Impact of cognitive behavior therapy on osteoarthritis-associated pain, insomnia, depression, fatigue, and physical function in patients with knee/hip osteoarthritis: A systematic review and meta-analysis of randomized controlled trials

BackgroundThis meta-analysis aimed at evaluating the efficacy of cognitive behavior therapy (CBT) against osteoarthritis-associated symptoms in patients with knee/hip osteoarthritis.MethodsMedline, PubMed, Cochrane Library, and EMBASE databases were searched from inception to July 2022 to identify randomized controlled trials (RCTs) comparing the efficacy of CBT with other treatment approaches in adults with confirmed knee/hip osteoarthritis. The pain intensity (primary outcome) and the secondary outcomes including insomnia severity, sleep efficiency, physical function as well as the severity of depression and fatigue were assessed at two time points (i.e., immediately after treatment and during the follow-up period). The effect size is expressed as standardized mean difference (SMD) with SMDs of < 0.2, 0.2–0.5, and 0.5–0.8, and > 0.8 representing negligible, small, medium, and large effect sizes, respectively.ResultsFifteen RCTs were included for analysis. Immediately after CBT intervention, meta-analysis showed similar treatment effect in pain severity [SMD = –0.46, 95% confidence interval (CI): –0.95 to 0.04, 11 studies, 1557 participants] and other symptoms including depression (SMD = –0.26, 95% CI: –0.58 to 0.06, five studies, 735 participants), fatigue (SMD = –2.44, 95% CI:–6.53 to 1.65, two RCTs, 511 participants), and physical function (SMD = –0.11, 95% CI:–0.25 to 0.02, five RCTs, 720 participants) between CBT and control groups, while there was an improvement in insomnia severity (SMD = –0.65, 95% CI: –1.06 to –0.24, four RCTs, 639 participants, medium treatment effect) and sleep efficiency (SMD = 0.32, 95% CI: 0.04 to 0.59, three RCTs, 352 patients, small treatment effect). During follow-up, CBT improved pain severity (SMD = –0.52, 95% CI: –1.03 to –0.01, eight studies, 1447 participants, medium treatment effect), insomnia (SMD = –0.43, 95% CI: –0.85 to –0.01, three RCTs, 571 participants, small treatment effect), and depression (SMD = –0.39, 95% CI: –0.59 to –0.18, four RCTs, 791 participants, small treatment effect). Nevertheless, sleep efficiency, fatigue, and physical function were not improved in the follow-up period.ConclusionOur results may suggest the durability of CBT-associated treatment benefits, supporting its role as a potential promising alternative or complementary intervention for patients with knee/hip osteoarthritis, especially against pain and insomnia. Future large-scale investigations are warranted to verify our findings.Systematic review registration[https://www.crd.york.ac.uk/prospero/], identifier [CRD42022331165]

Origin, Transport, and Vertical Distribution of Atmospheric Polluntants over the Northern Sourth China Sea During the 7-SEAS-Dongsha Experiment

During the spring of 2010, comprehensive in situ measurements were made for the first time on a small atoll (Dongsha Island) in the northern South China Sea (SCS), a key region of the 7-SEAS (the Seven South East Asian Studies) program. This paper focuses on characterizing the source origins, transport processes, and vertical distributions of the Asian continental outflows over the region, using measurements including mass concentration, optical properties, hygroscopicity, and vertical distribution of the aerosol particles, as well as the trace gas composition. Cluster analysis of backward trajectories classified 52% of the air masses arriving at ground level of Dongsha Island as having a continental origin, mainly from northern China to the northern SCS, passing the coastal area and being confined in the marine boundary layer (0-0.5 km). Compared to aerosols of oceanic origin, the fine mode continental aerosols have a higher concentration, extinction coefficient, and single-scattering albedo at 550 nm (i.e., 19 vs. 14 microg per cubic meter in PM(sub 2.5); 77 vs. 59 M per meter in beta(sub e); and 0.94 vs. 0.90 in omega, respectively). These aerosols have a higher hygroscopicity (f at 85% RH = 2.1) than those in the upwind inland regions, suggesting that the aerosols transported to the northern SCS were modified by the marine environment. In addition to the near-surface aerosol transport, a significant upper-layer (3-4 km) transport of biomass-burning aerosols was observed. Our results suggest that emissions from both China and Southeast Asia could have a significant impact on the aerosol loading and other aerosol properties over the SCS. Furthermore, the complex vertical distribution of aerosols-coinciding-with-clouds has implications for remote-sensing observations and aerosol-cloud-radiation interactions

Bone marrow niche trafficking of miR-126 controls the self-renewal of leukemia stem cells in chronic myelogenous leukemia

Leukemia stem cells (LSCs) in individuals with chronic myelogenous leukemia (CML) (hereafter referred to as CML LSCs) are responsible for initiating and maintaining clonal hematopoiesis. These cells persist in the bone marrow (BM) despite effective inhibition of BCR–ABL kinase activity by tyrosine kinase inhibitors (TKIs). Here we show that although the microRNA (miRNA) miR-126 supported the quiescence, self-renewal and engraftment capacity of CML LSCs, miR-126 levels were lower in CML LSCs than in long-term hematopoietic stem cells (LT-HSCs) from healthy individuals. Downregulation of miR-126 levels in CML LSCs was due to phosphorylation of Sprouty-related EVH1-domain-containing 1 (SPRED1) by BCR–ABL, which led to inhibition of the RAN–exportin-5–RCC1 complex that mediates miRNA maturation. Endothelial cells (ECs) in the BM supply miR-126 to CML LSCs to support quiescence and leukemia growth, as shown using mouse models of CML in which Mir126a (encoding miR-126) was conditionally knocked out in ECs and/or LSCs. Inhibition of BCR–ABL by TKI treatment caused an undesired increase in endogenous miR-126 levels, which enhanced LSC quiescence and persistence. Mir126a knockout in LSCs and/or ECs, or treatment with a miR-126 inhibitor that targets miR-126 expression in both LSCs and ECs, enhanced the in vivo anti-leukemic effects of TKI treatment and strongly diminished LSC leukemia-initiating capacity, providing a new strategy for the elimination of LSCs in individuals with CML

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Heat Transfer Enhancement in Gravity Heat Pipes Using AAO Nanostructure Generated on Condenser Section Inner Surface

This study mainly focuses on the influence of anodic aluminum oxide (AAO) nanostructure generated on condenser section inner surface on the heat transfer performance of gravity heat pipes. AAO nanotubes were first grown by anodizing the inner wall surface of the condenser section of aluminum alloy gravity heat pipes through different anodizing voltages and treatment times. The nanostructure effect on the temperature distribution and overall thermal resistance was then investigated by using a thermal performance test system under different input heat powers. The experimental results showed that the generation of AAO nanostructure on the inner surface significantly enhances heat transfer performance; that is, the temperature difference between the evaporator and condenser sections and overall thermal resistance are reduced. Such an effect can be more significant in the case of a lower heat source. The percentage decreases in temperature difference and overall thermal resistance can be reduced by up to 58.83% and 58.79%, respectively, compared to the unprocessed heat pipe

Silica Geothermometry Applications in the Taiwan Orogenic Belt

The silica concentrations from 130 hot spring measurements were calculated and used to indicate the heat flow distribution in the active Taiwan orgenic belt. The heat flow spatial distribution seems to be controlled by the Taiwan arc-continent collision zone tectonic development. Two abnormally high silica heat flow regions, 160 and 190 mW m-2, are identified in northeastern and southeastern Taiwan, respectively. In northeastern Taiwan, the Chingshui area, the data suggests that the anomalous heat flow distribution may be controlled mainly by hot fluids and faults. The highest heat flow in southeastern Taiwan may be generated by heat advection caused by a rapidly uplifting hot crust with a decreasing mature arc-continent collision zone exhumation rate. In addition, we estimated the exhumation rate in different tectonic zones in Southern Taiwan by applying fission track ages and silica heat flow values. The exhumation rates are 1.33, 1.72 - 3.87, and 0.51 - 1.74 mm yr-1 in the tectonic zones around Taiwan for advanced, initial arc-continent collision and accretionary wedge deformation, respectively

Characterizing Tyrosinase Modulators from the Roots of Angelica keiskei Using Tyrosinase Inhibition Assay and UPLC-MS/MS as the Combinatorial Novel Approach

In this study, an in vitro tyrosinase inhibition assay in combination with ultra performance liquid chromatography-orbitrap mass spectrometry (UPLC-orbitrap-MS) was developed for the rapid screening and identification of tyrosinase modulators from roots of Angelica keiskei. Of the 15 candidates considered, nine chalcones, xanthoangelols (1), B (2), D (3), E (4), G (5), H (6), 4-hydroxyderricin (7), xanthokeismin B (8) and (2E)-1-[4-hydroxy-2-(2-hydroxy-2-propanyl)-2,3-dihydro-1-benzofuran-7-yl]-3-(4-hydroxyphenyl)-2-propen-1-one (9), five coumarins, umbelliferone (10), selinidin (11), isopimpinellin (12), phellopterin (13) and xanthyletin (14), and one other compound, ashitabaol A (15), were distinguished between the test samples and the controls with statistical significance, and the structure of each compound was determined by comparing with in-house standards and the literature. Among these, six compounds, xanthoangelol (1), xanthoangelol D (3), xanthoangelol H (6), 4-hydroxyderricin (7), laserpitin (16) and isolaserpitin (17), were isolated from roots of A. keiskei. Of the compounds isolated, compounds 1, 7 and 16 were subjected to tyrosinase inhibitory assay, and the IC50 values were 15.87 ± 1.21, 60.14 ± 2.29 and >100 μM, respectively. The present study indicated that the combination of in vitro tyrosinase inhibition assay coupled with UPLC-MS/MS could be widely applied to the rapid screening of active substances from various natural resources.Science, Faculty ofNon UBCMicrobiology and Immunology, Department ofReviewedFacult

Integrating Stable Isotopes with Mean Residence Time Estimation to Characterize Groundwater Circulation in a Metamorphic Geothermal Field in Yilan, Taiwan

This paper presents a water circulation model by combing oxygen and hydrogen stable isotopes and mean residence time (MRT) estimation in a high-temperature metamorphic geothermal field, Tuchen, in Yilan, Taiwan. A total of 18 months of oxygen and hydrogen stable isotopes of surface water and thermal water show the same variation pattern, heavier values in summer and lighter values in the rest of the year. A shift of δ18O with a relative constant δD indicates the slow fluid–rock interaction process in the study area. Two adjacent watersheds, the Tianguer River and Duowang River, exhibit different isotopic values and imply different recharge altitudes. The seasonal variation enabled us to use stable isotope to estimate mean residence time of groundwater in the study area. Two wells, 160 m and 2200 m deep, were used to estimate mean residence time of the groundwater. Deep circulation recharges from higher elevations, with lighter isotopic values, 5.9‰ and 64‰ of δ18O and δD, and a longer mean residence time, 1148 days, while the shallow circulation comes from another source with heavier values, 5.7‰ and 54.4‰ of δ18O and δD, and a shorter mean residence time, 150 days. A two-circulation model was established based on temporal and spatial distribution characteristics of stable isotopes and the assistance of MRT. This study demonstrates the usefulness of the combined usage for further understanding water circulation of other various temperatures of metamorphic geothermalfields