Effect of daily Vitamin D3 Supplementation on Muscle Health: An Individual Participant Meta-Analysis

Background The role of vitamin D on muscle health is debated. Methods An individual participant metanalysis of four randomized placebo-controlled trials, investigating short term (three to nine months) effects of vitamin D3 in moderate (2800 IU) to high (7000 IU) daily oral doses on muscle health and quality of life (QoL). Inclusion criteria were either obesity (N=52), newly diagnosed primary hyperparathyroidism (N=41), Graves’ disease (N=86) or secondary hyperparathyroidism (N=81). Results Overall (N=260) as well as in a subgroup analysis including only vitamin D insufficient (25(OH)D< 50 nmol/L) individuals (N=176), vitamin D supplementation did not affect measures of muscle health (isometric muscle strength, Timed Up and Go test, Chair Rising Test, body composition, and balance) or QoL. However, a beneficial effect was present on QoL (physical component score) in vitamin D deficient (25(OH)D≤ 25 nmol/L) individuals (N=34). Overall, relative changes in 25(OH)D inversely affected maximum muscle strength in a dose response manner. Stratified into BMI </≥ 30 kg/m 2, vitamin D supplementation had divergent effects on isometric muscle strength, with beneficial effects in obese individuals (N=93) at knee flexion 90° (p=0.04), and adverse effects in non-obese individuals (N=167) at handgrip (p=0.02), knee extension 60° (p=0.03) and knee flexion 60° (p<0.01). Conclusion Overall, short-term treatment with moderate to high daily doses of vitamin D did not affect muscle health or QoL. A potential beneficial effect was present on muscle strength in severe obese individuals and on QoL in vitamin D deficient individuals. Subgroup analyses however suggested negative effects of large relative increases in p-25(OH)D.

Heterogeneity of the Relative Benefits of TICI 2c/3 over TICI 2b50/2b67

Purpose Incomplete reperfusion after mechanical thrombectomy (MT) is associated with a poor outcome. Rescue therapy would potentially benefit some patients with an expanded treatment in cerebral ischemia score (eTICI) 2b50/2b67 reperfusion but also harbors increased risks. The relative benefits of eTICI 2c/3 over eTICI 2b50/67 in clinically important subpopulations were analyzed. Methods Retrospective analysis of our institutional database for all patients with occlusion of the intracranial internal carotid artery (ICA) or the M1/M2 segment undergoing MT and final reperfusion of ≥eTICI 2b50 (903 patients). The heterogeneity in subgroups of different time metrics, age, National Institutes of Health Stroke Scale (NIHSS), number of retrieval attempts, Alberta Stroke Programme Early CT Score (ASPECTS) and site of occlusion using interaction terms (pi) was analyzed. Results The presence of eTICI 2c/3 was associated with better outcomes in most subgroups. Time metrics showed no interaction of eTICI 2c/3 over eTICI 2b50/2b67 and clinical outcomes (onset to reperfusion pi = 0.77, puncture to reperfusion pi = 0.65, onset to puncture pi = 0.63). An eTICI 2c/3 had less consistent association with mRS ≤2 in older patients (>82 years, pi = 0.038) and patients with either lower NIHSS (≤9) or very high NIHSS (>19, pi = 0.01). Regarding occlusion sites, the beneficial effect of eTICI 2c/3 was absent for occlusions in the M2 segments (aOR 0.73, 95% confidence interval [CI] 0.33–1.59, pi = 0.018). Conclusion Beneficial effect of eTICI 2c/3 over eTICI 2b50/2b67 only decreased in older patients, M2-occlusions and patients with either low or very high NIHSS. Improving eTICI 2b50/2b67 to eTICI 2c/3 in those subgroups may be more often futile.

Ethnobotanical and Pharmacological Importance of the Herbal Plants With Anti-Hair Fall and Hair Growth Activities

The primary aim of this study is to access the salient herbal plants with the active constituent of potentially anti-hair fall activities. It also presents the various reasons behind hair loss ailments. As part of this study, a focus is placed on active phytochemicals within these medicinal plants or natural products in terms of various hair fall disease treatments. As natural products have a beneficial effect to minimize hair loss and have promoted the potential for new hair growth, it presents the medicinal values of natural plants in reference to safety and effectiveness for health.

CAN SOCIAL MEDIA BE A TOOL FOR INCREASING TOURISTS’ ENVIRONMENTALLY RESPONSIBLE BEHAVIOR?

For the sustainable development of a tourism destination, environmentally responsible behavior (ERB) is a vital issue. This study developed an implicated model based on the Stimulus-Organism-Response (S-O-R) framework showing the usages of social media by tourists regarded as a stimulus; environmental awareness, and place attachment generated from using social media regarded as an organism; and tourists' ERB thereby bringing behavioral intension regarded as responses. The integrated tourists' ERB model was experimentally tested using survey data from 467 Bangladeshi tourists by SEM-based methodology. The study found that social media has a beneficial effect on environmental awareness and place attachment, negatively impacting ERB. Furthermore, environmental awareness and place attachment has a favorable impact on ERB. This article discusses theoretical discoveries as well as practical consequences.

Peculiarities of Reparative Osteogenesis in Fractures of the Proximal Femur in Patients with Concomitant Arterial Hypertension

Treatment of patients with fractures of the proximal femur is an important problem in modern traumatology. Hip fractures are more commonly associated with osteoporosis. Elderly and senile people make up a significant proportion of patients with fractures. Arterial hypertension (AH) in the elderly population is a disease with a high prevalence. When treating fractures of the proximal femur, it is necessary to take into account the features of reparative osteogenesis characteristics of patients with concomitant arterial hypertension. Medicines used to treat hypertension have a beneficial effect on bone tissue. Pharmacological correction of hypertension in these patients is essential to optimize fracture healing.

Another Look at Obesity Paradox in Acute Ischemic Stroke: Association Rule Mining

Though obesity is generally associated with the development of cardiovascular disease (CVD) risk factors, previous reports have also reported that obesity has a beneficial effect on CVD outcomes. We aimed to verify the existing obesity paradox through binary logistic regression (BLR) and clarify the paradox via association rule mining (ARM). Patients with acute ischemic stroke (AIS) were assessed for their 3-month functional outcome using the modified Rankin Scale (mRS) score. Predictors for poor outcome (mRS 3–6) were analyzed through BLR, and ARM was performed to find out which combination of risk factors was concurrently associated with good outcomes using maximal support, confidence, and lift values. Among 2580 patients with AIS, being obese (OR [odds ratio], 0.78; 95% CI, 0.62–0.99) had beneficial effects on the outcome at 3 months in BLR analysis. In addition, the ARM algorithm showed obese patients with good outcomes were also associated with an age less than 55 years and mild stroke severity. While BLR analysis showed a beneficial effect of obesity on stroke outcome, in ARM analysis, obese patients had a relatively good combination of risk factor profiles compared to normal BMI patients. These results may partially explain the obesity paradox phenomenon in AIS patients.

The Effect of the Preoperative Fasting Regimen on the Incidence of Gastro-Oesophageal Reflux in 90 Dogs

This study aimed to investigate the effect of three different preoperative fasting regimens on the incidence of gastro-oesophageal reflux (GOR) in dogs under general anaesthesia. Ninety dogs undergoing non-abdominal and non-thoracic elective surgery were included in the study and equally allocated to three groups. Dogs received canned food providing half the daily resting energy requirements (RER) 3 h prior to premedication (group 3H), a quarter of the daily RER 3 h before premedication (group 3Q), and half the daily RER 12 h before premedication (group 12H). The animals were premedicated with acepromazine and pethidine, anaesthesia was induced with propofol and maintained with isoflurane vaporised in oxygen. Oesophageal pH was monitored throughout anaesthesia. Demographic and surgery-related parameters were not different among groups. The incidence of GOR was 11/30 in group 3H (36.7%), 9/30 in group 3Q (30.0%) and 5/30 in group 12H (16.7%), which was not statistically different (p = 0.262). Reduction of the amount of the preoperative meal from half to a quarter of the daily RER did not reduce the incidence of GOR but resulted in a lower oesophageal pH (p = 0.003). The results of this study suggest that the administration of a meal 3 h before anaesthesia does not have any beneficial effect in the reduction of GOR incidence in dogs compared to the administration of a meal 12 h before anaesthesia.