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Abstract Objectives Our aim is to investigate the effects of a innovative modular prone positioning tools on patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 during awake prone positioning (AW-PP). Methods This prospective randomized controlled study initially enrolled 168 patients with COVID-19 due to ARDS. However, 92 were subsequently disqualified, leaving 76 patients who were randomly assigned to either the observation group (n = 38) or the control group (n = 38). The observation group utilized innovative modular prone positioning tools for non-invasive respiratory support (NIRS), while the control group used soft pillows for the same treatment. Data were collected on comfort levels, adverse events, and efficacy indicators. Additionally, the comfort, incidence of adverse events, and treatment efficacy in both groups were evaluated. Results The observation group had shorter the daily duration spent on executing the AW-PP (2.74 ± 0.86 min vs. 4.64 ± 1.02 min, P 0.05). However, the observation group experienced significantly fewer adverse events, including kinking NIRS circuit, pain, shortness of breath, dizziness, and pressure ulcers (P

Introduction Children diagnosed with developmental coordination disorder (DCD) exhibit a range of challenges in both gross and fine motor skills, characterised by sluggish and awkward movements. Additionally, they experience deficits in balance and coordination. Without appropriate intervention, these difficulties may endure into adolescence and adulthood, impacting various facets of their daily lives, including learning, social interactions and recreational activities.Methods and analysis Employing a randomised controlled trial design, 60 children diagnosed with DCD will be randomly assigned to two groups. The experimental group will receive Baduanjin training in addition to health education, while the control group will undergo health education alone. Following an 8-week intervention period, assessments using motor assessment battery for children-second edition, ProKin 254 Balance Test System will be conducted to evaluate the impact of Baduanjin on the motor coordination and balance in children with DCD. Furthermore, functional near-infrared spectroscopy will be employed to capture haemodynamic data from the children’s brain movement-related cortex during functional activities. These data will be analysed to assess the level of cortical activation, strength of functional connectivity and their correlation with changes in motor function, with the goal of investigating the cerebral blood oxygenation mechanisms underlying the effectiveness of the Baduanjin intervention.Ethics and dissemination This study has been submitted for approval and has received ethical clearance from the Medical Ethics Committee of Shanghai Fourth People’s Hospital (2023080-001). The results of the study will be published in a peer-reviewed scientific journal.Trial registration number ChiCTR2300078980.

PurposeThe aim of the study was to synthesize previous evidence and clarify the prevalence of developmental coordination disorder (DCD) in children by meta-analysis.MethodsA comprehensive computerized search of databases, including PubMed, Embase, Web of Science, The Cochrane Library, CINAHL, and PsycINFO databases, was conducted to identify relevant national and international articles published before 18 December 2023 on DCD prevalence in children. The meta-analysis of prevalence was conducted using Stata 18.0.ResultsA total of 18 papers involving 31,203 patients were included. The prevalence of children with DCD was found to be 5%. A subgroup analysis showed that prevalence was 7% [95% confidence interval (CI) 4%–10%] and 4% (95% CI 3%–7%) for boys and girls, respectively; 4% (95% CI 2%–8%), 2% (95% CI 2%–2%), and 6% (95% CI 3%–10%) in Asia, Europe, and North America, respectively; and 18% (95% CI 8%–31%) and 6% (95% CI 4%–7%) for preterm (

BackgroundDonepezil in combination with memantine is a widely used clinical therapy for moderate to severe dementia. However, real-world population data on the long-term safety of donepezil in combination with memantine are incomplete and variable. Therefore, the aim of this study was to analyze the adverse events (AEs) of donepezil in combination with memantine according to US Food and Drug Administration Adverse Event Reporting System (FAERS) data to provide evidence for the safety monitoring of this therapy.MethodsWe retrospectively analyzed reports of AEs associated with the combination of donepezil and memantine from 2004 to 2023 extracted from the FAERS database. Whether there was a significant association between donepezil and memantine combination therapy and AEs was assessed using four disproportionality analysis methods, namely, the reporting odds ratio, proportional reporting ratio, Bayesian confidence propagation neural network, and multi-item gamma Poisson shrinker methods. To further investigate potential safety issues, we also analyzed differences and similarities in the time of onset and incidence of AEs stratified by sex and differences and similarities in the incidence of AEs stratified by age.ResultsOf the 2,400 adverse drug reaction (ADR) reports in which the combination of donepezil and memantine was the primary suspected drug, most of the affected patients were female (54.96%) and older than 65 years of age (79.08%). We identified 22 different system organ classes covering 100 AEs, including some common AEs such as dizziness and electrocardiogram PR prolongation; fall, pleurothotonus and myoclonus were AEs that were not listed on the drug label. Moreover, we obtained 88 reports of AEs in men and 100 reports of AEs in women; somnolence was a common AE in both men and women and was more common in women, whereas pleurothotonus was a more common AE in men. In addition, we analyzed 12 AEs in patients younger than 18 years, 16 in patients between 18 and 65 years, and 113 in patients older than 65 years. The three age groups had distinctive AEs, but lethargy was the common AE among all age groups. Finally, the median time to AE onset was 19 days in all cases. In both men and women, most AEs occurred within a month of starting donepezil plus memantine, but some continued after a year of treatment.ConclusionOur study identified potential and new AEs of donepezil in combination with memantine; some of these AEs were the same as in the specification, and some of the AE signals were not shown in the specification. In addition, there were sex and age differences in some of the AEs. Therefore, our findings may provide valuable insights for further studies on the safety of donepezil and memantine combination therapy, which are expected to contribute to the safe use of this therapy in clinical practice.

Developmental Coordination Disorder (DCD) is a neurodevelopmental disorder characterized by deficits in motor skills, with gross and fine motor dysfunction being the main symptom. This condition greatly impairs children’s daily life, learning, and social interaction. Symptoms typically appear during preschool or school age, and if left untreated, they can persist into adulthood. Thus, early assessment and intervention are crucial to improve the prognosis. This study aims to review the existing literature on DCD, providing a comprehensive overview of the assessment for children with DCD in terms of body functions and structures, activities and participation, and environmental factors within the framework of the International Classification of Functioning, Disability, and Health - Children and Youth (ICF-CY). Additionally, specific rehabilitation interventions will be described, offering valuable insights for the clinical assessment and intervention of children with DCD.

Multiple Sclerosis (MS) is a neurologic autoimmune disease whose exact pathophysiologic mechanisms remain to be elucidated. Recent studies have shown that the onset and progression of MS are associated with dysbiosis of the gut microbiota. Similarly, a large body of evidence suggests that mitochondrial dysfunction may also have a significant impact on the development of MS. Endosymbiotic theory has found that human mitochondria are microbial in origin and share similar biological characteristics with the gut microbiota. Therefore, gut microbiota and mitochondrial function crosstalk are relevant in the development of MS. However, the relationship between gut microbiota and mitochondrial function in the development of MS is not fully understood. Therefore, by synthesizing previous relevant literature, this paper focuses on the changes in gut microbiota and metabolite composition in the development of MS and the possible mechanisms of the crosstalk between gut microbiota and mitochondrial function in the progression of MS, to provide new therapeutic approaches for the prevention or reduction of MS based on this crosstalk.

IntroductionBrain tissue damage caused by ischemic stroke can trigger changes in the body’s metabolic response, and understanding the changes in the metabolic response of the gut after stroke can contribute to research on poststroke brain function recovery. Despite the increase in international research on poststroke metabolic mechanisms and the availability of powerful research tools in recent years, there is still an urgent need for poststroke metabolic studies. Metabolomic examination of feces from a cerebral ischemia–reperfusion rat model can provide new insights into poststroke metabolism and identify key metabolic pathways, which will help reveal diagnostic and therapeutic targets as well as inspire pathophysiological studies after stroke.MethodsWe randomly divided 16 healthy adult pathogen-free male Sprague–Dawley (SD) rats into the normal group and the study group, which received middle cerebral artery occlusion/reperfusion (MCAO/R). Ultra-performance liquid chromatography–tandem mass spectrometry (UPLCMS/MS) was used to determine the identities and concentrations of metabolites across all groups, and filtered high-quality data were analyzed for differential screening and differential metabolite functional analysis.ResultsAfter 1 and 14 days of modeling, compared to the normal group, rats in the study group showed significant neurological deficits (p

ObjectiveTo explore the effect of 12 weeks of Tai Chi on neuromuscular responses and postural control in elderly patients with sarcopenia.MethodsOne hundred and twenty-four elderly patients with sarcopenia from ZheJiang Hospital and surrounding communities were selected, however, 64 were later disqualified. Sixty elderly patients with sarcopenia were randomly assigned to the Tai Chi group (n = 30) and the control group (n = 30). Both groups received 45-min health education sessions once every 2 weeks for 12 weeks, and the Tai Chi group engaged in 40-min simplified eight-style Tai Chi exercise sessions 3 times per week for 12 weeks. Two assessors who had received professional training and were unaware of the intervention allocation assessed the subjects within 3 days prior to the intervention and within 3 days after completion of the intervention. They chose the unstable platform provided by the dynamic stability test module in ProKin 254 to evaluate the patient’s postural control ability. Meanwhile, surface EMG was utilized to assess the neuromuscular response during this period.ResultsAfter 12 weeks of intervention, the Tai Chi group showed a significant decrease in neuromuscular response times of the rectus femoris, semitendinosus, anterior tibialis, and gastrocnemius and overall stability index (OSI) compared to before the intervention (p 0.05). In addition, these indicators in the Tai Chi group were significantly lower than those in the control group (p

Objective:To systematically review the clinical efficacy of Ziwuliuzhu acupuncture on primary insomnia therapy.Methods:Randomized controlled trials (RCT) about Ziwuliuzhu acupuncture on treating primary insomnia were electronically searched in CNKI, VIP, Wanfang Data, CBM, PubMed and the Cochrane Library. After conducting quality evaluation in accordance with Cochrane Review Handbook 5.1.0, the results of Meta analysis was analysed by RevMan 5.3 software.Results:A total of 12 RCTs involved 724 patients were finally included. The results of Meta-analysis indicated that to improve the effective rate, Ziwuliuzhu acupuncture was better than non-Ziwuliuzhu acupuncture [RR=1.20; 95%CI(1.13, 1.27); Z=6.23, PRR=1.71; 95%CI(1.33, 2.19); Z=4.18, PMD=-2.05; 95%CI(-2.43, -1.66); Z=10.31, PMD=6.09; 95%CI(2.32, 9.85); Z=3.17, P=0.002].Conclusion:Ziwuliuzhu acupuncture has a great advantage compare ith non-Ziwuliuzhu acupuncture in the treatment of primary insomnia, but larger scale and high quality RCTs are needed to verify the aforementioned conclusion.