingredients in Graviola extracts following the sonication cum microwave combined protocol.