title stringlengths 1 1.19k | keywords stringlengths 0 668 | concept stringlengths 0 909 | paragraph stringlengths 0 61.8k | PMID stringlengths 10 11 |
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Objective | osteoporosis | OSTEOPOROSIS | To evaluate three Tai Chi (TC) exercise programs as intervention measures to compare their effects on improving rate of change in bone mineral density (BMD) in elderly individuals with osteoporosis (OP) and to propose the optimal exercise duration. | PMC10712169 |
Methods | A randomized controlled trial (RCT) was conducted to identify study participants based on inclusion and exclusion criteria. Due to subject attrition, the number of participants analyzed decreased from 60 to 49. These participants were divided into four groups: 24-style TC Chuan group (24TCCG) ( | PMC10712169 | ||
Results | Compared with CG, all three TC groups showed significant improvements in BMD changes ( | PMC10712169 | ||
Conclusion | These three TC exercise programs have similar positive effects on the BMD of the femoral neck and greater trochanter. However, compared with other exercise schemes, 24TCC showed a more significant improvement in BMD of the L2-L4 lumbar vertebrae region after just 8 weeks, as well as a more pronounced improvement in BMD... | PMC10712169 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s13018-023-04324-0. | PMC10712169 | ||
Keywords | PMC10712169 | |||
Introduction | TC, osteoporosis | OSTEOPOROSIS | Aging is associated with decreased bone health and an increased risk of osteoporosis (OP) [In recent years, there has been growing interest in the potential benefits of Tai Chi (TC) exercise in improving BMD in this population. TC is a unique Chinese exercise method that combines gentle, flowing movements with rhythmic... | PMC10712169 |
Methods | PMC10712169 | |||
Research design | This investigation was structured as a randomized, double-blind controlled trial, executed with strict adherence to the ethical tenets delineated in the Declaration of Helsinki of the World Medical Association [ | PMC10712169 | ||
Research subjects | PMC10712169 | |||
Inclusion and exclusion criteria | OSTEOPOROSIS RISK | This study recruited middle-aged and older individuals engaged in teaching activities in TC societies through random selection. Inclusion and exclusion criteria were established to limit variability and maintain subject baseline characteristics. Inclusion criteria included being between 55 and 65 years of age, voluntar... | PMC10712169 | |
Power analysis and sample size estimation | We conducted a power analysis and estimated the sample size using G*Power software (version 3.1.9.7) [ | PMC10712169 | ||
Subjects grouping | This study employed randomization for coding subjects who met inclusion criteria, utilizing stratified random grouping with SPSS 26.0 software. Personnel not involved in the study were responsible for coding subjects to four different groups, including 24TCCG ( | PMC10712169 | ||
TC exercise program and protocols | PMC10712169 | |||
TC exercise program | In this study, we selected 24TCC, TCKFF, and TCSB as interventions for the participants, which are all related to Tai Chi (TC) but involve different exercise methods:(i) 24TCC: It consists of 24 movements, including the basic actions and postures of TC, focusing primarily on the smoothness and coherence of movements, w... | PMC10712169 | ||
Exercise protocols | Baseline characteristics of each subject group were recorded prior to experimentation, and homogeneity of the data was tested to ensure scientific and effective subsequent study. Mean and standard deviation data are presented in Table Baseline characteristics of the included subjects and data of each index before TC ex... | PMC10712169 | ||
Indicator measurements | L2-L4 lumbar vertebrae | This study utilized dual-energy X-ray absorptiometry (DXA) to measure BMD at four anatomical sites (L2-L4 lumbar vertebrae, Ward's triangle, femoral neck, and greater trochanter) over five consecutive noncardiac rate scans in g/cm | PMC10712169 | |
Statistical analysis | PMC10712169 | |||
Data entry | All BMD data and intervention results were subject to meticulous two-person cross-entry and verification. The intervention effect was assessed via the formula of (after intervention-before intervention)/before intervention × 100%, with percentages before and after intervention systematically observed. Given that BMD is... | PMC10712169 | ||
Statistical analysis | Statistical analysis of data processing was performed using SPSS 26.0 software. Abnormal data and normal distribution were detected using the Shapiro–Wilk test in Explore, and any such data were systematically verified and eliminated. To determine the change rate of a given index between groups before and after the int... | PMC10712169 | ||
Image rendering | GraphPad Prism 8.0.2 software was utilized to generate graphical representations of BMD change rates in L2-L4, Ward's triangle, femoral neck, and greater trochanter regions before and after intervention in each group. | PMC10712169 | ||
Results | PMC10712169 | |||
Subjects were included in the completion condition | RECRUITMENT | From February to April in 2023, 64 subjects were recruited for this study, with 60 subjects identified as "positive" by OMOST after excluding 4 subjects who did not meet the inclusion criteria. These subjects were randomly allocated to 24TCCG, TCKFFG, TCSBG, and CG, each consisting of 15 cases. A total of 49 cases comp... | PMC10712169 | |
Baseline data and data after 16-week TC exercise intervention | PMC10712169 | |||
Baseline data | Baseline data for each group are given in Table | PMC10712169 | ||
Data of BMD changes | The recorded data on BMD changes are given in Table Data of BMD changes after 16-week TC exercise intervention in each group | PMC10712169 | ||
Results of statistical analysis | Figure Trend plots that encapsulate the alterations in BMD subsequent to sixteen weeks of structured TC intervention across every study group. Note: The horizontal axis of each plot represents intervention duration (in weeks), whereas the vertical axis depicts the percentage rate of change in BMD (in %) | PMC10712169 | ||
L2-L4 lumbar vertebrae | During week 4, the comparison between 24TCCG and TCKFFG resulted in insignificant difference ( | PMC10712169 | ||
Ward's triangle | At weeks 4, 12, and 16, no significant difference was observed between 24TCCG, TCKFFG, and TCSBG ( | PMC10712169 | ||
Femoral neck | At the 4th week, no significant difference was observed among 24TCCG, TCKFFG, and TCSBG ( | PMC10712169 | ||
Greater trochanter | Following the assessments at the 4th, 8th, 12th, and 16th week intervals, there was no significant difference observed between 24TCCG, TCKFFG, and TCSBG ( | PMC10712169 | ||
Discussion | PMC10712169 | |||
Differences in the use of statistical methods between this study and other studies | Presently, considerable research is being conducted to investigate the influence of TC exercise on BMD in middle-aged and older populations. However, the employed statistical methodologies in these studies are diverse. For example, Chan et al. implemented the independent samples t-test to assess the impact of TC boxing... | PMC10712169 | ||
Analysis of the results of this study | PMC10712169 | |||
Controversial results on the effect of TC exercise on BMD | L2-L4 lumbar vertebrae BMD | A comparative analysis of data from 24TCCG and CG demonstrated a significant enhancement in BMD at Ward's triangle and the femoral neck regions over time, paralleling findings for L2-L4 lumbar vertebrae and femoral neck BMD in TCKFFG and CG, along with L2-L4 lumbar vertebrae BMD and femoral neck BMD in TCSB and CG comp... | PMC10712169 | |
Differences in the effects of different TC exercise programs and times on BMD improvement | skeletal muscle contraction, BMD loss | The present study revealed that each TC exercise program exhibited significant disparities in BMD changes across several skeletal regions including the L2-L4 lumbar vertebrae, Ward's triangle, femoral neck, and greater trochanter in comparison to CG, at various time points. These differences were particularly pronounce... | PMC10712169 | |
The potential impact of gender disparities on the trend in BMD changes | In this study, the number of males and females varies among different groups. Based on the existing research, females are more susceptible to OP due to hormonal differences, changes in menopausal hormones, and variations in peak bone mass [ | PMC10712169 | ||
Potential reasons for the decreasing trend in the rate of change of BMD in the subjects of this study | The present study utilized Plot trend analysis of BMD data by site to reveal a decrease in BMD in subjects, possibly due to the risk of OP. It has been suggested that a negative correlation exists between BMI and the risk of OP prevalence, with a higher risk of OP prevalence in subjects with lower BMI [ | PMC10712169 | ||
Potential reasons for better improvement in BMD with 24TCC compared to other TC exercise programs | In our study, we observed a better effect of 24TCC on BMD improvement, which may be attributed to a combination of biomechanical, physiological, and potential biochemical factors. Several potential mechanisms can be proposed: | PMC10712169 | ||
Advantage of movement characteristics | The superior effect of 24TCC and other TC exercise programs on BMD improvement may be attributed to their movement characteristics. Firstly, the 24TCC program consists of 24 different movements, focusing on the smoothness and continuity of the overall movements. These movements involve various joint motions and provide... | PMC10712169 | ||
Biomechanical characteristics | The superiority of 24TCC in improving BMD can be attributed to specific movements and biomechanical characteristics inherent in the program. The 24TCC training program consists of 24 different movements involving various joint motions, including weight shifting, rotations, and weighted postures. Some of these movements... | PMC10712169 | ||
Physiological and biochemical mechanisms: | RECRUITMENT | The superiority of 24TCC in improving BMD may involve physiological mechanisms. The execution of movements in 24TCC involves the integration of body alignment, breathing techniques, and mindful coordination. The precise execution of movements and the combination of mental focus may enhance the activation of neuromuscul... | PMC10712169 | |
Potential mechanisms for TC exercise to improve BMD | PMC10712169 | |||
Physical mechanisms | This study employed a RCT to investigate the effects of TC exercise on the prevention and treatment of OP in middle-aged and elderly individuals. While the results provide insight into the impact of TC exercise on BMD improvement, it is imperative to elucidate the underlying mechanism, which potentially involves mechan... | PMC10712169 | ||
Biochemical mechanisms | PROLIFERATION | The engagement in TC exercise has been demonstrated to generate mechanical stress on the skeletal system, subsequently stabilizing bone metabolism and enhancing BMD. Notably, this exertion may also potentially elicit hormonal, cytokine, noncoding RNA, and signaling pathway responses, thereby fostering osteogenesis.TC e... | PMC10712169 | |
Insights from TC exercise in traditional Chinese exercise control OP | Research has demonstrated the high prevalence of OP in our country [ | PMC10712169 | ||
Advantages and limitations | There exist several advantages to the present study: (i) Subjects in this study underwent OMOST and tested positive, thereby mitigating the error in baseline characteristics and selection bias, resulting in increased credibility of the RCT outcomes. (ii) In the statistical analysis of this study's RCT data, the exclusi... | PMC10712169 | ||
Suggestions | (i) Larger sample size: Conduct studies with a larger sample size to increase statistical power and enhance the generalizability of the findings. (ii) Long-term interventions: Implement longer intervention periods to investigate the effects of TC exercise programs on BMD over extended durations. (iii) Stratification ba... | PMC10712169 | ||
Conclusion | In conclusion, all 3 TC exercise programs yielded comparable positive outcomes on BMD in the femoral neck and greater trochanter. Nevertheless, 24TCC, the long-term (≥ 8 weeks) TC exercise intervention, exhibited superior improvements in BMD at L2-L4 lumbar vertebrae when compared to the other programs. Furthermore, 24... | PMC10712169 | ||
Authors contributions | RECRUITMENT | JK was responsible for the framework design, subject recruitment, experimental manipulation, data entry, and writing of the manuscript; CT and LZ were responsible for proofreading the manuscript. | PMC10712169 | |
Funding | This manuscript was sponsored by the Shandong Province Professional Degree Graduate Students Teaching Case Bank Program (SDYAL20103). | PMC10712169 | ||
Availability of data and materials | The datasets used in this study are available upon request from the first or corresponding author. Access to the data is subject to any applicable ethical and legal approvals. | PMC10712169 | ||
Declarations | PMC10712169 | |||
Ethics approval and consent to participate | The research in this manuscript was approved by the Biomedical Ethics Committee of Qufu Normal University, No. 2022075, and the ethical materials state that the research is consented for publication. | PMC10712169 | ||
Competing interests | All authors declare that they do not have any conflict of interest. | PMC10712169 | ||
References | PMC10712169 | |||
Background | TB | TUBERCULOSIS (TB) | Children under age five years, particularly those living with HIV (CLHIV), are at risk for rapid progression of tuberculosis (TB). We aimed to describe TB clinical presentations, diagnostic pathways and treatment outcomes in CLHIV compared to children without HIV in Cameroon and Kenya. | PMC10107571 |
Methods | TB, HIV infection | REGRESSION, MAY, HIV INFECTION | This sub-analysis of a cluster-randomized trial evaluating the integration of pediatric TB services from May 2019 to March 2021 enrolled children age < 5 years with TB. We estimated the HIV infection rate with 95% confidence interval (CI). We compared TB clinical presentations, diagnostic pathways and treatment outcome... | PMC10107571 |
Results | TB, co-infected with HIV, fatigue, night sweats, malnutrition | MALNUTRITION | We enrolled 157 children with TB (mean age was 1.5 years) and 22/157 (14.0% [9.0-20.4%]) were co-infected with HIV. CLHIV were more likely to initially present with acute malnutrition (AOR 3.16 [1.14–8.71], p = 0.027). Most TB diagnoses (140/157, 89%) were made clinically with pulmonary TB being the most common present... | PMC10107571 |
Conclusions | TB | These results altogether advocate for better integration of TB services into all pediatric entry points with a special focus on nutrition services, and illustrate the importance of non-sputum-based TB diagnostics especially in CLHIV. | PMC10107571 | |
Trial registration | NCT03862261, first registration 05/03/2019. | PMC10107571 | ||
Supplementary Information | The online version contains supplementary material available at 10.1186/s12879-023-08216-w. | PMC10107571 | ||
Keywords | PMC10107571 | |||
Background | TB, death, ®, HIV infection, Tuberculosis | HIV INFECTION, DISEASE, TUBERCULOSIS | Tuberculosis is one of the top ten causes of death in children worldwide [In children, the laboratory-based diagnosis of TB is particularly challenging due to the paucibacillary nature of the disease and the difficulty to obtain respiratory samples for bacteriological confirmation [Major advances in the diagnosis of TB... | PMC10107571 |
Methods | PMC10107571 | |||
Study design and setting | TB | This is a sub-analysis of the INPUT study. The INPUT study is a multi-national, cluster-randomized, stepped-wedge trial, which evaluates the major components of the Catalyzing Pediatric TB (CaP-TB) project, integrating pediatric TB screening and diagnostics into non-TB child healthcare services at the hospital and prim... | PMC10107571 | |
Study population | TB | MAY | From May 2019 to March 2021 (with a pause due to COVID-19 from April to July 2020), the INPUT study prospectively enrolled young children under the age of five years with a presumptive diagnosis of TB based on TB signs and symptoms, and followed them through TB diagnosis investigations and treatment where applicable. I... | PMC10107571 |
Data collection | TB, nasopharyngeal aspirate, pulmonary TB | MALNUTRITION | In the INPUT study, an electronic data capture system developed by CliniOps (Fremont, CA, USA) was used to standardize data collection across the study sites and to compile the data into one unified dataset. Research nurses entered data directly into a tablet via an electronic case report form. Data were synced regular... | PMC10107571 |
Statistical analysis | TB, HIV infection, HIV coinfection | REGRESSION, HIV INFECTION, HIV COINFECTION | The prevalence of HIV coinfection among children presumed and diagnosed with TB was estimated together with the associated 95% confidence interval (CI). Demographic and clinical characteristics of children diagnosed with TB at enrollment were summarized using means (standard deviations) or medians (interquartile range)... | PMC10107571 |
Power and sample size | No a priori power or sample size estimates were performed for this exploratory sub-analysis. We used the sample that was available from the INPUT study. | PMC10107571 | ||
Results | PMC10107571 | |||
Discussion | TB, death, fatigue, HIV infection, TB-HIV co-infection, sweats, malnutrition, Fatigue | HIV INFECTION, DISEASE TRANSMISSION, SEVERE MALNUTRITION, MALNUTRITION | The overall prevalence of TB-HIV co-infection was 14% among children under age five years diagnosed with TB in our study. Studies from Cameroon and Kenya have found estimates in children less than five years of age with TB-HIV co-infection to be between 41 and 52% [In this study, CLHIV did not necessarily have a wider ... | PMC10107571 |
Conclusions | TB, TB-HIV co-infection, malnutrition | MALNUTRITION | In this sub-analysis of the INPUT study comparing children under age five years with TB-HIV co-infection to those with TB living without HIV in Kenya and Cameroon, we identified a lower-than-expected proportion of TB-HIV co-infection. Children with TB and HIV presented with malnutrition more frequently compared to thos... | PMC10107571 |
Acknowledgements | ALBERT, GILCHRIST | We acknowledge contribution of the INPUT study group collaborators, in Cameroon: Anne Cecile Bissek, Desire A Cheugoue, Loic Feuzeu, Albert Kuate, Sandrine Kwedi, Muhamed Mbunka, Giscard N Nana, Ferdinand Ngong, Lucie Nguimbous, Bernadette Ngum, Pascal Nyamb, Pierrette Omgba, Patrice Tchendjou, Yanique B Tchouga. In Ke... | PMC10107571 | |
Authors’ Contributions | LP, LD, NR and AT conceptualized the sub-study. MO, SJP, RMas, BT collected the data. NH, SS and LD validated the data. NH and RMac performed the statistical analysis. All authors contributed to the interpretation of data. LP prepared the original draft. All authors reviewed and edited the draft. RMas, BT, LD and AT ad... | PMC10107571 | ||
Funding | The INPUT study was funded by UNITAID. The funding body is not involved in the study design implementation and in writing the manuscript. | PMC10107571 | ||
Data Availability | The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. | PMC10107571 | ||
Declarations | PMC10107571 | |||
Ethics approval and consent to participate | TB | MINOR, NAIROBI | The protocol has been reviewed and approved by the Cameroon National Ethics Committee for Research in Human Health (CNERSH) (number 2018/12/ 1131/CE/CNERSH/SP dated 14 Dec 2018), the Kenyatta National Hospital University of Nairobi Ethical Review Committee (KNH UON-ERC) (number KNH-ERC/A/44 dated 07 Feb 2019), the WHO ... | PMC10107571 |
Consent for publication | Not applicable. | PMC10107571 | ||
Competing interests | The authors declare that they have no competing interests. | PMC10107571 | ||
Abbreviations | TB, Mycobacterium tuberculosis, MTB, ® | CORONAVIRUS, SEVERE ACUTE RESPIRATORY SYNDROME, PEDIATRIC AIDS, IMMUNODEFICIENCY | AntigenAdjusted odds ratioAntiretroviral therapyCatalyzing pediatric TB innovationsComprehensive care center for HIVChildren living with HIVCameroon national ethics committee for research in human healthConfidence intervalCoronavirus disease 2019Elizabeth Glaser Pediatric AIDS FoundationExtra-pulmonary TBEthics review ... | PMC10107571 |
References | PMC10107571 | |||
Background | TB, Tuberculosis | TUBERCULOSIS, TUBERCULOSIS (TB) | The authors have declared that no competing interests exist.Current address: Connect TB, Hague, the Netherlands‡ These authors are joint first-authors on this work.¶ Membership of the TREATS Study Team is provided in the Acknowledgements.Tuberculosis (TB) prevalence remains persistently high in many settings, with new ... | PMC10490889 |
Methods and findings | TB, fever, chest pain, cough, sweats, weight loss | The study population of the HPTN 071 (PopART) trial included individuals aged ≥15 years living in 21 urban and peri-urban communities in Zambia and South Africa, with a total population of approximately 1 million and an adult HIV prevalence of around 15% at the time of the trial. Two sputum samples for TB testing were ... | PMC10490889 | |
Conclusions | TB | There was no evidence that the PopART intervention reduced TB prevalence. Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of several years. Including chest X-ray screening alongside TB symptom screening could substant... | PMC10490889 | |
Trial registration | TB | The TREATS study was registered with In a population based cohort study, Eveline Klinkenberg and colleagues examine the impact of the PopART intervention on TB prevalence in Zambia and South Africa. | PMC10490889 | |
Author summary | PMC10490889 | |||
Why was this study done? | TB, Tuberculosis | TRANSMISSION, TUBERCULOSIS, TUBERCULOSIS (TB) | Tuberculosis (TB) prevalence remains persistently high in many settings, with new or expanded interventions required to achieve substantial reductions.The HIV Prevention Trials Network (HPTN) 071 Population Effects of Antiretroviral Therapy to Reduce HIV Transmission (PopART) community-randomised trial, conducted in 21... | PMC10490889 |
What did the researchers do and find? | TB | We conducted a TB prevalence survey during 2019 to 2021, among around 50,000 randomly selected individuals aged ≥15 years in the 21 urban and peri-urban communities that were included in the HPTN 071 (PopART) trial.Overall, estimated TB prevalence was 0.92% (457/49,556). There was no evidence of a difference in TB prev... | PMC10490889 | |
What do these findings mean? | TB | This study found no evidence that the PopART intervention reduced TB prevalence, compared with standard-of-care.Systematic screening for TB that is based on symptom screening alone may not be sufficient to achieve a large reduction in TB prevalence over a period of a few years.Including chest X-ray screening alongside ... | PMC10490889 | |
Data Availability | The analysis dataset that was used to produce the results that are presented in this paper can be accessed from the LSHTM data repository, and the DOI is | PMC10490889 | ||
Introduction | TB, death, viral suppression | COVID-19 (CORONAVIRUS DISEASE 2019), TUBERCULOSIS, TUBERCULOSIS (TB) | Tuberculosis (TB) overtook HIV as the leading infectious cause of death worldwide, prior to the Coronavirus Disease 2019 (COVID-19) pandemic, requiring a major policy shift if it is to be controlled in line with the global commitment to “end TB” [Meanwhile, 4 community-randomised trials have shown that delivery of univ... | PMC10490889 |
Methods | PMC10490889 | |||
Ethics statement | The TREATS study was approved by the research ethics committees of the London School of Hygiene & Tropical Medicine, the University of Zambia (UNZABREC), and Pharma-Ethics (Pty) in South Africa. Individuals gave written informed consent to survey participation, and for individuals aged 15 to 17 years, assent and parent... | PMC10490889 | ||
HPTN 071 (PopART) community-randomised trial design, PopART intervention, and TREATS study design | TB, sweats, weight loss, cough | The HPTN 071 (PopART) community-randomised trial was conducted during 2013 to 2018. All communities were urban or peri-urban, 12 were in Zambia and 9 were in the Western Cape Province of South Africa, with a total population of around 1 million individuals and estimated adult HIV prevalence of around 15%. In the HPTN 0... | PMC10490889 | |
TREATS TB prevalence survey design | PMC10490889 | |||
Sample size and survey timing | TB | The TREATS TB prevalence survey was conducted among a random sample of individuals aged ≥15 years during 2019 to 2021. The target sample size was 3,000 to 4,000 participants in each arm C community and 1,500 to 2,000 participants in each arm A and arm B community, with a total targeted sample size of around 50,000 part... | PMC10490889 | |
Field procedures | TB | Within each community, random sampling was structured according to geographically defined blocks of around 200 households. For every randomly selected block, all households were visited by a research assistant. If an adult household member was found at home, permission was sought to enumerate (list) all household membe... | PMC10490889 | |
Eligibility to provide 2 sputum samples (S1 and S2) for Xpert-Ultra testing | TB, chest pains, fever, cough, sweats, weight loss | “Sputum-eligible” individuals were identified based on TB screening using symptoms and chest X-ray. An individual was sputum-eligible based on TB symptoms if they had a cough for ≥2 weeks or if they had 2 or more among 5 “TB suggestive” symptoms (cough of any duration, unexpected weight loss for ≥4 weeks, night sweats ... | PMC10490889 |
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