Long-term Change in Cardiorespiratory Fitness and All-Cause Mortality: A Population-Based Study

Maintaining cardiorespiratory fitness over time is important for reducing the risk of all-cause mortality.

Is long-term change in cardiorespiratory fitness (CRF), measured by respiratory gas exchange during exercise, associated with all-cause mortality?

Hypothesis: The study aimed to investigate if long-term change in CRF is associated with all-cause mortality, implying a hypothesis that changes in CRF would correlate with mortality risk.

A population-based sample of 579 men, aged 42 to 60 years, with complete data at baseline (V1) and 11-year reexamination (V2) was included. Maximal oxygen uptake (VO2max) was measured at both visits using respiratory gas exchange during maximal exercise testing, and the difference (ΔVO2max) was calculated. Deaths were tracked annually for 15 years after V2 using national death certificates. Multivariate analysis adjusted for various baseline factors was performed.

The mean ΔVO2max was -5.2 mL/min*kg. During a median follow-up of 13.3 years, 123 deaths (21.2%) were recorded. A 1 mL/min*kg higher ΔVO2max was associated with a 9% relative risk reduction of all-cause mortality (hazard ratio, 0.91; 95% CI, 0.87-0.95) in multivariate analysis.

Long-term reduction in cardiorespiratory fitness was associated with an increased risk of all-cause mortality in this population.

The study population consisted only of men aged 42 to 60 years at baseline, limiting generalizability to other demographics. The abstract does not explicitly state other limitations.


Thresholds of handgrip strength for all-cause, cancer, and cardiovascular mortality: a meta-analysis

Grip-Strength Dynamometer;Hand Grip Dynamometer Pro

Lower handgrip strength is linked to increased mortality risk, with the specific dose-response varying by cause of death.

Is the association between handgrip strength and all-cause, cancer, and cardiovascular mortality dose-dependent?

Hypothesis: The study aimed to investigate the dose-response relationship of handgrip strength with all-cause, cancer, and cardiovascular mortality.

A systematic review and meta-analysis were conducted using data from PubMed/MEDLINE, Web of Science, and Scopus up to February 8, 2022. Prospective cohort studies of healthy adults with objective handgrip strength measures were included. A random forest model and a two-stage random-effects hierarchical meta-regression model were used to analyze the dose-response relationship for all-cause, cancer, and cardiovascular mortality.

Forty-eight studies with 3,135,473 participants (49.6% women, aged 35-85 years) were included. Random forest models indicated a significant inverse association between handgrip strength and all-cause and cause-specific mortality. Dose-response meta-analyses showed that higher handgrip strength significantly reduced all-cause mortality risk within 26-50 kg in a close-to-linear inverse fashion. Cancer mortality showed a U-shaped association with significant risk reduction between 16 and 33 kg, while cardiovascular mortality displayed a close-to-linear inverse shape with significant risk reduction ranging from 24 to 40 kg.

There is strong evidence that lower handgrip strength is associated with higher all-cause, cancer, and cardiovascular mortality risk. The dose-response relationship of handgrip strength varies substantially depending on the cause of mortality.

The abstract does not explicitly state limitations of the study.


Association of Muscle Strength With All-Cause Mortality in the Oldest Old: a 28-country cohort

Higher muscle strength is gradually associated with a lower risk of death in people aged 90 and older.

favorable-cue: "associated with a lower"

Does muscle strength associate with all-cause mortality risk in the oldest old in a gradual or threshold-specific manner?

Hypothesis: The study investigates the prospective association of muscle strength with all-cause mortality in the oldest old.

This study included 1890 adults aged 90 years or older from 27 European countries and Israel. Muscle strength was measured using handgrip dynamometry. Time-varying Cox regression with restricted cubic splines was used to determine the association of muscle strength with mortality, adjusting for several confounding factors.

Over a mean follow-up of 4.2 years, 51.4% of participants died. Mean handgrip strength was 20.4 kg overall, with men having 26.7 kg and women 16.4 kg. Lower and higher levels of muscle strength were associated in a gradual and curvilinear fashion with higher and lower mortality risk, respectively, using the median strength (18 kg) as reference. The 10th percentile of muscle strength (10 kg) had a hazard ratio (HR) of 1.27, while the 90th percentile (31 kg) had an HR of 0.69. Sex-stratified results showed similar trends, with the 10th percentile for men (15 kg) having an HR of 1.33 and for women (10 kg) an HR of 1.19. The 90th percentile for men (35 kg) had an HR of 0.75 and for women (23 kg) an HR of 0.75.

Muscle strength is gradually and inversely associated with mortality risk in the oldest old, rather than having a specific threshold.

The abstract does not explicitly state limitations, but the findings were confirmed by sensitivity analyses.


Quantitative ultrasound and mortality: a prospective study

Lower quantitative ultrasound (QUS) readings are linked to a higher risk of death in older women, independent of other health factors.

Is there a relationship between quantitative ultrasound (QUS) measurements and mortality in older women?

Hypothesis: The study aims to investigate the relationship between QUS and mortality, building on previous findings that low bone mineral density (BMD) is associated with increased mortality.

The study included 5816 women over age 70 from the Study of Osteoporotic Fractures. Baseline measurements included QUS of the calcaneus and BMD of the calcaneus and hip. Vital status was monitored every 4 months over 5.0 years, with deaths confirmed by death certificates or hospital records and classified by ICD-9 code. Statistical adjustments were made for various factors including age, health status, and lifestyle.

During 5.0 years of follow-up, 677 women died. Women in the lowest quintile of QUS had the highest mortality. After adjustments, each 1 SD reduction in broadband ultrasonic attenuation (BUA) was associated with a 16% increase in mortality. Low QUS was linked to increased mortality from cardiovascular disease, cancer, and other causes, though the association with cancer deaths was not statistically significant after adjustments. Low BMD also showed an increased risk of total and cause-specific mortality, but BUA and BMD were not found to be independent predictors of mortality.

In older women, low quantitative ultrasound (QUS) is associated with both total and cause-specific mortality, independent of other mortality-related factors. This suggests QUS and BMD may reflect aspects of aging not captured by traditional factors.

The study found little evidence that BUA and BMD were independent predictors of mortality, suggesting potential overlap in what these measures reflect.


Long-term systolic blood pressure variability is associated with mortality and cardiovascular events: a meta-analysis

Higher long-term systolic blood pressure variability is associated with increased risks of death and cardiovascular events, particularly stroke.

unfavorable-cue: "associated with increased"

Is long-term systolic blood pressure variability (SBPV) associated with cardiovascular (CV) outcomes, even after adjusting for mean blood pressure?

Hypothesis: The study aims to evaluate the associations between mean blood pressure adjusted long-term SBPV and CV outcomes, suggesting a potential association.

A systematic review and meta-analysis was conducted by searching PubMed, Scopus, and Science Direct on January 4, 2023. The analysis included 43 studies with a total of 9,944,254 subjects.

Long-term SBPV was associated with an increased risk of all-cause mortality (HR 1.21), CV mortality (HR 1.10), major adverse cardiovascular events (MACE) (HR 1.10), cerebrovascular stroke (HR 1.22), and myocardial infarction (HR 1.13). European populations showed a generally higher risk compared to other continents.

Long-term SBPV is associated with all-cause mortality, CV mortality, MACE, myocardial infarction, and stroke. Poor outcomes linked to long-term SBPV appear to be more driven by cerebrovascular events than coronary events.

The abstract does not explicitly state limitations of the meta-analysis itself, but notes the questionability of the association after adjusting for mean BP, which the study aimed to address.


Can Serum Gamma-Glutamyl Transferase Predict All-Cause Mortality in Hypertensive Patients?

Higher serum GGT levels are associated with an increased risk of all-cause mortality in hypertensive men.

Can serum gamma-glutamyl transferase (GGT) predict all-cause mortality in hypertensive patients?

Hypothesis: The study hypothesized that serum GGT levels would be associated with all-cause mortality in hypertensive patients.

The study analyzed 1,101 female (average age 69 years) and 916 male (average age 67 years) hypertensive participants from the Nomura cohort study. Participants were followed for a median of 13.9 years, and Cox proportional hazards models were used to calculate adjusted hazard ratios for mortality risk.

During a median follow-up of 13.9 years, 716 deaths occurred (360 men, 356 women), with a mortality rate of 25.5 deaths per 1,000 person-years. Male participants with serum GGT levels of 42-86 IU/L had a 64% increased risk of all-cause mortality (HR: 1.64), and those with GGT levels of 87 IU/L or higher had a 93% elevated risk (HR: 1.93) compared to men with GGT levels below 19 IU/L. This association was more pronounced in men than in women, with a significant interaction between gender and baseline serum GGT (p = 0.020).

Irregular GGT levels are notably correlated with overall mortality in Japanese individuals with hypertension. GGT activity is a critical biomarker for predicting long-term survival, especially in older males.

The abstract does not explicitly state any limitations of the study.


Cystatin C Is a Predictor for Long-Term, All-Cause, and Cardiovascular Mortality in US Adults With Metabolic Syndrome

Higher cystatin C levels are linked to increased risk of death from all causes, cardiovascular disease, and cancer in adults with metabolic syndrome.

What is the relationship between cystatin C (CysC) levels and all-cause, cardiovascular disease (CVD), and cancer mortality in US adults with metabolic syndrome (MetS)?

Hypothesis: The study implicitly hypothesized that higher cystatin C levels would be associated with increased mortality rates in MetS patients.

This prospective cohort study utilized data from the 1999-2002 National Health and Nutrition Examination Survey (NHANES), including 1980 MetS participants. Researchers used fitted curves, Kaplan-Meier survival curves, Cox regression analysis, and receiver operating characteristic curves to assess the relationship between CysC levels and mortality outcomes.

During a mean follow-up of 15.3 years, 819 deaths occurred. Higher CysC levels were linked to increased all-cause, CVD, and cancer mortality rates. After adjustment, CysC was associated with all-cause mortality (HR 1.63), CVD mortality (HR 1.53), and cancer mortality (HR 1.53). Participants in the highest CysC tertile had higher risks for all-cause (HR 1.87), CVD (HR 1.97), and cancer mortality (HR 1.72) compared to the lowest tertile. CysC showed higher predictive efficacy for mortality outcomes than eGFR, urea nitrogen, creatinine, uric acid, and C-reactive protein. CysC alone had substantial predictive value for all-cause (AUC 0.773) and CVD mortality (AUC 0.726), which improved when combined with age (AUC 0.861 for all-cause, AUC 0.771 for CVD mortality).

Elevated cystatin C levels are associated with a higher risk of all-cause, cardiovascular disease, and cancer death in patients with metabolic syndrome. Cystatin C may serve as a predictor for all-cause and cardiovascular mortality in this population.


NT-proBNP and mortality across the spectrum of glucose tolerance in the general US population

Higher NT-ProBNP levels are independently linked to increased risk of death from any cause and cardiovascular disease, regardless of blood sugar levels.

Can N-terminal pro-B natriuretic peptide (NT-ProBNP) levels identify individuals at higher cardiovascular risk, independent of their blood glucose levels?

Hypothesis: The study aims to evaluate if NT-ProBNP can help identify subjects at higher cardiovascular risk, independently of blood glucose levels.

Serum NT-ProBNP levels were measured in 5502 participants aged 45-79 years without heart failure from the 1999-2004 National Health and Nutrition Examination Survey. Participants included 3380 with normoglycemia, 1125 with pre-diabetes, and 997 with diabetes. Cox and Fine Gray models, adjusted for cardiovascular risk factors, were used to assess the association between NT-ProBNP levels and all-cause and cardiovascular mortality through December 2015.

After a median follow-up of 13 years, 1509 participants died, with 330 deaths due to cardiovascular causes. Compared to participants with NT-ProBNP < 100 pg/ml, those with levels 100-300 pg/ml had a higher incidence of all-cause mortality (HR 1.61) and cardiovascular mortality (HR 1.57). Participants with NT-ProBNP levels ">=" 300 pg/ml had an even higher incidence of all-cause mortality (HR 2.96) and cardiovascular mortality (HR 2.08). This association remained consistent across subgroups based on glycemic status, obesity, age, and sex.

Elevated NT-ProBNP is independently associated with all-cause and cardiovascular mortality in the general population and may help identify patients at the highest risk.

The study design does not evaluate whether intensification of treatment based on biomarker data might lead to improvements in cardiovascular risk reduction.


Preoperative NT-proBNP and Cardiovascular Events After Noncardiac Surgery: A Cohort Study

Measuring preoperative NT-proBNP levels can significantly improve the prediction of cardiovascular complications and death after noncardiac surgery.

Does preoperative N-terminal pro-B-type natriuretic peptide (NT-proBNP) provide additional predictive value beyond a clinical risk score for vascular death and myocardial injury after noncardiac surgery (MINS) within 30 days?

Hypothesis: Preoperative NT-proBNP may improve risk prediction in patients undergoing noncardiac surgery.

This was a prospective cohort study involving 10,402 patients aged 45 years or older undergoing inpatient noncardiac surgery across 16 hospitals in 9 countries. All patients had NT-proBNP levels measured before surgery and troponin T levels measured daily for up to 3 days after surgery.

Compared with NT-proBNP values less than 100 pg/mL, higher levels were associated with increased adjusted hazard ratios for the primary outcome (vascular death and MINS). Specifically, levels of 100 to less than 200 pg/mL had an HR of 2.27, 200 to less than 1500 pg/mL had an HR of 3.63, and 1500 pg/mL or greater had an HR of 5.82. The incidences of the primary outcome for these groups were 12.3%, 20.8%, and 37.5%, respectively. Adding NT-proBNP thresholds to clinical stratification (Revised Cardiac Risk Index) resulted in a net absolute reclassification improvement of 258 per 1000 patients. Preoperative NT-proBNP values were also significantly associated with 30-day all-cause mortality, with incidences of 0.3% for less than 100 pg/mL, 0.7% for 100 to less than 200 pg/mL, 1.4% for 200 to less than 1500 pg/mL, and 4.0% for 1500 pg/mL or greater.

Preoperative NT-proBNP is strongly associated with vascular death and MINS within 30 days after noncardiac surgery and improves cardiac risk prediction beyond the Revised Cardiac Risk Index.

External validation of the identified NT-proBNP thresholds in other cohorts would reinforce these findings.


Dose response of transcranial near infrared light stimulation on cognition in older adults

High-dose near-infrared light stimulation improved brain connectivity and processing speed in older adults in a small study.

What are the effects of different doses of transcranial near-infrared light stimulation (photobiomodulation) on cognition and resting-state brain functional connectivity in older adults?

Hypothesis: The study implicitly hypothesizes that photobiomodulation will affect brain activity and cognition in humans, with a dose-response relationship.

Twenty-five cognitively normal adults aged 55-70 years were randomized to a single session of either a sham group, a "low-dose" group (26 J/cm2 transcranial, 9 J/cm2 intranasal), or a "high-dose" group (52 J/cm2 transcranial, 18 J/cm2 intranasal) of near-infrared light stimulation. The effects on cognition and resting-state brain functional connectivity were then compared.

The "high-dose" group showed a significant increase in resting-state functional connectivity of the left superior frontal gyrus with the left planum temporale (p = 0.0016) and with the left inferior frontal gyrus, pars triangularis (p = 0.0235), compared to the "sham" group. This group also demonstrated a significant improvement in visual search and processing speed (p = 0.012). These effects were observed only in the "high-dose" group.

A single session of high-dose transcranial near-infrared light stimulation can significantly increase resting-state functional connectivity in specific brain regions and improve visual search and processing speed in cognitively normal older adults.

The study involved a small sample size of 25 participants and requires replication in an adequately powered randomized sham-controlled study.


Transcranial Near Infrared Light Stimulations Improve Cognition in Patients with Dementia

Transcranial near-infrared light therapy appears safe and improves cognitive function, sleep, and mood in dementia patients.

Can transcranial near-infrared (tNIR) light stimulations safely improve cognitive function in patients with mild to moderate dementia?

Hypothesis: Transcranial near-infrared light stimulations will be safe and provide therapeutic benefits for patients with dementia.

Patients with mild to moderate dementia were randomized into active and sham treatment groups at a 2:1 ratio. The active group received low-power tNIR light stimulations for 6 minutes twice daily over 8 weeks, while the sham group received the same routine with a sham device. Neuropsychological tests were administered before and after treatment, and outcomes were analyzed using ANOVA. Sixty subjects were enrolled, and 57 completed the study.

Fifty-seven subjects completed the study without reporting health or adverse side effects related to tNIR light. The active treatment group showed improvements in cognitive functions, including an average increase of MMSE by 4.8 points, Logical Memory Tests I and II by approximately 3.0 points, Trail Making Tests A and B by approximately 24%, and Boston Naming Test by approximately 9%. Improvements were also observed in Auditory Verbal Learning Tests across all subtest categories and overall performance time. Many patients reported improved sleep after about 7 days, and caregivers noted less anxiety, improved mood, energy, and positive daily routine after about 14-21 days.

Transcranial near-infrared light treatments are safe and lead to positive cognitive improvements in patients with dementia. The developed treatment protocol is suitable for home use.

The abstract does not explicitly state limitations of the study, but it suggests that additional trials are warranted.


Effects of Pulsed Electromagnetic Field Therapy on Pain and Physical Function in Osteoarthritis: a meta-analysis

Pulsed electromagnetic field therapy significantly reduces pain, stiffness, and improves physical function in osteoarthritis patients in the short term.

Does pulsed electromagnetic field (PEMF) therapy effectively treat symptoms and improve quality of life (QOL) in patients with osteoarthritis (OA)?

Hypothesis: The study aimed to examine the effects of PEMF therapy and its parameters on symptoms and QOL in OA patients, suggesting an underlying hypothesis that PEMF therapy may be beneficial.

A meta-analysis was conducted by searching multiple databases including Cochrane Central Register of Controlled Trials, PubMed, CINAHL, EMBASE, PEDro, clinical trial registers, and reference lists up to April 2019. The analysis included randomized, placebo-controlled trials published in English, focusing on OA patients and symptom/QOL outcomes. Data extraction and quality assessment were performed by two independent authors.

Sixteen studies were included in the systematic review, with 15 studies providing complete data for the meta-analysis. The standardized mean difference for pain was 1.06, for stiffness 0.37, for function 0.46, and for QOL 1.49. PEMF parameters did not influence symptoms.

PEMF therapy showed beneficial effects on pain, stiffness, and physical function in OA patients compared to placebo. The duration of treatment may not be a critical factor for pain management. Further research is needed to confirm the effects of PEMF therapy on QOL.

The current evidence was limited to the short-term effects of PEMF therapy. More studies are required to confirm the effects on quality of life.


Effects of 12-week whole-body vibration training versus resistance training in older people with sarcopenia

Both whole-body vibration and resistance training improve physical health in older adults with sarcopenia, with resistance training being better for muscle strength.

What are the effects of 12-week whole-body vibration training (WBVT) versus resistance training (RT) on body composition, muscle strength, physical performance, and blood biomarkers in older people with sarcopenia?

Hypothesis: The study hypothesized that both WBVT and RT would improve physical condition in older people with sarcopenia, with a potential for differential effects on specific outcomes.

This was a 12-week, 3-times-weekly, assessor-blinded, randomized controlled trial involving 27 older people with sarcopenia (aged ">= 65 years). Participants were randomized into a WBVT group (n = 14) and an RT group (n = 13). Primary outcome was knee extension strength (KES), with secondary outcomes including body composition, muscle strength, physical performance, blood biomarkers, and quality of life.

After 12 weeks, the WBVT group showed significant improvements in body weight, BMI, PBF, ASMI, KES, GS, SPPB, 5CST, IGF-1, growth hormone, FST, CK, and quality of life. The RT group showed significant improvements in body weight, BMI, PBF, KES, GS, SPPB, growth hormone, FST, CK, and quality of life. Between-group comparisons revealed significant differences only for KES (P = 0.007) and the role-physical dimension of the SF-36 (P = 007), with RT excelling in KES.

Both whole-body vibration training and resistance training improved the physical condition of older people with sarcopenia. Resistance training was superior in improving muscle strength (KES), while whole-body vibration training offers a valuable alternative, especially for individuals with physical restrictions, due to its low risk and flexibility.


Whole-body vibration on skeletal muscle mass index, physical fitness, and quality of life in older people with sarcopenia

Whole-body vibration may improve muscle mass, physical function, and quality of life in older adults with sarcopenia in institutional settings.

Can whole-body vibration improve skeletal muscle mass index, physical fitness, and quality of life in older adults with sarcopenia living in institutions?

Hypothesis: Whole-body vibration intervention will improve skeletal muscle mass index, physical fitness, and quality of life in older adults with sarcopenia living in institutions.

This quasi-experimental study used a single-group, pretest-posttest design. Older adults with sarcopenia living in institutions underwent a 3-month whole-body vibration intervention, training 3 times per week for 10 repetitions of 60 seconds with 30-second breaks. Skeletal muscle mass index, physical fitness, and quality of life were measured before and after the intervention, and nonparametric statistical methods were used for analysis.

After 12 weeks of whole-body vibration, significant improvements were observed in skeletal muscle mass index, physical fitness measures (standing on one foot, shoulder-arm flexibility, 8-ft up and go test, hand grip strength, and five repeated sit-to-stand tests), and quality of life.

Whole-body vibration intervention can improve skeletal muscle mass index, physical fitness, and quality of life in older adults with sarcopenia living in institutions.

The study used a quasi-experimental, single-group, pretest-posttest design, which may limit the generalizability and causal inference due to the lack of a control group.


Association of handgrip strength with all-cause mortality: a nationally longitudinal cohort study in China

Stronger handgrip strength is linked to a lower risk of death from all causes in middle-aged and older Chinese adults, especially in younger men.

What is the association between handgrip strength and all-cause mortality among middle-aged and older Chinese adults?

Hypothesis: The study hypothesized that handgrip strength would be associated with overall mortality risk among Chinese adults.

This was a longitudinal cohort study using data from the China Health and Retirement Longitudinal Study (CHARLS). Handgrip strength was measured for both hands using a dynamometer. Logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between handgrip strength and all-cause mortality, adjusting for various demographic and lifestyle factors. Deaths were ascertained through follow-up surveys.

Over an average follow-up of approximately 8 years, among 11,618 participants aged 45 and older, 1290 deaths were recorded. Greater handgrip strength was associated with a lower overall mortality risk. The adjusted ORs (comparing extreme tertiles) were 0.47 in men and 0.51 in women. This inverse association appeared stronger in younger men (OR = 0.29) compared to older men (OR = 0.49).

Handgrip strength was inversely associated with the risk of all-cause mortality, particularly among younger men.

The abstract does not explicitly state limitations, but it suggests that further investigations are needed to understand the underlying mechanism of the observed association.


Prognostic value of home blood pressure monitoring in patients under antihypertensive treatment

Home blood pressure monitoring independently predicts cardiovascular events in people already being treated for high blood pressure.

Does home blood pressure monitoring (HBPM) have prognostic value for cardiovascular events in treated hypertensive patients?

Hypothesis: The prognostic value of HBPM in treated hypertensive subjects is controversial, and this study aims to evaluate it.

Medicated hypertensive patients who performed a 4-day HBPM between 2008 and 2015 were followed for a median of 5.9 years. The occurrence of a composite primary outcome of fatal and non-fatal cardiovascular events was registered. Cox regression models were used to analyze the prognostic value of HBPM, considering 4-day measurements (discarding the first day) and analyzing morning, afternoon, and evening periods separately. The analysis included 1582 patients.

During follow-up, 273 cardiovascular events occurred. HBPM was significantly associated with cardiovascular events in all five scenarios in unadjusted models. After adjusting for office BP and other cardiovascular risk factors, the association remained marginally significant for the 4-day period (HR 1.04 [95% CI 1-1.1] and 1.04 [95% CI 1-1.1] when discarding the first day). The association was statistically significant for all separate measurement periods: morning (HR 1.32 [95% CI 1.01-1.72]), afternoon (HR 1.33 [95% CI 1.02-1.72]), and evening (HR 1.30 [95% CI 1.01-1.67]). When fatal and non-fatal events were analyzed separately, statistical significance was only maintained for fatal events.

HBPM is an independent predictor of cardiovascular events in hypertensive patients undergoing treatment.


Transcutaneous auricular vagus nerve stimulation in patients with mild cognitive impairment: a randomized clinical trial

Transcutaneous auricular vagus nerve stimulation improved cognitive function and sleep quality in patients with mild cognitive impairment over 24 weeks.

unfavorable-cue: "impairment" | favorable-cue: "improve"

Can transcutaneous auricular vagus nerve stimulation (taVNS) improve cognitive functions in patients with mild cognitive impairment (MCI)?

Hypothesis: Transcutaneous electrical stimulation of auricular acupoints in the distribution of the vagus nerve will be effective in improving cognitive functions in patients with MCI.

This was a randomized controlled trial involving 52 patients with MCI, aged 55-75 years. Patients were randomly assigned to either a taVNS group, where two auricular acupoints (heart and kidney in the concha) within the vagus nerve distribution were stimulated, or a sham taVNS group, where two other auricular acupoints (elbow and shoulder in the scaphoid fossa) outside the vagus nerve distribution were stimulated. The primary outcome was the Montreal Cognitive Assessment-Basic (MoCA-B), and secondary outcomes included various cognitive and sleep measures. Outcomes were assessed at baseline and after 24 weeks of intervention.

After 24 weeks, there was a significant difference in overall MoCA-B scores between the taVNS and sham taVNS groups (p = 0.033). In the taVNS group, compared to baseline, overall MoCA-B scores increased significantly (p < 0.001). Specific sub-indicators of the Auditory Verbal Learning Test-HuaShan version (N5 and N7) and Boston Naming Test (BNT) also significantly increased (all ps < 0.001) in the taVNS group. The Shape Trails Test B (STTB) significantly decreased (p = 0.016), and Pittsburgh Sleep Quality Index (PSQI), Rapid Eye Movement Sleep Behavior Disorder Screening Questionnaire (RBDSQ), Epworth Sleepiness Scale (ESS), and Functional Activities Questionnaire (FAQ) significantly decreased (p = 0.002, 0.025, <0.001, 0.006 respectively) in the taVNS group. One patient in the taVNS group reported mild, transient adverse reactions.

Transcutaneous auricular vagus nerve stimulation (taVNS) can improve cognitive performance in patients with mild cognitive impairment (MCI). This method may be recommended as a therapy to prevent or prolong the development of MCI into dementia, though further investigation is needed.

The abstract does not explicitly state limitations, but it does mention that further investigation is required, implying a need for more research to fully establish the therapy's efficacy and generalizability.


Effects of inspiratory muscle training on blood pressure and sleep in obstructive sleep apnea: a meta-analysis

Inspiratory muscle training may help lower blood pressure and improve sleep in people with obstructive sleep apnea, but more research is needed.

Does inspiratory muscle training (IMT) improve blood pressure and sleep in patients with obstructive sleep apnea (OSA)?

Hypothesis: Inspiratory muscle training (IMT) may reduce airway collapsibility and sympathetic output, potentially decreasing OSA severity and blood pressure.

This meta-analysis included seven randomized controlled trials (RCTs) with 160 patients with OSA. The researchers searched PubMed, EMBASE, Cochrane Library, Web of Science, and ClinicalTrials.gov for relevant RCTs published before November 2022.

Compared to control groups, the IMT group showed significantly lower systolic blood pressure (mean difference [MD]: -10.77 mmHg), diastolic blood pressure (MD: -4.58 mmHg), plasma catecholamine levels (MD: -128.64 pg/mL), Pittsburgh Sleep Quality Index (MD: -3.06), and Epworth Sleepiness Scale score (MD: -4.37). No significant differences were found in the apnea-hypopnea index, forced vital capacity, ratio of forced expiratory volume in 1 second to forced vital capacity, or adverse effects.

Inspiratory muscle training improved blood pressure and sleep-related outcomes in patients with OSA without causing adverse effects, suggesting it could be a reasonable option for lowering blood pressure in this population.

The level of certainty for the findings remains low, and additional studies with larger sample sizes and more rigorous designs are needed to increase this certainty.


Effects of high intensity inspiratory muscle training in patients with heart failure: a randomized controlled trial

High intensity inspiratory muscle training improves multiple health markers in patients with heart failure and reduced ejection fraction.

What are the effects of high intensity interval-based inspiratory muscle training (H-IMT) on cardiovascular, pulmonary, physical, and psychosocial functions in patients with heart failure and reduced ejection fraction (HFrEF)?

Hypothesis: The study hypothesized that determining the most appropriate IMT protocol, specifically high intensity interval-based inspiratory muscle training, would optimize training benefits in patients with heart failure.

Thirty-four HFrEF patients were randomized to either an H-IMT group or a control group for 8 weeks, 3 days/week. The H-IMT group trained at 70% of maximal inspiratory pressure, while the control group performed unloaded IMT. Each session involved 7 sets of 2-min training and 1-min interval, totaling 21 minutes. Various cardiovascular, pulmonary, physical, and psychosocial functions were assessed at baseline and after 8 weeks by blinded assessors.

Statistically significant between-group differences favoring the H-IMT group were observed in time domain parameters of heart rate variability, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific health-related quality of life.

High intensity interval-based inspiratory muscle training (H-IMT) is an effective protocol for improving cardiac autonomic function, arterial stiffness, inspiratory and quadriceps muscle strength, respiratory muscle endurance, diaphragm thickness, functional capacity, frailty, dyspnea, fatigue, and disease-specific quality of life in patients with HFrEF.


Device-guided slow breathing reduces blood pressure and sympathetic activity in young normotensive individuals

Device-guided slow breathing effectively reduces blood pressure and sympathetic activity in both young normotensive men and women.

Do blood pressure responses to slow breathing differ between men and women, and what are the autonomic contributors to these changes?

Hypothesis: An acute bout of slow breathing would induce larger decreases in blood pressure in males than in females, given that males typically have higher resting blood pressure.

Normotensive females (n=10, age: 22±2 y) and males (n=12, age: 23±3 y) were tested at baseline and during the last 5 minutes of a 15-minute RESPeRATE-guided slow breathing session. Measurements included blood pressure, muscle sympathetic nerve activity, and spontaneous cardiovagal and vascular sympathetic baroreflex sensitivity.

Overall, slow breathing reduced systolic blood pressure by 3.2±0.8 mmHg. Females had lower systolic blood pressure, but there was no interaction between sex and slow breathing. Slow breathing also reduced muscle sympathetic nerve activity burst incidence by -5.0±1.4 bursts/100 heartbeats, with no interaction between sex and slow breathing. Cardiovagal baroreflex sensitivity improved during slow breathing (21.0 vs. 36.0 ms/mmHg), with no effect of sex.

Slow breathing is equally effective in reducing blood pressure in both males and females, even in young, normotensive individuals, despite females having lower overall blood pressure. The RESPeRATE device is effective for reducing blood pressure in both sexes.

The study was conducted on young, normotensive individuals, which may limit generalizability to other populations, such as those with hypertension.


Device and nondevice-guided slow breathing to reduce blood pressure in hypertensive patients: a meta-analysis

Device-guided slow breathing did not significantly lower blood pressure in hypertensive patients compared to usual care.

What are the effects of device-guided slow breathing (DGSB) and nondevice-guided slow breathing (NDGSB) on blood pressure levels in patients with hypertension?

Hypothesis: The study aims to summarize the effects of DGSB and NDGSB on blood pressure levels, implying an investigation into whether these methods reduce blood pressure.

This systematic review and meta-analysis included randomized clinical trials involving hypertensive patients over 18 years old, of both sexes, with or without comorbidity or hypertensive medication. Studies compared groups performing DGSB and/or NDGSB with control conditions. The primary outcomes were systolic blood pressure (SBP) and diastolic blood pressure (DBP) values after interventions. A random effect model was used for quantitative analysis.

Twenty-two studies with 17,214 participants were included. DGSB did not significantly reduce SBP or DBP compared to usual care. For SBP, the mean difference was -2.13 mmHg (288 individuals), and for DBP, it was -0.90 mmHg (288 individuals). SBP variations showed a mean difference of -2.42 (443 individuals), and DBP variations showed a mean difference of -1.67 (443 individuals). Considerable heterogeneity was observed across studies.

Device-guided slow breathing (DGSB) did not reduce blood pressure in hypertensive patients. Nondevice-guided slow breathing (NDGSB) is suggested as a potential future research direction.

The abstract indicates considerable heterogeneity between the included studies, which may impact the generalizability of the findings.


The Effects of Intermittent Pneumatic Compression on Exercise-Induced Muscle Damage in Endurance Athletes

Intermittent pneumatic compression offers only short-term relief for muscle soreness and does not effectively reduce overall exercise-induced muscle damage in endurance athletes.

What are the effects of intermittent pneumatic compression (IPC) on the reduction of exercise-induced muscle damage (EIMD) in endurance athletes following prolonged exercise?

Hypothesis: The hypothesis was not explicitly stated in the abstract, but the studies investigated whether IPC could reduce EIMD.

A literature search was conducted to identify studies on the effects of IPC on EIMD. Three studies were selected: two randomized controlled trials and one randomized cross-over study. These studies investigated the effect of IPC on delayed onset muscle soreness (DOMS) and plasma creatine kinase (CK) in ultramarathoners, marathoners, triathletes, and cyclists.

All three selected studies concluded that intermittent pneumatic compression (IPC) was not an effective method for improving the reduction of exercise-induced muscle damage (EIMD) in endurance-trained athletes.

Intermittent pneumatic compression (IPC) may offer short-term relief for delayed onset muscle soreness (DOMS), but it does not provide sustained relief from exercise-induced muscle damage (EIMD).

The abstract does not explicitly state limitations of the reviewed studies beyond their findings regarding IPC's effectiveness.


Effects of intermittent pneumatic compression on delayed onset muscle soreness and recovery

Intermittent pneumatic compression may help reduce muscle soreness and improve muscle recovery 48-72 hours after intense exercise.

Does intermittent pneumatic compression (IPC) effectively prevent or treat delayed-onset muscle soreness (DOMS) induced by plyometric exercise?

Hypothesis: The study aims to characterize the therapeutic effect of IPC on DOMS induced by plyometric exercise, suggesting an expected benefit.

Twenty healthy untrained male college students were randomized into an IPC group (n=10) and a control group (n=10). DOMS was induced by lower limb plyometric exercises. The IPC group received 15 minutes of treatment immediately and at 24, 48, and 72 hours post-exercise. Muscle soreness (Visual Analog Scale) and muscle condition (tensiomyography for maximal radial displacement, contraction time, and sustain time) were measured at various time points up to 96 hours post-exercise.

The IPC group showed significantly improved recovery in muscle soreness (VAS), maximal radial displacement (Dm), and contraction time (Tc) compared to the control group. Significant differences were observed in VAS, Dm, and Tc at 48 and 72 hours post-exercise (all p < .05), and in sustain time (Ts) at 72 hours post-exercise (p < .05). A strong negative correlation between VAS score and Dm, and a positive correlation with Tc, delay time, relaxation time, and Ts were found 48 hours after exercise.

Intermittent pneumatic compression may mitigate exercise-induced DOMS following plyometric exercise, with peak therapeutic effects appearing 48-72 hours after exercise.


Effect of percussion massage therapy on recovery of delayed onset muscle soreness: a randomized controlled trial

Longer duration percussive massage therapy (40 minutes) is more effective than static stretching or shorter duration percussive massage (25 minutes) for recovering from delayed onset muscle soreness.

What is the effect of percussive massage treatment (PMT) on recovery from delayed onset muscle soreness (DOMS) in physically active young men, compared to static stretching and shorter duration PMT?

Hypothesis: The study implicitly hypothesizes that PMT, particularly longer durations, will be more effective than static stretching for DOMS recovery.

Thirty physically active male college students were randomized into three groups: static stretching (SS), short-duration PMT (S-PMT, 25 min), and long-duration PMT (L-PMT, 40 min). DOMS was induced via squats. Measurements of pain (VAS), knee joint range of motion (ROM), countermovement jump (CMJ), and integrated electromyography (iEMG) were taken at baseline, post-DOMS, post-intervention, 24h post-intervention, and 48h post-intervention.

At 48 hours post-intervention (P4), the L-PMT group showed significantly greater jump height, peak ground reaction force, and propulsion impulse during CMJ compared to both SS and S-PMT groups. Normalized iEMGs of three muscles in the L-PMT group were significantly lower than in both S-PMT and SS groups at P4. The L-PMT group also had significantly lower VAS scores and greater knee joint ROM than the SS group at P4.

Percussive massage treatment (PMT) is more effective than static stretching for DOMS recovery. Specifically, two 40-minute PMT sessions provided greater benefits than two 25-minute sessions for treating DOMS.


Risk Assessment and Prevention of Falls in Older Community-Dwelling Adults: A Review

Exercise, multifactorial interventions, cataract surgery, podiatry, and environmental modifications can reduce falls in older adults.

What are the risk factors for falls in older community-dwelling adults and what interventions are effective in preventing them?

Hypothesis: Not applicable; this is a review article summarizing existing research.

This review synthesized findings from meta-analyses of randomized clinical trials (RCTs) and quasi-randomized trials to assess risk factors and the effectiveness of various fall prevention interventions in older community-dwelling adults.

Major modifiable risk factors include gait and balance disorders, orthostatic hypotension, sensory impairment, medications, and environmental hazards. Exercise interventions were associated with 655 falls per 1000 patient-years in intervention groups vs 850 in control groups (RR 0.77). Multifactorial interventions were associated with 1784 falls per 1000 patient-years in intervention groups vs 2317 in control groups (RR 0.77). Other effective interventions included cataract surgery (RR 0.68), multicomponent podiatry interventions (RR 0.77), and environmental modifications for high-risk individuals (RR 0.74). Programs to stop medications associated with falls did not show a significant reduction in falls when studied in isolation.

Functional exercises to improve leg strength and balance are recommended for fall prevention in average-risk to high-risk populations. Multifactorial risk reduction, based on systematic clinical assessment for modifiable risk factors, may reduce fall rates among those at high risk.

The abstract does not explicitly state limitations of the review itself, but rather summarizes findings from other studies.


Effects of 8 Weeks of Balance Training on Strength, Balance, and Functional Mobility in Older Men

Combined balance and strength training is most effective for improving fall risk factors in older men, with virtual reality and traditional balance training also showing benefits.

Do traditional balance training (BT), virtual reality balance training (VR), or combined exercise (MIX) lead to greater improvements in strength, balance, and functional mobility in older men compared to a waitlist control group (CON)?

Hypothesis: The researchers hypothesized that 8 weeks of combined exercise (MIX) would lead to the greatest improvements in falls risk factors, followed by similar improvements after traditional balance training (BT) and virtual reality balance training (VR), relative to the control group (CON).

Sixty-four community-dwelling older men (average age 71.8 years) were randomly assigned to one of four groups: traditional balance training (BT), virtual reality balance training (VR), combined exercise (MIX), or a waitlist control group (CON). The training groups exercised for 40 minutes, 3 times per week, for 8 weeks. Primary outcomes included isokinetic quadriceps and hamstrings strength, while secondary outcomes assessed 1-legged stance, tandem stance, timed-up-and-go, and gait speed. One-way analyses of covariance were used to compare groups, with baseline scores as covariates.

Combined exercise (MIX) led to greater improvements in strength, balance, and functional mobility compared to BT, VR, and CON. Virtual reality balance training (VR) showed better balance and functional mobility than BT and CON. Traditional balance training (BT) also demonstrated better balance and functional mobility compared to CON.

Combined exercise (MIX) is an effective method for improving falls risk factors, including strength, balance, and functional mobility, among older adults. VR and BT also showed benefits in balance and functional mobility compared to control.

This study serves as a preliminary investigation for a larger trial that will be powered to assess actual falls.


Effect of transcutaneous electrical nerve stimulation on knee pain and physical function in osteoarthritis: a randomized clinical trial

TENS is not more effective than placebo for relieving knee pain in osteoarthritis and does not improve physical function.

Does transcutaneous electrical nerve stimulation (TENS) effectively relieve pain and improve physical function in patients with knee osteoarthritis compared to placebo TENS, and is it safe?

Hypothesis: The study implicitly hypothesizes that TENS will be more effective than placebo TENS in reducing knee pain and improving physical function, and will be safe.

This was a multi-centre, parallel, 1:1 randomized, double-blind, placebo-controlled clinical trial. 220 participants with knee osteoarthritis were randomized to receive either TENS (n=108) or placebo TENS (n=112) for 3 weeks. The primary endpoint was knee pain at 3 weeks, assessed by the WOMAC pain subscale, with secondary outcomes including the WOMAC physical function subscale and safety.

There was no significant difference in WOMAC pain between TENS and placebo TENS at the end of treatment (mean difference -0.06; P = 0.74) or throughout the trial (P = 0.98). Subgroup analyses also showed no interaction between patient/treatment characteristics and treatment effect on pain. Adverse event rates were similar, with 10.4% in the TENS group and 10.6% in the placebo TENS group (P = 0.95). No relevant differences were observed in secondary outcomes.

TENS does not improve knee osteoarthritis pain compared to placebo TENS. Therapists should consider alternative treatments for knee osteoarthritis pain and to facilitate exercise.

The abstract does not explicitly state limitations of the study, but rather emphasizes the conclusiveness of its findings.


Benefits and Harms of Cranial Electrical Stimulation for Pain, Depression, Anxiety, and Insomnia: A Systematic Review

Current evidence is insufficient to confirm significant benefits of cranial electrical stimulation for most conditions, though a modest benefit for anxiety and depression is possible.

What are the benefits and harms of cranial electrical stimulation (CES) for adult patients with chronic painful conditions, depression, anxiety, and insomnia?

Hypothesis: The clinical benefit of cranial electrical stimulation (CES) for pain, depression, anxiety, and insomnia is unclear.

A systematic review was conducted by searching several databases from inception to October 10, 2017, for randomized controlled trials comparing CES with usual care or sham CES. Studies reporting pain, depression, anxiety, or sleep outcomes in adults were included. Data extraction was performed by a single reviewer and checked by another, with dual independent quality assessment and strength-of-evidence grading.

Twenty-eight articles from 26 randomized trials were included. Two trials comparing CES with usual care found no statistically significant benefit for pain or anxiety. Fourteen sham-controlled trials for painful conditions had conflicting results. Five trials (four older, one recent) provided low-strength evidence of a possible modest benefit for anxiety and depression compared with sham. Trials for insomnia (n=2), insomnia and anxiety (n=1), or depression (n=3) had inconclusive or conflicting results. Low-strength evidence suggested CES does not cause serious side effects.

Evidence is insufficient to conclude that CES has clinically important effects on fibromyalgia, headache, neuromusculoskeletal pain, degenerative joint pain, depression, or insomnia. There is low-strength evidence suggesting a modest benefit in patients with anxiety and depression.

Most trials had small sample sizes and short durations. All included trials had a high risk of bias due to inadequate blinding.


Acute Effects of Foam Rolling, Static Stretching, and Dynamic Stretching on Flexibility and Strength

Foam rolling acutely improves flexibility more than static or dynamic stretching, and maintains or improves muscle strength, making it a good warm-up option.

Can foam rolling be used as part of a warm-up to acutely improve flexibility and muscle strength?

Hypothesis: The study aimed to examine and compare the acute effects of foam rolling, static stretching, and dynamic stretching as part of a warm-up on flexibility and muscle strength.

This was a crossover study involving 15 male and 15 female college students. Participants performed foam rolling, static stretching, and dynamic stretching in random order on three separate days. Isokinetic peak torque for knee extension and flexion was measured, and flexibility was assessed using the modified Thomas test for quadriceps and the sit-and-reach test for hamstrings.

Flexibility test scores improved significantly more after foam rolling compared to static and dynamic stretching. Knee extension peak torque improved significantly after dynamic stretching and foam rolling, but not after static stretching. Knee flexion peak torque remained unchanged across all interventions.

Foam rolling is more effective than static and dynamic stretching for acutely increasing quadriceps and hamstrings flexibility without negatively affecting muscle strength. It may be recommended as part of a warm-up for healthy young adults.

The study was conducted on healthy young adults, so the findings may not generalize to other populations. The abstract does not specify other limitations.


Resistance training with blood flow restriction on muscle strength and hypertrophy in arthritis: a meta-analysis

Low-intensity resistance training with blood flow restriction can improve muscle strength, mass, and function in arthritis patients, similar to higher intensity training, and better than low-intensity training alone.

What are the effects of low-intensity resistance training combined with blood flow restriction (LIRTBFR) on muscle strength, muscle mass, and functionality in patients with rheumatoid arthritis (RA) and osteoarthritis (OA)?

Hypothesis: Low-intensity resistance training combined with blood flow restriction (LIRTBFR) may be a new training strategy for RA and OA patients who may have intolerance to moderate or high-intensity resistance training.

A systematic review and meta-analysis of randomized clinical trials (RCTs) published in English between 1957 and 2021 was conducted using MEDLINE (PubMed), Embase, and Cochrane Library. Methodological quality was assessed using the Physiotherapy Evidence Database scale, and risk of bias was assessed using RoB2.0. Mean difference (MD) or standardized mean difference (SMD) and 95% confidence intervals (CI) were pooled using a random-effects model.

Five RCTs were included. No significant differences were found between LIRTBFR, moderate-intensity resistance training (MIRT), and high-intensity resistance training (HIRT) for muscle strength (quadriceps strength: SMD = -0.01, P = 0.96) and functionality (walking patterns: SMD = -0.04, P = 0.82). Muscle mass gain after LIRTBFR was similar to HIRT. LIRTBFR showed a higher effect on muscle strength (knee extension test) compared to low-intensity resistance training without blood flow restriction (LIRT).

LIRTBFR appears to be a promising strategy for improving muscle strength, muscle mass, and functionality in a sample predominantly composed of women with RA and OA.

The abstract does not explicitly state limitations of the meta-analysis, but the small number of included RCTs (five) could be considered an implicit limitation.


Muscle Strength and Mass Adaptations Between High-Load and Low-Load Resistance Training With Blood-Flow Restriction: a meta-analysis

High-load training is better for strength gains, but both high-load and blood-flow restriction training are equally effective for muscle growth.

Does low-load resistance training with blood-flow restriction (BFR-RT) produce similar increases in muscle strength and mass compared to conventional high-load resistance training (HL-RT)?

Hypothesis: The study aims to compare the effects of HL-RT versus BFR-RT on muscle adaptations.

A systematic review and meta-analysis were conducted, identifying studies from electronic databases. Inclusion criteria included pre- and post-training assessments of muscular strength and hypertrophy, comparison of HL-RT vs. BFR-RT, a PEDro score of at least 4, and reported means and standard deviations or estimable data.

High-load resistance training (HL-RT) resulted in greater increases in muscle strength compared to blood-flow restriction resistance training (BFR-RT). However, both HL-RT and BFR-RT showed similar effects on muscle hypertrophy.

Maximum muscle strength may be optimized by HL-RT, while both HL-RT and BFR-RT appear equally effective in increasing muscle mass. BFR-RT is a valid and effective approach for increasing muscle strength across various ages and physical capacities, especially for individuals with physical limitations.

The abstract does not explicitly state limitations of the meta-analysis itself, but rather discusses the applicability of BFR-RT for specific populations.


Effect of neuromuscular electrical stimulation on ICU-acquired weakness in mechanically ventilated patients: a randomized controlled trial

Combining neuromuscular electrical stimulation with early physical activity can prevent ICU-acquired weakness and shorten hospital stays for mechanically ventilated patients.

What is the effect of neuromuscular electrical stimulation (NMES) and early physical activity on ICU-acquired weakness (ICU-AW) in mechanically ventilated patients?

Hypothesis: The study aims to evaluate if NMES and early physical activity can prevent ICU-AW and reduce the duration of mechanical ventilation and ICU stay in mechanically ventilated patients.

A single-blinded randomized controlled trial was conducted in Alexandria, Egypt. Patients were assigned to one of four groups: NMES, range of motion (ROM) exercises, combined therapy (ROM + NMES), or conventional care (control group). ICU-AW was assessed using the Medical Research Council (MRC) scale over 7 days, and the duration of mechanical ventilation and ICU stays were recorded.

Of 124 patients, the ROM + NMES and NMES groups showed higher MRC scores on day 7 (50.37 and 49.77, respectively) compared to ROM (44.97) and control (41.10) groups. ICU-AW occurred in 0% of the ROM + NMES group, 60% of the ROM group, 13% of the NMES group, and 100% of the control group. The ROM + NMES group had a shorter mechanical ventilation duration (12.80 days) and ICU length of stay (17.43 days) compared to other groups.

Daily sessions of NMES and early physical activity were well tolerated, preserved muscle strength, prevented ICU-AW, and decreased the duration of mechanical ventilation and ICU stay.

The abstract does not explicitly state any limitations of the study.


Neuromuscular electrical stimulation after cardiovascular surgery mitigates muscle weakness in older individuals with diabetes

Neuromuscular electrical stimulation (NMES) can help reduce muscle weakness after cardiovascular surgery in older diabetic patients.

Does neuromuscular electrical stimulation (NMES) mitigate postsurgical muscle weakness in older individuals with diabetes mellitus after cardiovascular surgery?

Hypothesis: Neuromuscular electrical stimulation (NMES) will reduce postsurgical muscle weakness in older individuals with diabetes mellitus who have undergone cardiovascular surgery.

This was a multicenter, randomized, controlled trial. Patients aged 65 years or older with diabetes who underwent cardiovascular surgery were screened and randomly assigned to either the NMES or sham group. The primary outcome was the percent change in isometric knee extension strength (%ΔIKES) from preoperative to postoperative day 7. Secondary outcomes included percent change in usual walking speed (%ΔUWS), maximum walking speed (%ΔMWS), and grip strength (%ΔGS). Intention-to-treat analysis was performed by a blinded statistician using a student t-test.

Out of 1151 screened participants, 180 (90 in NMES, 90 in sham) were included in the primary analysis. The percent change in isometric knee extension strength (%ΔIKES) was significantly lower in the NMES group (mean -2%) compared to the sham group (mean -13%). The percent change in maximum walking speed (%ΔMWS) was also significantly lower in the NMES group, while percent changes in usual walking speed (%ΔUWS) and grip strength (%ΔGS) were lower but not significantly different between groups.

A short course of neuromuscular electrical stimulation (NMES) for less than one week mitigated postsurgical muscle weakness and functional decline in older individuals with diabetes mellitus.


Heart Rate Variability Biofeedback as a Treatment for Military PTSD: A Meta-Analysis

Heart rate variability biofeedback shows promise for reducing PTSD symptoms in military personnel with low attrition rates.

Does heart rate variability biofeedback (HRVB) effectively reduce PTSD symptoms in military populations?

Hypothesis: HRVB will be an effective treatment for reducing PTSD symptoms in military service members, with potentially lower attrition rates compared to traditional treatments.

A meta-analysis was conducted following PRISMA guidelines and registered with PROSPERO. A literature search for HRVB interventions was performed across PubMed, PsycINFO, Military Database, PTSDPubs, and EBSCO's Psychological and Behavioral Sciences Collection.

Five studies with a combined sample size of 95 military service members met the eligibility criteria. All studies showed negative effect sizes, indicating a reduction in PTSD symptoms, with effect sizes ranging from -1.614 to -0.414. The overall mean effect for HRVB was moderate to large (Hedges's g = -0.557; 95% CI = -0.818 to -0.296; P < .001). The cumulative attrition rate was 5.8%, which is significantly lower than typical rates for evidence-based treatments (16%-36%).

HRVB appears to be a viable treatment approach for reducing PTSD symptoms in military service members, supported by a moderate to large effect size and low attrition rates.

The meta-analysis was based on a relatively small number of studies (five) and a combined sample size of 95 military service members, which may limit the generalizability of the findings.


Remote Heart Rate Variability Biofeedback Interventions for Mental Health: A Systematic Review and Meta-Analysis

Remote heart rate variability biofeedback can help reduce depression and improve heart rate variability, with certain intervention characteristics enhancing its effectiveness.

What is the efficacy of remote heart rate variability biofeedback (HRV-B) interventions for mental health symptoms (depression, stress, anxiety, sleep) and heart rate variability (HRV)?

Hypothesis: The study hypothesized that remote HRV-B interventions would be effective in improving mental health symptoms and HRV.

A systematic literature search was conducted across five databases. Eighteen studies, comprising 1352 subjects from various populations, were included in this systematic review and meta-analysis. Meta-analysis was used to examine the effect sizes for different outcomes.

Meta-analysis revealed a medium effect size for HRV-B in improving depression (g = -0.41) and increasing HRV (g = 0.443) compared to control conditions. These findings remained significant after sensitivity analyses. The effect for stress was not significant (p = 0.152). Meta-regressions identified several moderators, including maximizing resonance, screen on the device, fewer lab visits, less than twenty minutes of daily practice, and female gender, as beneficial for intervention effectiveness.

Remote HRV-B is an effective intervention for reducing depressive symptoms and increasing HRV across different populations. Certain intervention variables may influence the outcomes.

The abstract does not explicitly state limitations of the study.


Assessment of Noninvasive Oxygen Saturation During Pulmonary Rehabilitation: Smartwatch versus Pulse Oximeter

Smartwatches are not accurate enough to monitor oxygen saturation in COPD patients during pulmonary rehabilitation.

Can wearable devices accurately measure oxygen saturation (S) in patients with COPD at rest and after physical exercise during pulmonary rehabilitation?

Hypothesis: The study aimed to examine the accuracy of S readings from wearable devices in patients with COPD, implying a question about their reliability compared to a standard pulse oximeter.

This cross-sectional study included 36 participants with COPD (20 women, ages 52-89). Oxygen saturation was measured concurrently using a Contec Pulse Oximeter CMS50D (comparator), an Apple Watch Series 7, and a Garmin Vivosmart 4. Measurements were taken at rest, immediately after a 30-s sit-to-stand test, and after a 6-min walk test (6MWT).

For the Apple Watch, the root mean squared error (RMSE) was 3.5% at rest, 4.1% after the 30-s sit-to-stand test, and 3.9% after the 6MWT. For the Garmin Vivosmart, RMSE was 3.3% at rest, 6.1% after the 30-s sit-to-stand test, and 5.4% after the 6MWT. Both devices showed considerable measurement variance and tended to be less accurate at lower saturation levels.

The Apple Watch Series 7 and Garmin Vivosmart 4 overestimated S when it was < 95% and underestimated it when S was > 95% in participants with COPD. Wearable devices should not be used for monitoring oxygen saturation during pulmonary rehabilitation.

The abstract does not explicitly state limitations beyond the observed inaccuracies of the devices, which inherently limit their utility.


Safety and effectiveness of weighted blankets for symptom management in mental disorders: a meta-analysis

Weighted blankets appear to be a safe and potentially effective complementary treatment for anxiety, insomnia, depression, and fatigue in people with mental disorders, but more robust research is needed.

What is the safety and effectiveness of weighted blankets for symptom management in patients with mental disorders?

Hypothesis: The study aimed to systematically evaluate and synthesize existing data on the safety and effectiveness of weighted blankets for symptom management among patients with mental disorders.

A comprehensive search was conducted across bibliographic databases, grey literature, and clinical trial registries for randomized controlled trials (RCTs) comparing weighted blankets to control conditions in patients with mental disorders. Two reviewers independently extracted data and assessed methodological quality using the RoB 2 tool. Meta-analysis was performed using Review Manager 5.3, with subgroup and sensitivity analyses where appropriate.

Eight studies involving 426 patients were included. Half of the studies had a high risk of bias due to unblinded participants for self-reported measures. No serious adverse events were reported. Meta-analysis of five studies showed a small decrease in anxiety (SMD = 0.40). The pooled estimate of three studies for insomnia was non-significant (MD = -1.92, 95% CI = -3.92-0.09, p = 0.06), but a sensitivity analysis of two homogeneous studies revealed reduced insomnia severity (MD = -2.78, 95% CI = -4.44 to -1.12, p = 0.001). Primary studies also reported positive effects on fatigue and depression, though summary estimates were not computed due to heterogeneity.

Weighted blankets may be a safe and effective add-on treatment for managing anxiety, insomnia, depression, and fatigue in psychiatric patients. However, these findings require further confirmation due to the limited number of studies, small sample sizes, and significant heterogeneity.

The review included a limited number of studies with small sample sizes and significant heterogeneity. Half of the included studies had a high risk of bias, mainly due to the inability to blind participants for self-reported outcomes.


Efficacy and safety of retinaldehyde 0.1% and 0.05% creams used to treat photoaged skin: a randomized double-blind controlled trial

Retinaldehyde creams at 0.1% and 0.05% improve skin hydration and texture, but only the 0.1% concentration also improves the melanin index.

What are the efficacy and safety of new anti-aging creams containing retinaldehyde (RAL) at 0.1% and 0.05% for treating photoaged skin?

Hypothesis: Retinaldehyde (RAL) creams at 0.1% and 0.05% will be effective and safe in treating photoaged skin, similar to retinoic acid but with a better safety profile.

Forty female Korean volunteers applied either RAL 0.1% or RAL 0.05% creams twice daily for 3 months. Quantitative assessments of wrinkles and skin texture on crow's feet were performed using the Antera 3D system. Transepidermal water loss (TEWL), skin hydration, melanin index, and skin brightness were also evaluated. Overall improvement was assessed by patients and dermatologists using a five-point scale.

After 3 months, both RAL 0.1% and RAL 0.05% groups showed 95% overall improvement in photoaging. Both concentrations significantly improved skin texture (13.7% for RAL 0.1%, 12.6% for RAL 0.05%), reduced TEWL (14.5% for RAL 0.1%, 17.9% for RAL 0.05%), and increased hydration (10.2% for RAL 0.1%, 6.0% for RAL 0.05%). No statistical differences were observed between the two groups for these parameters. Only RAL 0.1% significantly improved the melanin index by 6.5%. Both creams were well tolerated.

Both RAL 0.1% and RAL 0.05% creams are well tolerated and improve skin hydration and texture. However, only the RAL 0.1% cream significantly improved the melanin index.

The study was conducted on a specific population (40 female Korean volunteers), which may limit generalizability. The abstract does not mention a placebo control group, which could affect the interpretation of the results.


Retinaldehyde/hyaluronic acid fragments: a synergistic association for the management of skin aging

A combination of retinaldehyde and hyaluronic acid fragments effectively reduces signs of skin photoaging like wrinkles, hyperpigmentation, and loss of elasticity.

What is the efficacy of combining retinaldehyde (RAL) and intermediate-size hyaluronate fragments (HAFi) in correcting skin photoaging?

Hypothesis: The combination of retinaldehyde and intermediate-size hyaluronate fragments will be effective in managing skin photoaging.

This open, multicentric, international study involved 1462 subjects who applied either RAL 0.05%-HAFi 0.5% (group 1), RAL 0.05%-HAFi 1% (group 2), or both products (group 3) daily for 90 days. Overall photoaging severity was assessed by dermatologists using Larnier's scale at D0, D30, and D90. Wrinkles, furrows, and clinical signs of aging were evaluated using a 4-point scale, and skin microrelief of crow's feet was measured by optical profilometry in group 3.

After 3 months, overall photoaging significantly improved in all three groups. At D90, significant improvements in wrinkles were observed in groups 2 and 3, including forehead wrinkles (-19% and -10%), nasolabial folds (-20% and -16%), crow's feet (-27% in both groups), and perioral wrinkles (-34% and -23%). Clinical signs of photoaging, such as elasticity (-32% and -33%), hyperpigmentation (-34% and -31%), and ptosis (-18% and -22%), significantly improved in groups 1 and 3. Optical profilometry confirmed these results, and the products were well tolerated.

The combination of retinaldehyde and intermediate-size hyaluronate fragments is effective in managing aging skin, as demonstrated in a large patient cohort.

The study was open-label, which means participants and researchers knew which treatment was being administered, potentially introducing bias.


Topical delivery of l-ascorbic acid spanlastics for stability enhancement and treatment of UVB induced damaged skin

L-ascorbic acid delivered via spanlastic vesicles is more stable, penetrates skin better, and offers superior protection against UV-induced skin damage compared to a standard LAA solution.

Can l-ascorbic acid (LAA) loaded spanlastics improve LAA stability, skin permeation, and antioxidant protection against UVB-induced skin damage?

Hypothesis: Entrapment of a high dose of vitamin C in spanlastic vesicles will provide maximum stability and efficacy for topical delivery, protecting skin from premature aging and UVB-induced damage.

LAA-loaded spanlastics were prepared using the ethanol injection method. They were characterized for entrapment efficiency (EE%), particle size (PS), polydispersity index (PDI), zeta potential, deformability index (DI), and skin permeation. The stability of the selected spanlastic formula was assessed over 6 months. The efficacy of LAA spanlastics in treating UVB-induced damaged skin was evaluated in rats by measuring MMP2 and MMP9 levels via quantitative real-time PCR and Western blot, and through histopathological examination of rat skin.

A selected spanlastics formula (span 60 and tween 60 in a 5:1 ratio) achieved an EE% of 89.77% and a deformability of 11.13. This formula demonstrated good physical and chemical stability for 6 months. LAA spanlastics showed improved drug penetration into the stratum corneum compared to a topical LAA solution. In rats exposed to UV irradiation, LAA spanlastics significantly suppressed MMP2 and MMP9 levels by 30.4% and 65.3% respectively, compared to the control group. Histopathological studies confirmed that LAA-loaded spanlastics provided the highest skin protection, maintaining normal epidermal morphology and densely arranged dermal collagen fibers.

LAA-loaded spanlastics successfully improved LAA stability, enhanced skin permeation, and offered significant antioxidant protection against skin photodamage caused by UVB irradiation.


A clinical evaluation of a topical antioxidant formulation featuring vitamin C, astaxanthin, and fermented turmeric

A topical serum containing vitamin C, astaxanthin, and fermented turmeric improved skin quality and reduced fine lines and wrinkles in a 12-week study.

Can a novel topical antioxidant formulation featuring vitamin C, astaxanthin, and fermented turmeric improve overall skin quality and the appearance of fine lines, wrinkles, radiance, and hyperpigmentation?

Hypothesis: Supplementing the skin with this novel topical antioxidant formulation will help neutralize reactive oxygen species and improve overall skin quality, as well as the appearance of fine lines, wrinkles, radiance, and hyperpigmentation.

This was a single-center, prospective, open-label study that evaluated the safety and efficacy of twice-daily application of the test article (Asta C™ Vitamin C Age Defense Serum) in 32 healthy female subjects aged 35-60 with mild to moderate fine lines, wrinkles, and hyperpigmentation/uneven skin tone for 12 weeks. Subjects included Fitzpatrick skin types I-VI and all skin types (dry, normal, combination, oily), including those with sensitive skin.

All subjects demonstrated improvement in overall skin quality (face, neck, and chest) by the end of the 12-week study period. One hundred percent of subjects showed improvement in the appearance of fine lines at Week 12.

The clinical study demonstrates that Asta C™ is safe, well-tolerated, and effective in improving overall skin quality, as well as the appearance of fine lines, wrinkles, radiance, and hyperpigmentation of the skin.

This was an open-label study, which means participants and researchers knew which treatment was being administered, potentially introducing bias. The study was also single-center and had a relatively small sample size of 32 subjects.


The clinical anti-aging effects of topical kinetin and niacinamide in Asians: a randomized controlled trial

A combination of kinetin and niacinamide significantly improved multiple signs of skin aging in Asian subjects, outperforming niacinamide alone for some parameters.

What are the clinical anti-aging effects of topical kinetin and niacinamide, alone and in combination, on Asian skin?

Hypothesis: The study aims to assess the anti-aging effects and efficacy differences between kinetin plus niacinamide and niacinamide alone versus a vehicle placebo in an Asian cohort, hypothesizing that these compounds may have beneficial effects.

Fifty-two Taiwanese subjects participated in a randomized, double-blind, placebo-controlled, split-face comparative study. Group 1 applied 0.03% kinetin plus 4% niacinamide, while Group 2 applied 4% niacinamide. Treatments were applied to one side of the face and a placebo to the other for 12 weeks. Skin parameters were evaluated at baseline, 4, 8, and 12 weeks using noninvasive biometrological instruments.

Group 1 (kinetin + niacinamide) showed significant reductions in spot, pore, wrinkle, and evenness counts at weeks 8 and 12. This group also had a significant increase in corneal hydration at week 12 and persistent decreases in erythema index at weeks 8 and 12. Group 2 (niacinamide alone) showed significant reductions in pore and evenness counts at week 8 and wrinkle counts at week 12.

Kinetin and niacinamide demonstrate a synergistic anti-aging effect, suggesting they have multiactive, multifunctional, and pluripotent effects on skin and are promising for future anti-aging cosmeceuticals.


Topical Niacinamide Combined with Ultrasound for Improving Skin Ageing: A Double-blind Randomised Placebo-controlled Study

A topical niacinamide formulation improved skin hydration and reduced sebum, with subjective benefits in appearance, firmness, and wrinkles, especially when combined with ultrasound.

no-difference-cue: "did not show" | favorable-cue: "improved"

Can a topical niacinamide formulation, alone or combined with 5 MHz unfocused ultrasound (5-US), improve signs of skin aging?

Hypothesis: A topical formulation with niacinamide, especially when combined with facial application of unfocused 5-US, will improve signs of skin aging.

Sixty-seven women aged 30-60 with aged skin were randomized into four groups: (A) placebo formulation, (B) cosmetic formulation (with niacinamide), (C) placebo formulation plus 5-US, and (D) cosmetic formulation plus 5-US. Groups C and D received eight weekly 20-minute 5-US sessions. Clinical, instrumental, and subjective assessments were conducted at baseline (T0) and week eight (T8).

The niacinamide formulation improved stratum corneum aqueous content and reduced transepidermal water loss. Sebum reduction was observed in groups using the niacinamide formulation. Consumer evaluations indicated improvements in appearance, firmness, elasticity, and reduced wrinkles, particularly in Groups C and D. Sensory analysis showed overall product acceptability.

The niacinamide formulation improved skin hydration and reduced sebum content, and subjective evaluations indicated qualitative improvements in skin appearance. While 5-US alone did not show instrumental improvements, the combined approach suggests potential synergies for anti-aging interventions.

The study suggests that protocol adjustments and longer study periods might be needed for 5-US to show instrumental improvements.


Clinical Evaluation of a Nature-Based Bakuchiol Anti-Aging Moisturizer for Sensitive Skin

A bakuchiol-based moisturizer improved skin moisture and anti-aging signs in people with sensitive skin.

Can a nature-based bakuchiol-containing cleanser and moisturizer be tolerated and effective for anti-aging in individuals with sensitive skin?

Hypothesis: Bakuchiol, a meroterpene with retinol-like functionality, may provide anti-aging benefits without irritation for individuals with sensitive skin.

This 4-week study enrolled 60 female subjects aged 40-65 with Fitzpatrick skin types I-V and sensitive, mild to moderate photodamaged skin. The sensitive skin panel included subjects with eczema/atopic dermatitis, rosacea, or cosmetic intolerance syndrome. Subjects used a nature-based cleanser and moisturizer twice daily, with assessments for transepidermal water loss (TEWL), corneometry, tolerability, and efficacy at baseline, 5-10 minutes post-application, and week 4.

The skin care products were well tolerated and efficacious (P<0.001) in improving visual smoothness, tactile smoothness, clarity, radiance, overall appearance, and global anti-aging, as assessed by investigators. Cheek corneometry measurements showed a statistically significant 16% increase in skin moisture content (P<0.001).

A bakuchiol nature-based anti-aging moisturizer is well tolerated and effective for individuals with sensitive skin.

The study duration was 4 weeks, and the participant group was limited to females aged 40-65 with specific sensitive skin conditions and photodamage.


Efficacy of a Serum Combining Bakuchiol and Vanilla Tahitensis Extract to Prevent Skin Photoaging

A serum with bakuchiol and vanilla tahitensis extract reduced signs of skin aging in lab tests and improved firmness and radiance in women.

Can a serum combining bakuchiol (BK) and vanilla tahitensis extract (VTE) prevent skin photoaging in vitro and improve clinical outcomes for naturally aged skin?

Hypothesis: A combination of bakuchiol and vanilla tahitensis extract will have beneficial effects in preventing skin photoaging and improving clinical outcomes for naturally aged skin.

In vitro, human dermal fibroblasts were treated with active compounds, exposed to UVA, and analyzed for actin network morphology, IL-8 (inflammation), and p16 (senescence). Human skin explants were used to evaluate chronic UVA-induced GAG loss and the effect of topical BK+VTE serum. An open-label clinical trial involved 43 women applying the serum twice daily for 56 days, assessing skin remodeling (FaceScan), firmness (Dynaskin and clinical scoring), and radiance (photographs).

UVA exposure increased IL-8 and p16 expression and altered fibroblast morphology. BK or VTE alone prevented actin network alteration and IL-8 upregulation. The BK+VTE combination showed synergistic protection against IL-8 and p16 overexpression. Serum application prevented GAG loss at the dermo-epidermal junction and increased dermal GAG in UVA-exposed skin explants. In the clinical trial, face ptosis was reduced by 11% (up to 23%) in 26 subjects, skin deformation depth was reduced by 24% (up to 30%) in 30 subjects, and radiance improved by 29% in 33 subjects. The serum was well-tolerated.

The BK+VTE combination demonstrated anti-aging efficacy, potentially offering significant benefits for naturally aged skin in women due to synergistic effects on inflammaging and senescence.

The clinical trial was open-label, which may introduce bias. The study focused on naturally aged skin in women, limiting generalizability to other populations or skin types.


Efficacy of Treatments in Reducing Inflammatory Lesion Count in Rosacea: A Systematic Review

Oral isotretinoin was the most effective treatment for reducing inflammatory lesions in rosacea, though several other topical and systemic therapies also showed efficacy.

What is the effectiveness of topical and systemic therapies in reducing inflammatory lesion count in rosacea patients?

Hypothesis: The study aims to identify effective treatments for reducing inflammatory lesions in rosacea, which could alleviate the associated psychosocial burden.

A systematic review was conducted by searching Medline, Embase, and Cochrane CENTRAL databases. The review included 43 clinical trials with a total of 18,347 rosacea patients.

The most studied treatments were ivermectin, metronidazole, azelaic acid, minocycline, and doxycycline. Oral isotretinoin was found to be the most effective treatment in reducing inflammatory lesions.

Both topical and systemic therapies are effective in reducing inflammatory lesion count in rosacea patients, primarily by suppressing inflammation and killing mites. Oral isotretinoin is recommended for severe recalcitrant cases.

Additional research is needed to determine effective combination therapies for rosacea.


Glycolic acid peel therapy - a current review

Glycolic acid peels are a safe and effective treatment option for various skin conditions when applied correctly.

What are the current applications, efficacy, and safety considerations of glycolic acid peel therapy?

Hypothesis: Not applicable; this is a review article, not an original research study with a stated hypothesis.

This is a review article that discusses various studies on glycolic acid peels for indications such as acne, acne scars, melasma, postinflammatory hyperpigmentation, photoaging, and seborrhea. It also covers combination therapies, treatment procedures, and factors influencing peel depth and safety.

Glycolic acid peels are described as simple, inexpensive, and having no downtime. They have been found to be very safe for Fitzpatrick skin types I-IV. The depth of the peel can range from very superficial to medium, depending on the concentration of acid, number of coats, and application time. Important considerations include careful review of medical history, skin examination, pre-peel priming, proper patient selection, peel timing, and on-time neutralization to ensure good results and avoid side effects.

Glycolic acid peel therapy is a time-tested, popular, and safe procedure for various dermatological indications, particularly for Fitzpatrick skin types I-IV, when proper protocols are followed.

As a review, this article synthesizes existing literature without presenting new experimental data or specific study limitations. It does not quantify efficacy or safety outcomes from the reviewed studies.


Applications of hydroxy acids: classification, mechanisms, and photoactivity

Hydroxy acids are widely used in skincare for various conditions, but more research is needed to fully understand their mechanisms and long-term safety, especially regarding sun exposure.

What are the classifications, mechanisms, and photoactivity of hydroxy acids (HAs) in cosmetic and therapeutic applications?

This article is a review that discusses frequently used classes of hydroxy acids (α-hydroxy acids, β-hydroxy acids, polyhydroxy acids, and bionic acids) and their applications. It also evaluates the safety of these formulations, particularly regarding prolonged use on sun-exposed skin, and summarizes studies on their effects on photocarcinogenesis, melanogenesis, and tanning.

Hydroxy acids are widely used in cosmetic and therapeutic formulations for various skin benefits. They are applied in treating photoaging, acne, ichthyosis, rosacea, pigmentation disorders, and psoriasis. The review highlights that while there are many reports on their cosmetic and clinical effects, their biological mechanisms of action require further clarification. There are also a limited number of studies on the modifications evoked by topical HA application on photocarcinogenesis.

Hydroxy acids are important in cosmetic and dermatologic applications, but their biological mechanisms of action need more clarification. Safety, especially concerning prolonged use on sun-exposed skin and effects on photocarcinogenesis, requires further investigation.

The review notes that the biological mechanism(s) of action for hydroxy acids still require more clarification. It also points out the very limited number of studies dealing with the modifications evoked by topical application of HA-containing products on photocarcinogenesis.


Effectiveness of topical hyaluronic acid in xerosis cutis treatment in elderly: a double-blind, randomized controlled trial

Topical low molecular weight hyaluronic acid significantly improves skin hydration in elderly individuals with dry skin compared to high molecular weight hyaluronic acid or a vehicle.

Does topical low molecular weight hyaluronic acid (LMWHA) effectively treat xerosis cutis (dry skin) in the elderly compared to high molecular weight hyaluronic acid (HMWHA) or a vehicle?

Hypothesis: Low molecular weight hyaluronic acid (LMWHA) will be more effective in replenishing skin hydration in aging skin compared to High Molecular Weight HA (HMWHA) due to its ability to penetrate the stratum corneum.

A double-blind, randomized controlled trial was conducted on 36 nursing home residents in Jakarta, aged 60-80 years, diagnosed with dry skin. Participants applied three distinct, randomized moisturizing lotions (LMWHA, HMWHA, or vehicle) to three separate sites on their legs. Skin capacitance (SCap), transepidermal water loss (TEWL), and specified symptom sum score (SRRC) were measured at weeks 0, 2, and 4.

After four weeks, the LMWHA-treated area showed greater SCap values (56.37 AU) compared to HMWHA (52.37 AU, p = 0.004) and vehicle (49.01 AU, p < 0.001). No significant differences were observed in TEWL and SRRC scores across all groups, and no side effects were reported.

The application of a moisturizer containing LMWHA significantly improved skin hydration in the dry skin of elderly individuals compared to moisturizers containing HMWHA and vehicle, with similar safety profiles.

The study was conducted on a specific population (nursing home residents in Jakarta) and focused on leg application, which may limit generalizability. The abstract does not mention other limitations.


Effects of sunscreen on skin cancer and photoaging

Sunscreen use may help protect against skin cancer and photoaging, but more research is needed.

What are the effects of sunscreen application on skin cancer and photoaging?

Hypothesis: The abstract does not explicitly state a hypothesis, but it implies an investigation into the effects of sunscreen on skin cancer and photoaging.

This is a review of randomized controlled trials (RCTs) examining the effects of sunscreen application on skin cancer and photoaging.

The review found that the evidence, although limited, supports beneficial effects of sunscreen application on the occurrence of skin cancers and skin photoaging.

Limited evidence from randomized controlled trials suggests that sunscreen application has beneficial effects on skin cancer and photoaging.

The evidence supporting the beneficial effects of sunscreen on skin cancer and photoaging is limited.


In vivo stimulation of connective tissue accumulation by the tripeptide-copper complex GHK-Cu in rat wounds

GHK-Cu stimulates the accumulation of connective tissue components like collagen and glycosaminoglycans in rat wounds.

Does the tripeptide-copper complex GHK-Cu stimulate connective tissue accumulation in rat wounds in vivo?

Hypothesis: GHK-Cu, previously identified as a growth factor and potential activator of wound repair in vitro, will increase extracellular matrix accumulation in vivo.

Stainless steel wire mesh cylinders were subcutaneously implanted into the backs of rats. Rats were divided into groups receiving sequential injections of either saline (control) or various concentrations of GHK-Cu into the wound chambers. After the experiment, wound chambers were collected and analyzed for dry weight, total proteins, collagen, DNA, elastin, glycosaminoglycans, and specific mRNAs for collagens and TGF beta. A control tripeptide, L-glutamyl-L-histidyl-L-proline, was also tested.

GHK-Cu injections resulted in a concentration-dependent increase in dry weight, DNA, total protein, collagen, and glycosaminoglycan content within the wound chambers. Collagen synthesis was twice that of noncollagen proteins. Increases were observed in type I and type III collagen mRNAs, but not in TGF beta mRNAs. An increase in the relative amount of dermatan sulfate was also found. The control tripeptide had no significant effect.

GHK-Cu effectively increases extracellular matrix accumulation in wounds in vivo.

The study was conducted in rats using a specific wound chamber model, which may not directly translate to human wound healing processes.


Effects of low-level inhalation exposure to carbon dioxide indoors on human health and psychomotor performance

Exposure to low levels of indoor carbon dioxide can negatively impact human physiology, cognitive function, and respiratory health.

What are the effects of low-level indoor carbon dioxide (CO2) inhalation exposure on human health and psychomotor performance?

Hypothesis: The study does not explicitly state a hypothesis, but it aims to review existing literature to understand the effects of low-level CO2 exposure.

The study conducted a review of scientific literature and documents concerning the effects of CO2 inhalation exposure on human health and psychomotor performance.

Linear physiological changes in circulatory, cardiovascular, and autonomic systems were observed with CO2 exposure from 500 to 5000 ppm. Short-term CO2 exposure starting at 1000 ppm affected cognitive performances like decision making and problem resolution. Epidemiological studies showed an association between CO2 exposure beginning at 700 ppm and building-related symptoms, and respiratory symptoms in children exposed to over 1000 ppm, though other indoor pollutants might be involved.

Low-level indoor CO2 exposure can lead to physiological changes, affect cognitive performance, and be associated with building-related and respiratory symptoms. Further research is needed on long-term effects on the autonomic system.

The review notes that other indoor comorbid pollutants might be involved in the observed health effects, suggesting a potential confounder. It also highlights the need for further research on long-term effects.


Associations between indoor air exposures and cognitive test scores among university students

Higher classroom carbon dioxide levels, even in well-ventilated spaces, are associated with lower student cognitive test scores.

unfavorable-cue: "associated with higher" | favorable-cue: "benefits"

Do indoor carbon dioxide concentrations, reflecting ventilation and building occupancy, associate with cognitive test scores among university graduate students in classrooms with increased ventilation?

Hypothesis: The study implicitly hypothesizes that higher indoor carbon dioxide concentrations will be associated with lower cognitive test scores, even in classrooms with enhanced ventilation.

Graduate students (54 included in analysis) attending lectures in university classrooms with increased ventilation participated. Post-class cognitive performance tests (Stroop and Arithmetic) were administered via a smartphone app during the 2022-2023 academic year. Classrooms had continuous indoor environmental quality monitors providing real-time carbon dioxide concentrations. Mixed-effects statistical models were used to analyze temporally and spatially paired exposure and outcome data, examining different carbon dioxide exposure metrics and cognitive test scores.

Model estimates showed directionally consistent evidence that higher central and peak classroom carbon dioxide concentrations (ranging from approximately 440-1630 ppm) were associated with lower cognitive test scores. The strongest effect estimates were observed for 95th percentile class carbon dioxide concentrations, representing peak exposures.

Lower carbon dioxide concentrations are associated with higher cognitive test scores, even in classrooms with increased outdoor air ventilation. While not causal and with unknown underlying mechanisms, higher outdoor air ventilation appears to offer additional benefits beyond infection risk reduction by supporting student performance.

The study notes that the findings are not causal, and the underlying mechanisms for the observed associations remain unknown.


Short-term effects of fine particulate matter on daily health events in Latin America: a meta-analysis

Short-term exposure to fine particulate matter in Latin America is linked to higher risks of respiratory and cardiovascular deaths.

What are the short-term effects of fine particulate matter (PM2.5) exposure on morbidity and mortality in Latin America?

Hypothesis: The study hypothesized that short-term exposure to PM2.5 would be associated with increased morbidity and mortality in Latin America.

A systematic review and meta-analysis were conducted, searching six online databases and hand-searching for studies investigating short-term associations between PM2.5 and daily health events in Latin America. Two reviewers independently assessed study internal validity, and random-effect models were used for the meta-analysis.

Out of 1628 retrieved studies, nine were selected for qualitative analysis and seven for quantitative analysis. A 10 µg/m3 increment in daily PM2.5 concentrations was significantly associated with an increased risk for respiratory mortality in all ages (pooled RR = 1.02, 95% CI, 1.02-1.02) and cardiovascular mortality (pooled RR = 1.01, 95% CI, 1.01-1.02).

Short-term exposure to PM2.5 in Latin America is significantly associated with an increased risk for respiratory and cardiovascular mortality.

The evidence is concentrated in a few cities, and some studies presented a high risk of bias.


Short-term exposure to fine and coarse particles and mortality: a multicity time-series study in East Asia

Short-term exposure to fine particulate matter (PM2.5) is associated with increased all-cause, cardiovascular, and respiratory mortality in East Asian cities.

What is the association between short-term exposure to fine (PM2.5) and coarse (PM10-2.5) particulate matter and mortality in East Asian cities?

Hypothesis: The study hypothesized an association between increased concentrations of fine and coarse particulate matter and increased mortality.

A two-stage analysis was conducted across 11 East Asian cities. City-specific estimates were generated using a time-series analysis with a generalized additive model (Quasi-Poisson distribution), followed by a meta-analysis to estimate overall effects.

A 10-μg/m³ increase in PM2.5 (lag01) was associated with a 0.38% increase in all-cause mortality, a 0.96% increase in cardiovascular mortality, and a 1% increase in respiratory mortality. A 10-μg/m³ increase in PM10-2.5 (lag01) was associated with a 0.69% increase in cardiovascular mortality, but this association weakened after adjusting for other pollutants, particularly PM2.5.

Increased mortality was associated with increasing concentrations of both PM2.5 and PM10-2.5 across the 11 East Asian cities studied.

The abstract does not explicitly state any limitations of the study.


Disinfection By-Products in Drinking Water and Bladder Cancer

Water Purification (Reverse Osmosis & Ultrafiltration);Shower Dechlorination Filter

Exposure to disinfection by-products in drinking water may interact with a specific genetic variant to increase bladder cancer risk.

Do total trihalomethanes (TTHMs) in drinking water interact with bladder cancer susceptibility genes to increase bladder cancer risk?

Hypothesis: The study hypothesized that there would be a combined effect on bladder cancer risk from TTHMs and bladder cancer susceptibility variants.

The study analyzed data from two case-control studies: the New England Bladder Cancer Study (1,162 controls) and the Spanish Bladder Cancer Study (772 controls). Adjusted logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CI) for TTHMs and genetic variants, with and without interaction terms. Results from both studies were then combined using meta-analysis.

Of 16 loci, rs907611 at 11p15.5 showed the strongest association in the highest TTHM exposure category in both studies and in meta-analysis. For individuals with the rs907611-GG genotype in the highest exposure category, an odds ratio of 1.66 (95% CI: 1.17, 2.34) was observed. No other genetic variants showed consistent evidence of interaction.

The study found novel suggestive evidence for a multiplicative interaction between TTHMs and the rs907611-GG genotype, increasing bladder cancer risk.

The study notes that further work is needed to replicate and extend this finding and to understand potential molecular mechanisms.