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Sometimes goals cannot be attained due to factors beyond the participant's control e.g. a dance class not attended because of cancellation; giving a low attainment score would not reflect participant wellbeing, so the goal rating is omitted, and an explanation recorded. However, to avoid overestimation of goal attainment, low attainment is recorded if the reason relates to patient wellbeing; for example, they did not attend the dance class due to an injury. This distinction is an adaptation to the BGSI.
|
PMC11699366_p10
|
PMC11699366
|
Follow-up of attainment
| 1.820552 |
biomedical
|
Other
|
[
0.6242417693138123,
0.08287718147039413,
0.2928810715675354
] |
[
0.15837450325489044,
0.837952733039856,
0.001258316682651639,
0.002414494752883911
] |
en
| 0.999997 |
A key consideration was the frequency of goal follow-up, acknowledging that participants may select goals which are achievable in different timeframes and may subsequently wish to add another goal to replace an event-related goal. In the PRIME RCT, participants specify at baseline the timeframe in which they intend to achieve each goal. Regardless, all goals are followed up 3-monthly by a blinded assessor. Participants are reminded not to reveal their treatment allocation during the call and any unblinding is recorded.
|
PMC11699366_p11
|
PMC11699366
|
Frequency of data collection
| 2.667841 |
clinical
|
Other
|
[
0.4137279987335205,
0.5751250386238098,
0.011146968230605125
] |
[
0.3839157223701477,
0.6031198501586914,
0.0031857071444392204,
0.009778766892850399
] |
en
| 0.999997 |
The primary outcome is change in participant-rated attainment, calculated as shown in Fig. 2 . Whereas for classical measurement instruments a cut-off score may indicate a particular diagnosis and individual scores can be compared to normative data, intervention evaluation using a goal-based outcome relies on comparison of two group means . Follow-up at all 3-monthly timepoints will facilitate a secondary longitudinal analysis to determine whether any improved goal attainment is maintained. Secondary analyses will include change in caregiver-rated attainment and for the three goals rated as most important. Fig. 2 A worked example showing the process for calculating the change in attainment for one participant who had set three goals. Fig. 2
|
PMC11699366_p12
|
PMC11699366
|
Derivation of the score
| 3.66659 |
biomedical
|
Study
|
[
0.9818441271781921,
0.014856823720037937,
0.0032990751788020134
] |
[
0.9806017875671387,
0.018616968765854836,
0.0003076401771977544,
0.00047359755262732506
] |
en
| 0.999998 |
We have described how a goal-orientated outcome measure was adapted for use in a trial involving individuals with complexity, frailty and multimorbidity. As the trial progresses, we will gain crucial real-world experience of applying this in people with parkinsonism, including the time and resources required. We will also gather quantitative data on the numbers of goals set, typical domains chosen, agreement between patient and caregiver scores and the proportion unable to rate attainment (e.g. due to cognitive impairment).
|
PMC11699366_p13
|
PMC11699366
|
Conclusion
| 3.738421 |
biomedical
|
Study
|
[
0.967582106590271,
0.031191058456897736,
0.001226835185661912
] |
[
0.9512658715248108,
0.046605441719293594,
0.0007847617962397635,
0.0013439091853797436
] |
en
| 0.999997 |
The lack of a defined MCID for the BGSI is a limitation; determining this in a parkinsonism population would add to its utility and help to inform whether BGSI is better able to detect a meaningful difference than some other outcomes, as suggested [ , , ]. Whilst the evidence for responsiveness is encouraging , evidence for the validity and reliability of goal-orientated outcome measures is limited and relates mainly to the COPM . Future work could establish whether an improvement in goal attainment is associated with downstream benefits such as reduced unplanned hospitalisation, which would demonstrate predictive validity.
|
PMC11699366_p14
|
PMC11699366
|
Conclusion
| 3.904896 |
biomedical
|
Study
|
[
0.9985997080802917,
0.0006165097584016621,
0.0007838273886591196
] |
[
0.9565759897232056,
0.003682583337649703,
0.0395137220621109,
0.00022768160852137953
] |
en
| 0.999996 |
There are many potential benefits to wider use of goal-orientated outcome measures in clinical trials. They provide a holistic outcome not limited to specific conditions and with universal relevance, important for trials with broad inclusion criteria, enrolling heterogenous populations including adults with frailty and multimorbidity. Above all they aim to provide a meaningful measure of “what matters”. Knowledge gained from use of the adapted BGSI in the PRIME 10.13039/100014144 RCT will help to support its implementation in conditions besides neurodegenerative disease, the focus of its use so far.
|
PMC11699366_p15
|
PMC11699366
|
Conclusion
| 3.827771 |
biomedical
|
Study
|
[
0.9976422190666199,
0.0018082692986354232,
0.0005495059303939342
] |
[
0.7281188368797302,
0.221671000123024,
0.04912511631846428,
0.0010851197876036167
] |
en
| 0.999997 |
Emma Tenison: Writing – original draft, Methodology, Conceptualization. Katherine Lloyd: Writing – review & editing, Project administration, Methodology. Yoav Ben-Shlomo: Writing – review & editing, Supervision, Methodology, Conceptualization. Emily J. Henderson: Writing – review & editing, Supervision, Methodology, Funding acquisition, Conceptualization.
|
PMC11699366_p16
|
PMC11699366
|
CRediT authorship contribution statement
| 0.958863 |
other
|
Other
|
[
0.0911816656589508,
0.002864935202524066,
0.9059533476829529
] |
[
0.0025561454240232706,
0.9967149496078491,
0.00036653332062996924,
0.0003623802331276238
] |
en
| 0.999995 |
NCT05127057.
|
PMC11699366_p17
|
PMC11699366
|
Trial registration number
| 1.028178 |
biomedical
|
Other
|
[
0.6863654255867004,
0.1329202950000763,
0.18071426451206207
] |
[
0.04776123911142349,
0.9393104910850525,
0.006073403637856245,
0.0068548680283129215
] |
vi
| 0.999997 |
10.13039/501100000324 Gatsby Charitable Foundation , GAT3676 .
|
PMC11699366_p18
|
PMC11699366
|
Grant support
| 1.025671 |
other
|
Other
|
[
0.060029469430446625,
0.00214731995947659,
0.9378232955932617
] |
[
0.0028051359113305807,
0.9959069490432739,
0.0007542471867054701,
0.0005336483591236174
] |
en
| 0.999996 |
The PRIME-UK programme is funded by the 10.13039/501100000324 Gatsby Charitable Foundation .
|
PMC11699366_p19
|
PMC11699366
|
Funding sources
| 1.077723 |
other
|
Other
|
[
0.004324675537645817,
0.001334220403805375,
0.9943411350250244
] |
[
0.001163325272500515,
0.997445821762085,
0.000822917849291116,
0.0005680351168848574
] |
en
| 0.999998 |
The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: ET is funded by a 10.13039/501100000272 National Institute for Health and Care Research Academic Clinical Lectureship and has received a speaker honorarium from the Neurology Academy.
|
PMC11699366_p20
|
PMC11699366
|
Declaration of competing interest
| 1.028398 |
other
|
Other
|
[
0.00603488739579916,
0.0012005938915535808,
0.9927645325660706
] |
[
0.0010076443431898952,
0.9980529546737671,
0.00044134873314760625,
0.0004980527446605265
] |
en
| 0.999998 |
KL is in receipt of PhD fellowship funding from The Gatsby Foundation.
|
PMC11699366_p21
|
PMC11699366
|
Declaration of competing interest
| 0.947088 |
other
|
Other
|
[
0.003465762361884117,
0.0016828624065965414,
0.9948514103889465
] |
[
0.0016145554836839437,
0.9961936473846436,
0.0011584102176129818,
0.0010333647951483727
] |
en
| 0.999998 |
EH is HEFCE funded by University of Bristol for her academic work and has received honoraria from the Neurology Academy and travel support from Bial.
|
PMC11699366_p22
|
PMC11699366
|
Declaration of competing interest
| 0.968433 |
other
|
Other
|
[
0.0033365818671882153,
0.0014113709330558777,
0.9952520132064819
] |
[
0.0013572958996519446,
0.9967982172966003,
0.0009542623301967978,
0.0008903113775886595
] |
en
| 0.999998 |
YBS is partly funded by National Institute for Health and Care Research Applied Research Collaboration West (NIHR ARC West) and University of Bristol and has received funding from Parkinson's UK, Royal Osteoporosis Society, MRC, HQIP, Templeton Foundation, Versus Arthritis, Wellcome Trust, National Institute of Health Research, Gatsby Foundation.
|
PMC11699366_p23
|
PMC11699366
|
Declaration of competing interest
| 1.035476 |
other
|
Other
|
[
0.0034703444689512253,
0.0016394528793171048,
0.9948902130126953
] |
[
0.0009868023917078972,
0.9975747466087341,
0.0007121452363207936,
0.0007263627485372126
] |
en
| 0.999996 |
Medicinal plants have been an essential component of conventional health care around the world for ages since Ayurveda . According to these natural resources provide a wide range of chemicals that are bioactive with a variety of therapeutic potential. Tinospora cordifolia , often called Amrita or Guduchi, holds a great significance in Ayurveda owing to the presence of various secondary metabolites . Giloy leaves have historically been utilized to cure a variety of ailments, such as diabetes, rheumatism, jaundice, and skin diseases . Because of its historical use and the increasing popularity of natural therapies, scientists are looking into the possible therapeutic uses of giloy leaves and the underlying mechanisms behind their medicinal action .
|
PMC11699423_p0
|
PMC11699423
|
Introduction
| 3.331672 |
biomedical
|
Other
|
[
0.997805655002594,
0.0006948478985577822,
0.0014993957011029124
] |
[
0.09200721979141235,
0.560101330280304,
0.34550079703330994,
0.002390699926763773
] |
en
| 0.999995 |
Extract of the giloy leaves helps to alleviate the digestive ailments such as acidosis, gastroenteritis, parasitic infections, lack of appetite, stomach discomfort, extreme thirst, and nausea, as well as liver-related issues like hepatitis .
|
PMC11699423_p1
|
PMC11699423
|
Introduction
| 1.639925 |
biomedical
|
Other
|
[
0.9826533198356628,
0.006507037673145533,
0.01083951536566019
] |
[
0.004701940808445215,
0.9909960627555847,
0.0020880771335214376,
0.0022139602806419134
] |
en
| 0.999996 |
The latest study indicates that giloy leaves immunomodulatory capabilities may be associated with its numerous potential uses. These characteristics may strengthen the immunological response within the body, providing a natural means of promoting general well-being . Despite having a wide range of uses in traditional medicine, the immunomodulatory effects of giloy leaves is less known .
|
PMC11699423_p2
|
PMC11699423
|
Introduction
| 2.157964 |
biomedical
|
Other
|
[
0.9958464503288269,
0.0005911167827434838,
0.003562527010217309
] |
[
0.23964037001132965,
0.7148812413215637,
0.04306402802467346,
0.0024144193157553673
] |
en
| 0.999997 |
This review aims to reduce this gap by thoroughly analyzing immunomodulatory potential of giloy leaves. The research findings about its capacity to regulate the immune system, with particular attention to important pathways such as NF-κB signalling, inflammatory regulation, induction of apoptosis, phagocytosis stimulation, and interleukin modulation. Giloy leaves have been used in the creation of functional food products by comprehending these processes. Through the integration of contemporary scientific findings with traditional wisdom, our goal is to provide insight into the immunomodulatory mechanisms of Giloy leaves and their potential to enhance overall health and well-being. Then, by utilizing this knowledge, innovative giloy leaves-based functional food products can be made, bridging the gap between conventional wisdom and current medical developments.
|
PMC11699423_p3
|
PMC11699423
|
Introduction
| 4.03254 |
biomedical
|
Review
|
[
0.9894071221351624,
0.005345677491277456,
0.005247254390269518
] |
[
0.0036419795360416174,
0.0017480168025940657,
0.9941039681434631,
0.0005061226547695696
] |
en
| 0.999997 |
A systematic search of significant electronic databases such as PubMed, Scopus, and Google Scholar has been done to thoroughly examine the immunomodulatory activities of Giloy ( Tinospora cordifolia ) leaves. The search strategy included various terms that addressed multiple aspects of immune system regulation and prospective uses. Terms such as “ Tinospora cordifolia ” or “Giloy leaves” were used here, along with terms on general immunomodulatory effects, cellular mechanisms of the immune response, and product development, such as “cytokines,” “macrophages,” and “natural killer cells,” as well as terms related to immune system function and anti-inflammatory properties. This comprehensive strategy intended to collect all relevant data on how Tinospora cordifolia affects the immune system and to investigate the potential use of giloy leaves in the development of future functional food products.
|
PMC11699423_p4
|
PMC11699423
|
Identifying relevant research
| 4.036944 |
biomedical
|
Study
|
[
0.9995020627975464,
0.0002055979275610298,
0.0002923264692071825
] |
[
0.9887571930885315,
0.00034589201095514,
0.010795733891427517,
0.00010114839096786454
] |
en
| 0.999997 |
The review process involves a two-tiered selection procedure with a primary focus on research that clarifies the mechanisms of action by which giloy ( Tinospora cordifolia ) leaves affect the immune system. The featured research examines how Tinospora cordifolia affects immune cells or function in animal models or in vitro (lab-based), is published in scholarly journals that undergo peer review, and provides clear evidence of Tinospora cordifolia's action mechanisms on immunological function, including the involvement of specific bioactive chemicals extracted from its leaves.
|
PMC11699423_p5
|
PMC11699423
|
Inclusion and exclusion approach
| 3.955293 |
biomedical
|
Review
|
[
0.9958678483963013,
0.0018975615967065096,
0.002234657993540168
] |
[
0.012798106297850609,
0.004731751512736082,
0.981853187084198,
0.0006168801337480545
] |
en
| 0.999996 |
The research will focus on the utilization of Tinospora cordifolia in value-added products, particularly in functional foods, supplements, and other immunomodulatory products. Only studies that are published in reputable journals focused on product development or peer-reviewed scientific journals were considered. These studies must provide evidence of the product's effectiveness and safety. Research that does not meet these criteria or focuses on different plant species was excluded.
|
PMC11699423_p6
|
PMC11699423
|
Inclusion and exclusion approach
| 2.873206 |
biomedical
|
Study
|
[
0.9974695444107056,
0.0002992326917592436,
0.002231236081570387
] |
[
0.9775371551513672,
0.014872838743031025,
0.007367420941591263,
0.00022253274801187217
] |
en
| 0.999998 |
Tinospora cordifolia is a member of the Menispermaceae family, which is part of the Ranunculales order in the Magnoliopsida class (commonly known as dicots) of the plant world. This classification includes it amid a wide range of blooming plants, while the Menispermaceae family is best recognized for its climbing vines and bushes. Tinospora cordifolia , often known as Guduchi or Gurjo, is an ancient medicinal plant from the Menispermaceae family of moonseeds . The Menispermaceae family is abundant in tropical lowland environments, with 70 genera and 450 species. Tinospora is one of the most common genera in the Menispermaceae family, with around 15 different species . Tinospora cordifolia is extensively widespread in Tropical India and may reach elevations of 1000 feet in South Asia, Indonesia, Philippines, Thailand, Myanmar, China, and Sri Lanka . Ayurvedic and folk medicine systems frequently employ this compound, which may be found in a wide range of soil types (from acidic to alkaline) and only needs a small amount of soil moisture .
|
PMC11699423_p7
|
PMC11699423
|
Taxonomic position of Tinospora cordifolia
| 3.740023 |
biomedical
|
Study
|
[
0.9840421676635742,
0.00035354282590560615,
0.015604239888489246
] |
[
0.697438657283783,
0.2654229700565338,
0.036467403173446655,
0.0006710141315124929
] |
en
| 0.999998 |
Tinospora cordifolia , is a big, glabrous, perennial, deciduous vine with papery bark and juicy branches that spread widely. It is extensively distributed in Sri Lanka, Myanmar, and India . Guduchi is indigenous to India's tropical areas, where it can survive in temperatures between 25 and 45 °C at elevations of up to 500 m. The leaves are heart-shaped, straightforward, and have a deep, vivid green hue. They have a broadly elliptical lamina that is 10–12 cm long and 8–15 cm broad, and they are alternating, stipulate, and whole .
|
PMC11699423_p8
|
PMC11699423
|
Plant description
| 1.663336 |
other
|
Other
|
[
0.2237667292356491,
0.0017892851028591394,
0.774444043636322
] |
[
0.010333145037293434,
0.9886202812194824,
0.0005368466954678297,
0.0005096588865853846
] |
en
| 0.999997 |
The veins of leaves are multicostate and reticulated. The stems' surface has a completely studded appearance of warty tubercles. The skin's surface displays longitudinal fissures, with stems that have a diameter of 3–8 mm and a length of 3–5 cm. Large lenticels that resemble rosettes grow out of the succulent bark, which also includes deep clefts and spots . The bark can be either grey or creamy white in hue. The branches give rise to aerial roots that are long and thread-like branches are either light greyish brown in hue or long and dingy white.
|
PMC11699423_p9
|
PMC11699423
|
Plant description
| 1.659855 |
other
|
Other
|
[
0.2052881419658661,
0.002427814295515418,
0.7922840714454651
] |
[
0.009809340350329876,
0.9892120361328125,
0.00048761838115751743,
0.0004910700372420251
] |
en
| 0.999996 |
Grown on auxiliary and terminal racemes, the tiny, greenish-yellow blooms are unisexual. Female flowers often form single inflorescences, while male flowers are grouped . Six sepals total, arranged freely in two sets of three each on each flower. In addition, six free, oval, membrane petals are smaller than the sepals.: Fruits develop in the winter (November) while flowers blossom in the summer (March to June) . Fruits have a fleshy, orange-red hue and are composed of one to three ovoid, smooth droplets arranged in an aggregate on a stout stalk that has a subterminal-style scar. The moonseed family (Menispermaceae) is characterized by its bent seeds and embryo. Different decorations may be seen on the endocarp, or inner layer of the fruit wall .
|
PMC11699423_p10
|
PMC11699423
|
Plant description
| 1.895641 |
other
|
Other
|
[
0.19377069175243378,
0.0009685865952633321,
0.8052607178688049
] |
[
0.040242064744234085,
0.9580767750740051,
0.001222308725118637,
0.000458751484984532
] |
en
| 0.999997 |
Giloy leaves are a potent source of nutrients and other essential elements. It was found that dehydrated giloy leaves contained high levels of calcium, protein, iron, crude fiber and ash as depicted in Table 1 . All parts of Tinospora cordifolia , including leaves, stems, fruits, and roots, are used as functional foods. Tinospora cordifolia leaves are rich sources of nutrients, essential macronutrients, and micronutrients as shown in Table 1 . Table 1 Nutrient content of Tinospora cordifolia leaves per 100g . Table 1 Nutrients Fresh Dehydrated References Moisture % 31.36 9.64 [ , , ] Ash % 2.3 5.880 Carbohydrates (g) 3.34 7.53 Protein (g) 2.30 5.23 Fat (g) 0.36 1.05 Fibre (g) 11.321 52.295 Iron (g) 5.87 22.55 Calcium (g) 85.247 210 Vitamin C (mg) 56 16 Beta Carotene (μg) 303.7 428.5 Energy (Kcal) 88.64 240
|
PMC11699423_p11
|
PMC11699423
|
Phytochemistry and nutritional composition
| 4.031098 |
biomedical
|
Study
|
[
0.9990099668502808,
0.00012867237091995776,
0.0008613626123405993
] |
[
0.9991426467895508,
0.0005726780509576201,
0.00024422971182502806,
0.00004033598816022277
] |
en
| 0.999994 |
Giloy leaves are a potent source of bioactive compounds such as Alkaloids, Glycosides, Diterpenoids, and steroids as represented in Fig. 1 . Fig. 1 Bioactive components of Tinospora cordifolia (Giloy) leaves. Fig. 1
|
PMC11699423_p12
|
PMC11699423
|
Phytochemistry and nutritional composition
| 2.339502 |
biomedical
|
Other
|
[
0.996390163898468,
0.0004284410970285535,
0.0031813164241611958
] |
[
0.4707320034503937,
0.52199387550354,
0.005390591453760862,
0.0018834462389349937
] |
en
| 0.999996 |
The significant immunomodulatory qualities of Tinospora cordifolia leaves are attributed to a plethora of bioactive substances . These active ingredients include alkaloids (found primarily in the stem) and steroids (beta-sitosterol, d-sitosterol, and g-sitosterol), as well as glycosides (18-norclerodane glycosides, furanoid diterpene glycosides, and tinocordiside) and palmatine D, choline D, tinosporine, magnoflorine, tetrahydropalmatine, and isocolumbin) . Additional components found in its aerial sections include diterpenoid lactones (furanolactone, tinosporon, and columbin) as well as many other substances such cordifolioside A, 11-hydroxymuskatone, N-methyl-2-pyrrolidone, octacosanol, heptacosanol, and nonacosan-15-one . Interestingly, the alkaloid palmatine is also present in the root. RR1, a polysaccharide extracted from the leaves, has been found to possess immune stimulatory properties and has the potential to be used as an adjuvant to boost immunity . Additionally, the various bioactive ingredients present in giloy leaves affect the immune system by increasing cytokine synthesis, enhancing immune cell mitogenicity, and activating specialized immune cells like B cells and macrophages, which can trigger targeted immune responses , . Further research into the exact mechanisms of these active ingredients will help to clarify the immunomodulatory potential of giloy leaves. The various mechanisms through which bioactive compounds of leaves help in boosting the immunomodulatory properties of the body have been illustrated in Fig. 2 . Fig. .2 Immunomodulatory effects of giloy leaves. Fig. .2
|
PMC11699423_p13
|
PMC11699423
|
Immunomodulatory activity of giloy leaves
| 4.242826 |
biomedical
|
Study
|
[
0.9995365142822266,
0.00023270210658665746,
0.00023078180674929172
] |
[
0.9681753516197205,
0.000801028567366302,
0.030845897272229195,
0.0001776736753527075
] |
en
| 0.999998 |
Giloy leaf extract has a high concentration of bioactive components such as alkaloids, glycosides, and terpenoids, contributing to its well-known immunomodulatory activities. The leaf extract constitutes bioactive components that stimulate a variety of immune cells, including natural killer (NK) cells, B cells, and T cells, resulting in the generation of favourable immuno-stimulating cytokines [ , , ]. In addition, among HIV-positive patients, giloy leaves lower total leucocyte, neutrophil, and eosinophil counts . These immuno-stimulating effects are linked to several bioactive chemical compounds found in the leaf, including 11-hydroxymuskatone, N-methyl-2-pyrrolidone, cordifolioside A, magnoflorine, tinocordioside, and Synringin . These compounds specifically target immune cells present inside the human body such as B lymphocytes and macrophages, implying a regulated activation of the immune response . This increases haemoglobin levels and polymorphonuclear leukocytes, indicating an overall increase in immune response . These compounds are well known for their ability to promote a greater immune response by enhancing the proliferation and differentiation of lymphocytes. Thus, it increases total WBC, bone marrow cellularity and alpha esterase-positive cells in the marrow of bone which leads to an increase in humoral immune response. Some of the bioactive components appear to considerably raise IgG antibody levels, which are important components of the immunological response for complimentary inhibition of the pathway .
|
PMC11699423_p14
|
PMC11699423
|
Cellular and molecular mechanism of immunomodulation
| 4.373281 |
biomedical
|
Study
|
[
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[
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0.00012633061851374805
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en
| 0.999998 |
Inflammation is an immune system response that is necessary for healing, but it can be harmful if it is severe or chronic. Herbal medicines such as giloy leaves have long been utilized to treat inflammation, however, worries about potential side effects have been highlighted . It's important to note that while giloy ( Tinospora cordifolia ) has been used in Ayurvedic medicine for a long time, it should be used with caution due to potential negative effects, especially when taken in large amounts. Research indicates that exceeding the recommended dosage can lead to gastrointestinal issues such as nausea, upset stomach, and constipation . Some studies conducted by researchers exhibits potential hepatotoxic effects due to Giloy's influence on liver enzymes and metabolism . While the blood-sugar-lowering properties of giloy can be beneficial for diabetics, excessive use or concurrent use with blood-sugar-lowering medications can increase the risk of hypoglycemia (low blood sugar) . Finally, allergic reactions are a possibility, particularly for individuals sensitive to plants of the Menispermaceae family . These reactions may include skin rashes and swelling. Giloy leaf extract intake has been associated with the activation of phagocytic cells that aid in wound healing, as well as the acceleration of skin regeneration when applied topically to wounds and bruises. Giloy leaves' immunomodulatory properties, which have been explained by their bioactive chemical constituents such as alkaloids, glycosides, terpenoids, and polysaccharides, which contribute to their capacity to modulate immune responses and decrease inflammation [ , , ].
|
PMC11699423_p15
|
PMC11699423
|
Inflammation and immunity boosting
| 4.076622 |
biomedical
|
Review
|
[
0.9989677667617798,
0.00047523193643428385,
0.0005569924251176417
] |
[
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0.0005982255679555237
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en
| 0.999997 |
Tinospora cordifolia leaf extract encompasses bioactive chemical compounds that help to reduce inflammation and decrease immunological responses. The leaf extract contains a variety of metabolites, some of which have anti-inflammatory and antioxidant activities . A molecule known as 7,9-Di-tert-butyl-1-oxaspiro (4,5) deca-6,9-diene-2,8dione was discovered as a potential dual inhibitor of COX enzymes, which is critical for treating inflammation. This chemical compound has been demonstrated high binding energies against COX 1 and COX 2, showing its potential as a drug like molecule for inflammatory therapy . In addition, T. cordifolia leaf extract has been studied for in-vitro anti-inflammatory action and shown to decrease protein denaturation, a fundamental process in inflammation. These findings indicate that the chemicals in Tinospora cordifolia leaf extract produce anti-inflammatory actions and modify immunological responses by inhibiting COX and suppressing protein denaturation ,. Compounds in giloy leaves decrease inflammatory mediators, inhibit enzyme activity such as COX and alter immune cell function. Giloy leaves have the potential anti-inflammatory properties through a variety of pathways as shown in Fig. 3 about Inflammation and its action mechanism. More research will be required to determine their clinical benefits in controlling inflammatory diseases. Fig. 3 Lipopolysaccharide-induced inflammation and its attenuation by giloy leaf components through NF-kB pathway. Fig. 3
|
PMC11699423_p16
|
PMC11699423
|
Inflammation and immunity boosting
| 4.200626 |
biomedical
|
Study
|
[
0.9996175765991211,
0.00019105935643892735,
0.00019139073265250772
] |
[
0.9856385588645935,
0.0006447422201745212,
0.013579821214079857,
0.00013686897000297904
] |
en
| 0.999997 |
Giloy leaves anti-inflammatory mechanisms that have been studied. According to studies giloy leaf extract prevented lipopolysaccharide (LPS)-stimulated macrophages from releasing prostaglandin E2 (PGE2) and nitric oxide (NO) . Another study reported that giloy leaf extract reduced the expression of tumour necrosis factor-α (TNF-α) and interleukin-1β (IL-1β), two pro inflammatory cytokines in LPS-stimulated macrophages , . Studies demonstrated by that giloy leaf extract suppressed the activation of the transcription factor-kappa B (NF-κB) signalling pathway, which is crucial for the inflammatory response . Wilkinson showed that giloy leaf extract inhibited the activity of an enzyme produced by the human body cyclooxygenase-2 (COX-2), which plays a role in PGE2 synthesis .
|
PMC11699423_p17
|
PMC11699423
|
Modulation of NF-κB pathway
| 4.144284 |
biomedical
|
Study
|
[
0.9994552731513977,
0.00015404977602884173,
0.0003906518395524472
] |
[
0.9787230491638184,
0.000734232016839087,
0.020423628389835358,
0.00011907099542440847
] |
en
| 0.999997 |
These studies suggest that giloy leaves have multiple anti-inflammatory mechanisms, including the inhibition of NO and PGE2 production, the reduction of pro-inflammatory cytokine expression, and the suppression of NF-κB and COX-2 activity. These mechanisms make giloy leaves a promising natural anti-inflammatory agent with potential uses in the treatment of a variety of inflammatory conditions, which has been illustrated in Fig. 3 .
|
PMC11699423_p18
|
PMC11699423
|
Modulation of NF-κB pathway
| 3.934723 |
biomedical
|
Study
|
[
0.9996923208236694,
0.00015023996820673347,
0.0001574678608449176
] |
[
0.9877583384513855,
0.0013946299441158772,
0.010699977166950703,
0.0001470411370974034
] |
en
| 0.999998 |
Apoptosis is a process which helps in regulating the population of immune cells. For instance, after an immune response, excess immune cells may undergo apoptosis to prevent overactivity of the immune system. Apoptosis is used as a mechanism to eliminate infected cells . When a cell is infected with a virus or bacteria and gets damaged or destroyed beyond repair, it can trigger apoptosis to prevent the spread of the infection , . Some of the bioactive compounds of giloy leaves such as aporphine, magnoflorine, palmatine, tinocordiside, and cordifolioside -A, have demonstrated potential as anti-cancer agents . They induce apoptosis and inhibit the growth of cancer cells, suggesting their significance in cancer therapy. Cancer cells undergo apoptosis, a process of planned cell death, when exposed to giloy leaf extract. It triggers nuclear condensation, the production of apoptotic bodies, and the activation of the essential apoptotic enzyme caspase-3 . It also causes apoptosis in cancer cells by suppressing anti-apoptotic genes like Bcl-2 and upregulating pro-apoptotic genes like Bax (Bcl-2 associated X protein). Giloy leaf extract effectively inhibits cancer cell development by interfering with the G1 phase of the cell cycle , . Cell division and DNA replication depend on this stage. Giloy leaf extract stops the cell cycle at this point, which stops cancer cells from proliferating and growing. Nitric oxide (NO) generation is enhanced by the stimulation of immune cells, specifically macrophages, by giloy leaf extract. NO causes cancer cells to become cytotoxic, leading to their destruction , .
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PMC11699423_p19
|
PMC11699423
|
Regulation of apoptosis in immune cells
| 4.462732 |
biomedical
|
Study
|
[
0.9995642304420471,
0.00021748158906120807,
0.0002183511242037639
] |
[
0.975796103477478,
0.0021864259615540504,
0.02173064649105072,
0.0002868614683393389
] |
en
| 0.999997 |
Giloy leaves contain several polyphenolic chemicals, including tannins, magnoflorine, jatrorrhizine, tembetarine, tinosporine, isocolumbin, palmatine, and tetrahydropalmatine. These substances are good candidates for antioxidant therapy because of their demonstrated potent antioxidant properties . The giloy leaves extract's antioxidant capacity employs a range of in vitro tests. The extract exhibited noteworthy efficacy against DPPH, hydroxyl, and nitric oxide radicals, as demonstrated by the obtained results. The existence of energy-producing polyphenolic compounds that fight off free radicals and stop oxidative damage is the cause of this waste activity , . The antioxidant activity of giloy leaf extracts in human lymphocytes against oxidative stress - driven through DNA damage. Studies have indicated that these extracts can mitigate DNA damage resulting from exposure to hydrogen peroxide, which is a strong inducer of oxidative stress .
|
PMC11699423_p20
|
PMC11699423
|
Antioxidant
| 4.154385 |
biomedical
|
Study
|
[
0.9995601773262024,
0.00015914581308607012,
0.000280589796602726
] |
[
0.9990088939666748,
0.0002672917617019266,
0.0006707606953568757,
0.000053046183893457055
] |
en
| 0.999997 |
This protection is due to the antioxidant capabilities of giloy leaves polyphenols, which remove free radicals and prevent DNA oxidation . The effect of giloy leaf extract on oxidative stress and antioxidant state in rats with experimental liver injury . Studies indicate that these extracts can enhance Antioxidant enzymes such as glutathione peroxidase, catalase, and superoxide dismutase as well as lower oxidative stress markers like malondialdehyde . According to these results, giloy leaf extract may shield the liver from oxidative stress and liver damage . The majority of the research indicates that the polyphenols present in giloy leaves have significant antioxidant properties and can be used to treat a variety of oxidative disorders associated with stress using antioxidant-based therapy.
|
PMC11699423_p21
|
PMC11699423
|
Antioxidant
| 4.003393 |
biomedical
|
Study
|
[
0.9997124075889587,
0.00012843613512814045,
0.00015906186308711767
] |
[
0.9879336953163147,
0.0013865181244909763,
0.010544874705374241,
0.00013498390035238117
] |
en
| 0.999997 |
The immune-modulatory function of Tinospora cordifolia is associated with its bioactive compounds such as terpenes, glycosides, alkaloids, steroids, flavonoids, and polysaccharides . IL-17, Th17 Cells, and the JAK-STAT Pathway interplay is crucial for understanding the potential immunomodulatory activity of Giloy leaf extract ( Tinospora Cordiofolia ). Proinflammatory cytokines like interleukin-17 (IL-17) are released by Th17 cells among other immune cells . It is essential for protecting the body from infections, especially those caused by fungus and extracellular bacteria. Studies have shown that Autoimmune diseases and chronic inflammatory illnesses have been associated with elevated or dysregulated IL-17 generation .
|
PMC11699423_p22
|
PMC11699423
|
Interleukin modulation
| 4.124163 |
biomedical
|
Study
|
[
0.9997100234031677,
0.00014185915642883629,
0.00014818937052041292
] |
[
0.9723461270332336,
0.0020617800764739513,
0.025378702208399773,
0.00021333518088795245
] |
en
| 0.999997 |
T helper 17 (Th17) cells are a subset of CD4 + T lymphocytes that primarily secrete IL-17. Although they may contribute to autoimmune disorders, they are necessary for immune-mediated defence from external infections . The differentiation and activation of diverse immune cells, including Th17 cells, are facilitated by the JAK-STAT pathway, a crucial signalling cascade . It involves the phosphorylation of Janus kinases (JAKs) by cytokines attaching to particular cell surface receptors. Following JAK activation, STAT proteins (Signal Transducers and Activators of Transcription) relocate to the nucleus and regulate the expression of genes required for Th17 development and synthesis of IL17 .
|
PMC11699423_p23
|
PMC11699423
|
Interleukin modulation
| 4.379014 |
biomedical
|
Study
|
[
0.9992836117744446,
0.00043666231795214117,
0.00027972832322120667
] |
[
0.9337256550788879,
0.040580835193395615,
0.024846266955137253,
0.0008472662884742022
] |
en
| 0.999998 |
Studies have shown that Tinospora cordifolia extract can reduce the amount of IL-17 generating cells in CD4 + T cells developed under Th17-polarizing circumstances suggesting an immunomodulatory effect . Another study discovered that the water-soluble extract of Tinospora cordifolia improves macrophage phagocytic capabilities and significantly increases nitric oxide generation by stimulating splenocytes and macrophages at a dose of 1 mg/kg Research found that 100 μg/ml of Tinospora cordifolia extract caused 90 % cytotoxicity in B16F10 murine melanoma cells after 72 h of treatment .
|
PMC11699423_p24
|
PMC11699423
|
Interleukin modulation
| 4.117613 |
biomedical
|
Study
|
[
0.9996287822723389,
0.00016550409782212228,
0.00020572169160004705
] |
[
0.9991680383682251,
0.0002446497092023492,
0.0005319544579833746,
0.000055440606956835836
] |
en
| 0.999997 |
Another research identified a polysaccharide from Tinospora cordifolia, RR1, which has been demonstrated to have innate immune stimulatory capabilities and can offer adjuvant-like action in the formation of a Th1-type immune response to an antigen , . To put it in simple terms, Tinospora cordifolia activates the immune system by influencing cytokine synthesis, mitogenicity, and immune-effector cell activation, as well as enhancing phagocytic power and nitric oxide generation in macrophages . The specific mechanism of interleukin modulation by which Tinospora cordifolia extract produces these benefits is unknown and will require more investigation and study.
|
PMC11699423_p25
|
PMC11699423
|
Interleukin modulation
| 4.070821 |
biomedical
|
Study
|
[
0.9997325539588928,
0.00010826398647623137,
0.00015923810133244842
] |
[
0.9965511560440063,
0.0008322717621922493,
0.00253363698720932,
0.00008292609709315002
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en
| 0.999997 |
Research on the uses of giloy ( Tinospora cordifolia) leaf extract in various value-added products has revealed its significant immune-boosting properties and health benefits. Giloy extracts have been incorporated in different forms such as powder, fresh leaves, and stem juice to enhance the nutritional value and taste of the products which has been shown in detail in Table 2 , Table 3 . For instance, a combination of giloy leaf powder, besan, wheat flour, and adusa leaves was utilized to produce biscuits and sev, resulting in nutrient-rich products confirmed through tests like DPPH and Folin-Ciocalteu . The phytochemicals present in giloy have been found to have a positive impact on the immune system, leading to increased consumption of homemade kadha (a herbal concoction) containing fresh giloy leaves and other ingredients during the COVID-19 pandemic . Moreover, products like value-added cookies made with giloy and tulsi powders, herbal squash made with giloy leaf extract and pineapple juice, and herbal lassi made with giloy stem juice have displayed enhanced nutritional properties . Table 2 Immunomodulatory giloy leaves-based value-added products. Table 2 S. No. Objective of study Value added Product Overview of Study Reference 1. Evaluation of Herbal Leaves for the Development of Value-Added Food Product Biscuit and Sev In this study, the giloy leaves were used to make value-added products such as biscuits and sev. The greatest method to add medicinal plants' nutritional advantages to humans' everyday diets to help fight degenerative illnesses is to provide value to food items by including them. It shows that the nutrients in these products can help in the fight against diseases and improve immunity. 2. Consumption of natural products and Ayurvedic decoctions “Kadha” as immunity-boosting measures during the spread of COVID-19 in Delhi Ayurvedic Decoction “Kadha” This study aimed to explore the prevalence of consumption of natural products and Ayurvedic decoctions “kadha” as immunity-boosting measures during the initial phase of the COVID-19 pandemic. Around 540 responses were taken through an online survey which shows the usage of immunity-boosting measures and Ayurvedic decoctions “kadha” among the adult residents of Delhi belonging to different age groups was effective. 3. Development of Giloy leaves-based Herbal Squash incorporated with Pineapple Giloy leaves based Herbal Pineapple Squash This research work was an effort in the direction of producing value-added instant beverages. Due to the functional and nutritional goodness of both plants, it can be further exploited in the development of healthy beverage products to develop giloy leaves-based herbal squash incorporated with pineapple and to determine its physical and biochemical properties. 4. Development of value-added cookies supplemented with giloy leaves and Tulsi powder Cookies with giloy leaves and tulsi powder In this study, giloy leaves powder was utilized in place of whole wheat flour to create herbal biscuits. When preparing herbal cookies, whole wheat flour partially replaces the powdered tulsi leaves and giloy leaves stems. Table 3 Traditional Giloy leaves Based Value-added Products. Table 3 S. No. Objective of study Value-added Product Overview of Study Reference 1. Development of herbal lassi using giloy leaves stem juice Herbal lassi Based on the current study, giloy leaves may be utilized to successfully make herbal lassi. Based on microbiological characteristics, the produced lassi was deemed safe for consumption. Natural antioxidants, such as giloy leaves, effectively lower the risk of heart disease, cancer, and many inflammatory processes, and have a positive impact on cardiovascular illnesses. It also strengthens immunity. 2. Development of Antioxidant-Rich Herbal Tea Bags Herbal Tea Bags with Giloy leaves This study was conducted to develop herbal tea bags using giloy leaves and different herbs which can provide antioxidant properties, boost immunity and also enhance the efficacy of white blood cells which helps in fighting against infections and bacteria-causing diseases. 3. Value Addition and Fortification in NonCentrifugal Sugar (Jaggery): A Potential Source of Functional and Nutraceutical Foods Jaggery fortified with giloy leaves. Jaggery is classified as a nutraceutical since it contains a range of vital amino acids, antioxidants, phenolics, minerals (calcium, phosphorus, iron), and vitamins. Jaggery is a more natural source of nutrients for health benefits and might be utilized as a healthier nutritional option for white sugar. Giloy leaves are incorporated as a health-supporting herb to generate even superior antioxidant, detoxifier, digestive, and immune booster products with potential functional and nutraceutical value. 4. Formulation of Herbal Candies Containing Giloy Leaves Satva: A Nutritious and Palatable Herbal Confectionery Option Herbal Candies Containing Giloy leaves The addition of giloy leaves satva in confections shows potential for improving immunity as it fights free radicals and boosts the body's mechanisms for defence against infections. It offers an intriguing discipline of study and innovation, providing a natural and pleasant method for immunomodulation 5. Sensory Evaluation of Laddu Enriched with Giloy leaves ( Tinospora Cordifolia) - Iron-Rich Powder Laddu Enriched with Giloy leaves The purpose of this study is to formulate and establish a standard giloy leaves laddu for people with anaemia and to determine its level of acceptability. The goal is to make a healthy laddu and put giloy leaves powder into it. 6. A study on incorporation of giloy leaves for the development of shelf-stable goat milk-based functional beverage Goat milk incorporated with giloy leaves By combining debittered giloy leaf juice with goat milk, a study was carried out to develop a shelf-stable giloy leaves goat milk beverage. The product profile was examined in depth, including its proximate composition, bioactive qualities, sensory, rheological, and structural characteristics. The addition of giloy leaves in this creates a functional beverage with a longer shelf life that targets health issues and boosts immunity.
|
PMC11699423_p26
|
PMC11699423
|
Application of value-added products
| 4.177432 |
biomedical
|
Study
|
[
0.9988031387329102,
0.0003509150701574981,
0.0008460070821456611
] |
[
0.9993420243263245,
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0.000044187305320519954
] |
en
| 0.999997 |
The research has shown that giloy can be used in a plethora of products. The sensory qualities of giloy leaves, tulsi, and ginger herbal tea bags were optimised . Additionally, herbal candies made from giloy stems juice and sugar offer a nutritious and nutrient-dense option . Fortified jaggery with giloy leaves powder has shown enhanced nutritional profiles, and shelf-stable goat milk enriched with giloy stem juice has demonstrated extended shelf life and stability . Furthermore, giloy powder has been used in giloy laddus, where it is combined with other components . These diverse uses highlight Giloy's leaf extract potential to improve the nutritional value and health-promoting properties of food items.
|
PMC11699423_p27
|
PMC11699423
|
Application of value-added products
| 2.558491 |
biomedical
|
Other
|
[
0.9593942761421204,
0.0007778271101415157,
0.039827898144721985
] |
[
0.23834073543548584,
0.5494911074638367,
0.21058964729309082,
0.001578554860316217
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en
| 0.999998 |
While traditional methods do not allow any combination of other ingredients, modern methods often combine giloy leaves with other herbs to enhance its effect for specific health concerns like stress, skin health, joint pain etc. Quality assurance varies in both traditional and modern value-added products, with modern manufacturing practices there is more focus on quality control and standardized formulations to ensure consistency and quality control in Giloy leaves-based products.
|
PMC11699423_p28
|
PMC11699423
|
Comparison between traditional and modern value-added products
| 2.035864 |
biomedical
|
Other
|
[
0.9541450142860413,
0.002111881272867322,
0.04374309629201889
] |
[
0.010833211243152618,
0.9861235618591309,
0.0025135320611298084,
0.0005297292373143137
] |
en
| 0.999999 |
Different Varieties of modern value-added products are available nowadays, while traditional value-added products are very limited as shown in Table 3 , Table 4 . Table 3 , Table 4 illustrate the contrast between traditional and current applications of giloy leaves. Table 4 displays the Giloy-based products available in the market, while Table 3 outlines traditional uses. There are various value-added products in today’s modern era like capsules, juice, giloy leaves powder, giloy leaves extract and many more while traditional value-added products were limited to most consumers where churan, and kadha (juice blend) are common among all. Modern products are fortified with different vitamins and minerals to enhance the nutritional value of the product while traditional products are not fortified and produced as it is consumed. Modern giloy leaves products are widely available in pharmacies, local stores and online platforms, and are greatly accessible to consumers worldwide, which is not the same in the case of traditional value-added products. Modern giloy leaves products offer a convenient form of consumption, making it easier for individuals to consume and incorporate into their daily routines plus they are less time-consuming. Modern giloy leaves products have a high shelf life as they are preservatives with chemicals like sodium benzoate and potassium sorbate etc. or with various modern preserving methods. Traditional giloy leaves products typically use natural and herbal ingredients plus no chemicals were used resulting in less shelf life of the product. Traditional value-added products are made by methods that are passed down from generation to generation. Which involves manual labour, the use of natural ingredients and traditional equipment, which helps in preparing the perfect desired product. In Modern value-added products, advanced technologies and machines are used for production which works on standardized methods. Automatic machines, standard measurements, and quality control techniques are very common for preparing required products. Table 4 Commercially giloy leaves based on value-added products. Table 4 Product Name Brand Name Health Claims Ingredients Reference Capsules/Tablets rowhead 1. Guduchi Immunity Wellness Himalaya ● Strengthens Immunity ● Fights infections ● Supports detoxification ● Helps in increasing the performance of white blood cells Giloy leaves Stem Extract https://www. amazon. in/HimalayaWellness-Herbs-Guduchi-Immunity/dp/B00B8ROM1M 2. Giloy leaves Immunity Booster Zandu ● Protection Against Infections & Immunity Booster. ● Promotes Liver Health ● Stress Relief ● Anti-oxidant Compounds for Good Skin Health. Giloy leaves Stem Extract https://www. amazon. in/ZanduGuduchi-herbs-immunitywellness/dp/B07V6TPRQ8 3. Guduchi (Giloy leaves) Ghanbati Baidyanath ● Boost Immunity ● Reduces anxiety and improves mental strength. ● Rich in antioxidants and has anti-allergic, antifungal & anti-bacterial benefits. ● Maintain strength and vitality ● Aids pitta disorders & improves digestion. Giloy leaves Stem Extract. Ashwagandha Amla Gorakhmundi https://www. amazon. in/Baidyanath-Guduchi-Giloy leaves-GhanBati/dp/B08CY425YB 4. Divya Giloy leaves Ghanvati Patanjali ● Immune boosting ● Antioxidant properties and anti-inflammatory effects. ● Provide liver support ● Promote respiratory health. Giloy leaves Stem Extract https://www. amazon. com/Patanjali-Giloy leaves-Ghan-Vati-Tablets/dp/B07HWTJ2G3 5. Jiva Giloy leaves Jiva ● Boosts Immunity. ● Helps fight respiratory problems. ● Helps reduce joint pain. ● Improve digestion. ● Helps in detoxification. Giloy leaves Stem Extract https://www. amazon. in/Jiva-Giloy leaves-Capsule-Respiatory-Detoxification/dp/B093KTSXX8 Powder rowhead 1. Organic Giloy leaves/Guduchi Stem Powder CARMEL ORGANICS ● Boosting the immune system. ● Improving digestion. ● Reducing stress and anxiety. ● Controls blood sugar level. Giloy leaves stem powder https://www. amazon. in/CertifiedAmruthavalli-Tinospora-cordifolia-Preservative/dp/B08CHGD429 2. Natural Organic Guduchi Powder/Giloy leaves Powder MY HERB ●Aids in detoxification, increases antibodies, and stimulates vitality. ●Relieves stress and anxiety while also replenishing the body. ●Combats illnesses related to respiration. Demonstrates anti-inflammatory and antiarthritic activities Giloy leaves stem powder https://www. amazon. in/GuduchiPowder-Tinospora-cordifoliaMetabolism/dp/B08MTZPL1C 3. Giloy leaves Satva Baidyanath ●Useful in treating burning sensation in hands & feet, headache, metallic taste in mouth & excessive thirst. ●Enhances immunity of the body. Giloy leaves extract powder https://www. amazon. in/Baidyanath-Giloy leaves-Satwa-Pack-140/dp/B08KT8VB8P Teas Moringa & Giloy leaves Green Tea with Lemongrass Care ●Support to build an Immune system. ●Make bones and joints healthy. ●Help in losing weight. ●Enhance metabolism. Moringa Giloy leaves Licorice Ginger Lemongrass https://www. amazon. in/Moringa-Lemongrass-Immunity-Management-Ayurvedic/dp/B0836MJH7G 2. Giloy leaves Immunity Tea Jiva ●Effective immunity booster. ●Improve skin condition and reduce acne and pimples. ●Helps with seasonal colds and coughs. ●Helps to improve overall health & well-being. Giloy leaves stem powder https://www. amazon. in/Jiva-Giloy leaves-150gm-Pack-Immune-Tea/dp/B085S4ZFZQ 3. Giloy leaves Tea One Herb ●Immunity booster. ●Improves digestion. ●Helps reduce skin infections. ●Relieves chronic fever. ●Help regulate blood sugar levels. ●Boosts metabolism and aids weight management. Giloy leaves stem powder https://www. amazon. in/One-Herb-Ultimate-Immunity-Infections/dp/B08VNLYKTW 4. Ayurvedic Herbs Giloy leaves Green Herbal Tea Rishtpusht ●Immunity booster. ●Helps maintain a healthy heart and nervous system. ●Fight allergies and common infections. ●It improves blood circulation and eliminates harmful substances from the body. Giloy leaves Satva, Dry ginger, Clove, Cardamom, Lemon Basil, Green tea, Cumin seed, Sugar. https://www.amazon.in/Rishtpusht-Ayurvedic-Immunity-Booster-Natural/dp/B091YTDSK8 Juice rowhead 1. Giloy leaves juice Dabur ●Natural immunity booster ●Antioxidant properties ●Good for liver and skin health ●Natural detoxifier Giloy leaves extract https://www. amazon. in/DABUR-Giloy leaves-Neem-JuiceTulsi/dp/B087DJ9L3K 2. Giloy leaves tulsi juice. Vansaar ●Cleans and detox the gut ●Boost immunity & fight against common cough cold ●Antioxidant ●Anti-microbial ●Anti-bacterial ●Anti-inflammatory Giloy leaves stem Tulsi leaves https://www. amazon. in/Enhancing benefits-Handpicked-all-round-Immunity/dp/B07CYYPFFR 3. Giloy leaves juice Baidyanath ●Boost immunity ●Rich source of antioxidant ●Helps maintain a healthy heart and nervous system Giloy leaves extract https://www. amazon. in/Baidyanath-Boost-Immunity-Natural-Giloy leaves/dp/B087LTSC5M 4. Wild tulsi and giloy leaves juice Krishna’s herbal & ayurveda ●Helps regulate blood sugar levels. ●Boost metabolism & improve digestion ●Stimulates insulin secretion ●Helps manage weight Giloy leaves, Jamun, Bel Patra, Amla, Methi, Karela, Kutki, Vijaysar, Tulsi, Gudmaar Neem https://www. amazon. in/Krishnas-Herbal-Ayurveda-GeloyTulsi/dp/B07PLYBMMB 5. Giloy leaves vital AVG health organics ●Immunity booster ●Anti-pyretic ●Reduces inflammation & pain in the body ●Glucose metabolism Giloy leaves Ashwagandha Basil Amla berry https://www. amazon. in/AVGHealth-Organics-Ashwagandha-Premium/dp/B08CYCPTV6
|
PMC11699423_p29
|
PMC11699423
|
Comparison between traditional and modern value-added products
| 3.452991 |
biomedical
|
Study
|
[
0.8141739368438721,
0.0007628746679984033,
0.1850631833076477
] |
[
0.5384619235992432,
0.28507906198501587,
0.17574305832386017,
0.0007158747757785022
] |
en
| 0.999995 |
These methods are often more precise and accurate as compared to traditional techniques which require a large amount of labor work. Traditional value-added products are higher in cost as compared to modern products as they have higher production costs which include labor-intensive processes, limited production scale, and the use of expensive and premium quality ingredients. As a result, they are often highly-priced. Modern products benefit from modern techniques, machines, high-scale production processes, and standardized measurement of ingredients. Which often leads to lower production costs and reasonable pricing.
|
PMC11699423_p30
|
PMC11699423
|
Comparison between traditional and modern value-added products
| 1.815173 |
other
|
Other
|
[
0.14566509425640106,
0.0015999038005247712,
0.8527349829673767
] |
[
0.005409518256783485,
0.9908096790313721,
0.0034864810295403004,
0.0002943928411696106
] |
en
| 0.999997 |
Traditional value-added products also lack innovation as they prioritize traditional or hereditary methods which lack creativity and innovation, resulting in passing down the methods and recipes without any modifications. In the case of modern value-added products modifications are done with time, and new researches are done resulting in new recipes, new flavours, new techniques etc. Traditional production methods have limitations in organizing due to their reliance on manual labour and different techniques. Increasing production volumes is also challenging without compromising quality and effectiveness.
|
PMC11699423_p31
|
PMC11699423
|
Comparison between traditional and modern value-added products
| 1.334957 |
other
|
Other
|
[
0.04264293983578682,
0.0012447858462110162,
0.956112265586853
] |
[
0.0027017646934837103,
0.9960387945175171,
0.0009788550669327378,
0.0002805404074024409
] |
en
| 0.999999 |
While Modern production methods are highly organized due to automation, Standardization and efficient manufacturing processes. Companies can easily adjust production volumes to meet different demands without sacrificing the quality and effectiveness of the product. Traditional products often target markets or consumers seeking authenticity, and local produce. They may be available through speciality stores or directly from the production area. Traditional products use less marketing while Modern products appeal to a broader consumer base due to their convenience, and wider distribution channels. They are often spread in supermarkets, online platforms, and large retail chains.
|
PMC11699423_p32
|
PMC11699423
|
Comparison between traditional and modern value-added products
| 1.206411 |
other
|
Other
|
[
0.00928710587322712,
0.0008597361156716943,
0.9898532032966614
] |
[
0.0012844398152083158,
0.9973760843276978,
0.0009763162233866751,
0.0003632869047578424
] |
en
| 0.999998 |
Tinospora cordifolia , also known as Giloy, is a revered medicinal plant in the Indian Ayurvedic tradition, renowned for its diverse therapeutic applications . However, recent studies have raised concerns about the potential hepatotoxic effects associated with the consumption of giloy leaves powder. The traditional use of giloy in Ayurveda has been well-established, with the plant being recognized for its anti-pyretic, anti-inflammatory, and hepatoprotective properties. However, a growing body of evidence suggests that prolonged or excessive consumption of Giloy leaves powder may lead to liver damage, a phenomenon known as hepatotoxicity.
|
PMC11699423_p33
|
PMC11699423
|
Safety and toxicity
| 3.752698 |
biomedical
|
Review
|
[
0.9988788962364197,
0.00036618064041249454,
0.0007549120928160846
] |
[
0.2763581871986389,
0.10525701940059662,
0.6168724894523621,
0.0015123626217246056
] |
en
| 0.999995 |
Several in vitro and animal studies have investigated the potential hepatotoxic effects of giloy. Researchers have observed that exposure to giloy extracts can result in increased lipid peroxidation, lactate dehydrogenase release, and a decline in glutathione-S-transferase activity, all of which are indicative of cellular stress and potential liver injury . Alkaloids (berberine, palmatine, and jatrorrhizine) and sinapic acid are believed to contribute to its hepatoprotective effects. Berberine, for instance, has been shown to reduce inflammation by inhibiting TNF-α-mediated proinflammatory pathways and nitrosative stress by suppressing iNOS activity . Beyond its hepatoprotective properties, Tinospora cordifolia exhibits a broad spectrum of biological activities, including anticancer, anti-inflammatory, antimicrobial, and antioxidant effects. It is generally considered safe at doses up to 2000 mg/kg. The pharmacological actions of Tinospora cordifolia are attributed to a diverse array of phytochemicals, including polyphenols, alkaloids, steroids, terpenoids, and glycosides . Hepatotoxicity, or liver damage, can be caused by a variety of factors, including the ingestion of toxic substances, overdose of medications, and even certain herbal preparations .
|
PMC11699423_p34
|
PMC11699423
|
Safety and toxicity
| 4.29325 |
biomedical
|
Study
|
[
0.9990208148956299,
0.000511599297169596,
0.0004675954987760633
] |
[
0.6937131881713867,
0.0012654532911255956,
0.3045281171798706,
0.0004932814626954496
] |
en
| 0.999997 |
Although information on the immunomodulatory qualities of giloy leaves is growing, there is still a significant lack of understanding about the precise processes behind these effects. The precise molecular pathways and cellular interactions underlying the observed antioxidant activity, inflammation modulation, Th17 cell regulation, inhibition of the NF-κB pathway, interleukin modulation, and immunosuppressive and white blood cell-enhancing properties remain unclear. To understand the full therapeutic potential of giloy leaves, it is imperative to close this gap between data and intricate processes. Therefore, future research on several areas should be done including important signalling pathways like NF-κB, which have previously been connected to giloy leaves effects, should be the focus of research. These processes have to be clearly understood. Targeted therapies need a clearer comprehension of the molecular interactions that components of giloy leaves have with these pathways. Extensive research is required to determine the particular pathways through which giloy leaves constituents interact with other types of immune modulatory cells, such as Th17 cells, macrophages, and natural killer cells. Having a thorough understanding of how giloy leaves affect these cells' activation, differentiation, and function would help develop therapeutic applications. Investigate the possible benefits that giloy leaves may have when combined with other widely consumed foods that are high in vitamins, minerals, or antioxidants. This can help with dietary suggestions for enhancing immune function and for nutraceutical development. Examine the impacts of food matrices and determine which food ingredients can improve the bioavailability of the bioactive chemicals found in giloy leaves. This information can help formulate products in a way that maximizes health benefits. Contrast the immunomodulatory properties of giloy leaves with known immunomodulatory medications or natural compounds. This analysis can shed light on the distinct processes of giloy leaves and discover potential synergies in combination therapy. Through establishing a connection between current data and comprehensive research, scientists can fully realize the potential of giloy leaves as a medicinal agent. This all-encompassing strategy will open the door for focused therapies and enhanced formulations for particular immune-related ailments. In Future researchers should prioritize the development of standardized protocols for giloy leaves to ensure consistent quality and efficacy. Further research is necessary for negotiating the regulatory environment for giloy-based applications in order to commercialize the product.
|
PMC11699423_p35
|
PMC11699423
|
Future prospective
| 4.384852 |
biomedical
|
Review
|
[
0.9968492388725281,
0.0008413743344135582,
0.0023093915078788996
] |
[
0.11741195619106293,
0.004767000675201416,
0.8773632645606995,
0.00045782237430103123
] |
en
| 0.999996 |
In conclusion, the study we did on the immunomodulatory properties of giloy leaves states that they have many health benefits such as boosting immunity, regulating apoptosis in immune cells and acting as antioxidants. They have active compounds such as alkaloids, polysaccharides, flavonoids, and terpenes present in them that help in immune cell activation which stops cell damage and immune cells like macrophages and B cells which help in inflammation reduction and stop cancer cells from increasing. Giloy leaves modulate interleukins and Th17 cells which helps in protection against infections and increasing immunity.
|
PMC11699423_p36
|
PMC11699423
|
Conclusion
| 3.870665 |
biomedical
|
Study
|
[
0.999642014503479,
0.0000917189972824417,
0.00026623174198903143
] |
[
0.9942986965179443,
0.0022583208046853542,
0.0033228739630430937,
0.00012013036757707596
] |
en
| 0.999997 |
Many modern products are now available in the market that are adapted, formulated and fortified from traditional uses of giloy leaves which can help in treating immunity-related disorders and other diseases. However, for better application and usage of this, further research and studies are required to understand its mechanisms which further helps in understanding its effects, applications and how they work with other compounds and treatments to enhance its use. Giloy leaves contain active ingredients that may be responsible for these benefits. Convenient options to include Giloy into daily routines are provided by modern products. It is crucial to recognize that there may be interactions between giloy leaves and specific drugs. Therefore, we advise speaking with a healthcare professional before incorporating giloy-based products into daily routine to ensure safe and effective use, particularly if you are taking any medications.
|
PMC11699423_p37
|
PMC11699423
|
Conclusion
| 2.649664 |
biomedical
|
Other
|
[
0.9906229376792908,
0.002641084138303995,
0.006735885050147772
] |
[
0.005285486113280058,
0.9876736998558044,
0.006326557137072086,
0.0007142099202610552
] |
en
| 0.999996 |
Overall, giloy leaves are said to be a natural immunomodulatory agent having many other properties such as antioxidant, hepatoprotective, anti-inflammatory and many more which required the researchers to go further to understand its properties fully.
|
PMC11699423_p38
|
PMC11699423
|
Conclusion
| 2.160337 |
biomedical
|
Other
|
[
0.9951686859130859,
0.0009021230507642031,
0.003929307218641043
] |
[
0.03332678601145744,
0.9440601468086243,
0.021300800144672394,
0.0013122492237016559
] |
en
| 0.999997 |
Jyoti Singh: Writing – review & editing, Writing – original draft, Conceptualization. Etika Saxena: Writing – original draft. Anjali Raj Chaudhary: Writing – review & editing. Mandeep Kaur: Writing – review & editing. Molly Salotra: Writing – original draft, Supervision. Prasad Rasane: Writing – review & editing, Writing – original draft. Sawinder Kaur: Writing – review & editing, Supervision. Sezai Ercisli: Writing – review & editing, Methodology, Investigation. Melekber Sulusoglu Durul: Writing – review & editing, Supervision, Formal analysis. Mehmet Ramazan Bozhuyuk: Writing – review & editing, Resources. Ahmet Hakan Urusan: Writing – review & editing, Software. Riaz Ullah: Writing – review & editing, Resources.
|
PMC11699423_p39
|
PMC11699423
|
CRediT authorship contribution statement
| 0.920552 |
other
|
Other
|
[
0.11158619076013565,
0.003033630782738328,
0.8853802680969238
] |
[
0.0028076795861124992,
0.9963500499725342,
0.00041811863775365055,
0.00042409918387420475
] |
en
| 0.999996 |
This study did not require informed consent or review and approval by an ethical committee because it was a literature analysis that solely used data from published studies and did not involve any direct experimentation or studies on living beings.
|
PMC11699423_p40
|
PMC11699423
|
Ethics declaration
| 1.525876 |
biomedical
|
Other
|
[
0.970070481300354,
0.0010725280735641718,
0.02885689213871956
] |
[
0.2718367278575897,
0.7229936122894287,
0.003804934211075306,
0.001364674186334014
] |
en
| 0.999997 |
The research reported in the paper did not involve the utilization of any data. This article's accompanying data has not been added to any publicly accessible databases.
|
PMC11699423_p41
|
PMC11699423
|
Data availability statement
| 0.971851 |
other
|
Other
|
[
0.08723586797714233,
0.0012594889849424362,
0.9115046262741089
] |
[
0.0050551858730614185,
0.9939311742782593,
0.0006349125178530812,
0.00037876126589253545
] |
en
| 0.999996 |
This study received no explicit financing from public, commercial, or non-profit organizations.
|
PMC11699423_p42
|
PMC11699423
|
Funding
| 1.046732 |
other
|
Other
|
[
0.009948003105819225,
0.0007815484423190355,
0.9892704486846924
] |
[
0.003725033951923251,
0.9952953457832336,
0.0005449122982099652,
0.0004347217036411166
] |
en
| 0.999997 |
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
|
PMC11699423_p43
|
PMC11699423
|
Declaration of competing interest
| 0.981821 |
other
|
Other
|
[
0.004888111725449562,
0.0006584165967069566,
0.994453489780426
] |
[
0.001968854106962681,
0.9968124032020569,
0.0006366003071889281,
0.0005821675877086818
] |
en
| 0.999997 |
Oral health has a major impact on overall health, medical costs, and quality of life. Major oral conditions include dental caries, periodontal disease, and tooth loss. Between 1990 and 2017, the global burden of these conditions increased by 38% .
|
39706582_p0
|
39706582
|
Introduction
| 2.071942 |
biomedical
|
Other
|
[
0.992148220539093,
0.0025961603969335556,
0.0052555580623447895
] |
[
0.01847134716808796,
0.9439094066619873,
0.036038365215063095,
0.0015808207681402564
] |
en
| 0.999997 |
There are reports of an increase in the burden of oral diseases in the Kingdom of Saudi Arabia (KSA) over the last few decades . This increase is likely due to transformations in lifestyle, such as changes in dietary habits, particularly an increase in consumption of sugary foods and tobacco products . Thus, oral health conditions constitute one of the major public health concerns in KSA.
|
39706582_p1
|
39706582
|
Introduction
| 1.914213 |
biomedical
|
Other
|
[
0.9846839308738708,
0.0021495302207767963,
0.01316660176962614
] |
[
0.01676797866821289,
0.9776540398597717,
0.004689357243478298,
0.000888669048435986
] |
en
| 0.999995 |
Self-reported oral health status has been used as an important subjective health indicator of oral health care needs and to evaluate the individual’s quality of life . Self-reported information is a cost-effective and time-saving method of data collection. Self-reported oral health can be affected by several factors, such as sociodemographic and socioeconomic factors, cultural values and beliefs, and existing oral health conditions .
|
39706582_p2
|
39706582
|
Introduction
| 2.842982 |
biomedical
|
Other
|
[
0.9955527186393738,
0.000752442458178848,
0.0036948141641914845
] |
[
0.16419056057929993,
0.7381542921066284,
0.09669973701238632,
0.0009554862044751644
] |
en
| 0.999997 |
The Multidimensional Conceptual Model of Oral Health proposed by Gilbert et al states that oral diseases and related tissue damage can result in oral pain (OP) and challenges in daily living that affect self-rated oral health (SROH) status. OP can cause difficulties in chewing and sleep disturbances . In addition, it can affect school and work attendance, causing a loss of a significant number of study and working hours per year . Because of these concerns, OP is frequently incorporated into national health surveys. A 1989 report from the United States reported that 14.5% of adults experienced OP during the past 6 months , while in the United Kingdom, 28% of adults were reported to experience difficulty from OP during the past year in 1998 .
|
39706582_p3
|
39706582
|
Introduction
| 3.921348 |
biomedical
|
Review
|
[
0.9959420561790466,
0.0005282030906528234,
0.0035296787973493338
] |
[
0.26501792669296265,
0.011204119771718979,
0.7233909368515015,
0.00038695387775078416
] |
en
| 0.999997 |
SROH status serves as a valuable indicator of general oral health status . It is considered a comprehensive index reflecting various dimensions of oral health, including functional, psychological, and social impacts on overall well-being . It has been linked to clinical oral health status, such as dental caries, tooth mobility, and tooth loss . Furthermore, SROH has been found to predict future oral health outcomes, as seen in longitudinal studies assessing maternal SROH and their children's caries experience in adulthood .
|
39706582_p4
|
39706582
|
Introduction
| 3.822185 |
biomedical
|
Study
|
[
0.9987071752548218,
0.0002717593451961875,
0.001020974013954401
] |
[
0.7439637780189514,
0.004308648407459259,
0.25142964720726013,
0.00029792083660140634
] |
en
| 0.999998 |
Distal and proximal influences play significant roles in shaping oral health outcomes such as OP and SROH. Proximal influences such as oral health-related behaviors and the use of oral health services directly impact oral health . On the other hand, distal influences encompass broader determinants such as socioeconomic status and access to care determinants, which also have a substantial influence on oral health outcomes . Understanding the interplay between distal and proximal influences is essential for addressing oral health status among populations and developing effective interventions to improve oral health outcomes across diverse populations.
|
39706582_p5
|
39706582
|
Introduction
| 3.812003 |
biomedical
|
Review
|
[
0.9969090819358826,
0.0006812389474362135,
0.0024097159039229155
] |
[
0.1934405416250229,
0.05860696732997894,
0.747393786907196,
0.0005587637424468994
] |
en
| 0.999997 |
The use of conceptual frameworks for understanding determinants in oral health research can serve as a coherent map to guide researchers when inquiring about oral health conditions. Conceptual frameworks can also help researchers to include multiple factors that may explain an outcome and aid in designing statistical analyses . The objective of this study was to explore how proximal and distal influences on oral health are related to both OP experience and SROH status among KSA residents by using data from a national demographic and health survey (DHS) that was conducted in 2017 in KSA. A conceptual framework was developed to guide the analysis.
|
39706582_p6
|
39706582
|
Introduction
| 4.0065 |
biomedical
|
Study
|
[
0.9987086057662964,
0.0002500706759747118,
0.0010413527488708496
] |
[
0.999518871307373,
0.00024261507496703416,
0.0002012957847910002,
0.00003724212001543492
] |
en
| 0.999995 |
The original data collection was approved by the institutional review board (IRB) of the Ministry of Health of the Kingdom of Saudi Arabia . No additional IRB approval was needed for the secondary analysis, as it qualifies under Exemption 4 of US federal regulations [45 CFR 46.104(d)(4)] due to the use of existing, nonidentifiable data. The authors have permission to use the data, which was collected with participant consent. Data analysis was conducted at the Indiana University School of Dentistry, the Department of Biostatistics at the Indiana University School of Medicine, and the Richard M. Fairbanks School of Public Health, Indianapolis. The Human Research Protection Program from the Office of Research Compliance at Indiana University determined that this secondary analysis does not require further IRB review . Neither the study principal investigator nor key personnel had any financial conflict of interest concerning this research. The data were available at the office of the Directorate of Primary Health Care Centers (Ministry of Health, Headquarters, Riyadh, KSA). The Ministry of Health used a probability multistage stratified random sampling for the DHS. Details of the sampling procedure were published previously . Briefly, house-to-house visits were conducted to interview the head of a family or an eligible representative and other specific family members between February 12, 2017, and May 23, 2017. Participants answered questions related to demographic, environmental, and health-related topics. The data were received in SPSS (IBM Corp) software format, and an analysis file was created, which comprised selected variables of interest. In total, 3 parallel analyses were performed based on the age of the respondent: children, 5-14 years; adolescents, 15-24 years; and adults, ≥25 years (details are given in ). The analysis was done at the Biostatistics Department, Indiana University School of Medicine, Indianapolis, Indiana, United States .
|
39706582_p7
|
39706582
|
Data Source
| 2.478027 |
biomedical
|
Study
|
[
0.9669655561447144,
0.002054822165518999,
0.03097965568304062
] |
[
0.9752393364906311,
0.023980865254998207,
0.00045389507431536913,
0.00032597724930383265
] |
en
| 0.999996 |
Based on existing models, a multi-level conceptual framework was developed for oral health influences in KSA on self-reported OP and SROH status among KSA residents. Constructs from the Multidimensional Conceptual Model of Oral Health proposed by Gilbert et al and the World Health Organization Model for Oral Health Surveillance were adapted by expanding the concept of proximal (direct) influences on oral health—such as diet and oral hygiene—to include distal (indirect) influences such as socioeconomic determinants.
|
39706582_p8
|
39706582
|
Development of the Model
| 3.978231 |
biomedical
|
Study
|
[
0.9988394379615784,
0.000187357232789509,
0.0009733151528052986
] |
[
0.998364269733429,
0.0005402909591794014,
0.001052612904459238,
0.000042845636926358566
] |
en
| 0.999997 |
Model variables were selected after a careful review of the literature, identifying those that were both available in the survey and previously reported to influence OP and SROH status. The model variables were classified as exogenous and endogenous. Exogenous variables are those that are not affected by other variables in the model (the distal or indirect influences), while endogenous variables are affected by other variables in the model, such as proximal influences and outcome variables. In total, 13 exogenous variables were included for the adult group, and 11 and 12 exogenous variables were included for the adolescent and children groups, respectively. In total, 8 endogenous variables were included for the adult group and 7 endogenous variables were included for the adolescent and children's groups, respectively. The variables are listed in ( Table 1 ). Exogenous variables (distal influence variables) included the age of participants as a continuous variable and gender as a binary variable (males or females). Citizenship status was coded as a binary variable: citizens and noncitizens. Geographic regions were classified into the East, West, and Central versus the North and South. Marital status was dichotomized into currently married and not married (≥25 years only). Completed education level was categorized as primary, intermediate, high school, intermediate diploma, and college or higher education. In total, 5 levels of household monthly income were included: lower class income , marginal middle-class income , basic middle-class income , upper middle-class income (22,901-38,200 Riyals), and upper-class income (>38,200 Riyals). Household crowding was calculated by dividing the number of family members by the number of sleeping rooms. The responses were then grouped into 4 levels: <1, 1-2, 2-3, and >3 persons per room. Past accident experience and physical disability were assessed as binary no or yes responses. BMI was dichotomized as normal (BMI=18.5-24.9) and abnormal (BMI <18.5 and >24.9). Health insurance was expressed as a binary variable of insured versus not insured. Access to oral health services in the year prior to the survey was dichotomized into “no or I do not know and yes” responses. The source of dental care was dichotomized into a government versus private clinic.
|
39706582_p9
|
39706582
|
Selection of Endogenous and Exogenous Variables
| 4.069931 |
biomedical
|
Study
|
[
0.9990653395652771,
0.00037647481076419353,
0.0005582185694947839
] |
[
0.999428927898407,
0.00013689184561371803,
0.0003887280181515962,
0.000045363227400230244
] |
en
| 0.999998 |
Endogenous variables (proximal influences and outcome variables) included the frequency of consuming sweets , individuals responded to the following question “How often do you eat sweets?” as “I don't eat at all, many times per month, once per week, many times per week, once per day, many times per day.” For soft drinks consumption frequency , “How often do you drink soft drinks?” responses were “I don't drink at all, many times per month, once per week, many times per week, once per day, many times per day.” For smoking status, yes or no responses to the question “Do you smoke?” Frequency of tooth brushing had 6 levels: “I have never cleaned my teeth, I clean my teeth some days but not daily, once weekly, many times per week, once daily, twice or more daily.” The frequency of dental visits was determined as from response to the question “How many times have you visited a dentist in the past year?” Valid answers include “never visited a dentist/I do not know or do not remember, did not visit the dentist in the past year, once, more than once.” For the type of visit, responses were dichotomized into visits for a complaint versus visits for routine examination and treatment . For OP , the question was phrased as: “How many times during the past year have you felt pain in your teeth?” There were 4 levels of response: “never felt, rarely, sometimes, many times.” For SROH , participants were asked, “How would you describe the health of your teeth and gums?” Responses were “bad, acceptable, good, very good, excellent.”
|
39706582_p10
|
39706582
|
Selection of Endogenous and Exogenous Variables
| 3.667897 |
biomedical
|
Study
|
[
0.9957476258277893,
0.0006374646909534931,
0.0036149807274341583
] |
[
0.9995049238204956,
0.0003444646717980504,
0.00010994752665283158,
0.000040681166865397245
] |
en
| 0.999995 |
SPSS (IBM Corp) was used to perform descriptive analysis for the model variables ( Table 1 ). R software (R Foundation for Statistical Computing) was used to perform the path analysis considering the sample weights. Missing values were not replaced or imputed in this analysis. The first step was to assess the multivariate normality of endogenous variables. Both skewness and kurtosis statistics confirmed that endogenous variables did not follow a multivariate normal distribution ( P <.05). Owing to the presence of non-normal and missing data, full-information maximum likelihood estimation to perform path analysis available in the lavaan package (version 0.6.12) was used . Robust standard errors (Huber-White) and scaled test statistics were calculated . The software estimated the direct effect, as hypothesized in the model in , of each oral health influence, as well as the indirect effect for each exogenous variable on OP and SROH status through a path mediated by each proximal influence on oral health . For example, the effect of sex on OP was mediated by the frequency of tooth brushing. The total indirect effects on OP and SROH status reflected the effect of the path between each exogenous variable via all proximal influences on oral health. The total effects comprised the sum of the total indirect and direct effects of each distal influence on OP and SROH status.
|
39706582_p11
|
39706582
|
Data Analyses
| 4.10078 |
biomedical
|
Study
|
[
0.9992558360099792,
0.0002871555043384433,
0.0004569769953377545
] |
[
0.9994325041770935,
0.00030862115090712905,
0.0002101756981573999,
0.000048715926823206246
] |
en
| 0.999998 |
A separate model was estimated for each age group—children 5–14 years, adolescents 15–24 years, and adults ≥25 years. Model fit was evaluated using the robust comparative fit index>0.9, robust Tucker-Lewis index>0.9, robust root mean-square-error of approximation <0.08, and robust standardized root-mean-square residual<0.08 .
|
39706582_p12
|
39706582
|
Data Analyses
| 3.361609 |
biomedical
|
Study
|
[
0.979814350605011,
0.0003686273703351617,
0.019816966727375984
] |
[
0.9961363673210144,
0.0034947870299220085,
0.0003168768307659775,
0.000051978302508359775
] |
en
| 0.999997 |
The conceptual model states that OP and SROH status are directly influenced by distal and proximal influences on oral health. Furthermore, OP and SROH status are indirectly influenced by distal influences via all proximal influences except past accident experience, physical disability, and BMI, where they were indirectly influenced by OP and SROH status via only dental visit frequency, type of visit, and frequency of tooth brushing .
|
39706582_p13
|
39706582
|
Results
| 3.650224 |
biomedical
|
Study
|
[
0.9961214661598206,
0.00043019329314120114,
0.0034483359195291996
] |
[
0.9072225689888,
0.0708809420466423,
0.021540595218539238,
0.00035588807077147067
] |
en
| 0.999997 |
The final analysis included 29,274 adults ≥25 years of age (mean 42.2, SD 12.97), 9910 adolescents aged 15–24 (mean 20.4, SD 2.98) years, and 11,653 children aged 5 and 14 (mean 10.58, SD 2.84) years. Complete descriptive statistics are published elsewhere . Table 1 presents a summary of the weighted and non-weighted estimates.
|
39706582_p14
|
39706582
|
Results
| 2.83265 |
biomedical
|
Study
|
[
0.9969608187675476,
0.0008782240911386907,
0.0021609060931950808
] |
[
0.9984710812568665,
0.0012760655954480171,
0.00015561790496576577,
0.00009729584417073056
] |
en
| 0.999996 |
Despite 39% children, 48.5% adolescents, and 47.1% adults reporting OP in the past year, 92.9% children, 87.1% of adolescents, and 87.1% adults reported good, very good, or excellent SROH status, respectively.
|
39706582_p15
|
39706582
|
Results
| 2.035318 |
biomedical
|
Study
|
[
0.9855331778526306,
0.004597640596330166,
0.009869157336652279
] |
[
0.9729060530662537,
0.025889979675412178,
0.0007214584038592875,
0.00048242395860143006
] |
en
| 0.999996 |
The model goodness-of-fit measures showed an acceptable fit to the data, meeting the recommended values for the fit statistics ( Table 2 ) .
|
39706582_p16
|
39706582
|
Results
| 2.208206 |
biomedical
|
Study
|
[
0.960433304309845,
0.0015823696739971638,
0.03798427805304527
] |
[
0.9922881126403809,
0.0068102735094726086,
0.0007163904374465346,
0.000185321579920128
] |
en
| 0.999997 |
A higher tooth brushing frequency was strongly associated with less OP and positive SROH status in all groups. In contrast, a higher number of dental visits was associated with more OP and less favorable SROH status in all age groups. Routine examination and treatment were linked to less OP in all age groups and better SROH status in the adult and adolescent groups. Consumption of sweets was linked to greater OP in adolescents (β=0.033, P =.007) and negative SROH status in children (β=–0.086, P <.001), adolescents (β=–0.079, P <.001), and adults (β=–0.068, P <.001). Soft drinks were linked to lower OP in the adolescent group (β=–0.034, P =.005). Higher consumption of soft drinks was associated positively with SROH status (β=0.063, P <.001) in the adolescent and adult groups (β=0.068, P <.001). Smoking was associated with more OP (β=0.030, P <.001) in the adult group ( Table 3 ).
|
39706582_p17
|
39706582
|
Proximal Influences on Oral Health Effects
| 4.071934 |
biomedical
|
Study
|
[
0.9988930821418762,
0.0003454670077189803,
0.0007614894420839846
] |
[
0.9994762539863586,
0.00013002722698729485,
0.00035486972774378955,
0.0000389211782021448
] |
en
| 0.999995 |
Tables 3 - 5 illustrate the direct, total indirect, and total effects, respectively, of oral health influences on OP and SROH status. Tables S1, S2, and S3 in Multimedia Appendix 1 show the direct effects of the distal influences on the proximal influences and the indirect effects of each distal influence on both OP and SROH status via each proximal influence.
|
39706582_p18
|
39706582
|
Distal Influences on Oral Health Effects
| 3.342989 |
biomedical
|
Study
|
[
0.9975922703742981,
0.0002133742527803406,
0.0021943836472928524
] |
[
0.9982707500457764,
0.001395933679305017,
0.000283120374660939,
0.00005014285125071183
] |
en
| 0.999997 |
There was a negative direct effect between age and SROH ( Table 3 ) in both the children (β=–0.044, P =.001) and adolescent (β=–0.033, P =.008) groups. An indirect positive effect (β=0.062, P <.001) was found between age and OP in the children group ( Table 4 ). Total effect ( Table 5 ) of age was detected in the children group for both OP (positive relation) and SROH status (negative relation).
|
39706582_p19
|
39706582
|
Age and Sex
| 4.055113 |
biomedical
|
Study
|
[
0.9970524311065674,
0.00029910015291534364,
0.0026484860572963953
] |
[
0.9996336698532104,
0.00017807212134357542,
0.0001593773195054382,
0.000028872205803054385
] |
en
| 0.999998 |
Among female children, a negative direct effect (β=–0.030, P =.009) was found with SROH ( Table 3 ). Total indirect effect showed a negative association between female adults and OP (β=–0.016, P =.04; Table 4 ). This total indirect effect was mediated by dental visits and tooth brushing frequency, as a positive direct link was found between female sex and tooth brushing frequency in both the child (β=0.073, P <.001) and adult groups (β=0.026, P =.04; Tables S1 and S3 in Multimedia Appendix 1 ). Also, the total indirect effect revealed a positive association between female children (β=0.006, P =.04) and adults (β=0.006, P =.03) with SROH ( Table 4 ). However, total effect showed a negative association between female children and SROH (β=–0.024, P =.04; Table 5 ).
|
39706582_p20
|
39706582
|
Age and Sex
| 4.108088 |
biomedical
|
Study
|
[
0.9984025359153748,
0.0003743807610590011,
0.0012230891734361649
] |
[
0.9996167421340942,
0.000152175547555089,
0.0001922406372614205,
0.00003885610567522235
] |
en
| 0.999997 |
Among non-Saudi citizens, the direct (β=–0.081, P <.001) and total (β=–0.085, P <.001) effects showed a negative association with OP in the children’s age group but a positive association in the adult group (β=0.023, P =.02) through the total indirect effect.
|
39706582_p21
|
39706582
|
Citizenship, Regions, and Education Levels
| 3.072388 |
biomedical
|
Study
|
[
0.946153998374939,
0.000603830034378916,
0.053242143243551254
] |
[
0.9985195994377136,
0.00126201706007123,
0.00017492054030299187,
0.000043377658585086465
] |
en
| 0.999997 |
Adolescents and adults from the north and south regions were linked to less OP than those from the east, west, and central regions through the total (β=–0.033, P =.01 and β=–0.045, P <.001) effects pathways ( Table 5 ). However, OP was positively linked to children from the southern and northern regions through the total indirect pathway (β=0.027, P <.001).
|
39706582_p22
|
39706582
|
Citizenship, Regions, and Education Levels
| 3.255305 |
biomedical
|
Study
|
[
0.9588873386383057,
0.0005375416367314756,
0.04057513177394867
] |
[
0.9991983771324158,
0.0005915361107327044,
0.0001781861501513049,
0.000031892774131847546
] |
en
| 0.999997 |
Higher education level was associated with positive SROH status directly (β=0.046, P =.003) and through the total direct effect pathway (β=0.050, P =.002). Furthermore, higher education was linked with greater tooth brushing frequency and less OP indirectly via tooth brushing frequency (β=–0.004, P <.001) and positive SROH status (β=0.008, P <.001) (Table S3 in Multimedia Appendix 1 ).
|
39706582_p23
|
39706582
|
Citizenship, Regions, and Education Levels
| 4.035799 |
biomedical
|
Study
|
[
0.9980791807174683,
0.00029885186813771725,
0.0016219289973378181
] |
[
0.9996618032455444,
0.000149933373904787,
0.00015697501657996327,
0.000031381383450934663
] |
en
| 0.999997 |
In the children group, higher household income was associated with less OP through the direct pathway (β=–0.030, P =.02), but higher income was positively associated with greater OP through the total indirect pathway (β=0.024, P =.003). In addition, higher income was associated with less OP (β=–0.002, P =.03) and a positive SROH status (β=0.006, P =.007) when mediated by tooth brushing frequency (Table S1 in Multimedia Appendix 1 ).
|
39706582_p24
|
39706582
|
Monthly Household Income and Insurance
| 4.061885 |
biomedical
|
Study
|
[
0.9982500672340393,
0.0002999713469762355,
0.0014499243116006255
] |
[
0.9996730089187622,
0.00015525819617323577,
0.00014136568643152714,
0.00003040340197912883
] |
en
| 0.999999 |
In the children group, having health insurance was associated with less OP through direct (β=–0.36, P =.03), total indirect (β=–0.023, P =.03), and total effect pathways (β=–0.058, P =.003). On the other hand, insurance was associated positively with OP through the direct pathway in both adolescents (β=0.051, P =.004) and adults (β=0.042, P <.001). Moreover, in adults, insurance was linked to less OP indirectly via dental visit frequency (β=–0.028, P =.01).
|
39706582_p25
|
39706582
|
Monthly Household Income and Insurance
| 4.009834 |
biomedical
|
Study
|
[
0.9968482851982117,
0.0004294648242648691,
0.002722238888964057
] |
[
0.9995585083961487,
0.00017826516705099493,
0.00023307438823394477,
0.000030175428037182428
] |
en
| 0.999997 |
In the children group, lack of access to oral health care was linked to more OP and negative SROH status through direct, total indirect, and total effects ( Tables 2 - 4 ).
|
39706582_p26
|
39706582
|
Access to Oral Health Services
| 2.683788 |
biomedical
|
Study
|
[
0.9953314661979675,
0.0006727793370373547,
0.003995797131210566
] |
[
0.998427152633667,
0.001172748627141118,
0.0003071353130508214,
0.00009305129060521722
] |
en
| 0.999996 |
Private clinic visits as the regular source of dental care were associated with more OP and worse SROH status in the children group through the direct (for OP: β=0.053, P =.001 and for SROH status: β=–0.136, P <.001, respectively) and through total effect pathways (for OP: β=0.039, P =.03; for SROH status: β=–0.124, P <.001). However, private clinic visits as the regular source of dental care were associated with better SROH status through a total indirect effect (β=0.012, P =.009). Private clinic as the regular source of dental care was associated with less OP and better SROH status in the children group through the indirect effect via tooth brushing frequency (for OP: β=–0.005, P =.003; for SROH status: β=0.017, P <.001).
|
39706582_p27
|
39706582
|
Access to Oral Health Services
| 4.06631 |
biomedical
|
Study
|
[
0.9986559152603149,
0.0004577399813570082,
0.000886319437995553
] |
[
0.9995500445365906,
0.00019416182476561517,
0.00021698337513953447,
0.00003883087993017398
] |
en
| 0.999998 |
In the adult group, past accident experience was negatively associated with SROH status through the direct (β=–0.043, P <.001) and total effects pathways (β=–0.036, P =.002) and positively associated with SROH status through the total indirect pathway (β=0.008, P =.01).
|
39706582_p28
|
39706582
|
Past Accident Experience and Physical Disability
| 3.991395 |
biomedical
|
Study
|
[
0.9972698092460632,
0.0003051293024327606,
0.0024249698035418987
] |
[
0.9996232986450195,
0.0002156636182917282,
0.0001286609040107578,
0.00003231764640077017
] |
en
| 0.999998 |
Physical disability was linked to OP and negative SROH status in the child group through the total-effects pathway ( Table 4 ). In the adult group, physical disability was associated with greater OP and worse SROH status through the direct and total effect pathways ( Tables 2 and 4 ).
|
39706582_p29
|
39706582
|
Past Accident Experience and Physical Disability
| 2.851575 |
biomedical
|
Study
|
[
0.9913631677627563,
0.0006141484482213855,
0.008022619411349297
] |
[
0.9988341927528381,
0.0009000482386909425,
0.0002015398204093799,
0.00006414118979591876
] |
en
| 0.999997 |
Normal BMI was linked to better SROH status through the direct pathway (β=0.051, P <.001) and through the total effect pathway (β=0.047, P <.001). In the adolescent group, normal BMI was linked to less OP and better SROH status through the direct and total effects pathways ( Tables 2 and 4 ). In the adult group, normal BMI was linked to less OP through the total indirect and total effect pathways ( Tables 3 and 4 ).
|
39706582_p30
|
39706582
|
BMI
| 4.009111 |
biomedical
|
Study
|
[
0.9987618923187256,
0.00029204596648924053,
0.0009460592409595847
] |
[
0.9996311664581299,
0.00016884217620827258,
0.0001676498504821211,
0.00003229121648473665
] |
en
| 0.999998 |
The findings of this study partially support the adapted conceptual framework for distal and proximal influences on self-reported OP and SROH status in Saudi Arabian residents . All proximal influences were associated with OP, except sweets and soft drink consumption in the children and adult groups. Unexpectedly, the consumption of soft drinks was associated with less OP in the adolescent group, although OP was positively associated with greater consumption of sweets. Moreover, all proximal influences were associated with SROH status except soft drink consumption and type of dental visit in the children’s age group and smoking in the adult group. In addition, greater consumption of sweets and a higher number of dental visits were negatively associated with SROH status in the adolescent and children groups, but soft drink consumption was positively linked to SROH status in the adolescent and adult groups. Regarding distal influences, the majority of them showed an association with both OP and SROH status through the direct, indirect, and total effect pathways.
|
39706582_p31
|
39706582
|
Principal Findings
| 4.066637 |
biomedical
|
Study
|
[
0.9963622689247131,
0.00040358901605941355,
0.0032340865582227707
] |
[
0.999646782875061,
0.00010378643492003903,
0.00021352597104851156,
0.00003582923818612471
] |
en
| 0.999997 |
This study indicated that the prevalence of OP in Saudi Arabia is high. Data from 20 different countries in a meta-analysis illustrated that OP prevalence in children and adolescents was 36.2% . This is almost half of the prevalence found in this study in similar age groups (60.2% for children and 67.8% for adolescents in KSA). Furthermore, the findings from this study differed from National Health and Nutrition Examination Survey (NHANES) 2015-2018 data on adult US residents where OP was associated with education and income level, while in KSA it was not.
|
39706582_p32
|
39706582
|
Principal Findings
| 3.783866 |
biomedical
|
Study
|
[
0.9990870952606201,
0.00030685277306474745,
0.0006060494342818856
] |
[
0.9994465708732605,
0.0002828915894497186,
0.00021183842909522355,
0.00005867670552106574
] |
en
| 0.999998 |
The findings from this study indicated that dental visit frequency was positively associated with OP and negatively associated with SROH status, while routine visits were associated with less pain and better SROH status in all age groups. It would be expected that a higher frequency of dental visits would be associated with better oral health; however, it appears that Saudi residents visit the dentist mainly when they have a complaint, such as OP, and do not normally visit the dentist for a routine check-up. A similar trend has been previously reported in national and some subnational studies in Saudi Arabia . The lack of interest in routine oral examinations and treatment visits (9.0% of children, 6.2% of adolescents, and 5.4% of adults reported routine dental visits) can be explained by the habitually optimistic view of the Saudi population about their oral health, as 92.9% of children, 87.1% of adolescents, and adults self-rated their oral health as good to excellent despite roughly two-thirds of them having reportedly experienced OP during the previous 6 months. Infrequent routine visits and optimistic SROH status combined with less frequent tooth brushing is a critical finding of this study because the conclusion of these combined observations is that Saudi residents do not recognize risk factors that can adversely affect their oral health. This could be due to the cultures and beliefs in KSA, which are reinforced by the family and community . Oral health officials and policy makers should consider raising public awareness about the importance of oral hygiene and routine dental clinic visits to improve oral health in the general population.
|
39706582_p33
|
39706582
|
Principal Findings
| 4.122972 |
biomedical
|
Study
|
[
0.9989926218986511,
0.0005892827757634223,
0.00041814014548435807
] |
[
0.9989402890205383,
0.00022881108452565968,
0.0007584187551401556,
0.00007250020280480385
] |
en
| 0.999998 |
This study had several important limitations. Its cross-sectional nature, like all similar DHS studies, limits the ability to investigate distal and proximal influences on OP and SROH status over time, hindering the assessment of causal relationships between the predictive factors considered and the study outcome. On the other hand, this study is the first to assess the association between a number of predictive factors and oral health outcomes using a conceptual framework to guide the analysis. To our knowledge, no longitudinal study has measured changes in oral health status in Saudi Arabia, which is needed to determine oral health risk factors specific to this country’s population.
|
39706582_p34
|
39706582
|
Principal Findings
| 4.033181 |
biomedical
|
Study
|
[
0.9990412592887878,
0.0003468430077191442,
0.0006119096069596708
] |
[
0.999622106552124,
0.0001456255413359031,
0.00019018763850908726,
0.00004205297591397539
] |
en
| 0.999996 |
Another major limitation in this study is the subjectivity of a self-reported survey over objective clinical evaluation, which may introduce response bias such as recall bias in the responses (such as dental visit frequency in the past year) or social desirability bias (such as not revealing smoking status). Such biases may have influenced the response to the question related to the consumption of soft drinks, particularly in the adolescent group. Adolescents who consume more soft drinks might underreport their OP due to a perception that admitting to pain could lead to restrictions on their soft drink consumption by parents or guardians , which in turn may have resulted in the apparent association of increased soft drink consumption with lower OP and better SROH status, which goes against clear evidence of an association between higher soft drink consumption and negative oral health outcomes in a number of cross-sectional and longitudinal studies . Furthermore, self-reported OP and SROH status may not reflect exact oral health clinical status because they express a person’s perception of their OP and oral health, which can be influenced by psychosocial and cultural factors. For example, NHANES 2003-2004 data from the United States showed that Latinos reported better SROH status than White individuals, while Latino individuals had more oral disease and lower access to and use of dental care . Although using SROH indicators over a clinical measurement may have introduced some reporting bias, it is still a convenient, cost-effective, and expedited method to assess oral health status at a national level with a large sample and has shown a positive association with clinical oral health status . Self-reported oral health measures have been used in many countries and national surveys, such as NHANES .
|
39706582_p35
|
39706582
|
Principal Findings
| 4.100751 |
biomedical
|
Study
|
[
0.9991218447685242,
0.00045574113028123975,
0.00042248526006005704
] |
[
0.9990079998970032,
0.00016825852799229324,
0.0007642799755558372,
0.00005941258859820664
] |
en
| 0.999996 |
Despite these limitations, this study has a number of strengths, including the use of data from the 2017 KSA DHS, which applied a random sampling design with a large sample size, over a wide geographic distribution, and broad age range, which ensured the representative nature of the findings to the entire KSA, a heterogeneous country characterized by areas of very high income within a developing country. The second advantage is the use of the conceptual framework to guide the analysis, which enabled the use of path analysis. This is a preferred approach to delineate complex relationships, including both the direct and indirect effects of numerous predictive factors, over traditional multiple regression methods. This enabled testing the direct and indirect effects of different oral health influences on SROH status and OP. In this regard, the conceptual framework in this study is a significant contribution to the understanding of oral health influences in Saudi Arabia. However, the inclusion of other important oral health influences, such as coping skills and social support constructs, could have increased the explanatory power of the study .
|
39706582_p36
|
39706582
|
Principal Findings
| 4.092293 |
biomedical
|
Study
|
[
0.9990494847297668,
0.00033506451291032135,
0.0006155137671157718
] |
[
0.9995958209037781,
0.0001270619686692953,
0.00023651392257306725,
0.00004056999023305252
] |
en
| 0.999998 |
Although OP is prevalent among Saudi residents, they still have a positive view of their oral health. Frequent tooth brushing, routine dental visits, and reduced sweet consumption are associated with less OP and better SROH. However, more frequent dental visits seem to address complaints rather than preventive care. Future research should investigate why residents have a positive perception of oral health despite high levels of OP and negative outcomes.
|
39706582_p37
|
39706582
|
Conclusions
| 2.522815 |
biomedical
|
Study
|
[
0.9919787645339966,
0.0008212627726607025,
0.007199904881417751
] |
[
0.827897310256958,
0.16304191946983337,
0.008425031788647175,
0.0006357635138556361
] |
en
| 0.999997 |
People often struggle with skin conditions such as a dull complexion, enlarged pores, skin aging, and the proliferation of pimples and acne. Various types of skin‐care products offer different functions, such as whitening, antiaging, antiacne, moisturizing, antisensitivity, and sun protection . However, conventional skin‐care products contain a variety of chemical ingredients, which can potentially irritate the skin, accelerate aging, and even induce tumors. Consequently, consumers have begun to prefer natural ingredients . Natural ingredients are extracted directly from animals and plants. The sources of natural ingredients include herbs, flowers, leaves, fruits, livestock skins, fats, and shells . Most of the natural ingredients added to skin‐care products are plant extracts. These extracts include antioxidants, tyrosinase inhibitors, and antibacterial agents with antiaging, whitening, antibacterial, and other effects . The effectiveness of plant extract‐based skin‐care (PEBSC) products depends on the skin's ability to absorb their ingredients and on the physiological effects of these ingredients. The extraction method, the ratio of plants to solvents, and the content of active ingredients can influence product effectiveness .
|
39754370_p0
|
39754370
|
Introduction
| 3.968827 |
biomedical
|
Review
|
[
0.9962267875671387,
0.0010493010049685836,
0.0027238402981311083
] |
[
0.04060930758714676,
0.005827553104609251,
0.9532423615455627,
0.00032085704151540995
] |
en
| 0.999997 |
The skin‐care product market has substantial growth potential. Despite the decline in the growth rate of the overall cosmetics market since the outbreak of the COVID‐19 pandemic, the skin‐care product market has grown during this time . However, Taiwan's skin‐care product industry is overly reliant on imported raw materials, the supply of which is controlled by major international manufacturers . Because of the global instability arising from various factors (such as the Russo‐Ukrainian war, which has disrupted agricultural production, and the COVID‐19 pandemic, which resulted in closures of transportation routes), the skin‐care product industry is facing a shortage of raw materials, which has resulted in increasing costs and ultimately affected consumer behavior. This shortage of raw materials must be overcome urgently by identifying appropriate local agricultural products to achieve supply independence. Research and development regarding key raw materials can not only fill the gap in industrial demand but also increase the competitiveness of domestic skin‐care products in the international market . Although Taiwan has a thriving agricultural industry, agricultural by‐products and waste can cause environmental pollution. However, agricultural by‐products are rich in carbohydrates, proteins, lipids, and other compounds that can be used as raw materials for skin‐care products, health products, medicines, and other products . Skin‐care product manufacturing requires little investment, has low risk, and can provide high gross profits. Therefore, the Taiwanese government should invest resources in researching the efficacy of PEBSC products and assist agricultural enterprises in developing these products.
|
39754370_p1
|
39754370
|
Introduction
| 2.609317 |
biomedical
|
Other
|
[
0.5037997364997864,
0.00099063606467098,
0.49520957469940186
] |
[
0.1033644899725914,
0.8910521268844604,
0.005256874021142721,
0.00032648578053340316
] |
en
| 0.999996 |
In recent years, increases in consumer awareness regarding health and the environment have enhanced their willingness to purchase PEBSC products. Consumer lifestyles and personal experiences affect their loyalty to skin‐care products . Although positive consumption experiences promote customer loyalty, poor experiences that do not meet expectations can result in negative consumer attitudes and low repurchase intention. Involvement is closely related to prior experience. The levels of consumer involvement with a specific product, the product information, and the consumption situation can differ and are affected by their needs or interests. A higher degree of involvement suggests greater attention paid to consumption and greater customer loyalty . Positive experiences and in‐depth involvement are closely related to a high degree of perceived value. Perceived value refers to a consumer's comprehensive evaluation of a product on the basis of product utility and loss. A higher evaluation naturally strengthens customer loyalty . This behavioral pattern is also reflected in the consumption of skin‐care products . In addition, demographic characteristics, especially sex, age, income, place of residence, and skin type can strongly affect customer loyalty for skin‐care products . Although the skin‐care product industry has paid increasing attention to consumer behavior in recent years, few studies have investigated customer loyalty to PEBSC products; in‐depth research is urgently required to fill this gap .
|
39754370_p2
|
39754370
|
Introduction
| 1.83804 |
other
|
Study
|
[
0.046857405453920364,
0.0005401792586781085,
0.9526023864746094
] |
[
0.5636662840843201,
0.4105055332183838,
0.02469373680651188,
0.001134440302848816
] |
en
| 0.999998 |
PEBSC products have high consumer appeal and favorable global market prospects . Therefore, in the present study, Taiwanese PEBSC products were selected as the research target, and the effects of prior experience, involvement, and perceived value on customer loyalty were investigated. Moreover, the effects of various demographic factors on customer loyalty were determined. The goal of the aforementioned investigations was to better understand consumption patterns for PEBSC products in Taiwan; perform theoretical innovation; provide recommendations regarding research and design, production, and marketing for Taiwan's agricultural enterprises; and offer policy suggestions to the Taiwanese government to assist it in achieving improvements in the skin‐care and agricultural industries.
|
39754370_p3
|
39754370
|
Introduction
| 1.467385 |
other
|
Study
|
[
0.03526492789387703,
0.0005714457365684211,
0.964163601398468
] |
[
0.9707006812095642,
0.028171833604574203,
0.0006778165698051453,
0.0004495878820307553
] |
en
| 0.999998 |
Subsets and Splits
Clinical Cases Sample
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High-Score Clinical Cases
The query retrieves a limited set of clinical case documents with a high educational score, providing a basic filtered view of the dataset.