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One-day low-residue diet is equally effective as the multiple-day low-residue diet in achieving adequate bowel cleansing: a meta-analysis of randomized controlled trials

Clin Endosc. 2024 Dec 12. doi: 10.5946/ce.2024.061. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Colonoscopy is widely used as a diagnostic and preventive procedure for colorectal diseases. The most recent guidelines advocate the use of a low-residue diet (LRD) for bowel preparation before colonoscopy. LRD duration varies considerably, with recommended 1-day and multiple-day regimens in clinical practice.

METHODS: We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched multiple databases for randomized controlled trials (RCTs) and analyzed the outcomes using a fixed-effects model.

RESULTS: Six RCTs with 2,469 subjects were included in this study. The rates of adequate bowel preparation for 1-day and >1-day were 87.2% and 87.1%, respectively. No statistically significant differences were observed between the 1-day and >1-day LRD in adequate bowel preparation (odds ratio [OR], 1.03; 95% confidence interval [CI], 0.76-1.41; p=0.84; I2=0%), polyp detection rate (OR, 0.91; 95% CI, 0.76-1.09; p=0.29; I2=16%), adenoma detection rate (OR, 0.87; 95% CI, 0.71-1.08; p=0.21; I2=0%), and withdrawal time (mean difference, -0.01; 95% CI, -0.25 to 0.24; p=0.97; I2=63%).

CONCLUSIONS: The efficacy of 1-day and multiple-day LRD is comparable in achieving satisfactory bowel preparation, highlighting their similar impact on the detection of polyps and adenomas during colonoscopy.

PMID:39722139 | DOI:10.5946/ce.2024.061

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Identification of Brain Cell Type-Specific Therapeutic Targets for Glioma From Genetics

CNS Neurosci Ther. 2024 Dec;30(12):e70185. doi: 10.1111/cns.70185.

ABSTRACT

BACKGROUND: Previous research has demonstrated correlations between the complex types and functions of brain cells and the etiology of glioma. However, the causal relationship between gene expression regulation in specific brain cell types and glioma risk, along with its therapeutic implications, remains underexplored.

METHODS: Utilizing brain cell type-specific cis-expression quantitative trait loci (cis-eQTLs) and glioma genome-wide association study (GWAS) datasets in conjunction with Mendelian randomization (MR) and colocalization analyses, we conducted a systematic investigation to determine whether an association exists between the gene expression of specific brain cell types and the susceptibility to glioma, including its subtypes. Additionally, the potential pathogenicity was explored utilizing mediation and bioinformatics analyses. This exploration ultimately led to the identification of a series of brain cell-specific therapeutic targets.

RESULTS: A total of 110 statistically significant and robust associations were identified through MR analysis, with most genes exhibiting causal effects exclusively in specific brain cell types or glioma subtypes. Bayesian colocalization analysis validated 36 associations involving 26 genes as potential brain cell-specific therapeutic targets. Mediation analysis revealed genes indirectly influencing glioma risk via telomere length. Bioinformatics analysis highlighted the involvement of these genes in glioma pathogenesis pathways and supported their enrichment in specific brain cell types.

CONCLUSIONS: This study, employing an integrated approach, demonstrated the genetic susceptibility between brain cell-specific gene expression and the risk of glioma and its subtypes. Its findings offer novel insights into glioma etiology and underscore potential therapeutic targets specific to brain cell types.

PMID:39722126 | DOI:10.1111/cns.70185

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The morphological dietary preferences of an outbreaking population of corallivorous crown-of-thorns sea stars (Acanthaster sp.) in the Gulf of Thailand

Environ Monit Assess. 2024 Dec 26;197(1):95. doi: 10.1007/s10661-024-13582-2.

ABSTRACT

The current study investigated the morphological dietary preferences of an outbreaking population of corallivorous crown-of-thorn sea stars (Acanthaster sp.) in Koh Tao, situated in the Gulf of Thailand. The local effects of such populations deemed to be in outbreak are currently poorly understood. Therefore, the aim of this study was to investigate the localised feeding behaviours of Acanthaster sp. within an outbreak population, so as to better understand the reefs vulnerable to future outbreaks. Data was collected over a 2-year period, using underwater visual census methods. Survey parameters included sea star abundance, as well as substrate composition and frequency of observed predation scarring. Acanthaster sp. populations were observed to consistently exceed regional outbreak definitions (34.4 individuals ha-1), and demonstrated unimodal size distribution consistent with a primary outbreak. Analysis of feeding behaviour displayed some evidence to support previous claims of density-dependent predation within Acanthaster sp. populations. Van der Ploeg and Scavia tests of dietary preference appeared to suggest that Acanthaster sp. have a marked preference for coral morphologies belonging to tabular and arborescent coral types, and a strong avoidance for massive, laminar, submassive, and solitary coral morphs. Furthermore, Acanthaster sp. displayed a preference towards small coral colonies between 0 and 20 cm. This finding has potential significance for reef resilience and diversity within areas at risk of CoT outbreaks, and seemingly opposes previous literature in other regions. Overall, the current study displays a host of evidence shedding light on Acanthaster sp. ecology and dietary preferences within an outbreaking population density in the Gulf of Thailand. Moreover, there is clear evidence highlighting large spatial variation in the ecology of crown-of-thorns sea stars feeding ecology, and as such demonstrates the requirement for increased localised studies of Acanthaster sp. that accounts for environmental and ecological heterogeneity.

PMID:39722068 | DOI:10.1007/s10661-024-13582-2

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Celiac in the twenty-first century-the change in BMI of children at diagnosis over the last two decades

Eur J Pediatr. 2024 Dec 26;184(1):105. doi: 10.1007/s00431-024-05835-6.

ABSTRACT

This study examined the prevalence of different BMI categories among newly diagnosed pediatric celiac disease (CD) patients in Israel from 2002 to 2018. A retrospective cross-sectional study using the database of Clalit Health Services in Israel included 5520 newly diagnosed CD children aged 2-18 between 2002 and 2018. Data on BMI, gender, ethnicity, and socioeconomic status (SES) were collected and analyzed Of the 5520 CD patients, 57.5% were female, 39.7% had low SES, and 77.1% were Jewish. At diagnosis, 13.1% were underweight, 73% had normal BMI, 9.1% overweight, and 4.8% were obese. Underweight and obese patients tended to be older at diagnosis (9 years) compared with normal and overweight patients (8 years) (P < 0.001). A higher proportion of Arab patients were underweight, while more Jewish patients were obese. Lower SES was significantly associated with increased underweight risk (P < 0.001). Over time, diagnosed patients had improved SES and were less underweight (P < 0.001). Male gender increased obesity risk (OR 1.36 [95% CI 1.06-1.74], P = 0.017), while Arab ethnicity was protective for obesity (OR 0.67 [95% CI, (0.45-0.99)], P = 0.047)Conclusion: Underweight prevalence significantly decreased in the second decade, but no significant change in overweight and obesity was noted. Underweight was associated with older age at diagnosis, poverty, and Arab ethnicity. Obesity was associated with older age and was more frequent in Jewish and male patients. Physicians should have a low threshold for CD screening regardless of BMI status to enable timely diagnosis and treatment to prevent long-term health consequences. What Is Known: • Celiac disease is traditionally associated with underweight due to malabsorption, but recent reports suggest an increasing prevalence of overweight and obesity in pediatric patients at diagnosis What Is New: • This study found that underweight prevalence decreased significantly over time, while overweight and obesity prevalence remained unchanged. Underweight was associated with older age, poverty, and Arab ethnicity, while obesity was more common in Jewish and male patients.

PMID:39722061 | DOI:10.1007/s00431-024-05835-6

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Does going against the norm on women’s economic participation increase intimate partner violence risk? A cross-sectional, multi-national study

Glob Health Res Policy. 2024 Dec 26;9(1):53. doi: 10.1186/s41256-024-00399-2.

ABSTRACT

BACKGROUND: Women’s economic empowerment (WEE) is believed to reduce the risk of intimate partner violence (IPV), yet the relationship between WEE and IPV has proven to be highly variable. Little attention has been given to how the normative WEE environment may influence this relationship across different settings. This study tests whether IPV is associated with Vanguard WEE, defined as individual economic participation that deviates from community norms.

METHODS: This cross-sectional study draws on Demographic and Health Surveys conducted in 44 low- and middle-income countries. The analytic sample was partnered women who participated in the domestic violence module, living in communities with sufficient data to construct WEE norms (n = 186,968). The relationship between Vanguard WEE-measured by the number of WEE activities a woman engaged in that were non-normative in her community-and the incidence of past-year physical IPV, sexual IPV, and partner control was evaluated using a mixed-effects multilevel logistic model. The study also explored interactions between Vanguard WEE and household wealth.

RESULTS: Women who did not deviate from the community norm had an adjusted probability of 0.15 for experiencing physical IPV in the past year. However, this probability increased to 0.17 (marginal effect (ME): 0.014; 95% CI 0.007,0.021), 0.17 (ME: 0.020; 95% CI 0.010,0.030), and 0.19 (ME: 0.037; 95% CI 0.022,0.051) for women with one, two, and three or more vanguard WEE items, respectively. Physical IPV associated with vanguard WEE was higher among poorer women (p = 0.021). Additionally, the probability of past-year sexual IPV and current partner control increased from 0.05 to 0.08 (p < 0.001) and from 0.38 to 0.44 (p < 0.001), respectively, for women with three or more vanguard WEE items.

CONCLUSIONS: The study provides evidence of partner backlash in the form of IPV among vanguard women-those whose economic activities contradicted local norms. Programs designed to economically empower women in contexts where such participation is non-normative should include mechanisms to monitor and mitigate potential backlash.

PMID:39722058 | DOI:10.1186/s41256-024-00399-2

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Sensitive liquid biopsy monitoring correlates with outcome in the prospective international GPOH-DCOG high-risk neuroblastoma RT-qPCR validation study

J Exp Clin Cancer Res. 2024 Dec 26;43(1):331. doi: 10.1186/s13046-024-03261-y.

ABSTRACT

BACKGROUND: Liquid biopsies offer less burdensome sensitive disease monitoring. Bone marrow (BM) metastases, common in various cancers including neuroblastoma, is associated with poor outcomes. In pediatric high-risk neuroblastoma most patients initially respond to treatment, but in the majority the disease recurs with only 40% long-term survivors, stressing the need for more sensitive detection of disseminated disease during therapy.

METHODS: To validate sensitive neuroblastoma mRNA RT-qPCR BM testing, we prospectively assessed serial BM samples from 345 international high-risk neuroblastoma patients, treated in trials NB2004 (GPOH) or NBL2009 (DCOG), using PHOX2B, TH, DDC, CHRNA3, and GAP43 RT-qPCR mRNA markers and BM GD2-immunocytology. Association between BM-infiltration levels and event-free survival (EFS) and overall survival (OS) was estimated by using Cox regression models and Kaplan-Meier’s methodology.

RESULTS: BM infiltration >10% by RT-qPCR at diagnosis was prognostic for survival (adjusted hazard ratio (HR) 1.82 [95%CI 1.25-2.63] and 2.04 [1.33-3.14] for EFS and OS, respectively). Any post-induction RT-qPCR positivity correlated with poor EFS and OS, with a HR of 2.10 [1.27-3.49] and 1.76 [1.01-3.08] and 5-years EFS of 26.6% [standard error 5.2%] versus 60.4% [6.7] and OS of 43.8% [5.9] versus 65.7% [6.6] for RT-qPCR-positive patients versus RT-qPCR-negative patients. In contrast, post-induction immunocytology positivity was not associated with EFS or OS (HR 1.22 [0.68-2.19] and 1.26 [0.54-2.42]).

CONCLUSION: This study validates the association of not clearing of BM metastases by sensitive RT-qPCR detection with very poor outcome. We therefore propose implementation of RT-qPCR for minimal residual disease testing in neuroblastoma to guide therapy.

PMID:39722049 | DOI:10.1186/s13046-024-03261-y

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Is Teledentistry as Effective as Clinical Dental Diagnosis in Pediatric Patients?

Int J Paediatr Dent. 2024 Dec 25. doi: 10.1111/ipd.13290. Online ahead of print.

ABSTRACT

BACKGROUND: Teledentistry integrates telecommunications with dental practice, facilitating the exchange of clinical information and images for remote dental consultation and treatment planning. This approach enables dental care access across long distances, addressing the need for flexible healthcare solutions.

AIM: This study aimed to evaluate the effectiveness of teledentistry compared to clinical in-person dental diagnosis in pediatric patients during the COVID-19 pandemic.

DESIGN: The study sample consisted of 200 children aged 3-13 years, each undergoing both teledentistry-based and in-person clinical dental diagnosis. Caries index scores, including DMFT/dmft and DMFS/dmfs, as well as the identification of specific dental conditions such as molar incisor hypomineralization (MIH), black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, were recorded in both diagnostic settings. Statistical analysis was conducted using chi-square, Wilcoxon, and Fisher’s Exact tests.

RESULTS: The mean age of participants was 7.86 ± 2.40 years. Caries index scores (DMFT/dmft, DMFS/dmfs) showed compatibility between teledentistry and clinical diagnoses. While “d/D, f/F, ds/DS, fs/FS” scores were observed to be higher in clinical diagnoses compared to teledentistry, the difference was not statistically significant (p > 0.05). Scores for “m/M” and “ms/MS” were identical in both diagnostic methods. Additionally, the prevalence of dental anomalies, including MIH, black tooth staining, periodontal disease, dental trauma, and orthodontic anomalies, was comparable across both diagnostic approaches.

CONCLUSION: Findings suggest that teledentistry serves as an effective alternative to clinical in-person diagnosis for pediatric dental consultations and treatment planning, demonstrating comparable accuracy in identifying caries and dental anomalies in children.

PMID:39722045 | DOI:10.1111/ipd.13290

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Impact of the sense of power on loneliness among international students in China: the chain mediating role of perceived discrimination and loneliness stigma

BMC Psychol. 2024 Dec 26;12(1):784. doi: 10.1186/s40359-024-02292-6.

ABSTRACT

BACKGROUND: Loneliness is a common emotional experience among international students that can affect their mental health, cultural adaptation, and academic development. Therefore, the present study aimed to explore the relationship between a sense of power and loneliness among international students, and to examine the mediating role of loneliness stigma and perceived discrimination.

METHODS: The study used the generalized sense of power scale, experiences with discrimination scale, stigma loneliness scale (SLS), and UCLA loneliness scale-6 (ULS -6) for 529 international students in China. The study conducted descriptive statistical analysis, Pearson correlation analysis, Spearman correlation analysis, and chain mediation model test on the obtained data using SPSS 20.0 and PROCESS v4.0.

RESULTS: The sense of power was significantly negatively related to perceived discrimination, and loneliness stigma, with the result that loneliness, and perceived discrimination, loneliness stigma, and loneliness were significantly positively related. The sense of power can directly affect international students’ loneliness (β = -0.167, t = -4.298, p < 0.01), or indirectly affect loneliness through three paths: the mediating role of perceived discrimination, the mediating role of loneliness stigma, and the chain mediating role of perceived discrimination and loneliness stigma. The total indirect effect value was -0.234, and the indirect effect values for each pathway were -0.153, -0.059, and -0.022, respectively.

CONCLUSION: A sense of power can directly affect loneliness in international students and indirectly by reducing perceived discrimination and loneliness stigma. The results of this study contributed to a better understanding of the relationship between a sense of power and loneliness and its mechanism, providing a reference for carrying on mental health education work for international students.

PMID:39722038 | DOI:10.1186/s40359-024-02292-6

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Individual- and community-level factors associated with early initiation of breastfeeding in Mozambique: evidence from the 2022-2023 Demographic and Health Survey

Int Breastfeed J. 2024 Dec 25;19(1):81. doi: 10.1186/s13006-024-00691-4.

ABSTRACT

BACKGROUND: Early initiation of breastfeeding is defined as giving breast milk to the newborn within one hour of birth. It strengthens the link between mother and child, promotes cognitive development, and lowers the chance of obesity and non-communicable diseases during the prime years of life. Nowadays, only 50% of newborns worldwide receive breast milk within their first hour of life. This study examined the prevalence and individual- and community-level factors associated with early initiation of breastfeeding using the Demographic and Health Survey data and offers suggestions that can enhance the practice in Mozambique.

METHODS: Data from the nationally representative Mozambique Demographic and Health Survey were used in this cross-sectional analysis. The study included a weighted sample of 3,548 children born in the two years prior to the survey. Software for statistical analysis, STATA/SE version 14.0, was used to clean, recode, and analyze the data. Utilizing multilevel logistic regression, the factors associated with the outcome variable were identified. Statistical significance was attained by variables having a p-value less than 0.05.

RESULTS: The prevalence of early initiation of breastfeeding in Mozambique was 75.03% (95% CI: 73.58%, 76.43%). Factors like non-working [AOR = 0.62; 95% CI (0.50, 0.78)], wanted last pregnancy [AOR = 1.68; 95% CI (1.33, 2.12)], antenatal care attendance [AOR = 0.63; 95% CI (0.43, 0.93)], vaginal birth [AOR = 2.30; 95% CI (1.58, 3.36)], size of the child at birth [AOR = 1.77; 95% CI (1.26, 2.48)], urban residence [AOR = 2.99; 95% CI (1.90, 4.72)], community-level antenatal care utilization [AOR = 0.52; 95% CI (0.35, 0.77)], and community poverty level [AOR = 0.34; 95% CI (0.20, 0.58)] were significantly associated with early initiation of breastfeeding.

CONCLUSIONS: About three out of four newborn babies in Mozambique have an early initiation of breastfeeding. It is critical to concentrate on developing policies that support the early initiation of breastfeeding, particularly for mothers who have small children, unplanned pregnancies, non-vaginal deliveries, and reside in rural areas.

PMID:39722032 | DOI:10.1186/s13006-024-00691-4

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Nursing students’ metaphorical perceptions of professional communication and the concept of nursing in their first clinical practice: qualitative research

BMC Nurs. 2024 Dec 26;23(1):952. doi: 10.1186/s12912-024-02590-9.

ABSTRACT

BACKGROUND: Nursing education combines theoretical knowledge and clinical practice to prepare nursing students to meet the evolving demands of healthcare services. Understanding nursing students’ metaphorical perceptions of the nursing profession and professional communication during their first clinical experiences can provide valuable insights into their professional identity and communication skills, as well as giving information about necessary improvements in nursing education. This study aimed to reveal the metaphorical perceptions of nursing students regarding the concepts of professional communication and nursing during their first clinical practices.

METHODS: The study was conducted using a phenomenological design, a qualitative research method. A “student information form” and a “metaphor form,” developed by the researchers, were used as data collection tools. Participants’ sociodemographic data were analyzed on the Statistical Package for Social Sciences (SPSS). The analysis and evaluation of the metaphors used by nursing students for the concepts of nursing and professional communication were carried out in five stages by following the characteristics outlined in the qualitative data analysis approach called Metaphor Analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist was followed in the study.

RESULTS: All 45 participants in the study were first-year nursing students, with 81.0% being female and the average age being 19.88 ± 0.96 years. Of the participants, 66.7% had chosen the nursing department willingly, and 57.1% had preferred it due to job opportunities. Participants generated 35 metaphors for the nursing profession, which were categorized into four groups, and 32 metaphors related to professional communication, which were classified into six groups.

CONCLUSION: The metaphorical perceptions of nursing students during their first clinical practices provided profound insights into how they experienced professional communication and the nursing profession. These metaphors are of great importance in understanding the challenges, the skills gained, and the emotional responses encountered during the students’ professional development processes.

PMID:39722031 | DOI:10.1186/s12912-024-02590-9