Digestive System Disorders Research Articles

Editorial: Machine learning approaches for differential diagnosis, prognosis, prevention, and treatment of digestive system disorders

Editorial: Machine learning approaches for differential diagnosis, prognosis, prevention, and treatment of digestive system disorders

Pharmacological insight into The Potential Efficacy of Some Halophytes in Alleviating Digestive System Disorders

Pharmacological insight into The Potential Efficacy of Some Halophytes in Alleviating Digestive System Disorders

MiR-103–3p attenuates liver injury with severe acute pancreatitis by inhibiting pyroptosis through miR-103–3p/NLRP1 axis

BackgroundSevere acute pancreatitis (SAP) is a common digestive system disorder in clinical practice, and it is often associated with liver damage in patients with severe acute pancreatitis. Several studies have indicated that pyroptosis plays a role in liver damage following severe acute pancreatitis (SAP). However, the precise mechanisms remain unclear. This study aims to elucidate the association and specific mechanisms between liver injury following SAP and pyroptosis, providing theoretical support for research on SAP-induced liver injury. MethodsA rat model of SAP with concomitant liver injury was successfully established. The expression levels of miR-103–3p across different liver tissue groups were quantified using quantitative reverse transcriptase polymerase chain reaction (qRT-PCR). Bioinformatic analyses and dual-luciferase reporter assays confirmed that NLRP1 is a direct target of miR-103–3p. In vivo assessments of miR-103–3p levels were performed, and the extent of cell pyroptosis during liver injury post-SAP was evaluated through western blotting, qRT-PCR, scanning electron microscopy, histopathology, immunofluorescence, and immunohistochemistry. The role of miR-103–3p in regulating NLRP1-mediated pyroptosis and its impact on SAP-induced liver injury were validated. ResultsThis study reports that following SAP-induced liver injury, the expression of miR-103–3p in liver tissue was significantly decreased, and cell pyroptosis was involved in the process of liver injury. Experimental validation indicated that NLRP1 was a downstream target of miR-103–3p. Overexpression of miR-103–3p in vitro significantly alleviated the severity of liver injury following SAP, while simultaneously inhibiting cell pyroptosis. ConclusionThese findings indicate that pyroptosis may be linked to SAP-induced liver injury and that miR-103–3p mitigates hepatocyte pyroptosis by reducing liver injury through the suppression of NLRP1 expression.

Krankenhaussterblichkeit bei Patienten mit und ohne Demenz

Background: Studies reported a higher in-hospital mortality in patients living with dementia (PlwD) with limited evidence across age groups, clinical departments and admission diagnoses. Study aim was to compare the in-hospital mortality rate of PlwD with non-demented controls across groups, clinical departments and admission diagnoses. Methods: This case-control study included patients aged ≥ 60 years hospitalized in one of 36 German hospitals between January 2019 and July 2023. PlwD were matched to non-demented controls. The associations between dementia and in-hospital mortality across groups were assessed using univariable logistic regression analyses. Results: 29,203patients with and 29,203 without dementia were included (mean age: 84 years, 60% female). PlwD had a significantly higher in-hospital mortality rate than non-dementia controls. The excess mortality rate was highest in the youngest age group (60–70 years), decreased with age, and became non-significant in the oldest age group (≥ 90 years). Significant differences were found for digestive system, cardiovascular and cerebrovascular disorders, endocrine, nutritional and metabolic diseases, and pneumonia, as well as for internal medicine and gastroenterology departments. Conclusion: The excess mortality rate was highest in younger age groups, where the general mortality and complication rate is relatively low in the general population. Appropriate approaches are needed.

Utilization of Polygonum cognatum Meissn, a Gastronomic Product of the Turkish Culinary Culture, in the Production of Gluten-free Biscuits

ABSTRACT Polygonum cognatum Meissn. (Polygonaceae), locally known as “solucan otu” or “madimak” in Turkey, is a type of edible grass with functional properties that naturally grows in various regions of the country, particularly in Central Anatolia. Celiac disease is a prevalent digestive system disorder that impairs the absorption of food. Incorporating functional ingredients into gluten-free formulations can increase their value. To be a preferred alternative to commonly consumed products, a new product must be sensory-appealing. This study focuses on developing a healthy, functional, and enjoyable gluten-free cookie. Various proportions of P. cognatum flour (10%, 20%, 30%, and 40%) were utilized in the development of the product. The physical, textural, chemical, and sensory characteristics of the biscuit samples were compared to those of samples made with wheat flour (Control 1) and a gluten-free flour mixture (Control 2). The addition of P. cognatum flour proportionally increased the moisture content, ash value, dietary fiber, antioxidant, phenolic matter, and protein content of the biscuits without changing the fat content, according to experimental findings. Samples with 40% P. cognatum addition exhibited higher levels of moisture, ash, protein, dietary fiber, antioxidant, and phenolic matter compared with the other samples. However, the results of the sensory analysis revealed that utilizing more than 30% of P. cognatum flour significantly decreased consumer preference by negatively affecting sensory attributes such as texture, consistency, mouthfeel, taste, overall acceptability, color, and fracture. Hence, it was concluded that this type of flour should not exceed 30% when producing functional gluten-free biscuits. From this study, we advocate for the recognition of P. cognatum as a local and gastronomic product, which has the potential to be utilized in wider areas.

Patients' Expectations of Yoga and Associated Therapies Influence Treatment Outcome: A Convenience Sampling Pre-Post Study from India.

An association between expectations of treatment and treatment outcome has been reported for conventional medical and surgical treatments. However, this association has not been described for yoga therapy. The present study recruited patients (154 males and 145 females, n = 299; age 48.8 ± 14.7 years) who had been admitted to a residential wellness center, most commonly with diseases of the musculoskeletal system or connective tissue; endocrine, nutritional, or metabolic diseases; and digestive system disorders (all based on ICD-11). Assessments included: (1) expectations of yoga and associated therapies at baseline using two questionnaires (Treatment Expectation Questionnaire and Expectation for Treatment Scale); and (2) treatment outcome at baseline and after 7 days of yoga and associated therapies using the Physical Health Questionnaire and Global Perceived Effect scale. The intervention included yoga and additional therapies (e.g., hydrotherapy and ayurveda for approximately 40% of the time). Multivariable regression analyses (controlled for variation due to age, gender, education, and baseline Physical Health Questionnaire scores) demonstrated that expectations of (1) positive outcomes of all aspects of treatment significantly predicted better overall perceived effect of treatment; (2) symptom resolution (positive expectations) significantly predicted higher total Physical Health Questionnaire scores, with better digestion; and (3) low adverse outcomes significantly predicted better sleep. The findings support the premise that higher positive expectations and lower negative expectations of yoga therapy predict better treatment outcomes. These findings suggest that people should be well-informed about the reported benefits and the less-frequent negative outcomes of yoga therapy so that their expectations may be positive yet realistic, optimally influencing treatment outcomes.

Gut-Brain Nexus: Mapping Multi-Modal Links to Neurodegeneration at Biobank Scale.

Alzheimer's disease (AD) and Parkinson's disease (PD) are influenced by genetic and environmental factors. Using data from UK Biobank, SAIL Biobank, and FinnGen, we conducted an unbiased, population-scale study to: 1) Investigate how 155 endocrine, nutritional, metabolic, and digestive system disorders are associated with AD and PD risk prior to their diagnosis, considering known genetic influences; 2) Assess plasma biomarkers' specificity for AD or PD in individuals with these conditions; 3) Develop a multi-modal classification model integrating genetics, proteomics, and clinical data relevant to conditions affecting the gut-brain axis. Our findings show that certain disorders elevate AD and PD risk before AD and PD diagnosis including: insulin and non-insulin dependent diabetes mellitus, noninfective gastro-enteritis and colitis, functional intestinal disorders, and bacterial intestinal infections, among others. Polygenic risk scores revealed lower genetic predisposition to AD and PD in individuals with co-occurring disorders in the study categories, underscoring the importance of regulating the gut-brain axis to potentially prevent or delay the onset of neurodegenerative diseases. The proteomic profile of AD/PD cases was influenced by comorbid endocrine, nutritional, metabolic, and digestive systems conditions. Importantly, we developed multi-modal prediction models integrating clinical, genetic, proteomic and demographic data, the combination of which performs better than any single paradigm approach in disease classification. This work aims to illuminate the intricate interplay between various physiological factors involved in the gut-brain axis and the development of AD and PD, providing a multifactorial systemic understanding that goes beyond traditional approaches.

Multiple Adverse Reactions Associated With the Use of Second-Generation Antipsychotics in People With Alzheimer's Disease: A Pharmacovigilance Analysis Based on the FDA Adverse Event Reporting System.

Alzheimer's disease (AD) is a neurodegenerative condition leading to memory loss, cognitive impairment, and neuropsychiatric symptoms. Second-generation antipsychotics (SGAs) are commonly used to manage these neuropsychiatric symptoms, but their safety profile in patients with AD requires further investigation. The objective was to evaluate the safety of SGAs in patients with AD by analyzing adverse drug reactions (ADRs) using the US Food and Drug Administration Adverse Event Reporting System (FAERS) database. This study conducted a comprehensive analysis of FAERS data from 2014 to 2023, focusing on ADRs in patients with AD treated with SGAs such as risperidone, quetiapine, olanzapine, clozapine, and aripiprazole. Descriptive, disproportionality, time, and dose analysis were performed using the Bayesian confidence propagation neural network, Weibull, and physiologically based pharmacokinetic model. Out of 1289 patients with AD treated with SGAs, the most common ADRs involved the nervous system, gastrointestinal system, and cardiac disorders. Disproportionality analysis identified significant positive signals in cardiac, renal, and vascular systems. Quetiapine, risperidone, and olanzapine showed more positive signals compared with clozapine and aripiprazole. Time analysis indicated that cardiovascular ADRs occurred randomly, whereas renal ADRs increased with prolonged use. Dose analysis suggested that small doses of SGAs did not elevate the risk of multiple cardiac, renal, or vascular ADRs. The study underscores the importance of monitoring for ADRs, particularly in the cardiac and renal systems, when using SGAs in patients with AD. Future research incorporating more comprehensive clinical data is warranted to support safe and rational drug utilization.

Safety assessment of asenapine in the FAERS database: real adverse event analysis and discussion on neurological and psychiatric side effects

PurposeThis study aims to comprehensively assess the safety of Asenapine by conducting an comprehensive statistical analysis of adverse event reports in the FAERS database, with a particular focus on potential adverse reactions related to its use in the treatment of psychiatric disorders.MethodsEvent reports from the first quarter of 2009 to the third quarter of 2023 were collected and analyzed. Detailed examinations of gender, age, reporter identity, and other aspects were conducted to reveal the fundamental characteristics of Asenapine-related adverse events. Signal mining techniques were employed to systematically evaluate various adverse reactions associated with Asenapine.ResultsThe study found that adverse event reports involving Asenapine were more common among female patients, with the age group mainly distributed between 18 and 45 years. Physicians were the primary reporters of adverse events, and psychiatric disorders, neurological disorders, and gastrointestinal disorders were the most common areas affected by adverse reactions. In addition to known adverse reactions, potential risks not mentioned in the drug label were identified, such as anosognosia, attentional drift, and psychogenic compensation disorder.ConclusionAsenapine carries the risk of various adverse reactions alongside its therapeutic effects. In clinical practice, physicians should closely monitor the occurrence of neurological disorders, psychiatric disorders, and gastrointestinal system disorders.

Geniposide alleviates heart failure with preserved ejection fraction in mice by regulating cardiac oxidative stress via MMP2/SIRT1/GSK3β pathway.

Heart failure with preserved ejection fraction (HFpEF) is a complex clinical syndrome with cardiac dysfunction, fluid retention and reduced exercise tolerance as the main manifestations. Current treatment of HFpEF is using combined medications of related comorbidities, there is an urgent need for a modest drug to treat HFpEF. Geniposide (GE), an iridoid glycoside extracted from Gardenia Jasminoides, has shown significant efficacy in the treatment of cardiovascular, digestive and central nervous system disorders. In this study we investigated the therapeutic effects of GE on HFpEF experimental models in vivo and in vitro. HFpEF was induced in mice by feeding with HFD and L-NAME (0.5 g/L) in drinking water for 8 weeks, meanwhile the mice were treated with GE (25, 50 mg/kg) every other day. Cardiac echocardiography and exhaustive exercise were performed, blood pressure was measured at the end of treatment, and heart tissue specimens were collected after the mice were euthanized. We showed that GE administration significantly ameliorated cardiac oxidative stress, inflammation, apoptosis, fibrosis and metabolic disturbances in the hearts of HFpEF mice. We demonstrated that GE promoted the transcriptional activation of Nrf2 by targeting MMP2 to affect upstream SIRT1 and downstream GSK3β, which in turn alleviated the oxidative stress in the hearts of HFpEF mice. In H9c2 cells and HL-1 cells, we showed that treatment with GE (1 μM) significantly alleviated H2O2-induced oxidative stress through the MMP2/SIRT1/GSK3β pathway. In summary, GE regulates cardiac oxidative stress via MMP2/SIRT1/GSK3β pathway and reduces cardiac inflammation, apoptosis, fibrosis and metabolic disorders as well as cardiac dysfunction in HFpEF. GE exerts anti-oxidative stress properties by binding to MMP2, inhibiting ROS generation in HFpEF through the SIRT1/Nrf2 signaling pathway. In addition, GE can also affect the inhibition of the downstream MMP2 target GSK3β, thereby suppressing the inflammatory and apoptotic responses in HFpEF. Taken together, GE alleviates oxidative stress/apoptosis/fibrosis and metabolic disorders as well as HFpEF through the MMP2/SIRT1/GSK3β signaling pathway.

Sarcopenia-related traits and 10 digestive system disorders: insight from genetic correlation and Mendelian randomization.

Despite observational studies suggest hypotheses indicating a potential link, the precise causal connection between sarcopenia and digestive system illnesses has not been clearly defined. We first use Linkage Disequilibrium Score Regression (LDSC) testing to determine the genetic correlation of traits associated with sarcopenia and 10 specific gastrointestinal diseases. Subsequently, we performed a set of bidirectional Mendelian Randomization (MR) analyses to gauge the genetic inclination towards sarcopenia-related traits in relation to each gastrointestinal condition, individually, across the FinnGen, UK Biobank, and other extensive collaborative consortia. The analytical outcomes were synthesized using a fixed-effects meta-analytic model. For outcomes indicating substantial causal impacts, mediation MR analyses were executed. Additionally, a battery of sensitivity analyses was conducted to evaluate the study's strength and dependability. Our findings established a strong causal link between appendicular lean mass and gastroesophageal reflux disease (OR = 0.8607; 95% CI: 0.8345-0.8877; p < 0.0001) and a noteworthy correlation with nonalcoholic fatty liver disease (OR = 0.7981; 95% CI: 0.7281-0.8749; p < 0.0001), as per the meta-analysis data. We also evaluated the intermediary role of metabolic disorders in the association between appendicular lean mass and the aforementioned diseases. The intermediary effect towards gastroesophageal reflux disease is quantified as 0.0087 (95% CI, 8e-04, 0.0183), accounting for 5.9398% (95% CI, 0.5462, 12.4940%) of the overall effect. For non-alcoholic fatty liver, the intermediary impact is 0.0150 (95% CI, 0.0050, 0.0270), representing 19.7808% (95% CI, 6.5936, 35.6055%) of the total effect. The findings posit that augmenting muscle mass may serve as a preventative strategy against gastroesophageal reflux disease and non-alcoholic fatty liver, highlighting the critical role of metabolic disorder management in reducing the risks of these sarcopenia-related conditions.

Prevalence of Functional Gastrointestinal System Disorders Associated with Abdominal Pain in 6th, 7th and 8th Grade Students of Izmit Primary Schools

Prevalence of Functional Gastrointestinal System Disorders Associated with Abdominal Pain in 6th, 7th and 8th Grade Students of Izmit Primary Schools

Presence and significance of telocytes in cholelithiasis and biliary dilatation in benign biliary disorders

Telocytes are closely associated with the regulation of tissue smooth muscle dynamics in digestive system disorders. They are widely distributed in the biliary system and exert their influence on biliary motility through mechanisms such as the regulation of CCK and their electrophysiological effects on smooth muscle cells. To investigate the relationship between telocytes and benign biliary diseases,such as gallbladder stone disease and biliary dilation syndrome, we conducted histopathological analysis on tissues affected by these conditions. Additionally, we performed immunohistochemistry and immunofluorescence double staining experiments for telocytes. The results indicate that the quantity of telocytes in the gallbladder and bile duct is significantly lower in pathological conditions compared to the control group. This reveals a close association between the decrease in telocyte quantity and impaired gallbladder motility and biliary fibrosis. Furthermore, further investigations have shown a correlation between telocytes in cholesterol gallstones and cholecystokinin-A receptor (CCK-AR), suggesting that elevated cholesterol levels may impair telocytes, leading to a reduction in the quantity of CCK-AR and ultimately resulting in impaired gallbladder motility.Therefore, we hypothesize that telocytes may play a crucial role in maintaining biliary homeostasis, and their deficiency may be associated with the development of benign biliary diseases, including gallstone disease and biliary dilation.

Functional Bowel Disorder Management in Routine Practice with Tips for Hot Topics: Expert Opinion Review.

Functional gastrointestinal system disorders are common problems in practice. The most common symptoms are abdominal pain, gas, bloating, diarrhea, constipation, and a mixture of these, and similar symptoms can be seen in conditions such as inflammatory bowel disease, colorectal cancer, and celiac disease depending on the age of the patient, indicating the importance of differential diagnosis. The importance of patient management is shown by making a symptom-based diagnosis and making cost-effective, that is, limited advanced examinations. The pathophysiology of irritable bowel syndrome (IBS) is multifactorial, and stress is one of the leading triggers of IBS symptoms. Therefore, terminology will change to gut-brain interaction disorders in the future, and the patient-physician relationship has a special place in the treatment of functional bowel disorder. Dietary recommendation and medical treatment in IBS should be determined according to the predominant symptom and symptom severity. In addition to diet, some lifestyle changes can also be helpful in reducing IBS symptoms. Antispasmodics and antidepressants are not fast-acting. These drugs should be used for at least 2-4 weeks to see the efficacy of treatment. Drugs should be used according to the standard recommended duration and dose in intermittent treatments.

Pharmacognostic Study and Standardization of Leaves and Stem of Mentha spicata Linn.

Background:: Various Mentha species are cultivated all over the world due to their aroma and valuable therapeutic constituents. Along with its traditional use as a food flavor, it is well-established folklore medicine for treating digestive and cardiovascular problems. Mentha spicata L. is a perennial, aromatic herb belonging to the Lamiaceae family. M. spicata leaves have been used in traditional systems of medicines for treating various digestive system disorders since old times. Aim:: The present research work encompasses the pharmacognostic study, phytochemical screening and physicochemical parameter estimation of leaves and stem of M. spicata L. for standardization of Mentha plant. Materials and Methods:: Morpho-anatomical characterization, physicochemical analysis and preliminary phytochemical investigation of leaves and stems were performed. These investigations were done as per WHO guidelines to determine the main diagnostic characteristics for correct identification and standardization of whole plant and powdered drug of M. spicata L. Results:: The dimensions, size, color, and surface texture characteristics of fresh crude drug (leaf and stem) were determined. Compound microscope images of the transverse section (TS) of M. spicata leaf and stem revealed the cellular arrangement and main identification characters. Phytochemical and physicochemical analysis of powdered drugs confirmed the presence of important phytoconstituents such as phytosterol, terpeneoids, phenolic compounds, saponins, volatile oil, etc. Conclusion:: The results obtained are helpful for the characterization of the crude drug. Morphoanatomical characterization and physicochemical analysis are inexpensive methods and serve as a quality control tool for stem and leaf standardization. The ethanolic and aqueous extract of leaves and stem showed the presence of valuable medicinally active phytoconstituents.

Advancements in metabolomics research in benign gallbladder diseases: A review.

The burgeoning field of metabolomics has piqued the interest of researchers in the context of benign gallbladder diseases, which include conditions such as gallbladder polyps, gallstones, and cholecystitis, which are common digestive system disorders. As metabolomics continues to advance, researchers have increasingly focused their attention on its applicability in the study of benign gallbladder diseases to provide new perspectives for diagnostic, therapeutic, and prognostic evaluation. This comprehensive review primarily describes the techniques of liquid chromatography-mass spectrometry, gas chromatography-mass spectrometry, and nuclear magnetic resonance and their respective applications in the study of benign gallbladder disease. Metabolomics has made remarkable progress in various aspects of these diseases, ranging from early diagnosis, etiological research, assessment of disease progression and prognosis, and optimization of therapeutic strategies. However, challenges remain in the field of metabolomics in the study of benign gallbladder diseases. These include issues related to data processing and analysis, biomarker discovery and validation, interdisciplinary research integration, and the advancement of personalized medicine. This article attempts to summarize research findings to date, highlight future research directions, and provide a reference point for metabolomics research in benign gallbladder disease.

Pembuatan Permen Jelly Untuk Kesegaran Dan Kesehatan Tubuh Dari Jahe Bagi Ibu PKK Desa Cinta Rakyat Kabupaten Deli Serdang Percut Sei Tuan

Most of the daily activities of the people in Cinta Rakyat Percut Sei Tuan Village, Deli Serdang Regency, North Sumatra Province, are still being housewives and helping their husbands with farming and fishing. This village is ± 11 km from the Indah Medan College of Health Sciences campus. Most of the women in this village are members of PKK groups and village organizations and various activities in the village, but are limited to religious and other social activities, the rest mostly stay at home. Ginger jelly candy functions to help improve body health, warm the body, relieve body aches. So it has great potential to be developed into a superior product. These production results can later be marketed through daily necessities shops, supermarkets, restaurants, or through village unit cooperatives in Deli Serdang Regency, or online.The implementation method offered to support program realization, the first stage of this activity is conducting observations and making cooperation agreements with partners. The people of Cinta Rakyat Percut Sei Tuan Village, Deli Serdang, North Sumatra, have gained an understanding of the benefits of ginger jelly candy for health, skills in how to make, package and market Ginger jelly candy using plant ingredients that are healthy, strong and easy to obtain, in a safe way. easy and simple equipment. In conclusion, the people of Cinta Rakyat Village mostly work to help their husbands farm or take part in PKK women's activities. Jelly candy can function to help improve body health, so it has the potential to make ginger jelly candy products and can be sold at public figures or supermarkets to increase family income. Ginger functions to reduce allergies, relieve digestive system disorders, relieve menstrual pain

Lactobacillus casei-fermented Amomum xanthioides ameliorates metabolic dysfunction in high-fat diet-induced obese mice.

Amomum xanthioides (AX) has been used as an edible herbal medicine to treat digestive system disorders in Asia. Additionally, Lactobacillus casei is a well-known probiotic commonly used in fermentation processes as a starter. The current study aimed to investigate the potential of Lactobacillus casei-fermented Amomum xanthioides (LAX) in alleviating metabolic disorders induced by high-fat diet (HFD) in a mouse model. LAX significantly reduced the body and fat weight, outperforming AX, yet without suppressing appetite. LAX also markedly ameliorated excessive lipid accumulation and reduced inflammatory cytokine (IL-6) levels in serum superior to AX in association with UCP1 activation and adiponectin elevation. Furthermore, LAX noticeably improved the levels of fasting blood glucose, serum insulin, and HOMA-IR through positive regulation of glucose transporters (GLUT2, GLUT4), and insulin receptor gene expression. In conclusion, the fermentation of AX demonstrates a pronounced mitigation of overnutrition-induced metabolic dysfunction, including hyperlipidemia, hyperglycemia, hyperinsulinemia, and obesity, compared to non-fermented AX. Consequently, we proposed that the fermentation of AX holds promise as a potential candidate for effectively ameliorating metabolic disorders.

Transgender people in clinical trials of drugs and biologics: An analysis of ClinicalTrials.gov from 2007 to 2023.

Transgender people have unmet health needs related to chronic conditions such as dementia, osteoporosis and hypertension. Community-driven advocacy increased transgender representation in phase III trials for pharmacological prevention of HIV, but the extent to which drug trials for other conditions have included transgender people is unknown. We investigated the extent to which trials of drugs and biologics represented transgender people across therapeutic areas on ClinicalTrials.gov. Cross-sectional analysis of trials of drugs and biologics registered on ClinicalTrials.gov from 2007-2023. We included efficacy and effectiveness trials (phase II-IV) with transgender-related terms (e.g. 'transgend*'). We labelled trials as Inclusive or Exclusive of transgender people using the trial eligibility criteria. We compared trials (therapeutic area, trial design, enrolment), summarized trials registered from 2008 onward and characterized participant enrolment for Inclusive trials with primary trial publications. We summarized continuous data using median (range), categorical data using frequencies and percentages and compared trial characteristics using Fisher's exact test. Ninety-seven trials represented transgender people. Characteristics were similar between 85 Inclusive and 12 Exclusive trials. Among Inclusive trials, 58% focused on infectious diseases (e.g. treatment or prevention of HIV and COVID-19), 15% on mental health (e.g. post-traumatic stress disorder, substance use-related disorders), and the remainder focused on endocrine (9%), pain (5%), digestive system disorders (1%) and neoplasms (1%). Twenty (of 25) trials reported enrolment of transgender participants in primary trial publications or reported results. Transgender-inclusive trials have increased since 2008. Most trials focused on infectious diseases and mental health. Investigators should increase opportunities to include of transgender people in trials of drugs and biologics for chronic diseases.

Evaluation of TikTok videos on acute pancreatitis: content quality and reliability analysis

BackgroundAcute pancreatitis (AP) is a common acute digestive system disorder, with patients often turning to TikTok for AP-related information. However, the platform’s video quality on AP has not been thoroughly investigated.ObjectiveThe main purpose of this study is to evaluate the quality of videos about AP on TikTok, and the secondary purpose is to study the related factors of video quality.MethodsThis study involved retrieving AP-related videos from TikTok, determining, and analyzing them based on predefined inclusion and exclusion criteria. Relevant data were extracted and compiled for evaluation. Video quality was scored using the DISCERN instrument and the Health on the Net (HONcode) score, complemented by introducing the Acute Pancreatitis Content Score (APCS). Pearson correlation analysis was used to assess the correlation between video quality scores and user engagement metrics such as likes, comments, favorites, retweets, and video duration.ResultsA total of 111 TikTok videos were included for analysis, and video publishers were composed of physicians (89.18%), news media organizations (13.51%), individual users (5.41%), and medical institutions (0.9%). The majority of videos focused on AP-related educational content (64.87%), followed by physicians’ diagnostic and treatment records (15.32%), and personal experiences (19.81%). The mean scores for DISCERN, HONcode, and APCS were 33.05 ± 7.87, 3.09 ± 0.93, and 1.86 ± 1.30, respectively. The highest video scores were those posted by physicians (35.17 ± 7.02 for DISCERN, 3.31 ± 0.56 for HONcode, and 1.94 ± 1.34 for APCS, respectively). According to the APCS, the main contents focused on etiology (n = 55, 49.5%) and clinical presentations (n = 36, 32.4%), followed by treatment (n = 24, 21.6%), severity (n = 20, 18.0%), prevention (n = 19, 17.1%), pathophysiology (n = 17, 15.3%), definitions (n = 13, 11.7%), examinations (n = 10, 9%), and other related content. There was no correlation between the scores of the three evaluation tools and the number of followers, likes, comments, favorites, and retweets of the video. However, DISCERN (r = 0.309) and APCS (r = 0.407) showed a significant positive correlation with video duration, while HONcode showed no correlation with the duration of the video.ConclusionsThe general quality of TikTok videos related to AP is poor; however, the content posted by medical professionals shows relatively higher quality, predominantly focusing on clinical presentations and etiologies. There is a discernible correlation between video duration and quality ratings, indicating that a combined approach incorporating the guideline can comprehensively evaluate AP-related content on TikTok.