Effect of breathing exercises on patients with interstitial lung disease: A systematic review and meta-analysis.

PURPOSE: This study was designed to synthesize the efficacy and safety of breathing exercises in interstitial lung disease (ILD) patients by reviewing the literature and comparing the impact of different control group types, ILD subtypes, breathing exercise action modes or methods, and intervention durations on clinical efficacy. METHODS: Systematic searches were conducted across 9 electronic databases, including PubMed, to retrieve English and Chinese studies reporting on ILD patients from inception to February 12, 2024. Study selection and data extraction were independently conducted by two researchers. The quality of the included studies was assessed using the Cochrane risk of bias tool. The data were analysed using RevMan 5.4 and STATA 17.0 software. RESULTS: The search identified 25 studies. Compared to the control group, the breathing exercise group exhibited significantly improved lung function (FVC%pred: MD = 3.46, 95%CI = 1.04 to 5.88; DLCO%pred: MD = 3.20, 95% CI = 2.91 to 3.48), dyspnoea (MRC or mMRC scale: MD = - 0.50, 95%CI = - 0.77 to - 0.22), exercise capacity (6MWD: MD = 32.65, 95% CI = 14.77 to 50.53), and HRQoL (SGRQ: MD = - 6.53, 95% CI = - 8.72 to - 4.34) in ILD patients. According to the subgroup analysis, significant improvements consistent with the overall results were observed in the control group with usual treatment. Compared with the control group, breathing exercises had varying degrees of improvement in the mixed diagnostic group, known-cause group, and fibrotic group of ILD patients; breathing exercises alone significantly improved DLCO%pred, MRC (or mMRC), and SGRQ; and the improvement in breathing exercises as part of pulmonary rehabilitation (PR) was more notable. Different durations of breathing exercise could promote the efficacy of different aspects of treatment for ILD patients. CONCLUSIONS: Compared with usual treatment, breathing exercises can improve lung function, exercise capacity, and HRQoL in ILD patients, particularly without high requirements for intervention duration. The efficacy of breathing exercises varies for different ILD subtypes, and incorporating breathing exercises as part of PR can be more beneficial for ILD patients. No studies have shown significant risks for ILD patients engaging in breathing exercises.

Efficacy of cognitive functional therapy in patients with low back pain: A systematic review and meta-analysis.

BACKGROUND: Low back pain is a major public health problem worldwide, and there exists evidence that cognitive functional therapy may help improve patients' health condition. However, the utilization of cognitive functional therapy for low back pain is limited, and its clinical efficacy remains unclear. OBJECTIVES: To determine the efficacy of cognitive functional therapy in the management of disability, pain intensity, and fear-avoidance beliefs in low back pain patients. DESIGN: Systematic review and meta-analysis. METHOD: A comprehensive study search of Pubmed, Web of Science, Medline, CINAHL, Embase, PsycINFO, and the Cochrane Library databases was conducted from their inception to August 14th, 2023. Two researchers independently conducted the literature search and data extraction. All statistical analysis was performed using Stata Version 17.0. RESULTS: A total of eight randomized controlled trials were included. In the short-term, cognitive functional therapy significantly improved disability (7 studies, SMD = -1.05, 95 % CI = -1.74 to -0.35, I2 = 95.37 %, GRADE = very low), pain intensity (7 studies, SMD = -1.02, 95 % CI = -1.89 to -0.15, I2 = 97.21 %, GRADE = very low), and fear-avoidance beliefs (4 studies, SMD = -0.89, 95 % CI = -1.30 to -0.47, I2 = 82.49 %, GRADE = very low). In the medium-term, cognitive functional therapy also significantly improved disability (3 studies, SMD = -0.48, 95 % CI = -0.82 to -0.14, I2 = 77.97 %, GRADE = very low), pain intensity (3 studies, SMD = -0.34, 95 % CI = -0.58 to -0.10, I2 = 55.55 %, GRADE = very low), and fear-avoidance beliefs (2 studies, SMD = -0.62, 95 % CI = -1.19 to -0.04, I2 = 88.24 %, GRADE = very low). In the long-term, cognitive functional therapy significantly improved disability (4 studies, SMD = -0.54, 95 % CI = -0.95 to -0.13, I2 = 85.87 %, GRADE = very low) and fear-avoidance beliefs (3 studies, SMD = -0.76, 95 % CI = -1.17 to -0.34, I2 = 80.34 %, GRADE = very low). CONCLUSION: Cognitive functional therapy might be effective in reducing disability and fear-avoidance beliefs at any of short-, medium- and long-term follow-ups, and reducing pain at short- and medium-term follow-ups. No definitive conclusions can be drawn about the impact of cognitive functional therapy on low back pain patients due to the very low certainty evidence base. Additional rigorous randomized controlled trials are needed to further confirm these findings. REGISTRATION NUMBER: CRD42022287123 (PROSPERO).

Ultra-low concentration of chlorine dioxide regulates stress-caused premature leaf senescence in tobacco by modulating auxin, ethylene, and chlorophyll biosynthesis.

Exploring novel growth regulators for premature senescence regulation is important for tobacco production. In the present study, chlorine dioxide (ClO2) was explored as a novel plant growth regulator for tobacco growth, particularly its effect on leaf senescence and root development. The results showed that 0.15 µM ClO2 maintained the lushness of detached leaves and whole plants. Also, the leaves of ClO2-treated plants exhibited a chlorophyll content of 58% higher than in CK (control) plants (P < 0.05). Besides, ClO2 treatment increased the biomass of roots and aboveground parts by 54 and 16%, respectively. The ClO2-treated plants also showed enhanced activities of antioxidant enzymes and significantly reduced malondialdehyde contents (P < 0.05). Moreover, ClO2 treatment remarkably alleviated drought-caused premature senescence in the tobacco plants and partly rescued the exogenous ethylene-caused plant dwarfism. The indole-3-acetic acid content in ClO2-treated plants was higher than in non-treated plants (P < 0.05), but ethylene content was significantly lower (P < 0.05). Gene expression analysis showed that ClO2 treatment remarkably suppressed ethylene synthase genes. However, the auxin biosynthesis and transport genes were up-regulated, with NtIAA17 increasing by five folds (P < 0.05). Further, ClO2 remarkably up-regulated the expression of chlorophyll biosynthesis genes, with a >20-fold increase in NtHEMA1 and NtCHLH expressions. These results designate ClO2 as a potential regulator for improving tobacco productivity by retaining higher chlorophyll content and promoting root growth.

The Role of Standardized Phase Angle in the Assessment of Nutritional Status and Clinical Outcomes in Cancer Patients: A Systematic Review of the Literature.

Compared with the phase angle (PA), the predictive ability of the standardized phase angle (SPA) in assessing nutritional status and clinical outcomes in cancer patients remains uncertain. This review aimed to assess (1) the relationship between SPA and nutritional status and clinical outcomes (including complications and survival) in cancer patients; (2) the predictive ability of SPA alone and in comparison with the predictive ability of PA; and (3) the cut-off value of SPA in cancer patients. Studies that addressed the relationship of SPA use to nutritional status, complications, and survival in cancer patients were searched and identified from six electronic databases (PubMed, Medline, CINAHL, Embase, Web of Science, and the Cochrane Library). The included studies were considered to meet the following criteria: English studies with original data that reflected the effects of SPA on nutritional status and clinical outcomes (including complications and survival) and reported a cut-off value of SPA in cancer patients aged ≥18. Thirteen studies that included a total of 2787 participants were evaluated. Five studies assessed the relationship between SPA and nutritional status, and four of them reported a positive relationship between SPA and nutritional status in cancer patients, even considering SPA as a predictor. Twelve studies assessed the relationship between SPA and clinical outcomes in cancer patients. Two-thirds of the studies that evaluated complications reported the predictive ability of SPA; 30% of survival studies reported a positive relationship, 40% reported SPA as a predictor, and 30% reported no relationship. The standard cut-off value for SPA has not yet been determined. Data from the selected studies suggest that SPA might be a predictor of nutritional status. Further studies are needed to determine the value of SPA in predicting nutritional status and clinical outcomes in cancer patients.

Chemical characteristics, oxidative potential, and sources of PM2.5 in wintertime in Lahore and Peshawar, Pakistan.

The chemical characteristics, oxidative potential, and sources of PM2.5 were analyzed at the urban sites of Lahore and Peshawar, Pakistan in February 2019. Carbonaceous species, water soluble ions, and metal elements were measured to investigate the chemical composition and sources of PM2.5. The dithiothreitol (DTT) consumption rate was measured to evaluate the oxidative potential of PM2.5. Both cities showed a high exposure risk of PM2.5 regarding its oxidative potential (DTTv). Carbonaceous and some of the elemental species of PM2.5 correlated well with DTTv in both Lahore and Peshawar. Besides, the DTTv of PM2.5 in Lahore showed significant positive correlation with most of the measured water soluble ions, however, ions were DTT-inactive in Peshawar. Due to the higher proportions of carbonaceous species and metal elements, Peshawar showed higher mass-normalized DTT activity of PM2.5 compared to Lahore although the average PM2.5 concentration in Peshawar was lower. The high concentrations of toxic metals also posed serious non-carcinogenic and carcinogenic risks to the residents of both cities. Principle component analysis coupled with multiple linear regression was applied to investigate different source contributions to PM2.5 and its oxidative potential. Mixed sources of traffic and road dust resuspension and coal combustion, direct vehicle emission, and biomass burning and formation of secondary aerosol were identified as the major sources of PM2.5 in both cities. The findings of this study provide important data for evaluation of the potential health risks of PM2.5 and for formulation of efficient control strategies in major cities of Pakistan.

Seasonal variation of dicarboxylic acids in PM2.5 in Beijing: Implications for the formation and aging processes of secondary organic aerosols.

Dicarboxylic acids are a group of highly oxidized components, which can provide insights into the formation mechanism and aging process of secondary organic aerosols (SOA). Based on the 12-h day and night PM2.5 samples collected in downtown Beijing in January, April, July and October of 2017, dicarboxylic acids and relevant components were measured to investigate their seasonal variation pattern and sources. High concentrations of the identified organic acids were observed, following the decreasing order of July > January > October > April. The high fractions of phthalic acid and maleic acid in January indicated severe aromatic SOA pollution during the sampling period in winter, and the high malonic acid to succinic acid and malic acid to succinic acid ratios in July suggested strong photochemical formation over the sampling period in summer. Based on the calculation of principle component analysis and multiple linear regression, water-soluble organic acids were mainly formed from the aerosol aging process during the sampling periods except for January, while water-soluble organic carbon (WSOC) mostly originated from combustion sources. Correlation analysis was conducted between the CO-normalized concentrations of organic acids and PM2.5, O3, as well as the meteorological parameters. The results suggested that gas-phase photooxidation contributed significantly to the formation of these organic acids during the entire sampling period, and the aqueous-phase process played an important role over the severe haze event in January. Our results also suggested that the intensity of photooxidation and the aging degree of SOA were enhanced along with the reduction of PM2.5 in Beijing in recent years.

Characteristics and secondary formation of water-soluble organic acids in PM1, PM2.5 and PM10 in Beijing during haze episodes.

Water-soluble organic acids are widely involved in various atmospheric physicochemical processes and appear as an important fraction of atmospheric aerosols. Nineteen water-soluble organic acids in 12-h PM1, PM2.5 and PM10 samples collected in urban Beijing during haze episodes in winter and spring of 2017 were identified to investigate their characteristics and secondary formation mechanism. The molecular distributions of water-soluble organic acids as well as the high ratio of phthalic acid (Ph)/azelaic acid (C9) indicated severe aromatic secondary organic aerosol pollution during the haze episodes, especially in winter. The diurnal patterns, size distributions, and concentration ratios of specific organic acids were investigated to reveal the pollution characteristics and possible sources of major organic acids in particulate matter in Beijing during haze events. Multiple linear regression was used to tentatively quantify the relative contributions of photochemical oxidation and aqueous-phase oxidation to the formation of total water-soluble organic acids in PM1, PM2.5 and PM10 during haze episodes. The formation mechanism of sulfate and nitrate was also investigated for comparison. Different from the secondary formation of sulfate, the secondary formation of water-soluble organic acids showed enhanced contribution of gas-phase photochemical oxidation though the aqueous-phase oxidation was the dominant process. CAPSULE: Molecular analyses of organic acids in PM1, PM2.5 and PM10 in Beijing during haze periods revealed their pollution characteristics, possible sources and formation mechanism.

Variation, sources and historical trend of black carbon in Beijing, China based on ground observation and MERRA-2 reanalysis data.

Based on the ground-measurements and MERRA-2 (Modern-Era Retrospective Analysis for Research and Applications, Version 2) reanalysis data, the temporal-spatial variation of black carbon (BC) in Beijing and the affecting factors were investigated. According to the ground-measured BC concentration in November months of 2014, 2015 and 2016, the before-heating period in November 2014 showed the lowest BC concentration as a result of the efficient emission controls for the Asia-Pacific Economic Cooperation (APEC) meeting. Except for November 2014, the BC mass concentration during the heating periods was notably lower than the before-heating periods in November 2015 and 2016. Wind speed and relative humidity appeared to be two important meteorological parameters affecting BC pollution. The MERRA-2 BC concentration was validated through comparison with the continuous ground BC measurements in 2015 and 2016, affirming its reliability in demonstrating the large scale and long term variations of the ground BC concentration. The MERRA-2 BC spatial distribution, the potential source regions determined by concentration weighted trajectory (CWT) analysis, and the regional emission inventories were combined to reveal the potential source regions and source types of BC in Beijing. Transportation emission in Beijing and residential emissions in the neighboring regions such as Hebei appeared to be important sources of BC in Beijing. According to the historical trends of MERRA-2 BC concentration and typical fossil fuel consumption (1980-2017), local coal and coke are no longer the major factor affecting the BC concentration, instead, liquid fuels such as gasoline, kerosene, and diesel may highly contribute to the BC pollution in Beijing in recent years. Regional transport of BC may have also contributed to the loading of BC in Beijing. Open biomass burning may be a non-negligible factor for the short-term variation of BC in the atmosphere.