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Potential protective role of soluble fiber in mitigating tinnitus symptoms: A Case-Control Study
No full textBackground
Tinnitus, the perception of sound without any external source, affects millions of people worldwide and tends to increase with age. Evidence suggested that dietary fiber may play a critical role in mitigating the risk of tinnitus. This study aims to investigate the potential association between dietary fiber intake and the risk of tinnitus.
Methods
This cross-sectional study included a total of 300 Iranian women, with 150 stable tinnitus and 150 controls. Dietary intake was assessed using a validated questionnaire and analyzed using Nutritionist IV software. The association of dietary fiber intake and tinnitus was evaluated employing logistic regression analysis.
Results
Patients with tinnitus had significantly lower levels of daily soluble fiber intake compared to controls (P<0.05). The analysis demonstrated a negative association between tinnitus and the daily soluble fiber intake, with an adjusted odds ratio (OR) of 0.71 (95% CI: 0.51–0.97, P= 0.03). This association remained significant after further adjustment for calorie intake (OR: 0.71, 95% CI: 0.52–0.98, P= 0.04). No significant association was observed between tinnitus and the intake of total, crude, or insoluble fiber.
Conclusion
Our findings indicated that a diet rich in soluble fiber, such as fruits and grains, may help mitigate tinnitus symptoms. Further, longitudinal studies are needed to confirm these findings and explore the potential mechanisms by which dietary fiber impacts tinnitus risk
Exercise for depression
No full textRationale
Depression is a common cause of morbidity and mortality worldwide. Depression is commonly treated with antidepressants and/or psychological therapy, but some people may prefer alternative approaches such as exercise. There are a number of theoretical reasons why exercise may improve depression. This is an update of an earlier review first published in 2009.
Objectives
To determine the effectiveness of exercise in the treatment of depression in adults compared with no treatment or an active intervention (e.g., psychological, pharmacological, alternative treatments).
Search methods
We searched the Cochrane Depression, Anxiety and Neurosis Review Group’s Controlled Trials Register (CCDANCTR) to February 2016. As CCDANCTR was not updated after this search, we searched MEDLINE, EMBASE, PsycINFO and the Cochrane Central Register of Controlled Trials (CENTRAL) from 2016 to November 2023. No date or language restrictions were applied.
Eligibility criteria
Randomised controlled trials (RCTs) in which exercise was compared to standard treatment, no treatment or a placebo treatment, pharmacological treatment, psychological treatment or other active treatment in adults (aged 18 and over) with depression, as defined by trial authors. We included individual participant and cluster randomised trials. We excluded trials of postnatal depression. Two authors independently undertook study selection and data extraction.
Outcomes
The primary outcome assessed was a measure of depression or mood at treatment end and at any longer term follow-up. Other outcomes reported were acceptability of treatment, quality of life, cost and adverse events.
Risk of bias
Risk of bias was assessed using the Cochrane Collaboration 'Risk of bias' tool (version 1). Two authors independently performed the assessment.
Synthesis methods
Two authors extracted data on primary and secondary outcomes at the end of the trial and end of follow-up (if available). We calculated effect sizes for each trial using Hedges' g method and a means difference (MD) or standardised mean difference (SMD) for the overall pooled effect for continuous data, or a risk ratio for dichotomous data. Where trials used a number of different tools to assess depression, we included the main outcome measure only in the meta-analysis. Where trials provided several 'doses' of exercise, we used data from the biggest 'dose' of exercise, and performed sensitivity analyses using the lower 'dose'. We performed subgroup analyses to explore the influence on effect sizes of method of diagnosis of depression, intensity of exercise, number of sessions of exercise, type of exercise and type of control focusing on 'control' and the 'no treatment, waiting list, usual care and self monitoring'. Our sensitivity analyses explored the influence of study quality on outcome. Included studies Seventy-three RCTs (4985 participants) fulfilled our inclusion criteria, with 69 provided data for meta-analyses.
Synthesis of results
For the 57 trials (2189 participants) comparing exercise with no treatment or a control intervention, the pooled SMD for the primary outcome of depression at the end of treatment was -0.67 (95% confidence interval (CI) -0.82 to -0.52; GRADE: low), showing that exercise may result in a reduction in depressive symptoms. When we included only the seven trials (447 participants) with adequate allocation concealment, intention-to-treat analysis and blinded outcome assessment, the pooled SMD for this outcome was smaller (SMD -0.46, 95% CI -0.88 to -0.04). Pooled data from the 9 trials (405 participants) providing long-term follow-up was very uncertain about the effect of exercise on depressive symptoms (SMD -0.53, 95% CI -1.11 to 0.06; GRADE: very low). Ten trials compared exercise with psychological therapy (414 participants) finding little to no difference in the effect on depression symptom severity (SMD 0.03, 95% CI -0.16 to 0.23; GRADE: moderate). Five trials (n = 330) compared exercise with pharmacological treatment and found little to no difference in their effect on depression symptom severity (SMD -0.11, -0.33, 0.10; GRADE: low). Of five studies reporting measures of quality of life for exercise compared to no treatment or a control intervention, it was found that exercise may result in an increase environment (2 studies, 80 participants) (SMD 0.51 (95% CI: 0.05 to 0.96); I² = 0%, p = 0.82, GRADE: low) and physical domains (5 studies, 178 participants) (SMD 0.57 (95% CI: 0.15 to 0.98); I² = 44%, p = 0.13, GRADE: very low). Fifty-one trials
reported acceptability of treatment, the risk ratio was 1.00 (95% CI 0.98 to 1.02; GRADE: moderate). Adverse events were limited, with musculoskeletal injuries and depression affecting those undertaking exercise and diarrhoea, sexual dysfunction and fatigue reported by those receiving sertraline. When assessed using the Cochrane Collaboration 'Risk of bias' tool it was evident that many trials were affected by multiple sources of bias; randomisation was adequately concealed in 22 studies, 31 used intention-to-treat analyses and 23 used blinded outcome assessors. Blinding of those receiving and those delivering the interventions was inherently difficult, with trials judged at high risk of bias. Many trials used participant self-report rating scales, which also has the potential to bias findings.
Authors' conclusions
Exercise is moderately more effective than a control intervention for reducing symptoms of depression. When compared to psychological or pharmacological therapies, exercise appears to be no more effective, though this conclusion is based on a few small trials. Long-term follow-up was rare. The addition of 35 RCTs (2526 participants) in this update has had limited effect on the estimate of the benefit of exercise on symptoms of depression. If further research was to take place, it should focus on improving the quality of RCTs, on assessing which characteristics of exercise are effective for different people and explore issues around health equity
Moral Injury and Veterinary Nursing
No full textMoral injury is a relatively new concept in the veterinary world, but deeply relevant to the experiences of anyone working with animals. Veterinary professionals are frequently confronted with ethical challenges, each with the potential to cause psychological or emotional trauma. However, research on moral injury specific to veterinary professionals is limited and focused mainly on veterinary surgeons. This chapter looks instead at veterinary nurses and their experiences with moral injury, drawing on research from human nursing and other fields. Challenges specific to veterinary nurses are discussed, as well as ideas for mitigating the risk of moral injury and the potential associated harms
A national benchmarking survey to explore the use of dose error reduction software in adult intensive care units (ICUs)
No full textBackground:
Dose Error Reduction Software (DERS) are downloaded onto Smart Pumps with minimum and maximum infusion rate settings to reduce the risk of medication errors when administering intravenous medicines. There are no current national standards for the application of this technology on Adult Intensive Care Units (ICU), and clinical application and governance of this technology is currently unknown.
Method:
A multicentre, cross-sectional survey was conducted using a self-administered questionnaire to explore practical aspects of Smart Pump containing DERS use, such as whether a DERS library was present, how it was managed, how propofol was administered, what kind of error reporting processes were in place, as well as nursing qualifications and competencies on ICUs in England.
Results:
A response rate of 50.7% (136/268 responses) ICUs units in England was achieved and indicated that 63.2% (86/136 responses) of responding units had a Smart Pump containing a DERS library. Three administration strategies were used, mg/kg/h, mL/h and ‘Other’ (which most responses stated as mg/h) for propofol for continuous sedation in ICU Smart Pump containing DERS libraries. In 68.6% (49/86 responses) of ICUs, DERS use and DERS error rates are not reported through local operational and governance structures. DERS use was significantly associated with units having a Clinical Nurse Educator with a postgraduate education certificate ( p = 0.005).
Conclusions:
There are no standardised DERS settings for the anaesthetic agent propofol and inconsistent approaches to Smart Pump containing DERS governance oversight across ICUs in England. Further research is required to understand the clinical significance of identified variability
Selenium and the Heart: Molecular Insights into Cardioprotection: A Review
No full textSelenium is an essential trace element critical for cardiovascular health through its incorporation into antioxidant selenoproteins, such as glutathione peroxidase and thioredoxin reductase. The aim of this review is to explore the multifaceted role of selenium in maintaining cardiac structure and function, emphasizing its influence on redox homeostasis, ion channel regulation, and myocardial integrity. Selenium deficiency is linked to Keshan disease and other cardiomyopathies, with experimental models demonstrating impaired antioxidant defenses, mitochondrial dysfunction, and contractile failure. Supplementation restores antioxidant capacity, improves cardiac energetics, and reduces ischemia-reperfusion injury. Selenium also modulates calcium and potassium currents in cardiomyocytes, influencing action potential duration and arrhythmogenic risk. Electrocardiographic changes, including QT prolongation and low-voltage QRS complexes, are observed in selenium-deficient states and are reversible with selenium repletion. Studies using isolated perfused hearts and cardiac muscle preparations further elucidate selenium’s protective effects against oxidative stress and electrophysiological remodeling. Normal selenium concentrations in serum and myocardium are essential for optimal cardiac performance, while both deficiency and excess can be detrimental. Emerging therapeutic strategies, including selenium-based nanotechnology, highlight its potential in managing cardiovascular disease. Overall, selenium is a vital micronutrient in cardiac physiology, with implications for disease prevention and targeted intervention (200 words)
Immunomodulators and advanced therapies for induction of remission in Crohn’s disease: a systematic review and network meta-analysis
No full textBackground: Previous reviews for CD treatment have rarely considered advanced and immunomodulator medical therapies together. Our aim was to compare all therapies for efficacy and safety in induction of remission.
Methods: We searched databases up to June 2025. Our outcomes were clinical remission and response, endoscopic remission, and safety outcomes. We performed network meta-analyses and estimated RR and 95% CI. We used GRADE to assess certainty of results, and SUCRA for ranking treatments.
Results: A total of 79 RCTs with 20724 participants were included. Interventions ranged from two to 30 weeks. There was moderate GRADE certainty of effectiveness over placebo for clinical remission for combination of adalimumab with thiopurines (RR 2.87, 95%CI 1.99-4.14, RD=35.3%, NNT=3, large magnitude), guselkumab (RR 2.5, 95%CI 1.95-3.21, RD=28.4%, NNT=4, moderate magnitude, adalimumab (RR 2.46, 95%CI 1.84-3.29, RD=27.6% NNT=4, moderate magnitude), combination of infliximab with thiopurines (RR 2.43, 95%CI 1.71-3.44, RD=27%, NNT=4, moderate magnitude), and ustekinumab (RR 2.04, 95%CI 1.69-2.46, RD=19.6% NNT=5, small magnitude). For endoscopic remission there was moderate GRADE certainty of effectiveness for risankizumab (RR 3.48, 95%CI 2.18-5.58, RD=17.4%, moderate magnitude). The certainty on safety varied, but treatments appear generally safe short-term.
Conclusion: Combination of anti-TNFs and immunomodulators followed by anti-TNF monotherapy had large effect size with moderate certainty for the induction of clinical remission. More novel therapies appear to have similar effect sizes, but with increased imprecision of the estimates
Asteroseismic detection of a predominantly toroidal magnetic field in the deep interior of the main-sequence F star KIC 9244992
No full textAn asteroseismic analysis has revealed a magnetic field in the deep interior of a slowly-rotating main-sequence F star KIC9244992, which was observed by the Kepler spacecraft for four years. The star shows clear asymmetry of frequency splittings of high-order dipolar gravity modes, which cannot be explained by rotation alone, but are fully consistent with a model with rotation, a magnetic field and a discontinuous structure (glitch). Careful examination of the frequency dependence of the asymmetry allows us to put constraints on not only the radial component of the magnetic field, but also its azimuthal (toroidal) component. The lower bounds of the root-mean-squares of the radial and azimuthal components in the radiative region within 50 per cent in radius, which have the highest sensitivity in the layers just outside the convective core with a steep gradient of chemical compositions, are estimated to be B kG and B kG, respectively. The much stronger azimuthal component than the radial one is consistent with the significant contribution of the differential rotation although the star has almost uniform rotation at present. The estimated field strengths are too strong to be explained by dynamo mechanisms in the radiative zone associated with the magnetic Tayler instability. The aspherical glitch is found to be located in the innermost radiative layers where there is a steep gradient of chemical composition. The first detection of magnetic fields in the deep interior of a main-sequence star sheds new light on the problem of stellar magnetism, for which there remain many uncertainties
Individual and Language Differences in Rhythm Grouping Preferences: The Iambic-Trochaic Law Revisited
No full textImpact of COVID-19 pandemic on characteristics, extent, and trends in child maltreatment in 34 Euro-CAN COST Action Countries: a scoping review of the literature
No full textBackground
The COVID-19 pandemic intensified known risk factors for child maltreatment (CM). Yet, globally inconsistent trends were reported. Little is known about CM trends across Europe, given varying surveillance systems.
Objective
This scoping review systematically examined evidence on CM trends during the pandemic in 34 European countries in the COST Action Euro-CAN network.
Participants and Setting.
CM (physical, sexual, psychological abuse, neglect, and online harms) across various settings (population, healthcare, social care including NGOs, child protection services, judicial/police).
Methods
We searched PubMed, EMBASE, PsycINFO, Scopus, Web of Science, OPENGREY, and Google Scholar (January 2020–November 2024). Eligible studies included primary research and systematic or narrative reviews. Two reviewers independently screened and extracted data. Findings were synthesized narratively by CM type, sector, country, and study design, and reported following the PRISMA-ScR.
Results
Of 4658 records screened, 87 records were included (72 primary research, 15 reviews). Most studies used quantitative methods (n = 64, 89 %) and reported healthcare and population-based data. Physical abuse was the most frequently reported type (n = 42, 58 %). Results were mixed, showing increase, decrease, or no change in CM. The most consistent signal was an increase in physical abuse identified in French hospital datasets. Qualitative studies highlighted concerns about children's safety during school closures and changes in referral patterns.
Conclusion
This is the first comprehensive review of CM trends in Europe during the pandemic, covering the longest timeframe. Fragmented evidence reflects heterogeneous definitions, reliance on institutional data and underrepresentation of vulnerable groups. Findings stress for harmonised definitions and resilient surveillance systems
Cardiorespiratory Sound Separation Using Singular Spectrum Analysis
No full textCardiorespiratory signal separation is a critical task in biomedical signal processing, with significant implications for improving the accuracy of cardiovascular and pulmonary disease diagnoses. The presence of complex mixed signals and noise complicates the separation of cardiac and respiratory sounds from a single-channel recording. Traditional separation methods struggle due to the overlapping frequency ranges of these physiological signals. In this work, we propose a multi-stage Singular Spectrum Analysis (MSSA)-based framework for the separation of cardiac and respiratory sounds. The approach utilizes a two-stage SSA process where the first stage isolates the cardiac components through periodic structure analysis, while the second stage extracts respiratory components based on relative variance and cross-correlation. Key features of this method include a systematic selection of RCs that ensure high-quality signal separation, preserving physiological integrity. The framework was validated on real-world cardiorespiratory recordings obtained via electronic digital stethoscopes, demonstrating robustness across varying recording conditions