Effects of mesenchymal stem cell on dopaminergic neurons,motor and memory functions in animal models of Parkinson's disease:a systematic review and meta-analysis

Parkinson’s disease is chara cterized by the loss of dopaminergic neurons in the substantia nigra pars com pacta,and although restoring striatal dopamine levels may improve symptoms,no treatment can cure or reve rse the disease itself.Stem cell therapy has a regenerative effect and is being actively studied as a candidate for the treatment of Parkinson’s disease.Mesenchymal stem cells are considered a promising option due to fewer ethical concerns,a lower risk of immune rejection,and a lower risk of teratogenicity.We performed a meta-analysis to evaluate the therapeutic effects of mesenchymal stem cells and their derivatives on motor function,memory,and preservation of dopamine rgic neurons in a Parkinson’s disease animal model.We searched bibliographic databases(PubMed/MEDLINE,Embase,CENTRAL,Scopus,and Web of Science)to identify articles and included only pee r-reviewed in vivo interve ntional animal studies published in any language through J une 28,2023.The study utilized the random-effect model to estimate the 95%confidence intervals(CI)of the standard mean differences(SMD)between the treatment and control groups.We use the systematic review center for laboratory animal expe rimentation’s risk of bias tool and the collaborative approach to meta-analysis and review of animal studies checklist for study quality assessment.A total of 33studies with data from 840 Parkinson’s disease model animals were included in the meta-analysis.Treatment with mesenchymal stem cells significantly improved motor function as assessed by the amphetamine-induced rotational test.Among the stem cell types,the bone marrow MSCs with neurotrophic factor group showed la rgest effect size(SMD[95%CI]=-6.21[-9.50 to-2.93],P=0.0001,I^(2)=0.0%).The stem cell treatment group had significantly more tyrosine hydroxylase positive dopamine rgic neurons in the striatum([95%CI]=1.04[0.59 to 1.49],P=0.0001,I^(2)=65.1%)and substantia nigra(SMD[95%CI]=1.38[0.89 to 1.87],P=0.0001,I^(2)=75.3%),indicating a protective effect on dopaminergic neurons.Subgroup analysis of the amphetamine-induced rotation test showed a significant reduction only in the intracranial-striatum route(SMD[95%CI]=-2.59[-3.25 to-1.94],P=0.0001,I^(2)=74.4%).The memory test showed significant improvement only in the intravenous route(SMD[95%CI]=4.80[1.84 to 7.76],P=0.027,I^(2)=79.6%).Mesenchymal stem cells have been shown to positively impact motor function and memory function and protect dopaminergic neurons in preclinical models of Parkinson’s disease.Further research is required to determine the optimal stem cell types,modifications,transplanted cell numbe rs,and delivery methods for these protocols.

Global public concern of childhood and adolescence suicide:a new perspective and new strategies for suicide prevention in the post-pandemic era

Background Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years.Familial,social,psychological,and behavioral factors play important roles in suicide risk.As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people,there is a need to understand the current status of suicide in adolescents,including its epidemiology,associated factors,the influence of the pandemic,and management initiatives.Data sources We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases,Injuries,and Risk Factors Study(GBD)2019.The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization(WHO)regions.Additionally,we utilized electronic databases,including PubMed/MEDLINE and Scopus,and employed various combinations of terms such as“suicide”,“adolescents”,“youth”,“children”,“risk factors”,“COVID-19 pandemic”,“prevention”,and“intervention”to provide a narrative review on suicide within the pediatric population in the post-pandemic era.Results Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019,it remains high.The mortality rates from suicide by firearms or any other specified means were both greater in males.Additionally,Southeast Asia had the highest suicide rate among the six WHO regions.The COVID-19 pandemic seems to contribute to suicide risk in young people;thus,there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.Conclusions The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic,risk factors,and intervention strategies.Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era,further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era.It is necessary to identify effective prevention strategies targeting young people,particularly those at high risk,and successful treatment for individuals already manifesting suicidal behaviors.Care for suicidal children and adolescents should be improved with parental,school,community,and clinical involvement.

National trends in sexual intercourse and usage of contraception among Korean adolescents

Background The exact influence of the COVID-19 pandemic on sexual intercourse and usage of contraception remains largely uncharted territory.To bridge this gap in knowledge,we conducted a comprehensive,cross-sectional examination of long-term trends in the prevalence of sexual intercourse and usage of contraception among South Korean adolescents from 2006 to 2022.Methods In our research,we drew upon data encompassing 1,138,799 South Korean adolescents aged 12 to 18 years,derived from the Korean Youth Risk Behavior Web-based Survey(KYRBS)over a period spanning from 2006 to 2022.We focused on the prevalence of sexual intercourse,contraception utilization,and the underlying associated factors among this demographic.The KYRBS data was collected using a complex sampling strategy to determine the national prevalence estimates and shifts in prevalence before(2006-2019)and during(2020-2022)the COVID-19 pandemic era.Results During the pre-pandemic period,a decrease in adolescent sexual intercourse was observed(6.34%in 2006,5.53%in 2012,and 5.87%in 2019).However,in the post-pandemic period(2020-2022),there was a surge in sexual intercourse(4.55%in 2020 and 6.20%in 2022).This evident alteration in sexual intercourse trajectory between pre-and post-pandemic periods was statistically significant[βdiff,0.950;95%confidence interval(CI),0.756-1.144].Regarding contraceptive use among South Korean adolescents,there was an increase in the pre-COVID-19 pandemic phase across all demographic segments(14.61%in 2006,22.30%in 2012,and 47.69%in 2022)but a notable decline when compared with the pre-and post-pandemic periods(βdiff,-0.319;95%CI,-0.454 to-0.184).Additionally,during the study period,a decrease in sexual intercourse was observed in the pre-pandemic period(β,-0.129;95%CI,-0.148 to-0.110),followed by an increase in the post-pandemic period(β,0.821;95%CI,0.627 to 1.014).This shift is highlighted by an effect size of 0.96[weighted odds ratio(wOR);95%CI,0.92 to 1.00],indicating a substantial change in adolescent sexual behaviors across study periods.Conclusions The increase in sexual intercourse and decrease in usage of contraception observed in our study between the pre-and post-COVID-19 periods suggests a potential threat to sexual health among South Korean adolescents.This trend emphasizes the ongoing necessity of raising awareness about adolescent sexual behavior in South Korea.

Effects of physical rehabilitation interventions in COVID-19 patients following discharge from hospital:A systematic review

Background:Hospitalized patients recovering from coronavirus disease 2019(COVID-19)may experience disability and suffer from significant physical and mental impairment requiring physical rehabilitation following their discharge.However,to date,no attempt has been made to collate and synthesize literature in this area.Objective:This systematic review examines the outcomes of different physical rehabilitation interventions tested in COVID-19 patients who were discharged from hospital.Search strategy:A systematic search of MEDLINE/PubMed,CINAHL,Scopus and medRxiv was conducted to identify articles published up to March 2022.Inclusion criteria:This systematic review included studies of outpatient rehabilitation programs for people recovering from COVID-19 who received physical activity,exercise,or breathing training to enhance or restore functional capacity,pulmonary function,quality of life,and mental health or function.Data extraction and analysis:Selection of included articles,data extraction,and methodological quality assessments were conducted by two review authors respectively,and consensus was reached through discussion and consultation with a third reviewer.Finally,we review the outcomes of studies based on four categories including:(1)functional capacity,(2)pulmonary function,(3)quality of life,and(4)mental health status.Results:A total of 7534 titles and abstracts were screened;10 cohort studies,4 randomized controlled trials and 13 other prospective studies involving 1583 patients were included in our review.Early physical rehabilitation interventions applied in COVID-19 patients who were discharged from the hospital improved multiple parameters related to functional capacity,pulmonary function,quality of life and mental health status.Conclusion:Physical rehabilitation interventions may be safe,feasible and effective in COVID-19 patients discharged from the hospital,and can improve a variety of clinically relevant outcomes.Further studies are warranted to determine the underlying mechanisms.

Pediatric palliative care for children with cancer:a concept analysis using Rodgers’evolutionary approach

Background Providing access to pediatric palliative care(PPC)for children living with a serious illness,such as cancer,is of critical importance,although this specialized intervention,as a novel concept,still seems vague and complicated.The present study analyzed the concept of PPC for children with cancer.Methods Rodgers'evolutionary method was employed for the concept analysis.Articles on PPC,particularly those for children suffering from cancer,published between 2010 and 2021 were searched in valid academic research databases.The inclusion criteria for the full-text articles were based on the characteristics,antecedents,and consequences of PPC for children with cancer.Results In total,19 relevant articles were selected and then reviewed and analyzed after applying the inclusion criteria and the final sampling.The analysis of the concept of PPC for children affected with cancer revealed four characteristics,including"PPC as holistic and integrated care","PPC as patient-and family-centered care","PPC as early-start continuous care",and"PPC as interdisciplinary and team-based care".Some effective factors could also act as antecedents for this concept,i.e.,health care providers'training and expertise as well as human resources and financing.Moreover,improved quality of life,symptom reduction,and coordination between patient care and family support were among the PPC consequences for such children.Conclusions The study results demonstrated that delivering PPC to children with cancer demanded a comprehensive view of its various dimensions.Furthermore,numerous factors need to be delineated for its accurate and complete implementation.