Purpose To use meta-analysis techniques to evaluate the efficacy and safety of platelet-rich plasma (PRP) injections for the treatment knee of osteoarthritis (OA). Methods We performed a systematic ...literature search in PubMed, Embase, Scopus, and the Cochrane database through April 2016 to identify Level I randomized controlled trials that evaluated the clinical efficacy of PRP versus control treatments for knee OA. The primary outcomes were Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and function scores. The primary outcomes were compared with their minimum clinically important differences (MCID)—defined as the smallest difference perceived as important by the average patient. Results We included 10 randomized controlled trials with a total of 1069 patients. Our analysis showed that at 6 months postinjection, PRP and hyaluronic acid (HA) had similar effects with respect to pain relief (WOMAC pain score) and functional improvement (WOMAC function score, WOMAC total score, International Knee Documentation Committee score, Lequesne score). At 12 months postinjection, however, PRP was associated with significantly better pain relief (WOMAC pain score, mean difference −2.83, 95% confidence interval CI −4.26 to −1.39, P = .0001) and functional improvement (WOMAC function score, mean difference −12.53, 95% CI −14.58 to −10.47, P < .00001; WOMAC total score, International Knee Documentation Committee score, Lequesne score, standardized mean difference 1.05, 95% CI 0.21-1.89, P = .01) than HA, and the effect sizes of WOMAC pain and function scores at 12 months exceeded the MCID (−0.79 for WOMAC pain and −2.85 for WOMAC function score). Compared with saline, PRP was more effective for pain relief (WOMAC pain score) and functional improvement (WOMAC function score) at 6 months and 12 months postinjection, and the effect sizes of WOMAC pain and function scores at 6 months and 12 months exceeded the MCID. We also found that PRP did not increase the risk of adverse events compared with HA and saline. Conclusions Current evidence indicates that, compared with HA and saline, intra-articular PRP injection may have more benefit in pain relief and functional improvement in patients with symptomatic knee OA at 1 year postinjection. Level of Evidence Level I, meta-analysis of Level I studies.
Childhood obesity is a serious public health concern. School-based interventions hold great promise to combat the rising trend of childhood obesity. This systematic review aimed to assess the overall ...effects of school-based obesity prevention interventions, and to investigate characteristics of intervention components that are potentially effective for preventing childhood obesity.
We systematically searched MEDLINE, CENTRAL and Embase databases to identify randomized- or cluster randomized- controlled trials of school-based obesity interventions published between 1990 and 2019. We conducted meta-analyses and subgroup analyses to determine the overall effects of obesity prevention programs and effect differences by various characteristics of intervention components on body mass index (BMI) or BMI Z-score of children.
This systematic review included a total of 50 trials (reported by 56 publications). Significant differences were found between groups on BMI (- 0.14 kg/m
(95% confidence interval: - 0.21, - 0.06)) and BMI Z-score (- 0.05 (- 0.10, - 0.01)) for single-component interventions; significant differences were also found between groups on BMI (- 0.32 (- 0.54, - 0.09) kg/m
) and BMI Z-score (- 0.07 (- 0.14, - 0.001)) for multi-component interventions. Subgroup analyses consistently demonstrated that effects of single-component (physical activity) interventions including curricular sessions (- 0.30 (- 0.51, - 0.10) kg/m
in BMI) were stronger than those without curricular sessions (- 0.04 (- 0.17, 0.09) kg/m
in BMI); effects of single-component (physical activity) interventions were also strengthened if physical activity sessions emphasized participants' enjoyment (- 0.19 (- 0.33, - 0.05) kg/m
in BMI for those emphasizing participants' enjoyment; - 0.004 (- 0.10, 0.09) kg/m
in BMI for those not emphasizing participants' enjoyment). The current body of evidence did not find specific characteristics of intervention components that were consistently associated with improved efficacy for multi-component interventions (P > 0.05).
School-based interventions are generally effective in reducing excessive weight gain of children. Our findings contribute to increased understandings of potentially effective intervention characteristics for single-component (physical activity) interventions. The impact of combined components on effectiveness of multi-component interventions should be the topic of further research. More high-quality studies are also needed to confirm findings of this review.
Lithium‐metal electrodes have undergone a comprehensive renaissance to meet the requirements of high‐energy‐density batteries due to their lowest electrode potential and the very high theoretical ...capacity. Unfortunately, the unstable interface between lithium and nonaqueous electrolyte induces dendritic Li and low Coulombic efficiency during repeated Li plating/stripping, which is one of the huge obstacles toward practical lithium‐metal batteries. Here, a composite mixed ionic/electronic conductor interphase (MCI) is formed on the surface of Li by in situ chemical reactions of a copper‐fluoride‐based solution and Li metal at room temperature. The as‐obtained MCI film acts like the armor of a soldier to protect the Li‐metal anode by its prioritized lithium storage, high ionic conductivity, and high Young's modulus. The armored MCI can effectively suppress Li‐dendrite growth and work effectively in LiNi0.5Co0.2Mn0.3O2/Li cells. The armored MCI presents fresh insights into the formation and regulation of the stable electrode–electrolyte interface and an effective strategy to protect Li‐metal anodes in working Li‐metal batteries.
A composite mixed ionic/electronic conductor interphase (MCI) is formed on the surface of lithium by in situ chemical reactions of copper‐fluoride‐based solution and Li metal at room temperature. The as‐obtained MCI film acts like the armor of a soldier to protect the Li‐metal anode by its prioritized lithium storage, high ionic conductivity, and high Young's modulus.
Lithium metal batteries (such as lithium–sulfur, lithium–air, solid state batteries with lithium metal anode) are highly considered as promising candidates for next‐generation energy storage systems. ...However, the unstable interfaces between lithium anode and electrolyte definitely induce the undesired and uncontrollable growth of lithium dendrites, which results in the short‐circuit and thermal runaway of the rechargeable batteries. Herein, a dual‐layered film is built on a Li metal anode by the immersion of lithium plates into the fluoroethylene carbonate solvent. The ionic conductive film exhibits a compact dual‐layered feature with organic components (ROCO2Li and ROLi) on the top and abundant inorganic components (Li2CO3 and LiF) in the bottom. The dual‐layered interface can protect the Li metal anode from the corrosion of electrolytes and regulate the uniform deposition of Li to achieve a dendrite‐free Li metal anode. This work demonstrates the concept of rational construction of dual‐layered structured interfaces for safe rechargeable batteries through facile surface modification of Li metal anodes. This not only is critically helpful to comprehensively understand the functional mechanism of fluoroethylene carbonate but also affords a facile and efficient method to protect Li metal anodes.
A dual‐layered film is obtained on a Li metal anode by spontaneous chemical reaction between lithium plates and fluoroethylene carbonate solvents. Such film can protect the Li metal anodes from the corrosion of electrolytes and regulate the uniform deposition of Li to achieve a dendrite‐free Li metal anode.
Although proteins in the basic helix-loop-helix (bHLH) family are universal transcription factors in eukaryotes, the biological roles of most bHLH family members are not well understood in plants.
...The Arabidopsis thaliana bHLH122 transcripts were strongly induced by drought, NaCl and osmotic stresses, but not by ABA treatment. Promoter::GUS analysis showed that bHLH122 was highly expressed in vascular tissues and guard cells. Compared with wild-type (WT) plants, transgenic plants overexpressing bHLH122 displayed greater resistance to drought, NaCl and osmotic stresses. In contrast, the bhlh122 loss-of-function mutant was more sensitive to NaCl and osmotic stresses than were WT plants.
Microarray analysis indicated that bHLH122 was important for the expression of a number of abiotic stress-responsive genes. In electrophoretic mobility shift assay and chromatin immunoprecipitation assays, bHLH122 could bind directly to the G-box/E-box cis-elements in the CYP707A3 promoter, and repress its expression. Further, up-regulation of bHLH122 substantially increased cellular ABA levels.
These results suggest that bHLH122 functions as a positive regulator of drought, NaCl and osmotic signaling.
Abstract Large uncertainties in the determinations of the equation of state of dense stellar matter allow for the intriguing possibility that the bulk quark matter in beta equilibrium might be the ...true ground state of the matter at zero pressure. Also, quarks will form Cooper pairs very readily since the dominant interaction between quarks is attractive in some channels. As a result, quark matter will generically exhibit color superconductivity, with the favored pairing pattern at intermediately high densities being two-flavor pairing. In the light of several possible candidates for such self-bound quark stars, including the very low-mass central compact object in supernova remnant HESS J1731-347 reported recently, we carry out a one-field theoretic model, the Nambu–Jona–Lasinio model, to investigate the stability of the beta-stable two-flavor color superconducting (2SC) phase of quark matter, but find no physically allowed parameter space for the existence of 2SC quark stars.
Backgrounds
We intended to identify the incidence and risk factors (RFs) for Postoperative urinary retention (POUR) after applying a risk‐stratified catheterization optimization method in enhanced ...recovery after surgery (ERAS)‐total joint arthroplasty (TJA).
Methods
A total of 381 patients were prospectively monitored for POUR. POUR diagnosis was done by a perioperative specialist. Data on potential risk factors (RFs) for POUR were accumulated. Univariate analysis (UA) was conducted to identify possible indicators of POUR, followed by multivariate analysis (MA) of identified indicators.
Results
POUR occurred in 5.5% of cases, including 8 (3.4%) patients underwent total knee arthroplasty and 13 (10.4%) patients underwent total hip arthroplasty. In UA, age, sex, American Society of Anesthesiologists (ASA) score, and the type of operation were significantly different on UA (P = 0.046, P = 0.022, P = 0.000 and P = 0.049, respectively). Other additional predictors, including body mass index (BMI), international prostate symptom score (IPSS) score, preoperative haemoglobin (Hb), duration of operation, estimated intraoperative blood loss, intraoperative fluid volume, fluid infusion volume within 24 h postoperatively were not associated with POUR (P > 0.05). MA results demonstrated that age, ASA score, type of operation and standard intraoperative placement of an indwelling bladder catheter (SIP‐IBC) were strongly associated with POUR development risk (P < 0.05).
Conclusion
Overall, we had a low POUR incidence in our study cohort. However, with the shift from non‐ERAS TJA to ERAS TJA protocol, it is crucial to closely monitor the male gender, advanced age, THA and SIP‐IBC, as these variables can markedly enhance POUR risk.
Reducing in‐hospital complications post TJA is both crucial and urgent in enhancing treatment efficacy and patient experience. Herein, under ERAS protocol, the number of POUR cases that required bladder catheterization was 3.4% for TKA and 10.1% for THA, which is in accordance with other reports. We also found that male gender, advanced age, THA, and SIP‐IBC all significantly elevated POUR development risk.
The application of conventional metal–organic frameworks (MOFs) as electrode materials in supercapacitors is largely hindered by their conventionally poor electrical conductivity. This study reports ...the fabrication of conductive MOF nanowire arrays (NWAs) and the application of them as the sole electrode material for solid‐state supercapacitors. By taking advantage of the nanostructure and making full use of the high porosity and excellent conductivity, the MOF NWAs in solid‐state supercapacitor show the highest areal capacitance and best rate performance of all reported MOF materials for supercapacitors, which is even comparable to most carbon materials.
Conductive metal–organic framework (MOF) nanowire arrays (NWAs) are prepared as the sole electrode material for solid‐state supercapacitors. By taking advantage of their nanostructure and making full use of the high porosity and excellent conductivity, the MOF NWAs in the solid‐state supercapacitor show the highest areal capacitance and best rate performance of all reported MOF materials.
BackgroundAlthough clear cell renal cell carcinoma (ccRCC) is well known as a highly immunogenic tumor, only a small subset of patients could benefit from current immunotherapy, which might be due to ...the heterogeneity of immune microenvironment in ccRCC. So, it is meaningful to explore novel immunotherapy or combination therapy for improving therapeutic efficacy. HHLA2, a newly discovered B7 family member, is prevalently expressed in numerous tumors, including ccRCC. This study aimed to investigate the prognostic impact of HHLA2/PD-L1 co-expression and its relationship with tumor-infiltrating lymphocytes (TILs).MethodsThe expression levels of HHLA2, PD-L1, CD8, and CD4 in cancer tissues from cases (206 in the training cohort and 197 in the validation cohort) with surgically resectable primary ccRCC were evaluated by immunohistochemistry.ResultsThe positive rates of HHLA2 were much higher than those of PD-L1 in ccRCC tissues. HHLA2-positive expression was significantly associated with necrosis, microvascular invasion, advanced Fuhrman nuclear, and TNM stage and indicated a shorter progression-free survival (PFS) and overall survival (OS) in both cohorts. Moreover, patients with HHLA2/PD-L1 co-expression suffered the highest risk of disease progression and death by a significant margin. Besides, HHLA2/PD-L1 co-expression was significantly associated with a high density of CD8+ and CD4+ TILs. Notably, a new immune classification, based on HHLA2/PD-L1 co-expression and TILs, successfully stratified PFS and OS, especially in patients with TILs positivity.ConclusionsThe expression of HHLA2 is more frequent than PD-L1 in ccRCC. HHLA2/PD-L1 co-expression had an adverse impact on the prognoses of patients with ccRCC; this finding provides a rationale for combination immunotherapy with anti-HHLA2 and PD-L1 blockage for patients with ccRCC in the future.
As newly emerged crystalline porous materials, covalent organic frameworks (COFs) possess fascinating structures and some specific features such as modularity, crystallinity, porosity, stability, ...versatility, and biocompatibility. Besides adsorption/separation, sensing, catalysis, and energy applications, COFs have recently shown a promise in biomedical applications. This contribution provides an overview of the recent developments of COF‐based medicines in cancer therapeutics, including drug delivery, photodynamic therapy (PDT), photothermal therapy (PTT), and combined therapy. Furthermore, the major challenges and developing trends in this field are also discussed. These recent developments are summarized and discussed to help encourage further contributions in this emerging and promising field.
Magic bullet: In this minireview, recent advances in the field of covalent organic frameworks (COFs) for cancer therapeutic applications are highlighted, including those for drug delivery, phototherapy, and combined therapy.
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