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Nutrition research (New York, N.Y.) · 2026
Eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) are the most biologically active members of the omega-3 polyunsaturated fatty acids (PUFAs) and are crucial for neonatal brain development, healthy aging, and disease prevention. Fatty fish has long served as our core source of long-chain n-3 PUFAs but sustainability concerns have raised interest in alternate sources. Plant-based PUFA sources have emerged as the next best alternatives. Recent experimental studies have demonstrated that stearidonic acid (SDA, 18:4n-3) is converted to EPA more efficiently than α-linolenic acid (18:3n-3) as it bypasses the rate-limiting desaturation step. Several studies have reported potential health benefits from novel plant sources of SDA in preclinical experimental models. This review collected original research articles and reviews on SDA published from 2015 to 2025 using a bibliometric and systematic approach to provide valuable insights into its global network and current state of knowledge. Furthermore, recent advancements in its natural and transgenic sources, nutritional implications, and future perspectives were discussed. Key findings indicated the United States (18.0%) and Spain (13.11%) are the leading countries and Pennsylvania State University is the top institute publishing research on SDA. The term map identified Buglossoides arvensis as the most extensively exploited source with emphasis on health improvement applications. Recent evidence has highlighted a notable role for SDA in EPA/DHA enrichment in vitro and in vivo, although research gaps like safe oil production, dosage statistics, and identifying precise metabolism still need to be addressed.
Pharmacology research & perspectives · 2026
Cardiovascular diseases (CVD) remain to impose a main global burden of morbidity and mortality despite advances in anticipation and treatment. Omega-3 fatty acids, mainly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), have been extensively studied for potential cardioprotective effects, yet their impact on cardiovascular outcomes remains debated due to heterogeneity in formulation, dose, and patient subgroups. This meta-analysis evaluated the effects of EPA and DHA supplementation on major adverse cardiovascular events (MACE) and atrial fibrillation (AF), including postoperative AF (POAF), in patients with established CVD. A systematic search of Embase, PubMed/MEDLINE, Scopus, and Web of Science (January 2010-December 2021) identified randomized controlled trials (RCTs) of combined EPA + DHA supplementation in secondary prevention or perioperative settings. Data were synthesized using RevMan v5.3 with a random-effects model, and study quality was assessed via the Cochrane RoB 2 tool. From 3682 records, 25 RCTs (n = 25 578 patients) were included. Pooled analysis showed no significant reduction in MACE (effect estimate 0.042 ± 0.0499, Z = 0.850, 95% CI [-0.055, 0.140], p = 0.396; low heterogeneity) or AF/POAF incidence (trend toward reduction: -0.198 ± 0.1498, Z = -1.319, 95% CI [-0.491, 0.096], p = 0.187; modest heterogeneity). Neutral findings likely reflect moderate-dose combined EPA + DHA use, limited subgroup reporting on metabolic comorbidities (e.g., diabetes, hypertriglyceridemia) or concomitant therapies (e.g., statins), and high background guideline-directed medical therapy reducing residual risk. Although omega-3 fatty acids exert anti-inflammatory, antithrombotic, and lipid-modulating effects, this analysis indicates no broad benefit in reducing MACE or AF risk with combined moderate-dose EPA + DHA in heterogeneous post-event populations. Recent evidence highlights more MACE reductions with high-dose purified EPA monotherapy in high-metabolic-risk subgroups, balanced against dose-dependent AF increases at high doses (> 1.5 g/day). Future large-scale RCTs should prioritize biomarker-verified compliance, metabolic/concomitant therapy stratification, and formulation-specific comparisons to define targeted therapeutic roles. Trial Registration: This study has been registered in PROSPERO, and the registration code is 642795.
Voprosy pitaniia · 2026
Atopic dermatitis (AD) is a multifactorial disease, in its pathogenesis an imbalance of polyunsaturated fatty acids (PUFA) in favor of pro-inflammatory ω-6 over antiinflammatory ω-3 plays an important role. Although the role of ω-3 PUFAs in atopy prevention is established, data on their efficacy in the treatment of confirmed AD remain contradictory due to the differences in dosages and study design. The aim of the research was a comparative evaluation of the clinical efficacy and safety of two different doses of ω-3 PUFAs as part of complex therapy for AD in adult patients. We examined 101 patients with moderate to severe AD aged 18 to 59 years (Me 31 [23; 41] years). Sixty-five subjects were administrated ω-3 PUFAs in addition to basic therapy and were randomized into subgroups receiving a high (3.6 g/ day, 200/240 mg EPA/DHA) or low (0.72 g/day, 40/48 mg EPA/DHA) dose of fish oil for 30 days. The control group consisted of 36 patients on standard therapy. Efficacy was assessed by the dynamics of the SCORAD index, the severity of subjective symptoms (itching, sleep disorders), and the proportion of patients with complete resolution of clinical manifestations. The most significant reduction in disease severity was observed in patients receiving a high dose of ω-3 PUFAs: the SCORAD index decreased by 81.8% (from 55 [41; 70] to 10 [8; 13] points, p<0.001), itching intensity by 87.5%, and sleep disorders by 66.7%. In the low-dose group, the reduction in SCORAD was 63.6% (to 16 [12; 20], p<0.001), and in the control group - 50% (to 20 [17; 22], p<0.001). The inclusion of ω-3 PUFA in the complex therapy showed a statistically significant advantage in the degree of AD manifestation reduction over the control group (p<0.05). Analysis of the proportions of patients with complete symptom resolution confirmed the dose-dependent effect: for key symptoms (rash, itching, dry skin), the responder rate was significantly higher in the high-dose group compared to both the control and the low-dose group (p<0.05). No adverse events have been reported. The study demonstrated the dose-dependent efficacy of ω-3 PUFAs in the complex therapy of AD in adults. The intake in a dose of 200/240 mg EPA/DHA provides a significantly greater reduction in disease severity according to SCORAD, a decrease in the severity of subjective symptoms, and an increase in the proportion of patients with complete regression of symptoms compared to both a low dose of ω-3 PUFAs and standard therapy. The obtained data confirm the pathogenetic rationale for including ω-3 PUFAs in the AD treatment.
European journal of nutrition · 2026
This study investigated the effects of docosahexaenoic acid (DHA) supplementation on delayed onset muscle soreness (DOMS), physical function, and inflammation following eccentric exercise-induced muscle damage in physically trained male and female adults (training ≥ 5d/wk). Thirty-eight participants (12 Control, 26 DHA) completed a 12-week double-blind, placebo-controlled matched-pair trial. The Control group received high-oleic acid tablets. The DHA group received 715 mg/d of microencapsulated DHA tablets. Participants performed eccentric cycling at weeks 0 and 12, with assessments conducted pre-exercise, 0-h, 24-h, and 48-h post-exercise. The primary outcomes were DOMS (visual analogue scale) and the Omega-3 Index (O3I) (estimated by finger-stick dry blood spot). Secondary outcomes included neuromuscular function and inflammatory cytokines. O3I was not different between groups at week 0 but was elevated in the DHA group (∆2.43%, [95% CI; 2.10, 2.77], P < 0.001) and between Control at week 12 (P < 0.001). DOMS was lower at 24-h and 48-h post-exercise in the DHA group and between Control at week 12 (P < 0.01). At week 12, jump height and peak vertical force improved at 48-h post-exercise in the DHA group (P < 0.05), resulting in moderate (d = 0.60) and small (d = 0.32) effect sizes for 48-h post-exercise area under the curve (AUC) between groups, respectively. There were interaction effects for 48-h post-exercise AUC of IL-6 (P = 0.049), TNF-α (P = 0.010), and IL-10 (P = 0.026). A dietary achievable dose of DHA elevated the O3I and reduced DOMS in physically trained adults. These outcomes support protracted intake of DHA to attenuate the physiological impact of eccentric exercise and promote recovery.
Poultry science · 2026
This study employed a meta-analysis to systematically evaluate the effects of selenium supplementation on slaughter performance and tissue selenium concentrations in broilers. Relevant literature published between January 1, 2015, and November 1, 2025, was retrieved from Chinese National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database (VIP), Wanfang, Web of Science, Science Direct, and PubMed. Following systematic screening of 946 reports, 15 studies met the predefined inclusion criteria, comprising a total of 6,759 broilers. The analyzed outcomes included slaughter performance indicators (eviscerated yield, carcass yield, breast muscle yield, leg muscle yield, and abdominal fat percentage), as well as selenium concentrations in breast muscle and liver tissues. Sensitivity and subgroup analyses were performed to explore sources of heterogeneity, and publication bias was assessed using funnel plots and Egger's test. The results showed that dietary selenium supplementation significantly increased the eviscerated yield (SMD = 0.35, 95% CI [0.02, 0.68]) and carcass yield (SMD = 0.30, 95% CI [0.01, 0.59]), but had no significant effect on breast muscle yield, leg muscle yield, nor abdominal fat percentage. Selenium supplementation also significantly increased selenium concentrations in both breast muscle (SMD = 6.24, 95% CI [4.96, 7.51]) and liver (SMD = 5.06, 95% CI [3.56, 6.57]). Funnel plots and Egger's test suggested the presence of publication bias for the tissue selenium concentration indicators, but not for the slaughter performance indicators. Sensitivity analysis confirmed that the results were robust. The dose-response analysis indicated a discrepancy in the selenium levels required to optimize slaughter performance and tissue selenium concentration, with respective ranges of 0.41-0.50 mg/kg and 0.39-0.75 mg/kg. Considering both production efficiency and nutritional fortification, the recommended dietary selenium supplementation level is 0.41-0.50 mg/kg. In conclusion, dietary selenium supplementation improves specific slaughter performance traits and increased tissue selenium concentrations in broilers, suggesting potential applications in poultry production and the development of selenium-enriched chicken products.
Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis · 2025
Despite being generally safe, apheresis for peripheral blood stem cell collection potentially disrupts electrolyte balance owing to the use of citric acid as an anticoagulant. As prior research has primarily studied hypocalcemia, information on the kinetics of potassium levels during apheresis in healthy donors is scarce. We investigated the fluctuation in potassium levels during apheresis and the risk factors for hypokalemia. This subanalysis used data from an open-label, randomized controlled trial of "oral calcium supplementation versus placebo in mitigating citrate toxicity" conducted between January 2021 and July 2022, at Okayama University Hospital. Potassium levels were significantly reduced after 5-day granulocyte colony-stimulating factor (G-CSF) administration (p < 0.0001), with seven patients (16.7 %) given oral potassium administration before apheresis because the treating physician deemed potassium levels potentially unsafe and three (7.1 %) presenting with hypokalemia at apheresis. Potassium levels after apheresis were significantly lower than those before apheresis (baseline; p < 0.0001), and 28 of 42 donors (66.7 %) experienced biochemical, clinically unapparent hypokalemia immediately after the completion of apheresis. A > 15 % reduction in potassium levels from baseline was associated with age and the acid citrate dextrose solution A (ACD-A) volume in univariate analysis. In the multivariable analysis, both factors were associated (hazard ratio [HR], 11.60; 95 % confidence interval [CI], 1.60-83.70; p = 0.02 and HR, 17.50; 95 % CI, 1.07-136.00; p = 0.04). In conclusion, G-CSF administration and apheresis ultimately induced hypokalemia in two-thirds of the donors. Older age and higher ACD-A volume may affect potassium levels during apheresis in healthy donors. Clinical Trial registration: jRCTs061200035.
BMC musculoskeletal disorders · 2026
The choice of surgical approach in total hip arthroplasty (THA) significantly influences early recovery and complication rates. However, comprehensive evidence comparing the efficacy and safety of multiple contemporary approaches remains limited. We conducted a systematic review and network meta-analysis of randomized controlled trials (RCTs) from PubMed, Cochrane Library, Embase, and Web of Science (inception to July 2025). We included 85 RCTs (6,575 patients) comparing 13 surgical approaches. Frequentist framework NMA was performed, with effects reported as mean differences (MD), standardized mean differences (SMD), or risk ratios (RR) with 95% confidence intervals. Treatment rankings were assessed using surface under the cumulative ranking curve (SUCRA) values. The analysis of 85 RCTs (6,575 patients) demonstrated distinct performance profiles among the 13 surgical approaches. For functional recovery, the ranking probabilities suggested that minimally invasive anterolateral approach (MIS-ALA) was most likely to achieve the best early postoperative HHS (SUCRA = 88.7%), while modified direct anterior approach (DAA-Modified) ranked highest for medium-to-long-term HHS (SUCRA = 97.8%). regarding surgical efficiency, the minimally invasive posterolateral approach (MIS-PLA) was associated with the highest probability of having the shortest operative time (SUCRA = 98.4%), whereas MIS-ALA had the highest SUCRA value for blood loss control (SUCRA = 90.9%). For surgical trauma, MIS-PLA had the highest SUCRA value indicating the potential for the smallest postoperative CK increase (SUCRA = 82.4%), while anterior approaches (DAA-Modified, bikini direct anterior approach (DAA-Bikini), direct anterior approach (DAA)) ranked highest for suppressing CRP elevation (SUCRAs: 88.2%, 83.4%, and 80.8%). DAA had the highest SUCRA value for walking speed recovery (SUCRA = 91.8%), and supercapsular percutaneously-assisted total hip (SuperPath) had the highest SUCRA value for the physical component summary score (SUCRA = 95.4%). Safety analysis revealed direct lateral approach (DLA) had the highest SUCRA value for the lowest complication risk (SUCRA = 92.9%), while DAA-Bikini had the highest adverse event incidence. THA surgical approaches present distinct efficacy-safety profiles with varying probabilities of advantage. Clinical selection should be individualized based on patient characteristics and surgical expertise, as no single approach is universally superior across all outcomes. The online version contains supplementary material available at 10.1186/s12891-026-09683-3.
BMC endocrine disorders · 2026
Several studies have suggested the promising effects of alpha-lipoic acid (ALA) as an antioxidant in patients with nonalcoholic fatty liver disease (NAFLD). However, the results of randomized clinical trials (RCTs) have been contradictory. This meta-analysis examined the effect of ALA supplementation on NAFLD patients. PubMed, Scopus, Web of Science, and the Cochrane Library were systematically searched to include all eligible RCTs published up to February 2026. Weighted mean differences (WMD) with 95% confidence intervals (CI) were used to compare the changes in liver enzymes, obesity measures, lipid profiles, glycemic indices, and adipocytokines between the ALA and placebo groups using a random-effects model. Seven RCTs comprising 414 participants were analyzed. In the overall analysis, serum levels of liver enzymes, lipid profiles, glycemic indices, adipocytokines, and obesity measures were not significantly different between the intervention and placebo groups. Moreover, subgroup analyses by age of participants, sample size, baseline body mass index (BMI), method of NAFLD diagnosis, dose of ALA, and duration of follow-up consistently revealed no beneficial effect of ALA on the outcomes. Meta-regression and sensitivity analyses supported the findings. The findings indicated that ALA supplementation did not improve liver enzymes, lipid profiles, glycemic indices, adipocytokines, and obesity measures in patients with NAFLD. Not applicable.
Photobiomodulation, photomedicine, and laser surgery · 2026
Background: Acne vulgaris is a chronic inflammatory skin disease, and photo-based therapies have been adopted as noninvasive alternatives to pharmacological treatment.Objective: To systematically evaluate the therapeutic strategies and biological mechanisms of photo-based therapies in the management of acne vulgaris, focusing on sebum modulation, inflammation control, and the treatment of acne sequelae to inform phenotype-oriented clinical decision-making.Methods: Following PRISMA 2020 guidelines, a systematic search was conducted in PubMed and Web of Science for studies published between 2005 and 2025. From an initial 2,218 records, 64 articles comprising 42 clinical trials and 22 experimental studies were selected for inclusion based on their focus on the efficacy, safety, and molecular mechanisms of light-emitting diodes (LED), intense pulsed light (IPL), laser systems, and photodynamic therapy (PDT).Results: Analysis revealed that photo-based modalities target acne through three primary pathways: 1. Sebum Modulation: Aminolevulinic acid (ALA)-PDT demonstrates superior, durable efficacy in moderate-to-severe acne by inducing sebocyte apoptosis and downregulating lipogenesis via the PI3K/Akt/mTOR and OLR1-Wnt/β-catenin pathways. 2. Inflammation Control: Blue and red light (LED) and IPL provide gradual anti-inflammatory effects suitable for mild-to-moderate acne by reducing C. acnes colonization and modulating cytokines such as TGF-β1, IL-10, and TNF-α. 3. Tissue Remodeling: For acne sequelae, fractional CO2 and picosecond lasers promote collagen remodeling to improve atrophic scars, while vascular-targeted lasers (PDL, Nd:YAG) and IPL effectively reduce post-inflammatory erythema (PAE) and hyperpigmentation (PIH).Conclusions: Photo-based therapies are phenotype-specific rather than interchangeable. Strategies targeting sebaceous activity and inflammation are central to treating active lesions, while tissue-remodeling interventions are most effective for managing sequelae. This review establishes a strategy-oriented framework that supports personalized, evidence-based treatment planning in routine clinical practice.
Frontiers in endocrinology · 2026
Diabetic peripheral neuropathy (DPN) is a common diabetes complication. Buyang Huanwu Decoction (BYHWD) combined with α-lipoic acid (ALA) is used clinically, but evidence consistency and heterogeneity sources remain unexplored. To evaluate efficacy/safety of BYHWD+ALA for DPN and deconstruct heterogeneity via a multi-tiered framework. We searched PubMed, Web of Science, EMbase, Cochrane Library, CNKI, Wanfang, VIP, and CBM up to December 2025 for RCTs. Two reviewers independently screened studies, extracted data, and assessed risk of bias (Cochrane tool). Meta-analysis used RR (dichotomous) and SMD (continuous) with 95% CI. Heterogeneity (I²) was explored through subgroup analysis, sensitivity analysis, meta-regression, and descriptive synthesis. Twelve RCTs (926 patients) were included. BYHWD+ALA significantly improved overall response rate (RR = 1.24, 95%CI 1.17-1.32; I²=0%) and TCM syndrome scores (SMD=-0.76, 95%CI -0.98 to -0.54). For nerve conduction velocity (NCV), fundamental heterogeneity emerged (I²>92%). A five-tiered analysis revealed that only peroneal nerve motor NCV showed a robust improvement trend (SMD = 1.01, 95%CI 0.48-1.54), though heterogeneity remained high (I²=92%). Heterogeneity sources included non-standardized NCV measurement and complex intervention-patient matching. Oxidative stress markers (SOD, MDA, T-AOC) trended favorably; HbA1c and adverse events did not differ between groups. BYHWD+ALA safely improves subjective DPN symptoms, but NCV evidence is too heterogeneous to draw reliable quantitative conclusions. This study provides a methodological framework for deconstructing heterogeneity and guides future standardized research. https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=1267606, identifier CRD420251267606.
Pharmacological research · 2025
Ginseng has been commonly used as a traditional Chinese medicine in Asian countries for thousands of years. Ginsenosides are the main pharmacologically active ingredients isolated from ginseng and have neuroprotective effects in the treatment of neurodegenerative disorders, such as Parkinson's disease (PD) and Alzheimer's disease (AD). To summarise and investigate the protective roles of ginsenosides and their underlying mechanisms in PD and AD, we used ''Ginsenoside", ''Parkinson's disease", ''Alzheimer's disease", ''anti-inflammatory", ''antioxidant", and ''apoptosis" as keywords to search and extract relevant literature information from scientific databases such as Elsevier, PubMed, and Google Scholar databases. In particular, we used network pharmacology to identify the potential targets of ginsenosides Rg1 and Rb1 in PD and AD. By analysing the existing research advances and network pharmacology results, we found that the neuroprotective effects of ginsenosides, primarily mediated through anti-inflammation, anti-apoptosis and anti-oxidative stress, etc, may be associated with the PI3K/Akt, BDNF/TrkB, MAPKs, NF-κB, Nrf2 and Wnt/β-catenin signalling pathways. This review systematically summarises the different roles and mechanisms of ginsenosides Rg1, Rb1, and rare ginsenosides in PD and AD and provides new strategies for the treatment of neurodegenerative disorders. Network pharmacology provides a new research paradigm for the treatment of PD and AD using Rg1 and Rb1.
The Journal of prosthetic dentistry · 2026
The marginal and internal fit of fixed dental prostheses (FDPs) plays a crucial role in their long-term clinical success. Although selective laser melting (SLM) has become a widely used additive manufacturing technique for FDP fabrication, conclusive evidence regarding the factors influencing the fit of SLM-fabricated FDPs is still lacking. This systematic review aimed to evaluate the influence of tooth preparation design and manufacturing parameters on the marginal and internal fit of FDPs fabricated using SLM. The study followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines, with an electronic search conducted in 4 databases and manual searches up to July 2025. Following the population, intervention, comparison, outcome, study design (PICOS) framework, the population included tooth-supported metal-based FDPs fabricated via SLM; the intervention involved tooth preparation designs and manufacturing parameters; the comparison included designs or parameters not associated with fit; the outcome was marginal and internal fit; and the study design included in vitro, animal, and human studies. The risk of bias in in vitro studies was assessed using the Quality Assessment Tool for In Vitro Studies, while the Risk of Bias in Non-randomized Studies of Interventions tool was used for nonrandomized clinical studies. Sixteen studies comprising 14 in vitro and 2 quasi-experimental clinical studies were included. Key factors influencing the fit of SLM-fabricated FDPs included tooth finish line and preparation design, printing orientation, and printing parameters such as lamination layer thickness and laser settings. Evidence regarding the effects of alloy type and postprocessing steps, including heat treatment and ceramic veneering, remained inconsistent. Among the in vitro studies, 8 of 14 were assessed as having a medium risk of bias, while 6 demonstrated a low risk. Of the 2 nonrandomized clinical studies, one was rated as having a serious overall risk of bias, whereas the other showed a low risk. Within the limitations of current evidence, clinically acceptable fit was associated with cobalt chromium alloys printed at 0 or 30 degrees with a 25- to 50-µm layer thickness and optimized laser parameters. In contrast, a 90-degree printing orientation often resulted in marginal gaps exceeding acceptable thresholds.
Archives of osteoporosis · 2026
Osteoporosis in older men is often underdiagnosed and undertreated, increasing the risk of fractures and functional decline. Despite its clinical relevance, evidence specific to this population remains limited. This systematic review evaluated the effectiveness of pharmacological and non-pharmacological interventions in reducing fracture risk and improving bone mineral density (BMD) in older men with primary or secondary osteoporosis. Searches were conducted in PubMed, EMBASE, Scopus, Cochrane Library, Web of Science, SciELO, PEDro, and LILACS, in addition to gray literature sources. Randomized controlled trials (RCTs) evaluating pharmacological and non-pharmacological interventions were included. Analyses were performed using RStudio (v. 4.3.3), and risk of bias was assessed using the RoB 2 tool. Results Twelve RCTs were included (10 pharmacological, one nutritional, and one exercise-based). The mean age was 60.9 ± 5.2 years, with baseline T-scores of - 2.9 ± 0.3 at the lumbar spine and - 2.7 ± 0.4 at the femoral neck. Bisphosphonates and teriparatide showed modest improvements in BMD, while effects on fracture risk were inconsistent. Resistance exercise (60-90 min/day) and L-carnitine supplementation were associated with BMD benefits, although evidence was limited by methodological constraints. Risk of bias varied across studies. Pharmacological therapies improve BMD in older men; however, evidence remains insufficient to demonstrate consistent fracture risk reduction. Non-pharmacological interventions show potential benefits but are supported by limited evidence. Larger randomized trials with clinically relevant outcomes are needed.
Journal of plastic, reconstructive & aesthetic surgery : JPRAS · 2026
Targeted nipple-areola complex (NAC) reinnervation (TNR) aims to restore nipple sensation after gender-affirming (GA) chest surgery and oncologic mastectomy; however, the outcomes have not been systematically synthesized. We performed a PRISMA systematic review (PROSPERO CRD420250653209; March 20, 2025) of the PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov databases. Two independent reviewers performed screening and data extraction. Risk of bias was assessed using ROBINS-I. Random-effects meta-analysis pooled postoperative Semmes-Weinstein (SW) monofilament thresholds as mean differences (TNR minus control) at the longest comparable follow-up. Included studies were observational (prospective and retrospective cohorts and case series). Ten studies were included (4 GA; 6 oncologic/prophylactic), representing 281 unique patients. The meta-analysis included three comparative cohorts. TNR was associated with improved nipple sensation (-1.40 SW units; 95% CI -1.95, -0.86; I² 58.1%). In a GA subgroup (2 studies), the pooled effect was similar (-1.54; 95% CI -2.28, -0.80; I² 74.9%). Single-arm studies reported recovery of protective sensation after TNR. In the largest comparative cohort with multidimensional quantitative sensory testing, NAC cold detection differed by 11.1 °C (95% CI 7.6, 14.6), and NAC 2-point discrimination was present in 40% of TNR patients versus 0% of controls. In a nipple erection substudy, nipple erection was reported in 73% (16/22) of TNR nipples versus 39% (7/18) of controls. TNR was associated with improved postoperative NAC sensory outcomes, but the available evidence was observational and subject to moderate-to-serious risk of bias. Larger prospective multicenter studies with standardized sensory testing, longer follow-up, and validated patient-reported outcomes are needed.
Journal of animal science · 2026
Dietary supplementation with tryptophan in sows is a promising strategy for optimizing both performance and animal welfare. In addition to its role in protein synthesis, this essential amino acid is a precursor of serotonin and melatonin, which are bioactive compounds that influence appetite, social behavior, and stress regulation. However, the reported effects on reproductive outcomes and maternal metabolism remain inconsistent. This systematic review evaluated the evidence of tryptophan supplementation as a modulator of behavior and productivity in sows. Searches were conducted in Scopus and Web of Science databases. Experimental peer-reviewed studies that assessed tryptophan supplementation across different physiological phases (gestation and lactation), dietary levels, and environmental contexts were included. This review followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 guidelines, and the protocol was preregistered. Screening and data extraction were performed by two independent reviewers, and the risk of bias was assessed using the SYRCLE's (Systematic Review Center for Laboratory Animal Experimentation) risk of bias tool. Eleven studies met the eligibility criteria of this review. Tryptophan supplementation consistently reduced aggressiveness in group-housing systems and supported piglet survival and growth. However, the effects on reproductive performance and maternal metabolism vary depending on the dose, parity, and environmental conditions. The heterogeneity of the study designs and the absence of a meta-analysis due to data variability were identified as the main limitations. Overall, tryptophan supplementation demonstrated potential benefits for sow welfare and productivity, but the results remained context dependent. Long-term and standardized studies are required to clarify its impact, particularly on reproductive efficiency and maternal physiology. Tryptophan is an amino acid that can be added to sow diets to improve both their behavior and productivity. In addition to its role in protein synthesis, tryptophan serves as a precursor for bioactive compounds into substances that influence mood, appetite, and stress. However, the reported effects on sow productivity and metabolism have been inconsistent. This review analyzed scientific evidence to evaluate tryptophan supplementation to improve sow behavior and productivity, highlighting that while it has a positive effect on well-being, its results on production still vary.
Journal of gynecology obstetrics and human reproduction · 2026
Polycystic ovary syndrome (PCOS) is a common endocrine and metabolic disorder, the exact causes of which are still not known. However, studies have emphasized the role of oxidative stress in the pathogenesis of PCOS. The aim of this study is to investigate the effect of sildenafil and melatonin on oxidative stress markers in PCOS patients. 51 PCOS patients were randomly divided into three groups and received treatment for three months. Group 1, only received metformin; Group 2, received melatonin + metformin, and Group 3 received sildenafil + metformin. Blood samples were collected before and after the treatment started, and serum levels of malondialdehyde (MDA), nitric oxide (NO), ferric-reducing antioxidant power (FRAP), protein carbonyl (PC) and total thiol (T-SH) were measured. The findings of the study demonstrated a decline in the mean levels of MDA and PC in the metformin-only, sildenafil, and melatonin groups. This decline was statistically significant for MDA in the metformin-only group (P=0.008) and the sildenafil group (P=0.04), and for PC in the metformin-only group (P=0.005) and melatonin group (P=0.04). The antioxidant markers such as T-SH (P=0.009) and FRAP (P=0.03) levels significantly increased in the melatonin group after the intervention. Overall, biomarkers of oxidative stress improved in the metformin-only, melatonin, and sildenafil groups, suggesting that these drugs may have protective effects in PCOS patients. However, further studies are needed to determine their effectiveness.
British journal of anaesthesia · 2026
Postoperative sleep impairment is common in older adult patients and is associated with delayed recovery and a negative impact on overall health, daily functioning, and quality of life. Older adults are particularly vulnerable because of age-related physiological changes and reduced functional reserves. We conducted a systematic review to assess the efficacy of pharmacotherapeutic interventions for improving postoperative sleep in older adults. PubMed, the Cochrane Library, and Embase were searched from inception to August 20, 2025. Randomised controlled trials investigating pharmacological interventions aimed at improving postoperative sleep in patients aged ≥60 yr were included. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 tool, and certainty of evidence was evaluated using the GRADE framework. Random-effects meta-analysis was performed where appropriate. The review was registered in PROSPERO (CRD420250651275). Of the 525 identified studies, 21 met the inclusion criteria. Assessed interventions included dexmedetomidine, esketamine, alprazolam, remimazolam, melatonin, and zolpidem. Dexmedetomidine was the most consistently effective, improving both subjective and objective sleep. Subgroup meta-analysis comparing dexmedetomidine with placebo showed a moderate, statistically significant improvement in sleep quality (standardised mean differences -0.51; 95% confidence interval -0.86 to -0.17; p<0.001; I2=94%). Evidence for other agents was limited. Overall certainty of evidence was very low to low. Pharmacological interventions potentially improve postoperative sleep in older adults, but current evidence is limited. Dexmedetomidine appears most promising, with potential benefits across administration regimens. High-quality trials are needed to establish optimal dosing and timing and to assess longer-term effects on sleep and recovery in this vulnerable population.
Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026
To describe temporal patterns of use of sleep aids (benzodiazepine receptor agonists [BZRAs], non-BZRAs [e.g., melatonin]) from baseline to 6FU associated with cognitive behavioral therapy for insomnia (CBTI) combined with BZRA tapering and to assess the odds of BZRA use at 6FU associated with non-BZRA use at baseline. Using diary data from a trial comparing CBTI combined with a masked BZRA taper method (MTcap) versus standard open BZRA taper (SGT), we determined the frequency of four temporal patterns of sleep aid use at 6FU relative to baseline: 1) "less BZRA-nonBZRA", 2) "stable use BZRA-nonBZRA", 3) "more BZRA-nonBZRA", and 4) "less BZRA/more nonBZRA." We also assessed the use of specific non-BZAs (e.g., melatonin) and whether non-BZRA use at baseline predicted patterns of sleep aid use at 6FU. Of 139 participants (71 MTcap; 68 SGT), 63% used "less" (68% MTcap, 59% SGT), 26% were "stable use" (20% MTcap, 32% SGT), 5% used "more" (6% MTcap, 4% SGT), and 6% used "less BZRA but more nonBZRA" (7% MTcap, 4% SGT) at 6FU. Combination BZRA-nonBZRA was associated with increased odds of only nonBZRA use (OR = 9.05) and decreased odds of only BZRA (OR = .23) or no BZRA/nonBZRA (OR = .38) at 6FU compared to BZRA only at baseline. The MTcap and SGT programs, both incorporating CBTI, were associated with less use of sleep aids at 6FU. BZRA deprescribing initiatives that include CBTI are effective in lowering sleep aid use among middle-aged and older adults. Clinicaltrials.gov NCT03687086 Registered 9/27/2018. Protocols and clinical tapering guidelines are available to help patients taper off benzodiazepines and z-drugs used for insomnia. These protocols may be combined with cognitive behavioral therapy for insomnia to address underlying factors that perpetuate insomnia symptoms. However, discontinuing these medications may leave patients feeling like they need to turn to other medications or supplements to help them sleep. There is a paucity of empirical evidence on the types of sleep aids patients take after benzodiazepine and z-drug tapering, and whether cognitive behavioral therapy for insomnia in combination with benzodiazepine/z-drug tapering protocols is associated with discontinuation of other sleep aids. This analysis of data from a randomized trial found less sleep aid use 6 months after cognitive behavioral therapy for insomnia in combination with a benzodiazepine/z-drug tapering program. Only 6% of participants used more (i.e., increased) sleep aids that were not benzodiazepine/z-drugs at 6 months follow up.
Plant cell reports · 2026
Heavy metal (HM) pollution is a traditional and ongoing global ecological issue that requires continuous attention. Although studies have focused on how plants cope with HMs stress, the related results ineffectively serve phytoremediation and control HMs toxicity. Melatonin (MT), as a multifunctional signaling molecule, has significant potential in alleviating HMs toxicity in crops. In this meta-analysis, a dataset across different plant families comprising 2476 observations from 140 studies evaluates MT-mediated crosstalk regulating plant growth under HMs stress. Results revealed that exogenous MT significantly improved overall plant performance by 18% (95% CI = 19.5%-14.8%), including plant growth (41.4%), morphology (51.3%) and physiology (44.4%) by stimulating shoot and root biomass 45.5% and 39.5%, respectively. The marked increment in chlorophyll (33.6%) and antioxidant activities (31.8%) was observed by mitigating the adverse effects of oxidative damage (- 23.5%). The elevated nutrient acquisition (24%) and endogenous MT level (59%) were accompanied by 24.2% increase in metabolites and -19.4% reduction in HMs uptake. Random forest machine learning revealed that plant species, MT duration and HMs concentration were the dominant predictors of biomass, whereas HMs type and exposure duration followed by MT level and duration exerted significant influence on plant length and oxidative stress. These effects were significantly associated with MT-mediated genes response and dose or exposure duration, where MT ≤ 100 μM for ≤ 15 days significantly improved results, while excessive level of HMs and prolonged exposure duration diminished MT efficacy. These findings underscore the promising potential of MT-mediated mechanisms in attenuating the injurious effects of HMs on plants.
Physiological reports · 2026
Berberine has been shown to lower core temperature and heart rate during passive heat stress in animal models. This study evaluated the effect of dietary berberine supplementation on physiological and perceptual responses to exercise-heat stress in humans. Eight participants (6 men/2 women; Age: 23 ± 3 years, Stature: 1.75 ± 0.03 m, Mass: 71.8 ± 2.7 kg, VO2max: 57.5 ± 2.1 mL/kg lbm/min-1) ingested 1.5 g of Berberine or Placebo for 7d prior to a 1 h treadmill run (60% VO2max) in hot (35°C), moderately humid (39% RH) conditions. Mean body temperature (Tb), heart rate (HR), expired gasses (VO2, VCO2, RER), minute ventilation, respiratory rate (RR), tidal volume, and perceptual responses (thermal sensation, perceived discomfort, and perceived exertion) were measured throughout exercise. Data are reported as average ± standard deviation over the 60 min exercise trial. Tb was lower (p = 0.030) in Berberine (37.69 ± 0.53°C) than Placebo (37.84 ± 0.38°C). Heart rate was lower (p = 0.025) in Berberine (163 ± 28 bpm) than Placebo (166 ± 30 bpm). RR was lower (p = 0.045) in Berberine (38.8 ± 11.2 bpm) than Placebo (41.4 ± 10.6 bpm). Thermal sensation was lower (p = 0.002) in Berberine (9.5 ± 4.2) than Placebo (12.3 ± 5.0). Generalized discomfort was lower (p = 0.044) in Berberine (9.3 ± 5.1) than Placebo (12.1 ± 5.6). Perceived exertion was lower (p < 0.001) in Berberine (11.4 ± 3.4) than Placebo (13.1 ± 4.0). Dietary berberine supplementation improved mean body temperature, heart rate, respiratory rate, and perceptual responses during exertional heat stress. Many of these changes were of small magnitude, calling into question the potential utility of dietary berberine supplementation for work or exercise in hot ambient conditions.