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Background Physical activity (PA) may protect against infertility by modulating the hypothalamic-pituitary–gonadal axis, thereby reducing gonadotropin levels, elevating immune function, and inhibiting inflammation and circulating sex hormones. However, whether PA reduces the risk of infertility remains largely unknown. We therefore conducted a systematic review and meta-analysis to determine the preventive effects of PA on infertility. Methods We searched PubMed, Cochrane Library, EMBASE, and CINAHL databases to retrieve published epidemiologic studies on the relationship between PA and infertility. Following the PRISMA guidelines, we selected English literature publishedprior to 11 April 2022, and assessed study quality using the Newcastle–Ottawa Scale. Our protocol, including the full methods employed for this review, is available on PROSPERO (ID = CRD42020143344). Results Six cohort studies and four case–control studies based on 708,965 subjects and 12,580 cases were eventually screened and retained. High levels of PA were shown to reduced risk of infertility relative to low levels (cumulative relative risk [RR] = 0.59, with a 95% confidence interval CI 0.49–0.71), and we reported results for cohort studies (RR = 0.63, 95% CI 0.50–0.79) and case–control studies (RR = 0.49, 95% CI 0.35–0.67). Our findings were comparable for men (RR = 0.65, 95% CI 0.41–1.04) and women (RR = 0.56, 95% CI 0.47–0.66). The meta-analysis of six risk estimates from five studies of low, moderate, and high PA levels showed that moderate PA may also reduce the risk of infertility compared with low PA (RR = 0.54, 95% CI 0.38–0.77). However, high PA also appeared to slightly augment the risk of infertility compared with moderate PA (RR = 1.31, 95% CI 1.08–1.59). Conclusions This present systematic review comprehensively reflected an inverse relationship between different levels of PA and infertility, and our meta-analysis showed that a moderate-to-high PA level significantly reduced the overall risk of infertility, and that this level of PA activity was a common protective factor. In addition, limited evidence suggested that compliance with international PA guidelines would greatly lower the risk of infertility (RR = 0.58, 95% CI 0.45–0.74; I 2  = 0.0%). Future studies, however, need to be executed to further determine the frequency, optimal dosage, and duration required to effectively attenuate the risk of infertility.

* Microplastics are widely found in both aquatic and terrestrial environments. * Cleaning products and discarded plastic waste are primary sources of microplastics. * Microplastics have apparent toxic effects on the growth of fish and soil plants. * Multiple strains of biodegradable microplastics have been isolated. Microplastics (MPs) are distributed in the oceans, freshwater, and soil environment and have become major pollutants. MPs are generally referred to as plastic particles less than 5 mm in diameter. They consist of primary microplastics synthesized in microscopic size manufactured production and secondary microplastics generated by physical and environmental degradation. Plastic particles are long-lived pollutants that are highly resistant to environmental degradation. In this review, the distribution and possible sources of MPs in aquatic and terrestrial environments are described. Moreover, the adverse effects of MPs on natural creatures due to ingestion have been discussed. We also have summarized identification methods based on MPs particle size and chemical bond. To control the pollution of MPs, the biodegradation of MPs under the action of different microbes has also been reviewed in this work. This review will contribute to a better understanding of MPs pollution in the environment, as well as their identification, toxicity, and biodegradation in the ocean, freshwater, and soil, and the assessment and control of microplastics exposure.

Alternaria fungi are widely distributed plant pathogens that invade crop products, causing significant economic damage. In addition, toxic secondary metabolites produced by the fungi can also endanger consumers. Many of these secondary metabolites are chemically characterized as mycotoxins. In this study, Q Exactive Orbitrap mass spectrometry was used for the non-targeted analysis of the metabolome of seven Alternaria isolates cultured on Potato Carrot Agar (PCA), Potato Dextrose Agar (PDA) and Potato Sucrose Agar (PSA) medium. Due to the difficulty of detecting modified toxins, an analytical strategy with multiple visual analysis tools was also used to determine the presence of sulfate conjugated toxins, as well as to visualize the molecular network of Alternaria toxins. The results show that PSA medium exhibits more advantageous properties for the culture of Alternaria, with more toxigenic species and quantities and more obvious metabolic pathways. Based on high-resolution tandem mass spectrometry (MS/MS) data, the mycotoxins and their metabolites were mainly clustered into four groups: alternariol (AOH)/alternariol monomethyl ether (AME)/altenusin (ALU)/altenuene (ALT)/dehydroaltenusin (DHA)/Desmethyldehydroaltenusin (DMDA) families, Altertoxin-I (ATX-I) family, tentoxin (TEN) family and tenuazonic acid (TeA) family. Moreover, the PSA medium is more suitable for the accumulation of AOH, AME, ALU, ALT, DHA and DMDA, while the PDA medium is more suitable for the accumulation of ATX-I, TEN and TeA. This research may provide theoretical support for the metabolomics study of Alternaria.

Background Chronic fatigue syndrome (CFS) is an often overlooked and debilitating multisystem disorder. Furthermore, the risk factors and pathophysiology of this disease remain unknown. This study aimed to assess risk factors for CFS by investigating the relationships between fatigue, sleep quality, and gastrointestinal symptoms in CFS patients, and to explore the possible pathophysiology of CFS. Methods This is a prospective study conducted at the Health Check-up Center of Shanghai Shuguang Hospital. A total of 1,821 participants were included, with 956 in the case group and 865 in the control group. We performed a multidimensional assessment by evaluating various clinical symptoms, including multidimensional fatigue, insomnia, and gastrointestinal discomfort. Multivariable logistic regression was used to assess risk factors for CFS, including general biological, lifestyle, psychological, and social factors. Results An MFI-20 assessment revealed that the CFS group reported all aspects of fatigue twice as severe as those of the HC group, including more severe general fatigue [13.12 (12.95–13.30) vs 8.76 (8.55–8.96)], physical fatigue [12.91 (12.70–13.13) vs 7.94 (7.73–8.14)], reduced activity [12.88 (12.65–13.11) vs 7.71 (7.51–7.91)], reduced motivation [12.75 (12.52–12.97) vs 7.86 (7.65–8.07)], and mental fatigue [12.78 (12.56–13.00) vs 7.82 (7.62–8.02)] (p-values all <0.001). Compared with the HC group, the CFS group, CFS with insomnia group, and CFS with insomnia and gastrointestinal discomfort group showed increased scores in the MFI-20, PSQI, and GSRS. Participants who were male (adjusted OR [aOR]=1.579; 95% CI, 1.275–1.956, p<0.001), smokers (adjusted OR [aOR]= 0.693; 95% CI, 0.535–0.898, p=0.006), single (aOR=2.542; 95% CI, 1.076–6.007, p=0.034), or undergraduates (aOR= 0.563; 95% CI, 0.323–0.980, p=0.042) had higher odds of CFS. Discussion Age, smoking, marital status, educational level, and other general biological and lifestyle factors were associated with fatigue. CFS comorbidities and the presence of insomnia and gastrointestinal symptoms were closely linked to a poorer health status and were the main contributors to differences in health outcomes, which may represent an important area for future research.

Objective Delayed-onset muscle soreness (DOMS) is a symptom of exercise-induced muscle injury that is commonly encountered in athletes and fitness enthusiasts. Vibration is being increasingly used to prevent or treat DOMS. We therefore carried out a meta-analysis to evaluate the effectiveness of vibration in patients with DOMS. Method We searched nine databases for randomized controlled trials of vibration in DOMS, from the earliest date available to 30 May 2018. Visual analogue scale (VAS) and creatine kinase (CK) levels were set as outcome measures. Results The review included 10 identified studies with 258 participants. The meta-analysis indicated that vibration significantly improved the VAS at 24, 48, and 72 hours after exercise, and significantly improved CK levels at 24 and 48 hours, but not at 72 hours. Conclusion Vibration is a beneficial and useful form of physiotherapy for alleviating DOMS. However, further studies are needed to clarify the role and mechanism of vibration in DOMS.

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that causes joint inflammation and affects quality of life. Appropriate physical activity can enhance joint function and lower cardiovascular disease risk. However, individuals with RA often have reduced physical activity levels, likely due to kinesiophobia, or fear of movement. This study aimed to assess the prevalence of kinesiophobia among RA patients and its influence on functional impairment, physical activity, and pain-related anxiety. Using a convenience sampling method, we surveyed 350 RA patients attending outpatient clinics in the rheumatology and immunology departments of three tertiary hospitals in Henan Province, China, from August 18 to September 1, 2023. Participants completed the Tampa Scale of Kinesiophobia (TSK), the Signals of Functional Impairment Scale (SOFI), the International Physical Activity Scale-Short Form (IPAQ-SF), and the Pain Anxiety Symptoms Scale-20 (PASS-20). The Disease Activity Score 28 (DAS28) was retrieved for each participant to assess disease activity in RA patients. Descriptive analysis, Chi-square tests, Spearman correlation, and multiple linear regression assessed factors influencing kinesiophobia, with significance set at  < 0.05. Results indicated that 70.86% of participants experienced kinesiophobia, which was positively correlated with functional impairment and pain-related anxiety, while inversely related to physical activity levels (  < 0.001). Regression analysis revealed that kinesiophobia was explained by 65.5% of the variance, with gender, education level, functional impairment, pain-related anxiety, and pain severity identified as significant predictors (  < 0.05). The findings suggest that RA patients exhibit a high prevalence of kinesiophobia, predominantly influenced by factors such as gender, lower educational attainment, increased pain levels, greater functional impairment, and pain-related anxiety. Notably, physical activity levels did not serve as a predictor of kinesiophobia in this cohort.

Introduction Chronic fatigue syndrome (CFS) is a physical and mental disorder in which long-term fatigue is the main symptom. CFS patients are often accompanied by functional gastrointestinal diseases (FGIDs), which lead to decreased quality of life and increased fatigue. Prolong-life-with-nine-turn-method (PLWNT) is a kind of physical and mental exercise. Its operation includes adjusting the mind, breathing and cooperating with eight self-rubbing methods and one upper body rocking method. PLWNT was used to improve the digestive function in ancient China and to treat FGIDs such as functional dyspepsia and irritable bowel syndrome in modern times. Previous studies have shown that PLWNT can reduce fatigue in patients with CFS. But it is unclear whether the effect of PLWNT on CFS fatigue is related to gastrointestinal function. The aim of this study was to explore the relationship between PLWNT and fatigue and gastrointestinal function in patients with CFS. Methods This study is a non-inferiority randomized controlled trial (RCT). The whole study period is 38 weeks, including 2 weeks of baseline evaluation, 12 weeks of intervention and 6 months of follow-up. Ninety-six CFS patients will be stratified random assigned to the intervention group (PLWNT) and the control group (cognitive behavior treatment) in the ratio of 1:1 through the random number table generated by SPSS. In the evaluation of results, Multidimensional Fatigue Inventory-20 (MFI-20), Gastrointestinal Symptom Rating Scale (GSRS), Bristol Stool Form Scale (BSFS), and Short Form 36 item health survey (SF-36) will be evaluated at week 0 (baseline), week 6 (midterm), week 12 (endpoint) and month 9 (follow up). The intestinal flora will be evaluated at week 0 (baseline) and week 12 (endpoint). The data results will be processed by statistical experts. The data analysis will be based on the intention to treat principle and per-protocol analysis. In the efficacy evaluation, repeated measurement analysis of variance will be used for data conforming to normal distribution or approximate normal distribution. The data which do not conform to the analysis of repeated measurement variance will be analyzed by the generalized estimation equation Linear discriminant analysis will be used to clarify the difference species of intestinal flora. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session. Discussion This trial will provide evidence to PLWNT exerting positive effects on fatigue and gastrointestinal function of CFS. It will further explore whether the improvement of PLWNT on CFS fatigue is related to gastrointestinal function. Trial registration The trial was registered at Chinese Clinical Trial Registry

Sensory input mismatches among the vestibular system, autonomic control, and visual perception cause motion sickness. Anticholinergics and antihistamines are commonly used but have limited efficacy and cause significant side effects. Orexin-A, a hypothalamic neuropeptide, has recently garnered attention for its potential role in controlling motion sickness. To summarize current knowledge on the effects and mechanisms of orexin-A in reducing motion sickness, identify gaps, and propose future research directions. Five qualified animal experiments were identified after searching PubMed, Scopus, Cochrane Library, Embase, and WoS. The SYRCLE tool was used to evaluate study quality, followed by a qualitative synthesis. Orexin-A reduced motion-induced behavioral abnormalities, nausea, and vomiting in rat and cat models. These benefits are likely mediated by the modulation of hypothalamic nuclei activity, enhanced stomach motility, and improved vestibular function. However, several limitations were observed, including inadequate reporting on randomization, blinding, and allocation concealment, as well as heterogeneity in interventions and outcome measures. Animal model studies indicates that orexin-A mitigates motion sickness (MS) symptoms in animal models, but overall certainty is low to moderate owing to risk of bias and indirectness. Rigorous, blinded studies with standardized outcomes-and ultimately, early-phase clinical trials, are needed to clarify therapeutic potential.

Background Non-specific chronic neck pain (NCNP) is a common musculoskeletal disorder which has caused a huge economic burden due to its expensive health costs and high re-occurrence rate. Yijinjing and Tuina are widely used for non-specific chronic neck pain in China. But there is little scientific evidence to evaluate their efficacy for NCNP. The aim of this research is to compare the efficacy of Yijinjng combined with Tuina versus Tuina for patients with NCNP. Methods/design A randomized controlled trial in which 102 patients with non-specific chronic neck pain will be recruited and randomly allocated to either the Tuina group or the Yijinjng combined with Tuina group in a 1:1 ratio. The interventions for both groups will be carried out three times a week for 8 weeks. The patients in the two groups will receive follow-up 1 month after the intervention. The primary outcome will be the changes in the visual analog scale (VAS). Secondary outcomes will be measured by the Neck Disability Index (NDI), Self-Rating Anxiety Scale (SAS), and Tissue Hardness and Active Range of Motion (AROM). The data will be analyzed at the baseline, 4 weeks during the intervention, at the end of the intervention, and 1 month after the intervention. The significance level sets as 5%. The safety of interventions will be evaluated after each treatment session. Discussion The purpose of this trial is to determine whether Yijinjing combined with Tuina is not inferior to Tuina for patients with NCNP. This study will provide clinicians and stakeholders much-needed knowledge for a complementary and alternative therapy for patients with non-specific chronic neck pain. Trial registration ChiCTR registry (ChiCTR) 2000036805 . Registered on August 25, 2020

Background Insomnia is very common in current society, and patients are often accompanied by a certain degree of anxiety, depression, etc. Recent studies have found that the hypothalamic-pituitary-adrenal (HPA) axis excitement-inhibition state is an important indicator of sleep quality. Wrist-ankle acupuncture (WAA) is safe and effective for insomnia. Based on WAA theory, the acupressure wrist-ankle straps are portable WAA point compression straps that can treat diseases by automatically applying pressure to the treatment location and being operated by patients themselves. We design this trial to evaluate the clinical effect of the acupressure wrist-ankle strap in the treatment of mild insomnia patients with anxiety disorders. Methods/design This trial is a parallel-design, patients-assessor blinded, randomized, sham-controlled. In total, 114 patients diagnosed with mild insomnia and anxiety disorders will be randomly assigned into two groups, the acupressure wrist-ankle strap group or the non-acupressure wrist-ankle strap group; they will receive treatments for eight weeks with five sessions each week. Rating scales, sleep monitors, and laboratory tests will be used to observe the clinical effect. From the perspective of the circadian secretion of peripheral blood-related hormones in the hypothalamic-pituitary-adrenal (HPA) axis, the possible mechanism of acupressure wrist-ankle straps for treating insomnia is studied. Discussion The results of this study will confirm the efficacy of acupressure wrist-ankle strap in treating mild insomnia patients with anxiety disorder and whether its mechanism is related to the HPA axis. The acupressure wrist-ankle strap may become a pure physical, no side effect treatment of mild insomnia. Trial registration Chinese Clinical Trial Registry ChiCTR2000039352 . Registered on 24 October 2020.