Association of accelerometer-measured sleep duration and different intensities of physical activity with incident type 2 diabetes in a population-based cohort study

Purpose:The aim of the current study was to investigate the association of accelerometer-measured sleep duration and different intensities of physical activity(PA)with the risk of incident type 2 diabetes in a population-based prospective cohort study.Methods:Altogether,88,000 participants(mean age=62.2±7.9 years,mean±SD)were included from the UK Biobank.Sleep duration(short:<6 h/day;normal:6-8 h/day;long:>8 h/day)and PA of different intensities were measured using a wrist-won accelerometer over a 7-day period between 2013 and 2015.PA was classified according to the median or World Health Organization-recommendation:total volume of PA(high,low),moderate-to-vigorous PA(MVPA)(recommended,not recommended),and light-intensity PA(high,low).Incidence of type 2diabetes was ascertained using hospital records or death registries.Results:During a median follow-up of 7.0 years,1615 incident type 2 diabetes cases were documented.Compared with normal sleep duration,short(hazard ratio(HR)=1.21,95%confidence interval(95%CI):1.03-1.41)but not long sleep duration(HR=1.01,95%CI:0.89-1.15)was associated with excessive type 2 diabetes risk.This increased risk among short sleepers seems to be protected against by PA.Compared with normal sleepers with high or recommended PA,short sleepers with low volume of PA(HR=1.81,95%CI:1.46-2.25),not recommended(below the World Health Organization-recommended level of)MVPA(HR=1.92,95%CI:1.55-2.36),or low light-intensity PA(HR=1.49,95%CI:1.13-1.90)had a higher risk of type 2 diabetes,while short sleepers with a high volume of PA(HR=1.14,95%CI:0.88-1.49),recommended MVPA(HR=1.02,95%CI:0.71-1.48),or high light-intensity PA(HR=1.14,95%CI:0.92-1.41)did not.Conclusion:Accelerometer-measured short but not long sleep duration was associated with a higher risk of incident type 2 diabetes.A higher level of PA,regardless of intensity,potentially ameliorates this excessive risk.

Wild Nutrition’s Food-Grown® Magnesium Supplementation Increases Sleep Quality and Sleep Duration and Reduces Stress in a Healthy Adult Population: A Double-Blind, Randomised, Placebo-Controlled Study

Background: Magnesium, an essential mineral crucial for various bodily functions, has been shown to positively influence sleep patterns. This study aimed to evaluate the efficacy of Food-Grown® magnesium in enhancing sleep quality and duration, as well as overall well-being. Methods: Eighty participants were randomly assigned to receive either 80 mg of Food-Grown® magnesium or a placebo (microcrystalline cellulose) daily for 8 weeks. Participants completed questionnaires assessing sleep quality, daytime drowsiness, quality of life, anxiety, and stress levels. Additionally, participants maintained daily sleep diaries and wore wrist-worn actigraphy devices. The primary outcome measured was the change in sleep quality and duration. Results: Seventy-one participants fulfilled all study requirements (35 in the active group and 36 in the placebo group). Magnesium supplementation significantly improved reported sleep quality, with the active group showing a 32% increase compared to 16% in the placebo group (p = 0.034). Moreover, magnesium supplementation led to a decrease in reported stress scores at week 8 compared to the placebo group (3.7 ± 2.6 vs. 5.5 ± 3.1, respectively). Both the magnesium and placebo groups exhibited significant increases in reported sleep duration and reductions in time to fall asleep, sleep disturbance, sleep latency, sleep medication usage, and total Pittsburgh Sleep Quality Index score at week 8 compared to baseline. Conclusion: Magnesium supplementation notably enhanced sleep quality and reduced stress levels compared to the placebo group. These findings highlight the potential of magnesium as a beneficial supplement for improving sleep quality and overall well-being.

Spatiotemporal changes in sunshine duration and its influential factors in Chongqing,China from 1961 to 2020

The surface solar radiation in most parts of the world has undergone a phenomenon known as global dimming and brightening,characterized by an initial decrease followed by an increase.As a result,the sunshine duration(SD)has decreased in the past 60 years.Against the backdrop of global dimming and brightening,SD has decreased to varying degrees in many regions of China.Using the observed data of SD,cloud amount(total cloud amount and low cloud amount,abbreviated as TCA and LCA),precipitation,and relative humidity(RH)from 34 meteorological stations in Chongqing during the period of 1961-2020,along with a digital elevation model(DEM)with a resolution of 90 m,this study analyzed the spatiotemporal variations and influencing factors of SD.The analysis employed methods such as linear regression,Mann-Kendall test,wavelet transformation,and DEM-based possible SD distributed model.The results showed that the annual SD in Chongqing has significantly decreased over the last 60 years,with a decreasing interannual trend rate(ITR)of 40.4 h/10a.Except for no obvious trend in spring,SD decreased significantly in summer,autumn and winter at the ITR of 21.1 h/10a,8.5 h/10a and 7.5 h/10a,respectively.An abrupt decrease in the annual SD was found in 1979.The difference before and after the abrupt decrease was 177.7 h.The difference before and after the abrupt decrease was 177.7 h.The annual SD possessed the oscillation period of 11a.The spatial heterogeneity of the mean annual SD during the last 60 years was obvious.The distribution of SD in Chongqing is high in the northeast and low in the southeast.In addition,about 73%of the total area in Chongqing showed a significant and very significant decreasing trend.The regions with significant changes are mainly concentrated in the regions with altitudes of 200~1000 m.The increasing LCA was the main cause of the decrease of the annual SD in the regions with 200-400 m altitude decreased the most and changed the most.Increasing LCA is the primary cause of the reduction in annual SD,showing a strong negative correlation coefficient of-0.7292.In Chongqing,PM2.5 concentration showed a significant decrease trend in annual,spring,autumn and winter during 2000-2020,but the significant correlation between PM2.5 concentration and SD was only in autumn and reached an extremely significant level.

Dynamic Forecasting of Traffic Event Duration in Istanbul:A Classification Approach with Real-Time Data Integration

Today,urban traffic,growing populations,and dense transportation networks are contributing to an increase in traffic incidents.These incidents include traffic accidents,vehicle breakdowns,fires,and traffic disputes,resulting in long waiting times,high carbon emissions,and other undesirable situations.It is vital to estimate incident response times quickly and accurately after traffic incidents occur for the success of incident-related planning and response activities.This study presents a model for forecasting the traffic incident duration of traffic events with high precision.The proposed model goes through a 4-stage process using various features to predict the duration of four different traffic events and presents a feature reduction approach to enable real-time data collection and prediction.In the first stage,the dataset consisting of 24,431 data points and 75 variables is prepared by data collection,merging,missing data processing and data cleaning.In the second stage,models such as Decision Trees(DT),K-Nearest Neighbour(KNN),Random Forest(RF)and Support Vector Machines(SVM)are used and hyperparameter optimisation is performed with GridSearchCV.In the third stage,feature selection and reduction are performed and real-time data are used.In the last stage,model performance with 14 variables is evaluated with metrics such as accuracy,precision,recall,F1-score,MCC,confusion matrix and SHAP.The RF model outperforms other models with an accuracy of 98.5%.The study’s prediction results demonstrate that the proposed dynamic prediction model can achieve a high level of success.

A Proposal on the Novel Method to Estimate Optimal Sleep Duration Based on Self-Reported Survey Data

Background: Many adolescents have a sleep debt. Individuals sleeping for their optimal sleep duration are expected to experience no sleepiness. Then, it is important to recognize one’s optimal sleep duration to reduce sleep debt. However, there is no simple method to determine this value. Since body mass index and sleep duration exhibit a U-shaped association, it is expected that a person taking optimal sleep duration would show no marked deviation from the mean body mass index value for the population evaluated. By using self-reported sleepiness and standardized body mass index, this study aimed to estimate individual optimal sleep duration. Methods: Data from 2540 grade 5 - 11 students were used. Students who declared no sleepiness during class and also had a gender- and grade-standardized body mass index of ±1.5 were termed ideal students. The average sleep durations of ideal students were compared with those of non-ideal students. The differences of sleep duration between ideal and no-ideal students were added to habitual sleep duration of each non-ideal student to obtain assumed optimal sleep duration. A multiple regression line to predict assumed optimal sleep duration was calculated using the least squares method. Results: The mean sleep duration of 666 ideal students exceeded the lower limit of daily sleep duration proposed as “may be appropriate” for children aged 6 - 17 years by National Sleep Foundation of the USA, being longer than those of non-ideal students. Significant regression formula for assumed optimal sleep duration was obtained (adjusted R2 = 0.996, p Conclusions: No contradiction was identified in the sleep duration obtained from ideal students as with optimal sleep duration. Although further studies to confirm the current estimation are needed, a simple formula to estimate individual optimal sleep duration through easily obtainable parameters was proposed.

Contributors to tidal duration asymmetry with varied coastline configurations on western shelf of Yellow Sea

Coastal management in China is confronted with an urgent choice between natural restoration and maintenance of existing seawalls and reclaimed land for economic development.A key criterion for making this decision is the resilience to coastal flooding,which depends on the ability to predict tidal level.Tidal duration asymmetry(TDA)is a key parameter in determination of the arrival and duration of flood tides.This study selected the western inner shelf of the Yellow Sea(WYS)as the study area and investigated the responses of TDA to different shoreline configurations and relative sea level rise.The responses of TDA to shoreline reconstruction yielded spatial variability locally and remotely.In the nearshore area,the responses of TDA to the complex ocean environment mainly originated from the combined functions of reflection,bottom friction,and advection,which controlled the energy transfer from M2 or S2 constituents to their overtides or compound tides.The sensitivity of TDA to coastline typologies was not limited to coastal waters but could stretch over the entire inner shelf.The vulnerability of tidal responses was due to the displacement of the M2 amphidrome of the Kelvin wave on the WYS,which in turn changed tidal energy fluxes over the regime.The relative sea level rise could intensify the feedback of TDA to seawalls and land reclamation.

Vitamin D and selenium for type 2 diabetes mellitus with Hashimoto’s thyroiditis:Dosage and duration insights

This letter discusses the publication by Feng et al.Iodine,selenium,and vitamin D are closely associated with thyroid hormone production in humans;however,the efficacy of selenium and vitamin D supplementation for type 2 diabetes mellitus(T2DM)patients with Hashimoto’s thyroiditis(HT)remains controversial.In the retrospective study we discuss herein,the authors highlighted significant improvements in thyroid function,thyroid antibodies,blood glucose,and blood lipid in T2DM patients with HT following addition of vitamin D and selenium to their antidiabetic regimens,underscoring the value of these supplements.Our team is currently engaged in research exploring the relationship between micronutrients and HT,and we have obtained invaluable insights from the aforementioned study.Based on this research and current literature,we recommend a regimen of 4000 IU/day of vitamin D and 100-200μg/day of selenium for over three months to six months for patients with HT,particularly for those with concurrent T2DM.

Effects of different moxibustion durations on lumbar disk herniation:a clinical study

Objective:To explore the best duration of moxibustion on lumbar disk herniation(LDH).Methods:A total of 88 patients were randomly divided into control group and 15-min,30-min,and 45-min moxibustion groups.The control group was treated with conventional therapy,while the other 3 groups were intervened with different moxibustion durations.Low back pain,dysfunction,lumbar function,and effective rates were evaluated before,in the first week and second week of intervention.Results:In low back pain,compared with the control group,the score of the 15-min group had no significant difference,but it was significantly lower in the 30-min and 45-min groups.In dysfunction and lumbar function,compared with the control group,the scores of the 15-min,30-min,and 45-min groups were significantly higher,and the scores of the 30-min and 45-min groups were significantly higher,but there was no significant difference between the 30-min and 45-min group.In effective rates,there was no significant difference between the control group and 15-min group;the effective rates of the 30-min and 45-min groups were significantly higher than those of the control group.Conclusions:Moxibustion has good therapeutic effect on LDH with specific moxibustion time.

Study on Developmental Durations and Fecundity of Phenacoccus solenopsis Tinsley on Four Species of Hosts

[Objective] The aim was to study on the effect of hosts on development and reproduction of mealybug （Phenacoccus solenopsis Tinsley）. [Method] Observation was conducted on developmental durations and fecundity of Phenacoccus solenopsis Tinsley fed on Gossypium spp., Nicotiana tabacum, Solanum tuberosum L and Hibiscus rosa-sinensis. [Result] There were differences among all durations, generation durations and fecundities of the mealybug adult females. Specifically, the generation durations on cotton （Gossypium spp.）, tobacco（ Nicotiana tabacum）, potato （Solanum tuberosum L） and Hibiscus rosa-sinensis were 30.2, 28.2, 37.3, and 27.7 d, and the fecundities per female were 626.0, 417.2, 552.5, and 183.2 ind., respectively. [Conclusion] The mealybug would have strong pontential in population growth when fed on cotton, tobacco and potato.

Analysis on the Change Law and Meteorological Factor of Sunshine Duration in Dalian City in Recent 60 Years

[Objective] The change law and meteorological factor of sunshine duration in Dalian in recent 60 years were studied.[Method] Based on the statistical data of sunshine duration from base station in Dalian City from 1951 to 2009,the annual,seasonal,and monthly variation of sunshine duration in recent 60 years were analyzed,as well as its relationship with meteorological factors,and sunshine duration was detected by means of climate mutation theory.[Result] Annual sunshine duration in Dalian in recent 60 years showed decrease trend on the whole,and its climatic variation rate was-3.31 h/a,with larger annual variation,namely the difference between maximum value(1978) and minimum value(2003) reached 681 h;there was obvious seasonal variation in sunshine duration,with the order of autumn>summer>winter>spring,and their climatic variation rate were-1.18,-1.15,-0.91 and-0.62 h/a;except for March,sunshine duration in each month went down,especially October,while there was slight increase in March;sunshine percentage had inverse correlation relationship with total cloudiness,relative humidity and heavy fog days;annual sunshine duration reduced abruptly around 1983.[Conclusion] Our study could provide scientific foundation for the development of agriculture and forestry in Dalian City.

Effects of Planting Density, Duration of Disclosing Plastic Film and Nitrogen Fertilization on the Growth Dynamics of Rapeseed under No-tillage Cultivation

[ Objective] This study was to understend the optimized combination of planting density, duration of disclosing plastic film and nitrogen fertilization under no-tillage cultivation. [ Method] Quadratic polynomial regression and saturated D-optimal design were employed to investigate the effects of planting density, duration of disclosing plastic film and nitrogen fertilization on the dynamics growth of rapeseed under no-tillage cultivation.[ Result] Within the experimental range, the growth dynamics of no-tillage cultivated rapeseed assumed a rise-fall tend. For the effects to the growth dynamics of no-tillage cultivated rapeseed, nitrogen application amount was higher than planting density and duration of disclosing plastic film. The interaction effect between planting density and duration of disclosing plastic film was higher than that between nitrogen application amount and planting density, and between nitrogen application amount and duration of disclosing plastic film. [ Conclusion] The optimized combination of these factors for dynamic growth of rapeseed under no-tillage cultivation was determined to be： planting density of per hectare 154 925 individuals, duration of disclosing plastic film of 110 d, nitrogen application amount of 315 kg/hm^2.

Report on Childhood Obesity in China (10): Association of Sleep Duration with Obesity

Objectives To explore the association of sleep duration with obesity among children in urban areas of China.Methods A total of 6 576 children（3 293 boys and 3 283 girls） aged 7-11 years were randomly selected from 36 primary schools in 6 metropolitan cities in China.A 7-day Physical Activity Recall was used to assess the sleep duration and physical activity level.The height,weight,waist circumference（WC） and percentage of body fat（%BF,as determined by bioelectrical impedance analysis technique） were measured by following the standardized operation procedures.The information on demography,lifestyle and eating habits was collected with a self-administered questionnaire from participants and their parents.Results The average sleep duration per night in the children was 9.7 h with the decreasing trends along with the increase of age（P0.05）.The sleep duration was negatively associated with body mass index（BMI） and WC in both boys and girls after adjustment for confounders（β value-0.23 and-0.82 for boys,-0.24 and-0.91 for girls,respectively,P0.01）.However,no significant association of sleep duration with %BF was found.Children who slept less than 9.0 h per night had a higher risk for overweight and obesity（OR=1.29,95% CI：1.01,1.64） and abdominal obesity（OR=1.38,95% CI：1.04,1.83） as compared with those who slept for 10.0-10.9 h.Conclusions Short sleep duration is associated with obesity.It is important to ensure adequate sleep duration of children and foster their healthy lifestyle at an early stage of life.

Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion

Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture ma- nipulations and durations may result in different therapeutic effects. In the present study, the Neig uan （PC6） acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency （3 Hz） with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke.

Spring migration duration exceeds that of autumn migration in Far East Asian Greater White-fronted Geese (Anser albifrons)

Background:Migration theory suggests,and some empirical studies show, that in order to compete for the best breeding sites and increase reproductive success,long-distance avian migrants tend to adopt a time minimization strategy during spring migration, resulting in shorter duration spring migration compared to that in autumn.Methods:Using GPS/GSM transmitters,we tracked the full migrations of 11 Greater White-fronted Geese (Anser albifrons) between southeast China and the Russian Arctic,to reveal the migration timing and routes of the East Asian population, and compare the difference in duration between spring and autumn migration of this population.Results:We found that migration in spring (79 ± 12 days) took more than twice as long to cover the same distance as in autumn (35 ±7 days).This difference in migration duration was mainly determined by significantly more time spent in spring (59±16 days) than in autumn (23± 6days) at significantly more stopover sites. Conclusions:We suggest that these geese, thought to be partial capital breeders, spent almost three quarters of total migration time at spring stopover sites to acquire energy stores for ultimate investment in reproduction, although we cannot reject the hypothesis that timing of the spring thaw also contributed to stopover duration.In autumn,they acquired necessary energy stores on the breeding grounds sufficient to reach Northeast China staging areas almost without stop, which reduced stopover times in autumn and resulted in the faster autumn migration than spring.

Advanced Backcross QTL Analysis for the Whole Plant Growth Duration Salt Tolerance in Rice(Oryza sativa L.)

Salinity is a major factor limiting rice yield in coastal areas of Asia. To facilitate breeding salt tolerant rice varieties, the wholeplant growth duration salt tolerance（ST） was genetically dissected by phenotyping two sets of BC2F5 introgression lines（ILs） for four yield traits under severe natural salt stress and non-stress filed conditions using SSR markers and the methods of advanced backcross QTL（AB-QTL） analysis and selective introgression. Many QTLs affecting four yield traits under salt stress and nonstress conditions were identified, most（〉90%） of which were clustered in 13 genomic regions of the rice genome and involved in complex epistasis. Most QTLs affecting yield traits were differentially expressed under salt stress and non-stress conditions. Our results suggested that genetics complementarily provides an adequate explanation for the hidden genetic diversity for ST observed in both IL populations. Some promising Huanghuazhan（HHZ） ILs with favorable donor alleles at multiple QTLs and significantly improved yield traits under salt stress and non-stress conditions were identified, providing excellent materials and relevant genetic information for improving rice ST by marker-assisted selection（MAS） or genome selection.

Factors affecting breastfeeding duration in Greece:What is important?

AIM:To investigate factors associated with breastfeeding duration(BD) in a sample of mothers living in Greece.METHODS:Four hundred and twenty-eight mothers(438 infants) were initially recruited in a tertiary University Hospital.Monthly telephone interviews(1665in total) using a structured questionnaire(one for each infant) were conducted until the sixth postpartum month.Cox regression analysis was used to assess factors influencing any BD.RESULTS:Any breastfeeding rates in the first,third,and sixth month of the infant's life reached 87.5%,57.0%and 38.75%,respectively.In the multivariate analysis,maternal smoking in the lactation period[hazard-ratio(HR) = 4.20]and psychological status(HR = 1.72),and the introduction of a pacifier(HR =2.08),were inversely associated,while higher maternal education(HR_(university/college vs primary/high school) = 0.53,HR_(master's vs primary/high school) = 0.20),and being an immigrant(HR = 0.35) were positively associated with BD.CONCLUSION:Public health interventions should focus on campaigns against smoking during lactation,target women of lower educational status,and endorse the delayed introduction of pacifiers.

gastrointestinal symptom prevalence depends on disease duration and gastrointestinal region in type 2 diabetes mellitus

AIM To unravel relationships between gastrointestinal(GI)symptoms impairing quality of life(QOL)and clinical profiles of diabetes mellitus(DM)patients. METHODS We enrolled 134 outpatients with type 2 DM.Mean age was 64.7 years,mean body mass index was 24.7 RESULTS Lower abdominal symptoms were found to be more frequent than those affecting the upper abdomen.Diabetic duration and medications showed associations with GI symptoms.We identified differences in peak prevalences of the five symptoms.Gastralgia(P=0.02vs 10-14 years)and total GI symptoms(P=0.01 and P=0.02 vs 5-9 years and 10-14 years,respectively)peaked at a diabetes duration of 15-19 years.Heartburn(P=0.004)and postprandial fullness(P=0.03)tended to increase with disease duration.Constipation and diarrhea showed bimodal peaks,with the first early and the second late(e.g.,P=0.03 at 15-19 years vs 10-14years for diarrhea)in the disease course.Finally,GI symptoms showed clustering that reflected the region of the GI tract affected,i.e.,constipation and diarrhea had similar frequencies(P<0.0001). CONCLUSION Our study highlights the importance of questioning patients about QOL impairment due to abdominal symptoms,especially in the early and the late periods of diabetes.

Effect of Planting Methods on the Yield and Yield Attributes of Short Duration <i>Aman</i>Rice

To find out the effect of planting methods on the yield and yield attributes of short duration Aman rice varieties, a field trial was conducted at the farm of Bangladesh Rice Research Institute, Gazipur, during July to November 2012. The treatments comprised of three BRRI released high yielding varieties viz., BRRI dhan39, BRRI dhan49 and BRRI dhan57 and three planting methods viz., direct seeding of dry seed, direct seeding of sprouted seed and transplanting. It was a factorial experiment conducted in a Randomized Complete Block Design with three replications. Planting methods had a significant effect on the growth duration of rice. The rice crop established with direct seeding of the dry and sprouted seed matured 7 days earlier than transplanting. The variety BRRI dhan39 gave the highest yield (4.964 t·ha-1) when grown with direct seeding of sprouted seed compared to other varieties. The highest net return (23362.00 BDT ha-1) and cost benefit ratio (1:1.49) were observed in direct seeding of the sprouted seed method. So, direct seeding of sprouted seed might be the best planting method because about 19.94% production cost is reduced due to the omission of seedling raising and transplanting operations as well as the reduction in the length of the crop cultivation period.

Deriving the slope-mean shielded astronomical solar radiation spectrum and slope-mean possible sunshine duration spectrum over the Loess Plateau

Solar radiation is often shielded by terrain relief, especially in mountainous areas, before reaching the surface of the Earth. The objective of this paper is to study the spatial structures of the shielded astronomical solar radiation(SASR) and the possible sunshine duration(PSD) over the Loess Plateau. To this end, we chose six test areas representing different landforms over the Loess Plateau and the software package of Matlab was used as the main computing platform. In each test area, 5-m-resolution digital elevation model established from 1:10,000 scale topographic maps was used to compute the corresponding slope, SASR and PSD. Then, we defined the concepts of the slope-mean SASR spectrum and the slope-mean PSD spectrum, and proposed a method to extract them from the computed slope, SASR and PSD over rectangular analysis windows. Using this method, we found both spectrums in a year or in a season for each of the four seasons in the six test areas. Each spectrum was found only when the area of the corresponding rectangular analysis window was greater than the corresponding stable area of the spectrum. The values of the two spectrums decreased when the slope increased.Furthermore, the values of the stable areas of the spectrums in a year or in a season were positively correlated with the variable coefficients of the slope or the profile curvature. The values of the stable areas of the two spectrums in a year or in a season may represent the minimum value of test areas for corresponding future research on the spatial structures of the SASR or PSD. All the findings herein suggest that the spatial structures of the PSD and the SASR are caused by the interactions between solar radiation and terrain relief and that the method for extracting either spectrum is effective for detecting their spatial structures. This study may deepen our understanding of the spatial structure of solar radiation and help us further explore the distribution of solar energy in mountainous regions.

The effect of subcutaneous injection duration on patients receiving low-molecular-weight heparin:Evidence from a systematic review

To assess the effect of the injection duration of subcutaneous low-molecular-weight heparin(LMWH)on pain and bruising in patients.Randomized controlled trials and quasiexperimental studies were searched for in four electronic databases.The pooled effect size was expressed as relative risk(RR)andmeandifference(MD)with95%confidence intervals(CI)for dichotomous and continuous data.Cochrane Q and p value were used to assess heterogeneity and the I2 statistic was adopted to quantify the level.Finally,eight studies involving a total of 532 participants met our inclusion criteria.The slow(30 second)injection was associated with a reduction in pain intensity and duration,and lower bruising occurrence at 48-72 hours and 48 hours post injection.The bruising area was also smaller at 48 hours and 60 hours post injection.Nodifferenceswere identified betweenthe slowand fast(10 second)injectionin bruising area and bruising occurrence at 24 hours and 60 hours post injection.With present evidences,slow injection of LMWH is beneficial to the patient's well being,but further studies to identify the feasibility and standardization of the technique is recommended.