bluuebunny/crossref_metadata_2025 huggingface dataset:
P1240 Systematic review with meta-analysis: faecal microbiota transplantation as treatment of chronic pouchitis
Authors: Cold F , Halkjær S I , Lo B , Lauridsen K G , Kousgaard S J , Thorlacius-Ussing O , Petersen A M
Published: January 2024

Background

Pouchitis is inflammation of the ileal pouch-anal anastomosis after proctocolectomy in the surgical treatment of ulcerative colitis. Cohort studies have found evidence that allogenic faecal microbiota transplantation (FMT) can induce short term beneficial effects in patients with chronic pouchitis. Until recently results from randomized controlled trials (RCTs) have been missing. In this systematic review and meta-analysis, we investigated whether FMT treatment was superior to placebo in inducing remission in patients with chronic pouchitis.

Methods

We searched MEDLINE, Embase, and Cochrane Central Register of Controlled Trials from inception to 15th of November 2023, for RCTs assessing the efficacy of allogenic FMT in the treatment of chronic pouchitis. Autologous FMT or placebo was accepted as control treatment. The primary outcome was the improvement of symptoms as defined by the authors following four weeks.

Results

The systematic literature search identified a total of three RCTs on the efficacy of FMT in chronic pouchitis comprising 62 patients with 32 patients treated with FMT. Both treatments (FMT and Placebo) and definition of treatment response varied between studies (Table 1). Meta-analysis revealed that FMT was not superior to placebo (risk ratio=0,68;95% CI=(0,47-0,99); p=0.35) in improvement of symptoms four weeks following treatment (Figure 1).

Conclusion

FMT was not superior to placebo in inducing short-term beneficial effects four weeks after initial treatment in patients with chronic pouchitis. Whether FMT may induce long-term beneficial effects remains to be established.
P1241 Distinct gut microbiota in Crohn's Disease between inflammatory B1 and stricturing B2 phenotype
Authors: Zhang Q , Zhi M
Published: January 2024

Background

The gut microbiome represents a promising avenue to elucidate distinct underlying pathophysiology in Crohn's disease (CD).Our aim was to evaluate the composition of the microbiota in Inflammatory B1 and Stricturing B2 Phenotype.

Methods

We performed 16S ribosomal RNA sequencing on stool samples of 108 patients (64 B1 and 44 B2) included in the Chinese CD cohort and 58 health controls without any inflammatory disorder, in order to explore the structural composition of gut microbiota in different phenotype of CD.

Results

Comparison of gut microbiota between patients with CD and healthy controls, α diversity and β diversity were statistically different. At the genus level, compared with the normal group, the abundance of Blautia, Bifidobacterium, Faecalibacterium, Collinsella, Coprococcus, Gemmiger, Prevotella, Dialister, Roseburia and Clostridium were decreased significantly in the CD group. In contrast, the abundance of Bacteroides, Ruminococcus, Streptococcus, Enterococcus, Dorea, Escherichia, Phascolarctobacterium, Veillonella and Eubacterium increased significantly. Compared with B1 phenotype, Streptococcus, Collinsella, Veillonella, Coprococcus and Gemmiger were significant decreased in B2 phenotype group. However, Ruminococcus, Dorea, Lactobacillus and Dialister were significant increased.

Conclusion

Comparison of gut microbiota between patients with CD and healthy controls, α diversity and β diversity were statistically different. At the genus level, compared with the normal group, the abundance of Blautia, Bifidobacterium, Faecalibacterium, Collinsella, Coprococcus, Gemmiger, Prevotella, Dialister, Roseburia and Clostridium were decreased significantly in the CD group. In contrast, the abundance of Bacteroides, Ruminococcus, Streptococcus, Enterococcus, Dorea, Escherichia, Phascolarctobacterium, Veillonella and Eubacterium increased significantly. Compared with B1 phenotype, Streptococcus, Collinsella, Veillonella, Coprococcus and Gemmiger were significant decreased in B2 phenotype group. However, Ruminococcus, Dorea, Lactobacillus and Dialister were significant increased.
N16 Discontinuation of anti-TNF therapy in patients with inflammatory bowel disease in remission: a qualitative study on shared decision making and patients perspective
Authors: Nabibaks S , Devillers M , de Vries A
Published: January 2024

Background

Anti-tumor necrosis factor (TNF) therapy has been the mainstay for managing patients with moderate to severe inflammatory bowel diseases (IBD). Despite its effectiveness, anti-TNF therapy is associated with several side effects such as infections and infusion reactions, as well as considerable costs. Discontinuation of therapy may be considered in patients in long-term remission. Since prediction of the risk of relapse for an individual patient is difficult, shared decision making (SDM) on this decision is highly essential. The aim of this qualitative study is to explore the considerations of IBD patients in remission concerning the decision on discontinuation of anti-TNF therapy.

Methods

This is an explorative, single center study. Semi-structured interviews were conducted in adult IBD patients in clinical remission, after discontinuation of the anti-TNF therapy as treatment option was discussed by the patient and their treating gastroenterologist. Patients were identified by purposive sampling. Interviews were performed at the outpatient clinic or by telephone. The interviews were recorded, transcribed verbatim and thematically analyzed. Patients were interviewed until saturation was reached.

Results

Twelve patients were interviewed; age 25-79 years, 7 (58%) males, 7 CD and 5 UC. The duration of the anti-TNF treatment varied from 6 to 16 years. Seven patients were on first-line biological therapy, while 5 were on second or third-line biological therapy. With regard to the therapy decision, 5 patients decided to discontinue their anti-TNF treatment and 7 continued. Three main themes were identified in the interviews: patient considerations regarding the decision, patient education and perceived support of the physician. Key factors influencing decisions included the fear of relapse, with personal impact often prioritized over quantifying the risk. The memory of a previous ‘traumatizing period’ discouraged discontinuation. Notably, some patients were unaware of the efficacy of restarting anti-TNF therapy and alternative options in case of treatment failure. The study highlighted patients’ high appreciation for the support provided by gastroenterologists during the shared decision-making process.

Conclusion

Since considerations on discontinuation of anti-TNF therapy are diverse among patients, a thorough exploration of fears and impact of a relapse on the personal life is essential during the shared decision making process. Patient education on the therapeutic options in case of relapse is essential to reach a well-considered decision.
N20 Sexual health in IBD can be brought up with help from tools
Authors: Rasmussen Edelbo R , Faurskov Møller L , Bager P
Published: January 2024

Background

Sexual topics can be tabooed; both for patients with IBD and for the health care professionals (HCPs). Patients with IBD have more sexual problems than the background population. A considerable number of patients with IBD have other autoimmune diseases (Ads), which may exacerbate sexual problems. Based on patient reported data, we aimed to develop communication tools and models for talks about patients' sexual health. Furthermore, we aimed to generate informative patient leaflets for different ADs including one specific for patients with IBD.

Methods

A cross-sectional e-survey on sexual health among patients with IBD, dermatological- and/or rheumatologically diseases (both solely and in combination). Patients were invited consecutively as they tuned up in the out-patient clinics at our university hospital. Participation were anonymous and access were possible by using a QR-code.

The questions were ad hoc designed and focused on 1) disease-related sexual problems, 2) partner-related sexual problems, and 3) the need (and current practise) for talks with HCPs about sexual health. In addition, the participants could add qualitative descriptions. Quantitative data were analysed using descriptive statistics. NVivo™ were used to code the qualitative data. Based on the survey results we developed and implemented communication tools in daily practise.

Results

170 patients scanned the QR-code. 142 responded (61% females, 44% had IBD, 49% had a dermatologically disease, 40% had a rheumatologically disease, 33% had ≥ 2 AD). 51% of participants with only 1 AD reported disease-related sexual problems vs 71% for participants with ≥ 2 ADs. In IBD, the main reasons for impaired sexual health were: pain, fatigue, fistulas, incontinence and mental reasons. 86% responded that they didn't talk to HCPs about sexual issues (38% wish the HCPs to bring up the topic, 34% felt the topic to be a taboo, and 25% found it difficult to address problems).

Based on the findings, specialist nurses with knowledge of all 3 ADs developed communication tools. The tools were tested and evaluated by both patients and reviewed by Clinic for Sexual Health and include: i) communication aid for nurses; ii) action card for nurses; iii) leaflets to patients with IBD.

Conclusion

Disease-related sexual problems are common for patients with IBD and ADs. Even more prevalent for patients with more than one AD. Sexual health is seldom a topic between patients and HCPs. Based on patient reported data, simple tools are developed and implemented.

Figure 1: Typical levels of topics for the HCPs talks with patients about sexual health. HCPs will most often be able to help patients by focusing on the 2 lower levels.
N21 Shared Decision Making: A Qualitative Exploration of Clinical Nurse Specialists in Gastroenterology
Authors: Lukose T , Forry M , Lardner C , O Toole A , Boland K
Published: January 2024

Background

Clinical Nurse Specialists (CNS) participation in the Shared Decision Making (SDM) process and understanding basic concepts and principles related to the decision-making process are critical. (Storms et al. 2015). The core concept role of CNS includes a clinical focus on direct and indirect care of the patients in the specialist area, health educator and trainer, patient advocate, audit and research and consultation (NCNM, 2008). They have many opportunities to participate in the SDM process with patients arising from clinic visits, telephone helpline services and multidisciplinary team meetings. Nurses are progressively deemed influential in shared decision-making; however, studies on the SDM role of the CNS are limited; our study investigates the experiences of CNS in SDM, in the speciality of gastroenterology (GI) in both medical and surgical.

Methods

This study adopted a qualitative descriptive style. The survey was distributed to medical and surgical GI CNS at a tertiary referral hospital. This study aimed to look at three aspects of CNS's SDM experience: the CNS's knowledge about SDM, generating discussion and coordination, and respect for sociocultural factors. Semi-depth interviews were conducted for data collection. There were 11CNS participants from surgical and medical GI specialities, including IBD, hepatology, endoscopy, upper GI, and colorectal nursing. All interviews were recorded and transcribed verbatim and coded.

Results

Six themes emerged from the data collected: perceptions, attitudes, positive change, influential factors, reflection and obstacles. SDM is an unknown concept for the majority of the CNS.CNS self-identified as integral to the speciality and the patient's primary contact.

Conclusion

CNS has little understanding of the SDM concept. SDM is perceived as MDT (Multi-Disciplinary Team) making decisions without patient involvement. Formal education and increased awareness of the SDM process are essential for CNS active participation in individual patients. The procured knowledge of SDM enhances the CNS's confidence in active participation in MDT team meetings and the SDM process. It consequently improves patient experience, knowledge and participation in the SDM process.
N33 Experience of inflammatory bowel disease patients in relation to the practice of anal intercourse
Authors: Navarro Correal E , Marín Sanchez L , Mañosa Círia M , Domènech E
Published: January 2024

Background

Sexual health should be part of the management of people with chronic diseases. Receptive anal intercourse is a relatively common practice, and in Inflammatory Bowel Disease (IBD) it can be clearly compromised by the perianal and rectal involvement that many patients present. Understanding the experience of people with IBD in relation to anal intercourse will provide information to help them live their sexuality in a full and healthy way.

Methods

Observational, descriptive, cross-sectional study. Creation of ad-hoc online questionnaire through the REDCap platform. The study population was people between 18 and 75 years with IBD who have or have had sexual intercourse. The survey was distributed through social networks, advanced practice nurses and patient associations (ACCU). The study was approved by the Ethical Committee for Clinical Research of Hospital Universitari Germans Trias i Pujol, (reference PI-22-255, approval date November 11, 2022)

Results

1111 surveys answered, 766 (68.8%) completed. Mean agewas 41.86 years (SD10.32), 560 (73.3%) were women, and 50% had a university education. Sixty per cent (460) have Crohn's disease and 765 people (75.4%) are on immunosuppressive treatment. 22.4% (171) report perianal disease. 34.8% (266) practice anal sex, of these more than 60% do not use a condom during anal sex. 7.6% clean their bowels, 32.4% dilate their anus beforehand, and 60.5% use lubricants. Injuries, tearing and bleeding are reported after anal sex, with 78.5% of women reporting pain. More than 30% think that anal sex increases the urge to go to the toilet and 22% think that it worsens their IBD.

Conclusion

As nurses results obtained in this study direct us towards two main themes. We have to be aware of focusing on health education for the prevention of sexually transmitted diseases and the prevention of possible complications produced by anal sex.
N35 Inflammatory Bowel Disease (IBD) nurses' knowledge practice and attitudes related to Microscopic Colitis (MC)
Authors: Walsh C
Published: January 2024

Background

Microscopic Colitis (MC) is affiliated with and increasingly recognized as an Inflammatory Bowel Disease (IBD). Crohn's Disease and Ulcerative Colitis (IBD) were first described over a century ago. Microscopic Colitis was first described in 1976 and the last decade has seen increasing awareness and European guidelines developed. There is no education on microscopic colitis for IBD nurses and it is not known of the practice of MC by IBD nurses in Ireland. Furthermore it is not incorporated in the Nurse European Crohn's and Colitis Organisation (N-ECCO) guidelines. The aim was to assess knowledge, practice and attitudes of IBD nurses in relation to MC.

Methods

A quantitative cross sectional survey research methodology was conducted using a 17 point questionnaire. 29 (n=29) IBD nurses from the IBD national association of Ireland (IBDNAI) responded from a total of 52 (55.7%). The inclusion criteria was 1) registered practicing nurse 2) on IBDNAI register 3) willing to participate. Data was recorded and analysed using SPSS software. Descriptive statistics were implemented. Cronbach's Alpha for instrument reliability was 0.789.

Results

The majority were female (90%) between ages 36-55 years (86%). The greater number (41%) had over 11 years of experience, followed by 38% with 1-5 years experience. The highest work location was Clinical Nurse Specialist 65.5% (n=19) and the majority qualified at Post Grad level (27.6%, n=8) or Masters level (34.5%, n=10).

Mean and standard deviation scores for knowledge indicated no significant variation but variation was most significant with treatments for MC. Knowledge and years of experience revealed no significant variation. Less than one year experience (Mean 1.50 SD.707) and greater than 11 years (Mean 1.42 SD.669)

Knowledge scores for symptoms are high (65.5%-90%) but investigations and treatments are average (31%, 38% and 48.3%). In relation to practice the majority of IBD nurses 71% do not receive referrals and 78.5% do not review patients diagnosed with MC at the out-patient department. Attitudes from IBD nurses regarding MC as part of the IBD nurse caseload, 42.8% said no and 57.10% said yes. 67% agreed that MC should be incorporated into the N-ECCO guidelines.

Conclusion

Education on Microscopic Colitis for IBD nurses is required nationally in Ireland which will improve the integration into practice. IBD nurses are best placed to care for patients diagnosed with MC. Recognition for MC to be incorporated into the Nurse European Crohn's and Colitis (N-ECCO) guidelines needs to be considered.
ECCO Grant Risk of cardiovascular disease in patients with inflammatory bowel disease (IBD)
Authors: Sun Jiangwei
Published: January 2024

Background and Aims

Although evidence has suggested an increased risk of venous thromboembolism and arteriosclerotic events in patients with inflammatory bowel disease (IBD), there are still substantial knowledge gaps about the long-term risk of cardiovascular disease (CVD) in patients with IBD and how CVD risks vary by disease histological and clinical activity. The aims of this project are: 1) to investigate the long-term risk (both absolute and relative) of CVD in patients with IBD, and 2) to assess CVD risks for patients in different phases of histological and clinical periods of IBD.

Methods

We will apply epidemiological and statistical methods to tackle the proposed research questions through using data from a comprehensive linkage of a nationwide histopathology cohort, one quality register for IBD, and several nationwide registers in Sweden. Individual informed consent will be waived as the study is register-based.

Anticipated Impact

The project will address several important knowledge gaps and benefit the IBD community in multifaceted ways. Findings from Aim 1 will help us identify patients with IBD at a high risk of developing CVD and enhance the awareness of screening, management, and treatment of cardiovascular risk factors in patients with IBD among healthcare professionals as well as patients and their families. Findings from Aim 2 will contribute towards an improved comprehension of CVD risk in different periods of histological and clinical activity, which can offer novel insights into guiding current therapeutic strategies aiming to mitigate the risk of adverse cardiovascular events in IBD patients. Overall, knowledge from our project can provide valuable evidence for the development of clinical guidelines for CVD management in patients with IBD. Currently, such guidelines remain underdeveloped.
Monopsony, Job Tasks and Labour Market Concentration
Authors: Dodini Samuel , Lovenheim Michael , Salvanes Kjell , Willén Alexander
Published: January 2024

This paper extends the monopsony literature by taking a task-based approach and estimating the causal effect of concentration on labour market outcomes. Using detailed employer–employee data from Norway, we find that our job task-based measure shows lower degrees of concentration than conventional industry- and occupation-based measures. Exploiting mass lay-offs as exogenous shocks to local labour demand, we show that workers who experience mass separations in more concentrated markets have substantially worse subsequent labour market outcomes than workers in less concentrated markets. Our results point to the existence of employer market power that is driven by the concentration of skill demand across firms.
Minimally invasive surgery for clinical T4 non-small-cell lung cancer: national trends and outcomes
Authors: Rodriguez-Quintero Jorge Humberto , Elbahrawy Mostafa M , Montal Anne Michelle , Jindani Rajika , Vimolratana Marc , Kamel Mohamed K , Stiles Brendon M , Chudgar Neel P
Published: January 2024

OBJECTIVES

Recent randomized data support the perioperative benefits of minimally invasive surgery (MIS) for non-small-cell lung cancer (NSCLC). Its utility for cT4 tumours remains understudied. We, therefore, sought to analyse national trends and outcomes of minimally invasive resections for cT4 cancers.

METHODS

Using the 2010–2019 National Cancer Database, we identified patients with cT4N0-1 NSCLC. Patients were stratified by surgical approach. Multivariable logistic analysis was used to identify factors associated with use of a minimally invasive approach. Groups were matched using propensity score analysis to evaluate perioperative and survival end points.

RESULTS

The study identified 3715 patients, among whom 64.1% (n = 2381) underwent open resection and 35.9% (n = 1334) minimally invasive resection [robotic-assisted in 31.5% (n = 420); and video-assisted in 68.5% (n = 914)]. Increased MIS use was noted among patients with higher income [≥$40 227, odds ratio (OR) 1.24; 95% confidence interval (CI) 1.01–1.51] and those treated at academic hospitals (OR 1.25; 95% CI 1.07–1.45). Clinically node-positive patients (OR 0.68; 95% CI 0.55–0.83) and those who underwent neoadjuvant therapy (OR 0.78; 95% CI 0.65–0.93) were less likely to have minimally invasive resection. In matched groups, patients undergoing MIS had a shorter median length of stay (5 vs 6 days, P < 0.001) and no significant differences between 30-day readmissions or 30/90-day mortality. MIS did not compromise overall survival (log-rank P = 0.487).

CONCLUSIONS

Nationally, the use of minimally invasive approaches for patients with cT4N0-1M0 NSCLC has increased substantially. In these patients, MIS is safe and does not compromise perioperative outcomes or survival.
Rhizosphere assembly alters along a chronosequence in the Hallstätter glacier forefield (Dachstein, Austria)
Authors: Wicaksono Wisnu Adi , Mora Maximilian , Bickel Samuel , Berg Christian , Kühn Ingolf , Cernava Tomislav , Berg Gabriele
Published: January 2024

Rhizosphere microbiome assembly is essential for plant health, but the temporal dimension of this process remains unexplored. We used a chronosequence of 150 years of the retreating Hallstätter glacier (Dachstein, Austria) to disentangle this exemplarily for the rhizosphere of three pioneer alpine plants. Time of deglaciation was an important factor shaping the rhizosphere microbiome. Microbiome functions, i.e. nutrient uptake and stress protection, were carried out by ubiquitous and cosmopolitan bacteria. The rhizosphere succession along the chronosequence was characterized by decreasing microbial richness but increasing specificity of the plant-associated bacterial community. Environmental selection is a critical factor in shaping the ecosystem, particularly in terms of plant-driven recruitment from the available edaphic pool. A higher rhizosphere microbial richness during early succession compared to late succession can be explained by the occurrence of cold-acclimated bacteria recruited from the surrounding soils. These taxa might be sensitive to changing habitat conditions that occurred at the later stages. A stronger influence of the plant host on the rhizosphere microbiome assembly was observed with increased time since deglaciation. Overall, this study indicated that well-adapted, ubiquitous microbes potentially support pioneer plants to colonize new ecosystems, while plant-specific microbes may be associated with the long-term establishment of their hosts.
Preoperative Exclusive Enteral Nutrition Is Associated With Reduced Skin and Soft Tissue and Intra-abdominal Infections in Patients With Crohn’s Disease Undergoing Intestinal Surgery: Results from a Meta-Analysis
Authors: Krasnovsky Lev , Weber Andrew T , Gershuni Victoria , Pettke Erica , Lewis James D
Published: January 2024

Background

Malnutrition is an independent risk factor for adverse postoperative outcomes and is common among patients with Crohn’s disease (CD). The objective of this meta-analysis was to precisely quantify the association of preoperative exclusive enteral nutrition (EEN) and total parenteral nutrition (TPN) with surgical outcomes in patients undergoing intestinal surgery for CD.

Methods

PubMed, Embase, and Scopus were queried for comparative studies evaluating the impact of preoperative nutritional support on postoperative outcomes in patients undergoing surgery for CD. Random effects modeling was used to compute pooled estimates of risk difference. Heterogeneity was assessed using I2.

Results

Fourteen studies, all nonrandomized cohort studies, met inclusion criteria for studying EEN. After pooling data from 14 studies (874 EEN treated and 1044 control patients), the relative risk of intra-abdominal septic complications was decreased 2.1-fold in patients receiving preoperative EEN (relative risk 0.47, 95% confidence interval [CI], 0.35-0.63, I2 = 0.0%). After pooling data from 9 studies (638 EEN treated and 819 control patients), the risk of skin and soft tissue infection was decreased 1.6-fold (relative risk 0.63; 95% CI, 0.42-0.94, I2 = 42.7%). No significant differences were identified in duration of surgery, length of bowel resected, or operative blood loss. Among the 9 studies investigating TPN, no significant differences were identified in infectious outcomes.

Conclusions

Preoperative nutritional optimization with EEN was associated with reduced risk of infectious complications in CD patients undergoing intestinal surgery. Preoperative nutritional support with EEN should be considered for optimizing outcomes in CD patients requiring bowel resection surgery.
Synbiotics improve growth performance and nutrient digestibility, inhibit PEDV infection, and prevent intestinal barrier dysfunction by mediating innate antivirus immune response in weaned piglets
Authors: Luo Luhong , Gu Zhemin , Pu Junning , Chen Daiwen , Tian Gang , He Jun , Zheng Ping , Mao Xiangbing , Yu Bing
Published: January 2024

This experiment was conducted to explore the effects of dietary synbiotics (SYB) supplementation on growth performance, immune function, and intestinal barrier function in piglets challenged with porcine epidemic diarrhea virus (PEDV). Forty crossbred (Duroc × Landrace × Yorkshire) weaned piglets (26 ± 1 d old) with a mean body weight (BW) of 6.62 ± 0.36 kg were randomly allotted to five groups: control (CON) I and CONII group, both fed basal diet; 0.1% SYB group, 0.2% SYB group, and 0.2% yeast culture (YC) group, fed basal diet supplemented with 0.1%, 0.2% SYB, and 0.2% YC, respectively. On day 22, all piglets were orally administrated with 40 mL PEDV (5.6 × 103 TCID50/mL) except piglets in CONI group, which were administrated with the same volume of sterile saline. The trial lasted for 26 d. Before PEDV challenge, dietary 0.1% SYB supplementation increased final BW, average daily gain (ADG), and decreased the ratio of feed to gain during 0 to 21 d (P < 0.05), as well as improved the apparent nutrient digestibility of dry matter (DM), organic matter (OM), crude protein, ether extract (EE), and gross energy (GE). At the same time, 0.2% YC also improved the apparent nutrient digestibility of DM, OM, EE, and GE (P < 0.05). PEDV challenge increased diarrhea rate and diarrhea indexes while decreased ADG (P < 0.05) from days 22 to 26, and induced systemic and intestinal mucosa innate immune and proinflammatory responses, destroyed intestinal barrier integrity. The decrease in average daily feed intake and ADG induced by PEDV challenge was suppressed by dietary SYB and YC supplementation, and 0.1% SYB had the best-alleviating effect. Dietary 0.1% SYB supplementation also increased serum interleukin (IL)-10, immunoglobulin M, complement component 4, and jejunal mucosal IL-4 levels, while decreased serum diamine oxidase activity compared with CONII group (P < 0.05). Furthermore, 0.1% SYB improved mRNA expressions of claudin-1, zonula occludens protein-1, mucin 2, interferon-γ, interferon regulatory factor-3, signal transducers and activators of transcription (P < 0.05), and protein expression of occludin, and downregulated mRNA expressions of toll-like receptor 3 and tumor necrosis factor-α (P < 0.05) in jejunal mucosa. Supplementing 0.2% SYB or 0.2% YC also had a positive effect on piglets, but the effect was not as good as 0.1% SYB. These results indicated that dietary 0.1% SYB supplementation improved growth performance under normal conditions, and alleviated the inflammatory response and the damage of intestinal barrier via improving innate immune function and decreasing PEDV genomic copies, showed optimal protective effects against PEDV infection.
How Does Rating Specific Features of an Experience Alter Consumers' Overall Evaluations of That Experience?
Authors: Mehr Katie S , Simmons Joseph P
Published: January 2024

How does the way companies elicit ratings from consumers affect the ratings that they receive? In 10 pre-registered experiments, we find that consumers rate subpar experiences more positively overall when they are also asked to rate specific aspects of those experiences (e.g., a restaurant's food, service, and ambiance). Studies 1–4 established the basic effect across different scenarios and experiences. Study 5 found that the effect is limited to being asked to rate specific features of an experience, rather than providing open-ended comments about those features. Studies 6–9 provided evidence that the effect does not emerge because rating positive aspects of a subpar experience reminds consumers that their experiences had some good features. Rather, it emerges because consumers want to avoid incorporating negative information into both the overall and the attribute ratings. Lastly, study 10 found that asking consumers to rate attributes of a subpar experience reduces the predictive validity of their overall rating. We discuss implications of this work and reconcile it with conflicting findings in the literature.
Myeloid zinc finger 1 knockdown promotes osteoclastogenesis and bone loss in part by regulating RANKL-induced ferroptosis of osteoclasts through Nrf2/GPX4 signaling pathway
Authors: Qu Zechao , Zhang Bo , Kong Lingbo , Zhang Yong , Zhao Yiwei , Gong Yining , Gao Xiangcheng , Feng Mingzhe , Zhang Jingjun , Yan Liang
Published: January 2024

The overactivation of the osteoclasts is a crucial pathological factor in the development of osteoporosis. MZF1, belonging to the scan-zinc finger family, plays a significant role in various processes associated with tumor malignant progression and acts as an essential transcription factor regulating osteoblast expression. However, the exact role of MZF1 in osteoclasts has not been determined. In this study, the purpose of our study was to elucidate the role of MZF1 in osteoclastogenesis. First, we established MZF1-deficient female mice and evaluated the femur bone phenotype by micro–computed tomography and histological staining. Our findings indicate that MZF1−/− mice exhibited a low bone mass osteoporosis phenotype. RANKL could independently induce the differentiation of RAW264.7 cells into osteoclasts, and we found that the expression level of MZF1 protein decreased gradually. Then, the CRISPR/Cas 9 gene-editing technique was used to build a RAW264.7 cell model with MZF1 knockout, and RANKL was used to independently induce MZF1−/− and wild-type cells to differentiate into mature osteoclasts. Tartrate-resistant acid phosphatase staining and F-actin fluorescence results showed that the MZF1−/− group produced more tartrate-resistant acid phosphatase–positive mature osteoclasts and larger actin rings. The expression of osteoclast-associated genes (including tartrate-resistant acid phosphatase, CTSK, c-Fos, and NFATc1) was evaluated by reverse transcription quantitative polymerase chain reaction and Western blot. The expression of key genes of osteoclast differentiation in the MZF1−/− group was significantly increased. Furthermore, we found that cell viability was increased in the early stages of RANKL-induced cell differentiation in the MZF1−/− group cells. We examined some prevalent ferroptosis markers, including malondialdehyde, glutathione, and intracellular Fe, the active form of iron in the cytoplasm during the early stages of osteoclastogenesis. The results suggest that MZF1 may be involved in osteoclast differentiation by regulating RANKL-induced ferroptosis of osteoclasts. Collectively, our findings shed light on the essential involvement of MZF1 in the regulation of osteoclastogenesis in osteoporosis and provide insights into its potential underlying mechanism.
Angiogenic responses are enhanced by recombinant human erythropoietin in a model of periventricular white matter damage of neonatal rats through EPOR-ERK1 signaling
Authors: Zhu Lihua , Yuan Qichao , Jing Chunping , Sun Lingxian , Jiang Li
Published: January 2024

Recombinant human erythropoietin (rh-EPO) has been shown to stimulate neurogenesis and angiogenesis, both of which play crucial roles in the repair of brain injuries. Previously, we observed that rh-EPO treatment effectively reduced brain damage and enhanced angiogenesis in a neonatal rat model of periventricular white matter damage (PWMD). The objective of this research is to investigate the specific mechanism through which rh-EPO regulates angiogenesis following PWMD in premature neonates. We conducted experiments utilizing a neonatal PWMD model. Following rh-EPO treatment, the levels of erythropoietin receptor (EPOR) were found to be increased in the damaged brain of rats. Although the total amount of extracellular signal-regulated kinase (ERK), a downstream protein in the EPO signaling pathway, remained unchanged, there was clear upregulation of phosphorylated ERK1 (p-ERK1) levels. The increase in levels of p-ERK1 was inhibited by an ERK kinase inhibitor, while the total amount of ERK remained unchanged. Conversely, the levels of EPOR were not affected by the inhibitor. Notably, the introduction of rh-EPO led to a significant increase in the frequency of angiogenesis-related cells and the expression levels of angiogenic factors. However, these effects were nullified when the ERK pathway was blocked. These findings indicate that rh-EPO enhances angiogenic responses through the EPOR-ERK1 pathway in a neonatal PWMD model.
Musculoskeletal magnetic resonance imaging findings support a common spectrum of giant cell arteritis and polymyalgia rheumatica
Authors: Seitz Pascal , Cullmann Jennifer , Bucher Susana , Bütikofer Lukas , Reichenbach Stephan , Lötscher Fabian , Amsler Jennifer , Christ Lisa , Bonel Harald M , Villiger Peter M , Seitz Luca
Published: January 2024

Objectives

To investigate the proportion and distribution of contrast enhancement (CE) of musculoskeletal structures with MRI of the thorax/abdomen/pelvis in giant cell arteritis (GCA).

Methods

CE at 34 musculoskeletal sites was rated with a four-point ordinal scale. Patients were divided into groups with or without glucocorticoid (GC) treatment and with or without symptoms of polymyalgia rheumatica (PMR). Two composite scores were created: an MRI score, including seven sites, and a limited MRI score, including four sites.

Results

Retrospectively, 90 consecutive patients with GCA were included. The population included 54 and 36 patients with and without PMR symptoms, respectively, and 45 (50%) patients were receiving GCs at the time of MRI. CE was found in 90.7% of lumbar spines, 87.5% of the pelvis, 82.2% of shoulder girdles and in 95.6% at any site in patients without GCs. The proportion of patients without and with GCs with at least moderate enhancement was, respectively, 91.1% and 75.6% at ≥1–3 sites, 75.6% and 51.1% at ≥4–6 sites, and 64.4% and 28.9% at ≥7–9 sites. The mean difference between the proportion of pathological CE in patients with and without GCs was 27.4% for synovial sites and 18.3% for periarticular/musculotendinous sites. Both composite scores captured substantial differences between groups, and correlation was very strong between scores.

Conclusion

MRI shows CE of musculoskeletal structures typical of PMR in most patients with GCA, supporting the concept of ‘GCA-PMR spectrum disease’. Changes are more frequent at periarticular/musculotendinous sites and in the presence of PMR symptoms. A clear response to GCs is evident, less so for periarticular/musculotendinous sites.
The Zymoseptoria tritici Avirulence Factor AvrStb6 Accumulates in Hyphae Close to Stomata and Triggers a Wheat Defense Response Hindering Fungal Penetration
Authors: Alassimone Julien , Praz Coraline , Lorrain Cécile , De Francesco Agustina , Carrasco-López Cristian , Faino Luigi , Shen Ziqi , Meile Lukas , Sánchez-Vallet Andrea
Published: January 2024

Zymoseptoria tritici, the causal agent of Septoria tritici blotch, is one of Europe's most damaging wheat pathogens, causing significant economic losses. Genetic resistance is a common strategy to control the disease, Stb6 being a resistance gene used for more than 100 years in Europe. This study investigates the molecular mechanisms underlying Stb6-mediated resistance. Utilizing confocal microscopy imaging, we determined that Z. tritici epiphytic hyphae mainly accumulate the corresponding avirulence factor AvrStb6 in close proximity to stomata. Consequently, the progression of AvrStb6-expressing avirulent strains is hampered during penetration. The fungal growth inhibition co-occurs with a transcriptional reprogramming in wheat characterized by an induction of immune responses, genes involved in stomatal regulation, and cell wall-related genes. Overall, we shed light on the gene-for-gene resistance mechanisms in the wheat– Z. tritici pathosystem at the cytological and transcriptomic level, and our results highlight that stomatal penetration is a critical process for pathogenicity and resistance.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Pseudomonas syringae pv. tomato DC3000 Induces Defense Responses in Diverse Maize Inbred Lines
Authors: Jaiswal Namrata , Helm Matthew
Published: January 2024

Many phytopathogens translocate virulence (effector) proteins into plant cells to circumvent host immune responses during infection. One such pathogen is Pseudomonas syringae pv. tomato DC3000, which secretes at least 29 effectors into host cells, of which a subset elicits host defense responses in crop plant species. However, it is unknown whether P. syringae pv. tomato DC3000 activates immune responses in diverse maize inbreds. Here, we screened a diverse maize germplasm collection for effector-dependent recognition of this bacterial pathogen. As a control, we infiltrated P. syringae DC3000(D36E), a derivative of P. syringae pv. tomato DC3000 that lacks all endogenous effectors. In our evaluations, we observed a variety of responses to P. syringae pv. tomato DC3000 in maize and scored the phenotypes as either having no observable response (N) or exhibiting one of three responses: weak chlorosis (WC), chlorosis (C) with minimal cell death, and hypersensitive reaction (HR)-like cell death. Of the 26 maize inbreds screened, 13 were scored as N, 2 as WC, 2 as C, and 9 as HR-like cell death. Importantly, no maize line responded to P. syringae DC3000(D36E), demonstrating that the responses observed are likely dependent on recognition of one or more Pseudomonas effectors. Furthermore, the maize inbreds that recognize P. syringae pv. tomato DC3000 accumulated detectable hydrogen peroxide as well as an increase in transcript expression of a subset of maize defense genes. Collectively, our results will likely stimulate new research aimed at identifying the cognate maize disease resistance proteins that recognize the activities of one or more bacterial effectors.

[Formula: see text] Copyright © 2024 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Robotic True D3 Lymph Node Dissection with Superior Mesenteric Vein-Taping Technique for Right Colon Cancer
Authors: Ishizaki Tetsuo , Mazaki Junichi , Kasahara Kenta , Udo Ryutaro , Tago Tomoya , Enomoto Masanobu , Nagakawa Yuichi
Published: January 2024

BACKGROUND:

D3 is unaffected by anatomical factors even when the ileocolic artery runs along the dorsal side of the superior mesenteric vein. Complete “true D3” lymph node dissection in minimally invasive surgery for right colon cancer could be beneficial for certain patients with lymph node metastases.

IMPACT OF INNOVATION:

The study aimed to determine the safety and feasibility of robotic true D3 lymph node dissection for right colon cancer using a superior mesenteric vein taping technique.

TECHNOLOGY MATERIALS AND METHODS:

The superior mesenteric vein was slowly and gently separated from the surrounding tissues and taped. Lifting the tape with the robotic third arm and fixing it in place using rock-stable tractions provides a good surgical view, which cannot otherwise be obtained. As a result, the ileocolic artery that branches from the superior mesenteric artery can be accurately exposed. Handling of the taping then enables expansion to a different surgical view. As the lymph nodes are originally concealed on the dorsal side of the superior mesenteric vein, this technique provides a good view for lymph node dissection. The root of the ileocolic artery was clipped and separated, and true D3 was thus completed.

PRELIMINARY RESULTS:

Fourteen patients underwent robotic true D3 lymph node dissection for right colon cancer. No Clavien-Dindo classification Grade II or higher intraoperative or postoperative complications were observed. The 30-day mortality rate was 0%.

CONCLUSIONS:

Our robotic true D3 lymph node dissection with superior mesenteric vein taping technique is considered safe and feasible; it might be a promising surgical procedure for treating advanced right colon cancer.

FUTURE DIRECTIONS:

Even when the ileocolic artery runs along the dorsal aspect of the superior mesenteric vein, the technique seems promising for facilitating robotic D3 lymph node dissection. See Video.
Development and Effect of a Simulation-Based Disaster Nursing Education Program for Nursing Students Using Standardized Patients
Authors: PARK Yeon Mi , HWANG Won Ju
Published: January 2024

Background

Disaster nursing deploys professional nursing knowledge and skills systematically to reduce disaster-related risks to life and health. Disaster nursing education requires providing simulations using standardized patients.

Purpose

The purpose of this study was to develop, based on the International Council of Nurses' Framework of Disaster Nursing Competencies, a simulation-based disaster nursing education program for nursing students that employed standardized patients.

Methods

A nonequivalent, control group, pretest-and-posttest design was used. Participants were senior nursing students from two universities, with 70 assigned to the experimental group, 35 assigned to the comparison group, and 35 assigned to the control group. Data were collected from January 25 to April 3, 2019. The simulation-based disaster nursing education program consisted of a 60-minute theoretical lecture on disaster management and two scenarios. The effectiveness of the simulation-based disaster nursing education program was measured using levels of disaster nursing competencies, disaster triage competency, disaster preparedness, critical thinking disposition, and confidence in disaster nursing.

Results

Significant differences were found between the experimental and comparison/control groups in terms of disaster nursing competencies (F = 20.06, p < .001), nursing triage (F = 17.35, p < .001), disaster preparedness (F = 60.37, p < .001), critical thinking disposition (F = 19.63, p < .001), and confidence in disaster nursing (F = 20.24, p < .001).

Conclusions

Simulation-based disaster nursing education programs using standardized patients can be useful in disaster nursing education. They can contribute to future changes in nursing education and practice by improving the disaster nursing capabilities and preparedness of students.
Evaluation of large language models in breast cancer clinical scenarios: a comparative analysis based on ChatGPT-3.5, ChatGPT-4.0, and Claude2
Authors: Deng Linfang , Wang Tianyi , Yangzhang  , Zhai Zhenhua , Tao Wei , Li Jincheng , Zhao Yi , Luo Shaoting , Xu Jinjiang
Published: January 2024

Background

Large language models (LLMs) have garnered significant attention in the AI domain owing to their exemplary context recognition and response capabilities. However, the potential of LLMs in specific clinical scenarios, particularly in breast cancer diagnosis, treatment, and care, has not been fully explored. This study aimed to compare the performances of three major LLMs in the clinical context of breast cancer.

Methods

In this study, clinical scenarios designed specifically for breast cancer were segmented into five pivotal domains (nine cases): assessment and diagnosis, treatment decision-making, postoperative care, psychosocial support, and prognosis and rehabilitation. The LLMs were used to generate feedback for various queries related to these domains. For each scenario, a panel of five breast cancer specialists, each with over a decade of experience, evaluated the feedback from LLMs. They assessed feedback concerning LLMs in terms of their quality, relevance, and applicability.

Results

There was a moderate level of agreement among the raters (Fleiss’ kappa=0.345, P<0.05). Comparing the performance of different models regarding response length, GPT-4.0 and GPT-3.5 provided relatively longer feedback than Claude2. Furthermore, across the nine case analyses, GPT-4.0 significantly outperformed the other two models in average quality, relevance, and applicability. Within the five clinical areas, GPT-4.0 markedly surpassed GPT-3.5 in the quality of the other four areas and scored higher than Claude2 in tasks related to psychosocial support and treatment decision-making.

Conclusion

This study revealed that in the realm of clinical applications for breast cancer, GPT-4.0 showcases not only superiority in terms of quality and relevance but also demonstrates exceptional capability in applicability, especially when compared to GPT-3.5. Relative to Claude2, GPT-4.0 holds advantages in specific domains. With the expanding use of LLMs in the clinical field, ongoing optimization and rigorous accuracy assessments are paramount.