The development and validation of a prediction model for imminent vertebral osteoporotic fracture in postmenopausal women.

PURPOSE: This study aimed to develop and validate a new model that focused on the risk of imminent vertebral fractures in women with osteoporosis. METHODS: Data from 2,048 patients were extracted from three hospitals, of which 1,720 patients passed the inclusion and exclusion screen. The patients from Nanfang Hospital (NFH) were randomized at a 2:1 ratio to create a training cohort (n = 709) and an internal validation cohort (n = 355), with the patients from the other two hospitals (n = 656) used for external validation. The risk factors included in the imminent osteoporotic vertebral compression fractures (OVCFs) prediction model (labelled TVF) were sorted by the least absolute shrinkage and selection operator and constructed by logistic regression. The area under the receiver operating characteristic curve (AUC), the decision curve, and the clinical impact curves of the optimal model were analyzed to verify the model. RESULTS: There were 138 and 161 fresh fractures in NFH and the other two hospitals, respectively. The lowest BMD T value and the history of vertebral fracture were integrated into the TVF model. The prediction power of TVF was demonstrated by the AUCs of 0.788 (95% confidence interval [CI], 0.728-0.849) in the training cohort and 0.774 (95% CI, 0.705-0.842) in the internal validation cohort, and 0.790 (95% CI, 0.742-0.839) and 0.741 (95% CI, 0.668-0.813) in the external validation cohorts. CONCLUSION: The TVF model demonstrated good discrimination to stratify the imminent risk of OVCFs. We therefore consider the model as a pertinent commencement in the search for more accurate imminent OVCFs prediction.

Hepatic-associated vascular morphological assessment to predict overt hepatic encephalopathy before TIPS: a multicenter study.

BACKGROUND: To provide patients the chance of accepting curative transjugular intrahepatic portosystemic shunt (TIPS) rather than palliative treatments for portal hypertension-related variceal bleeding and ascites, we aimed to assess hepatic-associated vascular morphological change to improve the predictive accuracy of overt hepatic encephalopathy (HE) risks. METHODS: In this multicenter study, 621 patients undergoing TIPS were subdivided into training (413 cases from 3 hospitals) and external validation datasets (208 cases from another 3 hospitals). In addition to traditional clinical factors, we assessed hepatic-associated vascular morphological changes using maximum diameter (including absolute and ratio values). Three predictive models (clinical, hepatic-associated vascular, and combined) were constructed using logistic regression. Their discrimination and calibration were compared to test the necessity of hepatic-associated vascular assessment and identify the optimal model. Furthermore, to verify the improved performance of ModelC-V, we compared it with four previous models, both in discrimination and calibration. RESULTS: The combined model outperformed the clinical and hepatic-associated vascular models (training: 0.814, 0.754, 0.727; validation: 0.781, 0.679, 0.776; p < 0.050) and had the best calibration. Compared to previous models, ModelC-V showed superior performance in discrimination. The high-, middle-, and low-risk populations displayed significantly different overt HE incidence (p < 0.001). Despite the limited ability of pre-TIPS ammonia to predict overt HE risks, the combined model displayed a satisfactory ability to predict overt HE risks, both in the low- and high-ammonia subgroups. CONCLUSION: Hepatic-associated vascular assessment improved the predictive accuracy of overt HE, ensuring curative chances by TIPS for suitable patients and providing insights for cirrhosis-related studies.

Synergistic electrochemical catalysis by high-entropy metal phosphide in lithium-sulfur batteries.

The shuttle effect and sluggish redox kinetics of polysulfides have hindered the development of lithium-sulfur batteries (LSBs) as premier energy storage devices. To address these issues, a high-entropy metal phosphide (NiCoMnFeCrP) was synthesized using the sol-gel method. NiCoMnFeCrP, with its rich metal species, exhibits strong synergistic effects and provides numerous catalytic active sites for the conversion of polysulfides. These active sites, possessing significant polarity, can bond with polysulfides. In situ ultraviolet-visible were conducted to monitor the dynamic changes in species and concentrations of polysulfides, validating the ability of NiCoMnFeCrP to facilitate the conversion of polysulfides. The batteries with the NiCoMnFeCrP catalyst as functional separators exhibited minimal capacity decay rates of 0.04 % and 0.23 % after 100 cycles at 0 °C and 60 °C, respectively. This indicates that the NiCoMnFeCrP catalyst possesses good thermal stability. Meanwhile, its area capacity can reach 4.78 mAh cm-2 at a high sulfur load of 4.54 mg cm-2. In conclusion, NiCoMnFeCrP achieves the objective of mitigating the shuttle effect and accelerating the kinetics of the redox reaction, thereby facilitating the commercialization of LSBs.

"Next top" mouse models advancing CTCL research.

This review systematically describes the application of in vivo mouse models in studying cutaneous T-cell lymphoma (CTCL), a complex hematological neoplasm. It highlights the diverse research approaches essential for understanding CTCL's intricate pathogenesis and evaluating potential treatments. The review categorizes various mouse models, including xenograft, syngeneic transplantation, and genetically engineered mouse models (GEMMs), emphasizing their contributions to understanding tumor-host interactions, gene functions, and studies on drug efficacy in CTCL. It acknowledges the limitations of these models, particularly in fully replicating human immune responses and early stages of CTCL. The review also highlights novel developments focusing on the potential of skin-targeted GEMMs in studying natural skin lymphoma progression and interactions with the immune system from onset. In conclusion, a balanced understanding of these models' strengths and weaknesses are essential for accelerating the deciphering of CTCL pathogenesis and developing treatment methods. The GEMMs engineered to target specifically skin-homing CD4+ T cells can be the next top mouse models that pave the way for exploring the effects of CTCL-related genes.

DynGAN: Solving Mode Collapse in GANs With Dynamic Clustering.

Generative Adversarial Networks (GANs) are widely-used generative models for synthesizing complex and realistic data. However, mode collapse, where the diversity of generated samples is significantly lower than that of real samples, poses a major challenge for further applications. Our theoretical analysis demonstrates that the generator loss function is non-convex with respect to its parameters when there are multiple modes in real data. In particular, parameters that result in generated distributions with perfect partial mode coverage of the real distribution are the local minima of the generator loss function. To address mode collapse, we propose a unified framework called Dynamic GAN. This method detects collapsed samples in the generator by thresholding on observable discriminator outputs, divides the training set based on these collapsed samples, and trains a dynamic conditional model on the partitions. The theoretical outcome ensures progressive mode coverage and experiments on synthetic and real-world data sets demonstrate that our method surpasses several GAN variants. In conclusion, we examine the root cause of mode collapse and offer a novel approach to quantitatively detect and resolve it in GANs.

Multi-resolution auto-encoder for anomaly detection of retinal imaging.

Identifying unknown types of diseases is a crucial step in preceding retinal imaging classification for the sake of safety, which is known as anomaly detection of retinal imaging. However, the widely-used supervised learning algorithms are not suitable for this problem, since the data of the unknown category is unobtainable. Moreover, for retinal imaging with different types of anomalous regions, using a single-resolution input causes information loss. Therefore, we propose an unsupervised auto-encoder model with multi-resolution inputs and outputs. We provide a theoretical understanding of the effectiveness of reconstruction error and the improvement of self-supervised learning for anomaly detection. Our experiments on two widely-used retinal imaging datasets show that the proposed methods are superior to other methods, and further experiments verify the validity of each part of the proposed method.

Serine deficiency exacerbates psoriatic skin inflammation by regulating S-adenosyl methionine-dependent DNA methylation and NF-κB signalling activation in keratinocytes.

BACKGROUND: Serine metabolism is crucial for tumour oncogenesis and immune responses. S-adenosyl methionine (SAM), a methyl donor, is typically derived from serine-driven one-carbon metabolism. However, the involvement of serine metabolism in psoriatic skin inflammation remains unclear. OBJECTIVES: To investigate the association between serine metabolism and psoriatic skin inflammation. METHODS: Clinical samples were collected from patients with psoriasis and the expression of serine biosynthesis enzymes was evaluated. The HaCaT human keratinocyte cell line was transfected with small interfering RNA (siRNA) of key enzyme or treated with inhibitors. RNA sequencing and DNA methylation assays were performed to elucidate the mechanisms underlying serine metabolism-regulated psoriatic keratinocyte inflammation. An imiquimod (IMQ)-induced psoriasis mouse model was established to determine the effect of the SAM administration on psoriatic skin inflammation. RESULTS: The expression of serine synthesis pathway enzymes, including the first rate-limiting enzyme in serine biosynthesis, phosphoglycerate dehydrogenase (PHGDH), was downregulated in the epidermal lesions of patients with psoriasis compared with that in healthy controls. Suppressing PHGDH in keratinocytes promoted the production of proinflammatory cytokines and enrichment of psoriatic-related signalling pathways, including the tumour necrosis factor-alpha (TNF-α) signalling pathway, interleukin (IL)-17 signalling pathway and NF-κB signalling pathway. In particular, PHGDH inhibition markedly promoted the secretion of IL-6 in keratinocytes with or without IL-17A, IL-22, IL-1α, oncostatin M and TNF-α (mix) stimulation. Mechanistically, PHGDH inhibition upregulated the expression of IL-6 by inhibiting SAM-dependent DNA methylation at the promoter and increasing the binding of myocyte enhancer factor 2A. Furthermore, PHGDH inhibition increased the secretion of IL-6 by increasing the activation of NF-κB via SAM inhibition. SAM treatment effectively alleviated IMQ-induced psoriasis-like skin inflammation in mice. CONCLUSIONS: Our study revealed the crucial role of PHGDH in antagonising psoriatic skin inflammation and indicated that targeting serine metabolism may represent a novel therapeutic strategy for treating psoriasis.

Effectiveness of continuous home wound care on patients with diabetic foot ulcers.

AIMS: To explore the effectiveness of continuous home wound care on patients with diabetic foot ulcers (DFUs). DESIGN: A non-randomized parallel controlled non-inferiority trial. METHODS: Patients with Wagner grade I-III DFUs hospitalized in two distant campuses of the same hospital were included. All patients received infection treatment and wound bed preparation during hospitalization; after discharge, patients in one of the campuses received routine outpatient wound care, and those treated in the other received continuous home wound care. The per-protocol analysis was performed to compare ulcer healing indicators, knowledge, health belief, self-management behaviour and medical expenses of the two groups. RESULTS: Between October 2021 and December 2022, 116 patients were enrolled in the study; 107 completed. The home care was not inferior in terms of ulcer healing rate and demonstrated significant enhancements in the understanding of warning signs, health belief and self-management behaviour. Additionally, the home care saved 220.38 yuan (24.32 UK pounds) in direct medical expenses for each additional one square centimetre of ulcer healing. CONCLUSION: The continuous home wound care enhanced self-management behaviour of the patients and saved their medical expenses while not compromising ulcer healing. IMPACT: This is to date the first study to conduct continuous home wound care practice for patients with DFUs and confirmed its safety and non-inferiority in ulcer healing, and supported its superiority in improving self-management behaviour and saving medical expenses. REPORTING METHOD: We have adhered to the transparent reporting of evaluations with nonrandomized designs statements and the corresponding checklist was followed. PATIENT OR PUBLIC CONTRIBUTION: The patients and their primary caregivers were involved in intervention design, we received input from them about the factors that facilitate and hinder patient self-management behaviours to develop intervention strategies.

Effectiveness of continuous home wound care on wound healing, self-management behavior, and medical expenses of patients with diabetic foot ulcers.

OBJECTIVE: To explore the effectiveness of continuous home wound care on wound healing, self-management behavior, and medical expenses of patients with diabetic foot ulcers. MATERIALS AND METHODS: Patients were grouped by the campuses they were hospitalized. One group received home wound care, and the other one received outpatient wound care after their discharge. Non-inferiority testing was performed to compare ulcer healing. Their Diabetes-related Foot Ulcer Self-Management Behavior Scale (DFUSMBS) scores and medical expenses were compared. RESULTS: Between October 2021 and December 2022, fifty-five patients in the home wound care group and fifty-two in the outpatient wound care group completed the study. The home wound care was non-inferior concerning ulcer complete healing rate in total or stratified by Wagner grade or baseline ulcer area. Concerning wound healing time, the home wound care group was inferior for Wagner Grade Ⅲ ulcers (hazard ratio = 0.7772, 95 % CI = 0.2799-2.1581). In contrast, for ulcers with baseline area>5 cm2, the home care group was non-inferior and even can be superior, although the superiority was not statistically significant (Log-rank X2 = 0.257, p = 0.612). Moreover, the home wound care group showed significant improvement concerning timely wound treatment (t = 23.045, p < 0.001, Cohen's d = 4.460, Effect Size = 0.912) and wound care behavior (t = 33.410, p < 0.001, Cohen's d = 6.454, Effect Size = 0.955), while that of diabetes self-management was not statistically significant (t = -0.673, p = 0.502, Cohen's d = 0.128, Effect Size = 0.064). The medium direct medical expense per capita of the patients in the outpatient care group was statistically significantly heavier than that of the home wound care group (Z = -6.877, p < 0.001). CONCLUSION: The home wound care practice did not compromise ulcer healing, enhanced timely wound treatment and wound care behavior of the patients, and saved their medical expenses, hopefully providing a feasible wound care alternative with economic benefits for the physically and economically devastated patients.

CREB1-driven CXCR4hi neutrophils promote skin inflammation in mouse models and human patients.

Neutrophils have a pathogenic function in inflammation via releasing pro-inflammatory mediators or neutrophil extracellular traps (NETs). However, their heterogeneity and pro-inflammatory mechanisms remain unclear. Here, we demonstrate that CXCR4hi neutrophils accumulate in the blood and inflamed skin in human psoriasis, and correlate with disease severity. Compared to CXCR4lo neutrophils, CXCR4hi neutrophils have enhanced NETs formation, phagocytic function, neutrophil degranulation, and overexpression of pro-inflammatory cytokines and chemokines in vitro. This is accompanied by a metabolic shift in CXCR4hi neutrophils toward glycolysis and lactate release, thereby promoting vascular permeability and remodeling. CXCR4 expression in neutrophils is dependent on CREB1, a transcription factor activated by TNF and CXCL12, and regulated by de novo synthesis. In vivo, CXCR4hi neutrophil infiltration amplifies skin inflammation, whereas blockade of CXCR4hi neutrophils through CXCR4 or CXCL12 inhibition leads to suppression of immune responses. In this work, our study identifies CREB1 as a critical regulator of CXCR4hi neutrophil development and characterizes the contribution of CXCR4hi neutrophils to vascular remodeling and inflammatory responses in skin.

MoO2/t-C3N4 Heterogeneous Materials with Bidirectional Catalysis for the Rapid Conversion of S Species in Li-S Batteries.

Li-S batteries have drawn a lot of attention for their high theoretical specific capacity and significant economic benefits. However, the shuttle effect of polysulfides prevents them from being used widely. To tackle this difficulty, a heterogeneous structure based on tubular carbon nitride with evenly dispersed molybdenum dioxide nanoparticles (MoO2/t-C3N4) as the S host is constructed in this work. As a polar material with a large specific surface area, MoO2/t-C3N4 has a strong anchoring effect on polysulfide. Additionally, the heterogeneous material has excellent bidirectional catalytic ability for the redox process of S species based on the action of the built-in electric field formed by electron directional transfer. Not only does it improve the reaction kinetics of the redox process of the polysulfides but it also prevents polysulfides from accumulating on the surface of the modified material and deactivating it, further improving the utilization of the active material. Thus, MoO2/t-C3N4/S shows the high initial-discharge specific capacity of 812.7 mAh g-1 at the current density of 5C, and the Coulombic efficiency is maintained at more than 95% after 400 charge/discharge cycles. Moreover, MoO2/t-C3N4/S achieved a capacity retention of 89% after 100 cycles at the current density of 0.1C under the high S loading. Therefore, the research results of this work provide a trustworthy reference for the future commercial application of Li-S batteries.

Socs1-knockout in skin-resident CD4+ T cells in a protracted contact-allergic reaction results in an autonomous skin inflammation with features of early-stage mycosis fungoides.

Recent detailed genomic analysis of mycosis fungoides (MF) identified suppressor of cytokine signaling 1 (SOCS1), an inhibitor of JAK/STAT signaling, as one of the frequently deleted tumor suppressors in MF, and one-copy deletion of SOCS1 was confirmed in early-stage MF lesions. To better understand the functional role of SOCS1 in the genesis of MF, we used a genetically engineered mouse model emulating heterozygous SOCS1 loss in skin resident CD4+ T cells. In these mice an experimentally induced contact-allergic reaction was maintained for 20 weeks. Ten weeks after discontinuing contact-allergic challenges, only the skin with locally one-copy deletion of Socs1 in CD4+ T cells still showed high numbers of CD3+/CD4+ Socs1 k.o. cells in the dermis (p ＜ 0.0001) with prevalent Stat3 activation (p ＜0.001). And in one out of 9 mice, this had progressed to far more dramatic increases, including the thickened epidermis, and with an explosive growth of Socs1 k.o. T cells in circulation; indicative of cutaneous lymphoma. Hence, we show that Socs1 mono-allelic loss in CD4+ T cells locally in protractedly inflamed skin results in autonomous skin inflammation with features of early-stage MF.

Promoting dewatering efficiency of sludge by bioleaching coupling chemical flocculation.

In recent years, bioleaching has emerged as a cost-effective technology for enhancing the dewaterability of sludge. However, the lengthy treatment time involved in sludge bioleaching processes limits daily treatment capacity for sludge. Here, a novel approach was developed through a short time of sludge bioleaching with A. ferrooxidans LX5 (A. f) and A. thiooxidans TS6 (A. t) followed by polyferric sulfate (PFS) flocculation (A. f + A. t + PFS). After 12.5 h of the A. f + A. t + PFS treatment (30% A. f, 10% A. t, 40 mg/g DS S0, 60 mg/g DS FeSO4•7H2O, and 120 mg/g DS PFS), the reduction efficiency of specific resistance to filtration (SRF) and sludge cake moisture content reached 94.0% and 11.6%, respectively, which were comparable to the results achieved through 24 h of completed bioleaching treatment. In pilot-scale applications, the mechanical dewatering performance was notably improved following A. f + A. t + PFS treatment, with the low moisture content of the treated sludge cake (∼59.2%). This study provides new insights into the A. f + A. t + PFS process and holds potential for developing efficient and promising sludge dewatering strategies in engineering application.

Cyclodextrin-induced phase transformation of cesium copper bromide perovskite.

Phase transformation represents a fascinating way to tune the structural and optical properties of metal halide perovskites. Macrocyclic cyclodextrin could trigger transformation of cesium copper bromide, driven by strong interactions of the macrocyclic hydroxyl groups with the perovskite cesium and bromide ions.

Keratin 17 covalently binds to alpha-enolase and exacerbates proliferation of keratinocytes in psoriasis.

Dysregulated glucose metabolism is an important characteristic of psoriasis. Cytoskeletal protein keratin 17 (K17) is highly expressed in the psoriatic epidermis and contributes to psoriasis pathogenesis. However, whether K17 is involved in the dysregulated glucose metabolism of keratinocytes (KCs) in psoriasis remains unclear. In the present study, loss- and gain-of-function studies showed that elevated K17 expression was critically involved in glycolytic pathway activation in psoriatic KCs. The level of α-enolase (ENO1), a novel potent interaction partner of K17, was also elevated in psoriatic KCs. Knockdown of ENO1 by siRNA or inhibition of ENO1 activity by the inhibitor ENOBlock remarkably suppressed KCs glycolysis and proliferation. Moreover, ENO1 directly interacted with K17 and maintained K17-Ser44 phosphorylation to promote the nuclear translocation of K17, which promoted the transcription of the key glycolysis enzyme lactic dehydrogenase A (LDHA) and resulted in enhanced KCs glycolysis and proliferation in vitro. Finally, either inhibiting the expression and activation of ENO1 or repressing K17-Ser44 phosphorylation significantly alleviated the IMQ-induced psoriasis-like phenotype in vivo. These findings provide new insights into the metabolic profile of psoriatic KCs and suggest that modulation of the ENO1-K17-LDHA axis is a potentially innovative therapeutic approach to psoriasis.

Validity and reliability of Chinese version of the new diabetic foot ulcer assessment scale.

A specific assessment tool is urgently needed to guide effective wound care for diabetic foot ulcers. However, the tool has not been available in Chinese. We aimed to culturally translate and verify the validity and reliability of the new Diabetic Foot Ulcer Assessment Scale (DFUAS). The original scale was translated into Chinese according to the Brislin guidelines. Patients satisfying the inclusion and exclusion criteria were recruited. Each of the included foot ulcers was evaluated independently by two wound care specialists using the new DFUAS and by the third wound care specialists at the same time using the Bates-Jensen Wound Assessment Tool according to per guidelines. 210 diabetic foot ulcers were included for data analysis. The S-CVI of the Chinese version of the DFUAS was 0.96, and the I-CVIs ranged from 0.89 to 0.98. The total Cronbach's Alpha of the scale was 0.709, and the corrected item-total correlation of the items ranged from 0.4 to 0.872. The DFUAS had high inter-observer reliability of 0.997, and there were weak, moderate, and strong correlations between each pair of the items. The Bland-Altman plots showed a good agreement between the scale and the Bates-Jensen Wound Assessment Tool. We concluded that the Chinese version of the DFUAS showed good validity and reliability and is a reliable instrument for the assessment of diabetic foot ulcers.

CD36-SREBP1 Axis Mediates TSLP Production in Obesity-Exacerbated Atopic Dermatitis.

Obesity is associated with an increased risk of atopic dermatitis (AD) and may accelerate its development. Keratinocyte dysfunction has been observed in obesity-related skin diseases, including psoriasis and acanthosis nigricans, but is not fully understood in AD. In this study, we found that high-fat diet-induced obesity exacerbated AD-like dermatitis in mice, with elevated inflammatory molecules and increased CD36-SREBP1-related fatty acid accumulation in the lesional skin. Blocking CD36 or SREBP1 with chemical inhibitors effectively alleviated AD-like inflammation, decreased fatty acid accumulation, and downregulated TSLP expression in obese calcipotriol (MC903)-treated mice. Moreover, palmitic acid treatment induced TSLP overexpression in keratinocytes through the activation of the CD36-SREBP1 signaling pathway. The chromatin immunoprecipitation assay further revealed increased binding of SREBP1 to the TSLP promoter region. Our findings provide compelling evidence that obesity triggers the activation of the CD36-SREBP1-TSLP axis in keratinocytes, leading to epidermal lipid disorders and the aggravation of AD-like inflammation. By targeting CD36 or SREBP1, future combination therapies or modified treatment strategies could be developed to help manage patients with both obesity and AD.

Enhancing sludge dewatering efficiency through bioleaching facilitated by increasing reactive oxygen species.

Bioleaching facilitated by iron-oxidizing bacteria is regarded as a promising sludge dewatering method due to excellent dewaterability and low cost. However, a two-days bioleaching time for sludge conditioning decreased its daily treatment capacity. In fact, Fe2+ easily reacts with O2 to produce reactive oxygen species (ROS) with high oxidizing activity. Can bioleaching performed in Fe2+-rich system generate ROS to decompose sludge extracellular polymeric substances (EPS)? Here both contribution of ROS produced in bioleaching to improve sludge dewaterability and the increase of ROS content to shorten sludge bioleaching treatment time were investigated. The introduction of H2O2 in sludge bioleaching treatment (BS+H2O2) to increase ROS could simultaneously improve sludge dewaterability and decrease bioleaching time. Specific resistance to filtration (SRF) and capillary suction time (CST) reduction ratios (90.3% and 80.9%) in BS+H2O2 process were much higher than those in other processes after only 30 min reaction. Mechanisms of improving sludge dewaterability in BS+H2O2 mainly included ROS oxidation and Fe3+ flocculation by analysis of the contribution factors. These findings not only provide an effectively method to promote sludge dewatering efficiency of bioleaching, but also give new sights into the design of cost-efficient processes for improving the sludge dewatering.

Effect of a video-based exercise intervention on depression and sleep conditions of peritoneal dialysis patients.

OBJECTIVE: To evaluate the effectiveness of a video-based exercise intervention on depression and sleep conditions of peritoneal dialysis (PD) patients. MATERIALS AND METHODS: Participants satisfying the inclusion and exclusion criteria were recruited from the Peritoneal Dialysis Center, Department of Nephrology of the First Affiliated Hospital of Guangxi Medical University, and they were divided into an intervention group and a control group. The intervention group received video-based exercise intervention while the control group received routine care. Then their BDI-II and PSQI scores were collected and analyzed before and after the intervention. RESULTS: There were no significant differences in BDI-II score and the seven components of PSQI score between the two groups at the baseline measures (p > 0.05). However, after 12 weeks of intervention, the intervention group had a significantly lower score in BDI-II (p < 0.05) and in six components of PSQI (p < 0.05), with the exception of the "use of sleep medications" subscale (p > 0.05). Their depression level also improved significantly after intervention (p < 0.05), while that of the control group did not change significantly(p > 0.05). CONCLUSION: The video-based exercise intervention is safe and can remarkably improve the depression and sleep conditions of PD patients and is thus worthwhile to be applied widely.

Effectiveness of a video-based exercise program on nutritional status and quality of life of peritoneal dialysis patients: A pilot randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a video-based exercise program on nutritional status and quality of life (QOL) of peritoneal dialysis (PD) patients. MATERIALS AND METHODS: Participants satisfying the inclusion and exclusion criteria were recruited and divided into the intervention group and the control group. The intervention group received video-based exercise based on a manual advocated by the National Kidney Foundation, while the control group received routine exercise guidance. Their nutritional indicators and the Quality of Life Scale for Peritoneal Dialysis patients (QLSPD) scores were collected and analyzed. RESULTS: No adverse events occurred during the study. Baseline data between the two groups were comparable, and there were no significant differences in body mass index (BMI) (t = 0.214, p = 0.831), triceps skin fold thickness (TSF) (t = 0.407, p = 0.685), arm muscle circumference (AMC) (t = 0.310, p = 0.757), grip strength (Gs) (t = 0.557, p = 0.579), calf circumference (Cc) (t = 0.441, p = 0.660), serum albumin (Alb) (t = 0.261, p = 0.795), prealbumin (PA) (t = 0.218, p = 0.828), hemoglobin (Hb) (t = 0.114, p = 0.909), triglyceride (TG) (t = 0.192, p = 0.848), total cholesterol (TC) (t = 0.092, p = 0.927), low-density lipoprotein (LDL) (t = 0.124, p = 0.902), high-density lipoprotein (HDL) (t = 0.265, p = 0.792), blood urea nitrogen (BUN) (t = 0.540, p = 0.590), serum creatinine (SCr) (t = 0.255, p = 0.799), total urea clearance index (Kt/V) (t = 0.958, p = 0.340), total creatinine clearance rate (Ccr) (t = 0.166, p = 0.868), protein equivalent of nitrogen appearance (nPNA) (t = 0.240, p = 0.811), and QLSPD scores (p > 0.05) between the two groups at the baseline measures. However, after 12 weeks of intervention, the AMC (t = 2.993, p = 0.003) and Cc (t = 2.811, p = 0.006) of the intervention group improved significantly compared with the control group. The BMI (t = 2.068, p = 0.041) and TSF (t = 2.578, p = 0.011) showed a trend of improvement compared with baseline. And the intervention group scored less in body physiology function (t = 7.084, p < 0.001), disease factors (t = 13.336, p < 0.001), mental state (t = 9.555, p < 0.001), and social role (t = 5.156, p < 0.001) components, while their satisfaction hardly changed (t = 0.240, p = 0.811). CONCLUSION: The video-based exercise intervention is safe and can remarkably improve the nutritional status and QOL of PD patients.