Functional Disorders Research Articles

Relationships Between Age of Onset, Seizure Frequency, And Disease Duration with Cognitive Function in Epilepsy Patients at the Neurology Clinic of H. Adam Malik Central Hospital, Medan

Background: Cognitive function disorders often occur in individuals with epilepsy. The decline in cognitive function in epilepsy patients can be caused by various factors, including age of onset, seizure frequency, and duration of the disease. This study aims to investigate the relationship between the age of onset, seizure frequency, and disease duration on the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan Method: The chosen research design is a cross-sectional analytic. The study was conducted at the neurology outpatient clinic of the Adam Malik Central General Hospital in Medan. The samples used were patients diagnosed with epilepsy at the Neurology Outpatient Clinic of Adam Malik Central General Hospital in Medan, aged 18-65 years, and without any other medical conditions aside from epilepsy. The study involved 35 subjects.Result: The majority of the research subjects are aged 18-45 years (94.3%), with more males (51.4%) than females. Most have a high school education background (48.6%), and the largest group is unemployed (62.9%). The most common age group at onset is 0-18 years (48.6%). The majority of subjects experience seizures in the rare category (less than 1 time per month) at 62.9%. Most subjects have a disease duration of less than 15 years (65.7%). The majority of epilepsy patients at the Neurology Outpatient Clinic of H. Adam Malik Hospital (52.1%) have abnormal cognitive function based on the MoCA-Ina test results. Statistical analysis was conducted using the chi-square test and multivariate analysis with logistic regression. The chi-square test results revealed a significant relationship between age of onset and cognitive function (p=0,008), a significant relationship between seizure frequency and cognitive function (p=0,004), and a significant relationship between disease duration and cognitive function (p=0,012). The multivariate analysis results indicated that disease duration had a significant relationship with cognitive function, with an odds ratio of 0,081 (p-value=0,037, 95% CI 0,008-0,862).Conclusion: There is a relationship between age of onset, seizure frequency, and disease duration with the cognitive function of epilepsy patients at the Neurology Outpatient Clinic of Haji Adam Malik General Hospital in Medan

Constipated patients with functional defecatory disorder have secondary rectal hyposensitivity due to altered rectal biomechanics.

Rectal hyposensitivity (RH) is common in constipation and often coexists with functional defecatory disorder (FDD). Rectal sensory thresholds are routinely evaluated with the anorectal manometry probe; however, the gold standard for the assessment of rectal sensitivity is with a barostat, use of which is limited by time constraints and availability. A novel rapid barostat bag (RBB) may facilitate measurements of rectal sensitivity. The aim is to evaluate the relationship between RH (measured by the RBB) and FDD (defined as any minor disorder of rectoanal coordination by the London classification) in constipated patients. Consecutive constipated patients referred for anorectal function testing underwent anorectal manometry with the 3D-HDAM probe as well as rectal sensation testing with the RBB pump. RH was defined by volume to first sensation >30%, urge to defecate >80%, or discomfort >100% (normalized to rectal capacity). Fifty-three percent of constipated patients had RH. Patients with FDD had a significantly increased volume to first sensation (134.5mL vs 102.0, P=0.02), urge to defecate (187.0mL vs 149.0, P=0.04), and rectal capacity (253.5mL vs 209.0, P=0.04) compared to constipated patients without FDD. There was no difference in normalized sensory thresholds (percent of rectal capacity) nor the prevalence of hyposensitivity to each sensory threshold nor overall hyposensitivity. Patients with FDD, when measured with the RBB, have increased sensory thresholds on volumetric distension, but RH was not observed when sensory threshold volume were normalized to rectal capacity. This may reflect "secondary" RH due to altered rectal biomechanics.

Evaluation of functional gastrointestinal disorders in children aged 4-10 years with autism spectrum disorder.

Gastrointestinal system disorders are known to be prevalent among children with autism spectrum disorder (ASD). Some ASD-associated comorbidities are abdominal pain, constipation, diarrhea, gastroesophageal reflux, sleep disturbances, epilepsy, and psychiatric problems. Nonetheless, there is still limited information about the presence of functional GI disorders (FGIDs) among children with ASD, especially in Türkiye. Using the Rome criteria, we aimed to investigate FGIDs in children with ASD. The sample of the study consisted of 68 children aged 4-10 years, diagnosed with ASD according to the DSM-5 diagnostic criteria and had scores greater than 30 on the Childhood Autism Rating Scale (CARS-2) and an age-sex matched control group (n=78). The Rome III criteria were used to evaluate FGIDs. The frequency of FGIDs in the ASD group was higher (76.5%) compared to the control group (p < 0.001). Compared to the control group, abdominal migraine frequency increased 10 times (p=0.012), functional constipation 7 times (p < 0.001), and fecal incontinence 6 times (p < 0.001) in the ASD group. Stool retention was not present in most children in the ASD group who were found to have fecal incontinence. In this study, the most common FGIDs in the ASD group were abdominal migraine, functional constipation, and non-retentive fecal incontinence. The finding that most children with ASD who had fecal incontinence did not show stool retention implicated social, psychological, and behavioral factors as the causes of incontinence. Raising awareness of healthcare professionals about the frequency of FGIDs in children with ASD will improve many areas in the daily lives of these children.

THE INFLUENCE OF TRANSCRANIAL DIRECT CURRENT STIMULATION ON FUNCTIONAL RECOVERY AFTER STROKE: A SYSTEMATIC REVIEW

INTRODUCTION: Stroke is the third leading cause of death in the world and second in Brazil, whose main characteristics are global or focal disorders of brain functions, involving cognitive and mainly physical limitations, including motor, sensory changes, ataxias, apraxias and aphasias. Transcranial Direct Current Stimulation (ETCC) is a non-pharmacological treatment that has demonstrated relevant benefits in the rehabilitation of patients. OBJECTIVE: to verify the effects of ETCC on the functional capacity of post-stroke patients, focusing on efficacy and results in the face of individuals' motor disorders. METHOD: The searches were performed in the databases PeDRO, Cochrane, PubMed and MEDLINE. Eligible studies included at least one of the population outcomes ≥ 18 years, resulting from the intervention, therapeutic efficacy and Motor activity. RESULTS:Seven were selected according to the inclusion and exclusion criteria, published between 2015 and 2020. CONCLUSION: ETCC, applied in isolation, can be an effective technique to improve motor deficits after stroke, including injured upper limb function, lower limb strength, unilateral neglect, mobility and Daily Living Activities. It is suggested to carry out further studies for the standardization of a treatment protocol, as well as to verify the best moment of its application in the post-stroke patient.

The Mechanism of Elizabethkingia miricola Infection of the Black Spotted Frog as Revealed by Multi-Omics Analysis

Elizabethkingia miricola (E. miricola) is a significant pathogen that causes the crooked head disease in black spotted frogs. This disease has plagued numerous frog farms in China and has resulted in substantial losses to the frog farming industry. Nonetheless, the exact mechanism that causes the disease in frogs remains unknown. In this study, transcriptomic and microbiomic analyses were conducted to analyze frog samples infected with E. miricola to reveal the infection mechanism of the pathogen. Liver transcriptomic analysis indicated that the livers of infected frogs had 1469 differentially expressed genes when compared with an uninfected group. These DEGs are mainly involved in immunity and metabolism, including neutrophil extracellular trap formation, the NOD-like receptor signaling pathway, leukocyte transendothelial migration, chemokine signaling pathway, Fc gamma R-mediated phagocytosis, and “metabolism”-related pathways such as the pentose phosphate pathway, carbon metabolism, glycerophospholipid metabolism, and glycerolipid metabolism. Similarly, 4737 DEGs were found in the kidney of infected frogs. These DEGs are mainly involved in immunity, including neutrophil extracellular trap formation, the NOD-like receptor signaling pathway, B cell receptor signaling pathway, C-type lectin receptor signaling pathway, complement and coagulation cascade, and Toll-like receptor signaling pathway. Ten immune-associated DEGs were screened in liver and kidney DEGs, respectively. And it was hypothesized that E. miricola infection could influence the host immune response. Microbiome analysis results showed that some opportunistic pathogens such as Citrobacter, Shigella, and Providencia were significantly elevated (p &lt; 0.05) in infected frogs. Additionally, functional prediction confirmed that most of the microbiota in infected frogs were linked to metabolism-related KEGG pathways. In this study, the screened genes linked to immunity showed an association with the gut microbiome. The majority of these genes were found to be linked with the abundance of opportunistic pathogens. The results showed that E. miricola infection led to the downregulation of immune and metabolic-related genes, which led to the inhibition of immune function and metabolic disorder, and then increased the abundance of opportunistic pathogens in the gut microbiota. The findings of this study offer a preliminary foundation for comprehending the pathogenic processes of E. miricola infection in black spotted frogs.

The Relationship Between Shift Work Patterns and Cognitive Function Disorders in Health Workers at Hospital X, West Java, Indonesia

Introduction: Jobs with shift work patterns, especially irregular ones, can disrupt circadian rhythms and sleep quality, which then impacts cognitive function. Despite its importance, research on cognitive domain vulnerabilities related to shift work patterns is still limited. Sleep quality and cognitive function are critical in the context of hospital health services, where decisions and actions must be taken quickly and precisely to support patient safety.&#x0D; Methods: This research is a cross-sectional observational analytical study to determine the relationship between shift work patterns and impaired cognitive function. To measure sleep quality, the Pittsburgh Sleep Quality Index Indonesian (PSQI-Ina) is used, while cognitive function and cognitive domains were measured using Oxford Cognitive Screen (OCS) Indonesian (OCS-Ina), a cognitive instrument for stroke patients, which has been validated. The minimum sample size in this study was 72 samples. Correlation, principal component analysis, demographic analysis, and regression were used to characterize the relationship between PSQI-Ina, OCS-Ina, and other research variables.&#x0D; Results: A total of 83 health workers met the inclusion criteria and were included in the research. The results showed that 16 respondents (19.3%) experienced impaired cognitive function in the Attention domain and 2 respondents (2.4%) experienced impairment in 2 cognitive domains (Attention and Number Management). The results of statistical analysis showed a significant relationship with health workers who had part-time jobs having a 12.8-fold risk (OR 12.8; 95% CI 1.7-91; p = 0.011) of experiencing cognitive impairment. Then health workers who experience poor sleep quality (with a PSQI value &gt;5) have a 40.3 times greater risk (OR 40.3; 95% CI 2.2-708.1; p = 0.011) of experiencing cognitive impairment. Likewise, health workers with irregular shift work patterns have a 5.4 times risk of experiencing cognitive impairment (OR 5.4; 95% CI 0.1-26.6; p = 0.036).&#x0D; Conclusion: There is a relationship between shift work patterns and impaired cognitive function in the workplace. Hospitals should prioritize ergonomic shift work schedules, emphasizing speed and clockwise rotation, to support the well-being of their healthcare workers.

Clinical application of V-shaped folded submental flap in the repair of oral defect.

The repair of small and medium-sized defects in the oral has always been a challenge, free skin flap and distal pedicled tissue flaps are difficult to meet clinical needs, and the traditional under-chin flap has the risk of donor-area injury. This study aims to investigate the efficacy of V-shaped folded submental flap in the repair of small-sized and medium-sized oral defects. The clinical data of 28 patients with oral defect lesions, who were hospitalized in the Department of Stomatology, Third Xiangya Hospital of Central South University from March 2019 to December 2022, were retrospectively analyzed. Patients were divided into a V-shaped folded group (17 cases) and a conventional group (11 cases) according to different surgical methods. The V-shaped folded group was treated with a V-shaped folded submental flap for postoperative soft tissue repair, while the conventional group was treated with a conventional submental flap for repair. The postoperative follow-up time was 6-48 months. The survival status, repair time, and repair effect of the 2 groups were compared. There was no significant difference in flap survival rate, flap size, flap preparation time, repair surgery time, and postoperative hospital stay between the 2 groups (all P>0.05). At 6 months after the surgery, the V-shaped folded group had no difficulty in raising the head or everting the lower lip, no "cat ear" deformity in the submental skin. Scars in the V-shaped folding group were hidden at the lower edge of the mandible. The wound aesthetics and functional scores in the V-shaped folded group were significantly higher than those in the conventional group (both P<0.05). The V-shaped foldable submental flap has the advantages of flexible design, simple preparation, reliable blood supply, and protection of the donor area, which can effectively protect the appearance of the chin and avoid functional disorders.

Irritable bowel syndrome in children: pathogenetic significance of disorders of intestinal microbiota

Irritable bowel syndrome (IBS) is the most common functional disorder of the intestine in children. In recent years, IBS has been defined as functional pathology of the intestine, manifested by visceral recurrent pain that occurs at least once per week, characterized by the following two or more signs: associated with defecation; with changes in the frequency and shape of stools. These symptoms had to be noted in the patient for the last 3 months, with a total duration of at least 6 months, without signs of organic damage to the gastrointestinal tract (GIT). The gut microbiota is of particular importance in the pathogenesis of IBS. In patients with IBS, an increase in Enterobacteriaceae, Ruminococcus, Clostridium, Dorea species and a decrease in the number of Lactobacillus, Bifidobacterium and Faecalibacterium species were found. At the same time, a similar microbial profile was found in patients with different subtypes of IBS. The established patterns of changes in the composition of the microbiota in IBS in children and adults indicate IBS and functional disorders of the GIT to have a pronounced microbial pathogenesis. In this regard, the personalized use of prebiotics, probiotics, synbiotics, and fecal microbiota transplantation can effectively affect the intestinal microbiome in IBS. &#x0D; Conclusion. Correction of disorders of intestinal microbiota is the most important method of treating IBS in children. Determining the patterns of formation of changes in the intestinal microbiome in IBS children creates new opportunities for improving methods of their correction.

Biaxial Flexural Strength of Printed Splint Materials.

One therapeutical alternative in the treatment of functional disorders is the use of printed oral splints. The mechanical properties of these materials are highly essential to their clinical effectiveness, and their performance may vary depending on factors such as cleaning, post-polymerization, or their orientation during construction. The objective of this in vitro investigation is to evaluate the effectiveness of the selected materials in terms of their biaxial flexural strength in relation to the criteria listed above. Splint materials were used in the printing of 720 discs. The printing process was carried out in different orientations in relation to the building platform. Either an automatic or manual cleaning process was performed on the samples. For post-polymerization, either an LED or Xenon light was utilized. A piston-on-three-ball test was used to measure the biaxial flexural strength (BFS) of the materials after they were stored in water for either 24 h or 60 days. The homogeneity of the data was controlled by employing the Levene method, and the differences between the groups were analyzed using the ANOVA and Bonferroni methods. After being stored for twenty-four hours, the mean BFS ranged anywhere from 79 MPa to 157 MPa. Following a period of sixty hours, the BFS exhibited a substantial drop and revealed values that ranged from 72 to 127 MPa. There was no significant difference that could be identified between the materials or between the various cleaning processes. The results of post-polymerization showed that the LED light produced higher means than the Xenon light did. In terms of position, the mean values varied greatly, with 0°'s mean value being 101 MPa, 45°'s mean value being 102 MPa, and 90°'s mean value being 115 MPa. The use of a build orientation of 90° and post-polymerization with LED light resulted in significantly increased biaxial flexural strength. According to this study, this design should be implemented in order to ensure that splint materials have the highest possible strength.

Neonatal Orthoptic Screening Battery (NOSB): Four-decade Experience of Orthoptic Best Practice

The present study describes the neonatal orthoptic screening battery (NOSB), a comprehensive orthoptic screening, based on four decades of application, aimed at early identification of signs and symptoms of ocular pathology or functional disorders. The NOSB allows for verifying the integrity of ocular components and early detection of functional alterations in ocular movements that could lead to the development of amblyopia or strabismus. The NOSB is the result of 45 years of screening activity in a primary health center assured by the National Health System in the city of Ragusa – Italy. It aims to examine and assess the neonate within the first 3 days of extrauterine life to identify visual system issues as early as possible. The NOSB may be conducted by Orthoptists, healthcare professionals specializing in neonatal and pediatric visual prevention. The Neonatal Orthoptic Screening battery (NOSB) here reported is proposed as a standard suitable for widespread adoption to be considered a "Best Practice".

Irritable Bowel Syndrome as a Stress Prediction Model in Mexican Dentistry Students

The Irritable Bowel Syndrome is a functional gastrointestinal disorder associated with stress that may occur in the academic context, given that students are exposed to high demands during their education process which can lead to the development of diseases. The purpose of this study was to examine the correlation and predictive value between the Irritable Bowel Syndrome (IBS) with stress in dentistry students at a public university in Mexico, taking into account the gender variable. The design is cross-sectional with 740 dental students. Nowack’s Stress Profile was used as well as the ROMA III criteria to identify IBS. Multiple lineal regression models were built, in which the dependent variable was IBS and the independent ones were the stress profile variables and group data. Such models were built independently for each sex and their results were compared. The IBS model in males was significant in the following variables: IBS = – 1.454 (problem concentration) + .315 (negative valuation) – .390 (social support network) + .513 (type A behavior) – .464 (rest/sleep), with a strength of R2 = .685; F = 75.72; p &lt; .01 which explains 68% of the variance; and for females it was: ISB = – .041 (positive valuation) – .082 (eating habits/nutrition) with a strength of R2 = .643; F = 42.69; p &lt; .01, which explains 64% of the variance. The comparative análisis determined that male dental students are at a greater risk of developing IBS due to stress. Therefore, programs aimed at a timely identification of the stress risk variables would be recommended to prevent consequences to the health, inadequate academic performance and wellbeing of dental students in Mexico.

Ultrasound-augmented enzyodynamic-Ca2+ overload synergetic tumor nanotherapy

The excessive intracellular Ca2+ can induce oxidative stress, mitochondrial damage and cell apoptosis, which has been extensively explored for tumor therapy. However, the low Ca2+ accumulation originated from Ca2+-based nanosystems substantially weakens the therapeutic effect. Herein, a functional plant polyphenol-appended enzyodynamic nanozyme system CaFe2O4@BSA-curcumin (abbreviation as CFO-CUR) has been rationally designed and engineered to achieve magnified Ca2+ accumulation process, deleterious reactive oxygen species (ROS) production, as well as mitochondrial dysfunction through enzyodynamic-Ca2+ overload synergistic effect. The exogenous Ca2+ released by CaFe2O4 nanozymes under the weakly acidic tumor microenvironment and Ca2+ efflux inhibition by curcumin boost mitochondria-dominant antineoplastic efficiency. The presence of Fe components with multivalent characteristic depletes endogenous glutathione and outputs the incremental ROS due to the oxidase-, peroxidase-, glutathione peroxidase-mimicking activities. The ROS burst-triggered regulation of Ca2+ channels and pumps strengthens the intracellular Ca2+ accumulation. Especially, the exogenous ultrasound stimulation further amplifies mitochondrial damage. Both in vitro and in vivo experimental results affirm the ultrasound-augmented enzyodynamic-Ca2+ overload synergetic tumor inhibition outcomes. This study highlights the role of ultrasound coupled with functional nanozyme in the homeostasis imbalance and function disorder of mitochondria for highly efficient tumor treatment.

The influence of the probiotic “Bioseven” on indicators of survival and growth of calves in the early postnatal period

Dairy cattle breeding is one of the promising areas of agriculture. With a systematic approach and modern technologies, it is a highly profitable agrarian business that is dynamically developing. According to experts, the competitiveness and profitability of the industry can be increased due to the use of natural feed additives and preparations to obtain ecologically safe products for humans. Among them, preparations of microbiological origin are increasingly used, in particular, probiotics, which contain living microorganisms useful for the macroorganism. These drugs are used for prophylactic or therapeutic purposes. It is known that most microorganisms inhabiting the intestines are safe and do not cause diseases, but there is a constant competition between bacteria of different species for space and nutrients. The inconsistency of the microclimate parameters in the calf pens had a direct negative effect on the calf's body, especially in the early postnatal period. In particular, the deviation from the temperature balance, increased air humidity, and the presence of drafts caused a violation of the heat exchange processes of the calves' body with hypothermia and overheating of the body, and, as a result, provoked the frequent occurrence of respiratory diseases. In addition, increased air humidity and high microbial pollution caused the emergence of diseases with functional disorders in the digestive tract due to an imbalance of normal flora and increased activity of the development of transit microbes from the external environment, which negatively affected the homeostasis of the calves' body, weakened the natural resistance of calves, their growth, preservation and often led to the death of animals. Oral use of the probiotic “Bioseven” in a dose of 5.0 g (1.5·109 CFU/cm3) based on 10 kg of live weight ensured the complete preservation of the herd of young calves, accelerated their growth energy, as evidenced by exterior indicators of the animals of the experimental group against the control and probable (P &lt; 0.05) average daily gains in live weight – 1.236 ± 0.37 kg/day versus 1.002 ± 0.41 kg/day in the control group of calves. In further studies, we used a dose of the probiotic “Bioseven” – 5.0 g (1.5·109 CFU/cm3) based on 10 kg of live weight, as the optimal dose of the experimental drug, established by the results of research. Comparative results of studies of growth indicators in the calves of the experimental group showed a significant advantage in the actual probable (Р &lt; 0.01) increase in their live weight during the experimental period, which exceeded the similar indicators of the control by 23.6 %. The results of studies of indicators of average daily live weight gain were significantly (Р &lt; 0.05) higher than those of control calves by 28.5 % (Р &lt; 0.01), which testified to the effectiveness of the use of the probiotic “Bioseven” in young calves. Taking into account the obtained results, it becomes clear that the components of the probiotic drug “Bioseven” have a positive effect on the formation of cicatricial digestion in calves.

Frequent Request of Injectable Biperiden in a Young Patient with Uncommon Neck Deviation and History of Neurodevelopmental Disorder

Introduction: Malingering is a differential diagnosis in the field of medical disorders, especially in the field of forensic medicine. In medicine, malingering is when a person imitates a medical or psychiatric disorder with external motivations to gain financial gain or avoid social or occupational duties. In some cases, diagnosing a medical or psychological condition from malingering can be challenging and difficult. In this case report, a patient with a history of multiple hospitalization, neurodevelopmental disorders, and intellectual disability requested to receive injectable Biperiden due to aggression, irritable mood, and neck deviation, and in order to receive it, he deliberately showed neck dystonia. This report aimed to discuss on a neuropsychiatric symptom, after which the patient requested a drug injection to resolve it, in order to differentiate possible diagnoses such as drug complication, factitious disorder, and functional neurological symptom disorder. On the other hand, during the recent searches of similar texts, conflicting results and suggestions have been presented.

Validation of red flags in the workup of children with long-term abdominal pain - A retrospective study.

To evaluate red flags as an instrument to distinguish other medical conditions from Functional Gastrointestinal Disorders (FGID) in children with long-term abdominal pain. In a retrospective follow-up, data were collected from 317 children who were referred for medical assessment due to long-term abdominal pain between the years 2011 and 2012 at three Swedish paediatric open clinic units in Sweden. Throughout the review of medical records, any documented red flags at the primary consultation and finally set diagnosis after 1 year were noted for all cases. A non-FGID disease was diagnosed in 32 cases (10.1%). The sensitivity of red flags to predict inflammatory bowel disease (IBD) was 100% and the specificity 64.1%. The sensitivity of red flags to predict celiac disease was 45.5% and the specificity 63.7%. The sensitivity of red flags to predict any non-FGID disease was 59.4%, and the specificity was 65.6%. The use of red flags is a sensitive instrument to identify patients with IBD but less applicable when identifying celiac disease and other organic diseases. Specificity is generally low and future biomarkers for assessing children with long-term abdominal pain is needed.

The mechanism of curcumin to protect mouse ovaries from oxidative damage by regulating AMPK/mTOR mediated autophagy

BackgroundOxidative stress is considered the main cause of granulosa cell apoptosis in ovarian disease. Curcumin has various biological roles, but its potential role in protecting granulosa cells from oxidative damage remains unidentified. PurposeThe study revealed the protective effect of curcumin on granulosa cell survival under oxidative stress, and explored its mode of action. Study designThe protective effect of curcumin on oxidative stress-induced ovarian cell apoptosis was evaluated in vivo and in vitro, and the role of autophagy and AMPK/mTOR signaling pathway in this process was also demonstrated. MethodsFirst, mice were injected to 3-nitropropionic acid (3-NPA, 20 mg/kg/day) for 14 consecutive days to establish the ovarian oxidative stress model, at same time, curcumin (50, 100, 200 mg/kg/day) was given orally. Thereafter, functional changes, cell apoptosis, and autophagy in ovarian tissue were evaluated by hematoxylin-eosin staining, enzyme-linked immunosorbent assay, western blotting, TUNEL assays, and transmission electron microscopy. Finally, oxidative stress model of granulosa cells was established with H2O2in vitro and treated with curcumin. The underlying mechanisms of curcumin to protect the apoptosis under oxidative stress in vitro were determined using western blotting and TUNEL assays. ResultsIn our study, after curcumin treatment, the mouse ovarian function disorder under 3-nitropropionic acid-induced oxidative stress recovered significantly, and ovarian cell apoptosis decreased. H2O2 induced granulosa cell apoptosis in vitro, and curcumin antagonized this process. Autophagy contributes to tissue and cell survival under stress. We therefore examined the role of autophagy in this process. According to the in vivo and in vitro results, curcumin restored autophagy under oxidative stress. The autophagy inhibitor (chloroquine) exhibited the same effect as curcumin, whereas the autophagy activator (rapamycin) antagonized the effect of curcumin. In addition, the study found that the AMPK/mTOR pathway plays a crucial role in curcumin- mediated autophagy to protect against oxidative stress-induced apoptosis. ConclusionOur findings for the first time systematically revealed a new mechanism through which curcumin protects ovarian granulosa cells from oxidative stress-induced damage through AMPK/mTOR-mediated autophagy and suggested that it can be a new therapeutic direction for female ovarian diseases.

Epidemiology of Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis

Background: Irritable Bowel Syndrome (IBS) is one of the most common functional bowel disorders, but its prevalence appears to vary widely between different countries. In this systematic review and meta-analysis, we aimed to provide an updated comprehensive estimate of IBS prevalence at the country, regional, and global levels. Methods: The PubMed, EMBASE and Web of Science databases were searched (from January 1990 to December 2022), and eligible studies reporting the prevalence of IBS were selected. We extracted the prevalence data from the included studies, and the meta-analysis was completed using a random-effects model. Results: In total, 131 publications reporting 133 records from 39 countries with 292,951 participants were identified for our analysis. The global pooled prevalence of IBS was 15.0% (95% CI: 13.4%-16.6%), and the pooled prevalence of IBS varied substantially between countries and regions. The highest pooled prevalence of IBS was 18.9% in South America, and the lowest was 11.0% in Southeast Asia. The pooled prevalence of IBS in females was 15.0%, while that in males was 11.0%. The pooled prevalence of IBS was 14.2% from 1990 to 2000, 11.4% from 2001 to 2010 and 16.5% from 2011 to 2022.

The Time-Dependent Association Between Irritable Bowel Syndrome and All-Cause and Cause-Specific Mortality: A Prospective Cohort Study Within the UK Biobank.

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders, but few studies have evaluated mortality risks among individuals with IBS. We explored the association between IBS and all-cause and cause-specific mortality in the UK Biobank. We included 502,369 participants from the UK Biobank with mortality data through 2022. IBS was defined using baseline self-report and linkage to primary care or hospital admission data. We estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and cause-specific mortality using multivariable Cox proportional hazards regression models within partitioned follow-up time categories (0-5, >5-10, and >10 years). A total of 25,697 participants (5.1%) had a history of IBS at baseline. After a median follow-up of 13.7 years, a total of 44,499 deaths occurred. Having an IBS diagnosis was strongly associated with lower risks of all-cause (HR = 0.70, 95% CI = 0.62-0.78) and all-cancer (HR = 0.69, 95% CI = 0.60-0.79) mortality in the first 5 years of follow-up. These associations were attenuated over follow-up, but even after 10 years of follow-up, associations remained inverse (all-cause: HR = 0.89, 95% CI = 0.84-0.96; all-cancer: HR = 0.87, 95% CI = 0.78-0.97) after full adjustment. Individuals with IBS had decreased risk of mortality from breast, prostate, and colorectal cancers in some of the follow-up time categories. We found that earlier during follow-up, having diagnosed IBS was associated with lower mortality risk, and the association attenuated over time. Additional studies to understand whether specific factors, such as lifestyle and healthcare access, explain the inverse association between IBS and mortality are needed.

Factors Influencing Triage to Rehabilitation in Functional Movement Disorder.

Treatment of functional movement disorder (FMD) should be individualized, yet factors determining rehabilitation engagement have not been evaluated. Subspecialty FMD clinics are uniquely poised to explore factors influencing treatment suitability and triage. To describe our approach and explore factors associated with triage to FMD rehabilitation. We conducted a retrospective chart review of 158 consecutive patients with FMD seen for integrated assessment by movement disorders neurology and psychiatry, with the purpose of triage to rehabilitation. Demographic and clinical variables were compared between patients triaged to therapy versus no therapy, and logistic regression was used to explore factors predictive of triage outcome. Change in primary outcome scores were analyzed. Sixty-six patients (42%) were triaged to FMD therapy from July 2019 to December 2021. Patients triaged to therapy were more likely to have a constant movement disorder, gait disorder and/or tremor, hyperarousal, readiness for change, and people pleasing traits. Patients triaged to no therapy demonstrated persistent diagnostic disagreement, an inability to appreciate motor symptom inconsistency, low self-agency, a propensity to dissociate, and cluster B traits. 90% of patients triaged to rehabilitation had improved outcomes. The ability to "opt-in" to FMD rehabilitation relies on different factors than those relevant to establishing a diagnosis. Unlike many other neurological disorders, a triage and treatment planning step is recommended to identify those likely to meaningfully engage at that time. Holistic assessment through a transdisciplinary lens, and working collaboratively with the patient is essential to prioritize symptoms, determine engagement, and identify treatment targets.

Drawing the abdominal pain: A powerful tool to distinguish between organic and functional abdominal pain.

Abdominal pain (AP) in children imposes a large economic burden on the healthcare system. Currently, there are no reliable diagnostic tools to differentiate between organic and functional disorders. We hypothesized from previous research that the analysis of patients' graphic expression of subjective symptoms as well as their interactional behavior adds new ways to differentiate between functional and organic AP. Conversation analyses of physician-patient-encounters and graphical expression of AP-based pain were performed. Twenty-twointeractions were recorded and analyzed. Fifteenchildren were diagnosed with organic AP and seven with functional AP. We found marked differences between children with organic and functional AP. For example, all 15 children with organic AP saw the task of drawing a picture of the pain during the interview as a duty, whereas the seven children with functional AP took this as an opportunity to provide detailed descriptions about the nature of the pain, the circumstances, and how the AP impaired their quality of life. Analysis of patients' interaction strategies in response to the painting task provides relevant clues as to whether AP is functional or requires further workup for organic causes.