AIM: To determine the influence of psychosocial factors and health-seeking behaviour on the risk of falling among individuals with type 2 diabetes.
METHODS: This prospective study included community-dwelling adults aged ≥55 years selected through stratified random sampling from three neighbouring parliamentary constituencies. Data was collected at baseline in 2013-2015 with computer-assisted home-based interviews and follow-up in 2019 via telephone interviews.
RESULTS: Data on diabetes status and falls were available for 908 participants at baseline and follow-up. Diabetes was present in 42.2% of included participants at follow-up, of whom 22.8% at baseline and 25.3% at 5-year follow-up had at least one fall within the last 12 months. Diabetics had a higher risk of falls at baseline (OR: 1.484; 95% CI: 1.060-2.077) and follow-up (OR: 1.424; 95% Cl: 1.038-1.954) than non-diabetics. It was found that female gender, arthritis, alcohol and presence of depression anxiety or stress were associated with increased risk of falls in diabetics. The presence of any depression, anxiety or stress remained significantly associated with falls in diabetics (OR: 1.947; 95% Cl: 1.115-3.402) after adjustments for age, gender, ethnicity, and education but this relationship was attenuated after additional adjustment for arthritis (OR: 1.763; 95% CI: 0.996-3.122).
CONCLUSION: Our findings suggest that psychological issues are significantly associated with increased risk of falls at five-year follow-up in individuals aged 55 years and over with diabetes. These findings highlight the potential importance of psychosocial support among diabetics to reduce the risk of falls, improve patient outcomes and quality of life.
METHODS: We performed a retrospective review of paediatric DSS cases managed at seven hospitals across Malaysia, Myanmar and Vietnam. We explored the effects of both initial resuscitation (crystalloid alone or mixed crystalloid/colloid in the first 2 hours) and general management: group 1 (conservative-colloid, crystalloid only), group 2 (intermediate-colloid, colloid for 1-4 hours) or group 3 (liberal-colloid, continuous colloid for more than 4 hours) categorised according to the fluid given over the first 6 hours in clinically stable patients. We incorporated an inverse probability weighting score to adjust for potential differences in baseline severity.
RESULTS: Among all 691 patients, respiratory compromise (HR 2.08, p=0.022), requirement for nasal continuous positive airway pressure (NCPAP)/ventilation (OR 2.34, p<0.045) and days in hospital after DSS onset (risk ratio, RR 1.33, p=0.032) were significantly worse for mixed crystalloid/colloid versus crystalloid-only initial resuscitation regimens, after adjusting for baseline severity. Among the 547/691 children who stabilised within 2 hours, although a liberal-colloid general management strategy (group 3) was associated with a reduction in recurrent shock episodes (RR 0.13, p=0.043) when compared with a conservative-colloid strategy (group 1), the risks for respiratory compromise (OR 8.84, p<0.001) and requirement for NCPAP/ventilation (OR 8.16, p<0.001) were markedly increased. Additionally, the respective costs for group 3 vs group 1 were significantly higher.
CONCLUSIONS: The study highlights the potential benefits and risks of using colloid solutions in children with DSS. Formal randomised trials could help determine the most effective and safe parenteral fluid regimens for paediatric DSS. In the meantime, prolonged use of colloid solutions may be inappropriate, especially in settings without access to respiratory support.
METHODS: Ninety-six adults (59.4 ± 9.1 years; 84% female; BMI 22.7 ± 1.6 kg/m2) with hypertension were randomized into one of four groups: Breathing Exercise (BE), High-Intensity Bodyweight Interval Training (HIBIT), Combined Exercise (CE), or a Non-Exercise Control (CON) group. The intervention lasted 10 weeks, with all exercise groups having the same total training time of 3 days per week (BE: 30 min/day; HIBIT: 60 min/day; CE: BE 30 min/day plus HIBIT 60 min/day). Resting heart rate, resting blood pressure, hand grip strength, cardiorespiratory fitness assessed using 6-Minute Walking Test (6MWT) and blood lipids were measured pre- and post-intervention.
RESULTS: The BE group showed the greatest reduction in systolic blood pressure (SBP) compared to CON, although differences among the exercise groups were not statistically significant. The increase in 6MWT values in the combined exercise group differed significantly compared to the other three groups (p = 0.000 and effect size = 0.296). The combined exercise group showed significant reductions in total cholesterol, LDL and triglyceride levels compared to the control group. The average reduction in total cholesterol levels was 20.8 mg/dL (95% C: -41.9 - 0.4) with an effect size of 0.103. Meanwhile, the decrease in LDL and triglyceride levels was 20.1 mg/dL (95% CI: -37.6--2.5; p = 0.014) and -40.4 mg/dL (95% CI: -82.1-1.3; p = 0.04) with effect sizes of 0.118 and 0.101.
CONCLUSIONS: In conclusion combined exercise for 10 weeks could lower systolic and diastolic blood pressure, increase CRF, and improved lipid profile. As a clinical implication, the results of this study can be an alternative or complementary approach to treatment for hypertension, potentially reducing the need for medications and their associated side effects.
TRIAL REGISTRATION: TCTR20230707003 ( http://www.
CLINICALTRIALS: in.th/ ) registered on 28 January 2023.
METHOD: A cross-sectional study was conducted at Al Amal Cancer Center, Al-Thawra Hospital, Hodeida City, Yemen (January-March 2023). Data on sociodemographic characteristics, depression (Patient Health Questionnaire, PHQ-9), and social support (Oslo Social Support Scale, OSSS-3) were collected. Multivariate binary logistic regression identified significant depression factors, and Pearson's correlation was used to assess the relationship between social support and depression. A p value of 4 years) (AOR = 3.197, p = 0.006), and difficulty in activities (AOR = 8.704, p
METHODS: ASCs were cultured on chitosan nano-deposited surfaces to form 3D spheres. Mitochondrial activity and ATP production were assessed using MitoTracker staining, Seahorse XF analysis, and ATP luminescence assays. Single-cell RNA sequencing, followed by Ingenuity Pathway Analysis (IPA), was conducted to uncover key regulatory pathways, which were validated through molecular techniques. Pathway involvement was confirmed using epigenetic inhibitors or PPARγ-modulating drugs. Mitochondrial structural integrity and delivery efficiency were evaluated after isolation.
RESULTS: Chitosan-induced ASC spheres exhibited unique compact mitochondrial morphology, characterized by condensed cristae, enhanced mitochondrial activity, and increased ATP production through oxidative phosphorylation. High expressions of mitochondrial complex I genes and elevated levels of mitochondrial complex proteins were observed without an increase in reactive oxygen species (ROS). Epigenetic modification of H3K27me3 and PPARγ involvement were discovered and confirmed by inhibiting H3K27me3 with the specific EZH2 inhibitor GSK126 and by adding the PPARγ agonist Rosiglitazone (RSG). Isolated mitochondria from ASC spheres showed improved structural stability and delivery efficiency, suppressed the of inflammatory cytokines in LPS- and TNFα-induced inflamed cells, and rescued cells from damage, thereby enhancing function and promoting recovery.
CONCLUSION: Enhancing mitochondrial ATP production via the EZH2-H3K27me3-PPARγ pathway offers an alternative strategy to conventional cell-based therapies. High-functional mitochondria and delivery efficiency show significant potential for regenerative medicine applications.
AIM: This study is aimed at investigating the prevalence of TD among schizophrenia patients treated with antipsychotics and identifying the associated factors. This study also investigates the association of TD with personal and social functioning performance, and the severity of illness.
METHODS: This was a cross-sectional study conducted at a teaching hospital in Malaysia. Patients were assessed using the Abnormal Involuntary Movement Scale (AIMS), Personal and Social Performance Scale (PSP) and the Clinical Global Impression Scale (CGI).
RESULTS: Seventy-eight patients were recruited in this study. The prevalence of TD was 35.9%. Older age (OR 4.079, p = 0.006), Chinese ethnicity (OR 4.486, p = 0.020), longer duration of schizophrenia and antipsychotic treatment (OR 5.312, p = 0.001 and OR 5.500, p = 0.002 respectively) were also significantly associated with TD. TD patients notably demonstrated severe impairments in the self-care domain (71.4%). The presence of TD is associated with more severe overall clinical impairment (53.6%).
CONCLUSION: TD remains a prevalent and concerning side effect of antipsychotic treatment in schizophrenia patients. There is a need for regular monitoring and the use of standardized assessment tools to detect TD.
METHODS: We conducted a systematic review from PubMed and Scopus to identify the cost-effectiveness analyses of MMS compared to IFA for pregnant women up to January 2024. Data extraction included specific study characteristics, input parameters, cost elements, cost-effectiveness results, and key drivers of uncertainty. This systematic review adhered to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.
RESULTS: After removing 111 duplicates and following the screening process on the title and abstract of 1201 records, resulting in 125 full-text articles assessed for eligibility, a total of 5 studies fulfilled the inclusion criteria and were included in the review. All included studies were from low- and middle-income countries and demonstrated that MMS compared to IFA for pregnant women is cost-effective and even very cost-effective in some countries. All included studies implemented cost-effectiveness analysis (CEA) and estimated its cost-effectiveness using incremental cost-effectiveness ratio (ICER) per disability-adjusted life years (DALY) averted. Results suggested that the transition from IFA to MMS was cost-effective. The range of ICER per DALY averted in this study is USD 3.62 to USD 1024, depending on the scenario. Overall, the main determinant influencing cost-effectiveness was the cost of MMS procurement.
CONCLUSION: Our findings highlight that transitioning from IFA to MMS in certain conditions has been proven cost-effective, emphasizing this intervention's economic viability. MMS price and micronutrient deficiency-related disease burden are important determinants in assessing cost-effectiveness.
REGISTRATION: PROSPERO CRD42022319470.