Effects of different modalities of transcranial magnetic stimulation on post-stroke cognitive impairment: a network meta-analysis.

OBJECTIVE: The study aimed to evaluate, using a network meta-analysis, the effects of different transcranial magnetic stimulation (TMS) modalities on improving cognitive function after stroke. METHODS: Computer searches of the Cochrane Library, PubMed, Web of Science, Embass, Google Scholar, CNKI, and Wanfang databases were conducted to collect randomized controlled clinical studies on the use of TMS to improve cognitive function in stroke patients, published from the time of database construction to November 2023. RESULTS: A total of 29 studies and 2123 patients were included, comprising five interventions: high-frequency rTMS (HF-rTMS), low-frequency rTMS (LF-rTMS), intermittent theta rhythm stimulation (iTBS), sham stimulation (SS), and conventional rehabilitation therapy (CRT). A reticulated meta-analysis showed that the rankings of different TMS intervention modalities in terms of the Montreal Cognitive Assessment (MoCA) scores, Mini-Mental State Examination scores (MMSE), and Modified Barthel Index (MBI) scores were: HF-rTMS > LF-rTMS > iTBS > SS > CRT; the rankings of different TMS intervention modalities in terms of the event-related potential P300. amplitude scores were HF-rTMS > LF-rTMS > iTBS > CRT > SS; the rankings of different TMS intervention modalities in terms of the P300 latency scores were: iTBS > HF-rTMS > LF-rTMS > SS > CRT. Subgroup analyses of secondary outcome indicators showed that HF-rTMS significantly improved Rivermead Behavior Memory Test scores and Functional Independence Measurement-Cognitive scores. CONCLUSIONS: High-frequency TMS stimulation has a better overall effect on improving cognitive functions and activities of daily living, such as attention and memory in stroke patients.

Effect of different modalities of transcranial magnetic stimulation on Parkinson's patients cognitive impairment and long-term effectiveness: a systematic review and network meta-analysis.

Objective: This study used network Meta-analysis to compare the effects of different transcranial magnetic stimulation (TMS) modalities on the effectiveness and long-term validity of improving cognitive function in Parkinson's patients. Methods: Computer searches of the Cochrane Library, PubMed, Web of Science, Embass, CNKI and Wanfang Data were conducted to collect randomized controlled clinical studies on TMS to improve cognitive function in Parkinson's patients published from the time of library construction to December 2023. Results: A total of 22 studies and 1,473 patients were included, comprising 5 interventions: high frequency repetitive transcranial magnetic stimulation (HF-rTMS), low frequency repetitive transcranial magnetic stimulation (LF-rTMS), intermittent theta burst stimulation (iTBS), sham stimulation and conventional rehabilitation therapy (CRT). Network Meta-analysis showed that the ranking results of different TMS intervention modalities in terms of MoCA scores were: HF-rTMS > LF-rTMS > iTBS > sham > CRT, the ranking results of different TMS intervention modalities in terms of MMSE scores were: HF-rTMS > LF-rTMS > sham > CRT. The effect of TMS on improving Parkinsonian cognitive function lasted for 1 month compared to the no-stimulation group. Conclusion: TMS has some long-term sustained effects on improving cognitive function in Parkinson's patients. HF-rTMS is more effective in improving cognitive function in Parkinson's patients.Systematic review registration: https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023463958.

The telehealth program of occupational therapy among older people: an up-to-date scoping review.

BACKGROUND: The average life expectancy of older people is increasing, and most seniors desire to age at home and are capable of living independently. Occupational therapy (OT) is client-centered and uses patients' meaningful activities, or occupations, as treatment methods, thus playing an important role in later adulthood. Telemedicine removes the constraints of time and space, and the combination of OT and telemedicine can greatly improve medical efficiency and clinical effectiveness. AIMS: The purpose of this scoping review was to examine the scope and effectiveness of telehealth OT for older people. METHODS: This scoping review was conducted following the methodological framework proposed by Arksey and O'Malley. We searched the literature in five databases following the PICOS (Population, Intervention, Comparison, Outcome, Study design) guideline, from inception to April 2022. Two trained reviewers independently retrieved, screened, and extracted data, and used a descriptive synthesizing approach to summarize the results. RESULTS: The initial search yielded 1249 studies from databases and manual searches, of which 20 were eligible and were included in the final review. A thematic analysis revealed five main themes related to telehealth OT: occupational assessment, occupational intervention, rehabilitation counseling, caregiver support, and activity monitoring. CONCLUSIONS: Telehealth OT has been used widely for older people, focusing primarily on occupational assessment and intervention provided conveniently for occupational therapists and older clients. In addition, telehealth OT can monitor patients' activities and provide rehabilitation counseling and health education for the elderly and their caregivers, thus improving the security of their home life and the efficacy of OT. During the COVID-19 pandemic, telehealth will be an effective alternative to face-to-face modalities.

Insights into the hierarchical structure and digestibility of starch in heat-moisture treated adlay seeds.

In the present study, starches isolated from heat-moisture treated (HMT) adlay seeds were characterized with hierarchical structures and digestibility to understand the relationships in structural and digestible behaviors of starches in a HMT starch-based food system. The results indicated that HMT not only caused the disorganizations of hierarchical structures, but also promoted the molecular rearrangements and reassembly of starch chains to form a new ordered molecular aggregation architecture (i.e., highly ordered molecular structure, amylose-lipids complexes and thicker crystalline lamella). And the reinforced molecular interactions between starch molecules during HMT occurred to form more densely ordered structure, thus reducing the digestibility and digestion rate coefficients (k) of adlay starch. Particularly, HMT applied directly in adlay seeds with 30% moisture content displayed the highest resistant starch level (20.6%) and lowest k (2.74 × 10-3 min-1). Thus, the results are useful to realize the desired regulation of starch digestibility in adlay products following HMT.

Effect of germination temperature on hierarchical structures of starch from brown rice and their relation to pasting properties.

The study aimed to obtain the information on the effect of germination temperature on hierarchical structures (granular structure, crystal structure, short-range ordered structure and helical structures) of starch from brown rice and their relation to pasting properties. The results showed that brown rice had gradually elevated germination ability and α-amylase activity as the sprouting temperature rose. And the enhanced enzyme activities during germination promoted the erosion of starch granules, the decrease of relative crystallinity and short-range ordered degree, and the unwinding of double helix structure. In addition, the mathematical correlation and structure-pasting relationship were constructed in this work. These structural disorganizations of germinated rice starch resulted in reduced swelling degree and water-holding capacity, inducing the lower paste viscosity (e.g., peak and final viscosity), breakdown and setback value. Thus, it is concluded that germination can efficiently regulate the pasting properties of starch, which provide a crucial basis for the development and utilization of germinated brown rice products.

The startup performance and microbial distribution of an anaerobic baffled reactor (ABR) treating medium-strength synthetic industrial wastewater.

In this study, an anaerobic baffled reactor (ABR) with seven chambers was applied to treat medium-strength synthetic industrial wastewater (MSIW). The performance of startup and shock test on treating MSIW was investigated. During the acclimation process, the chemical oxygen demand (COD) of MSIW gradually increased from 0 to 2,000 mg L-1, and the COD removal finally reached 90%. At shock test, the feeding COD concentration increased by one-fifth and the reactor adapted very well with a COD removal of 82%. In a stable state, Comamonas, Smithella, Syntrophomonas and Pseudomonas were the main populations of bacteria, while the predominant methanogen was Methanobacterium. The results of chemical and microbiological analysis indicated the significant advantages of ABR, including buffering shocks, separating stages with matching microorganisms and promoting syntrophism. Meanwhile, the strategies for acclimation and operation were of great importance. Further work can test reactor performance in the treatment of actual industrial wastewater.