Electronic health (eHealth) data collection is increasingly used in many chronic illnesses, to track pattern of disease. eHealth systems have the potential to revolutionize care. Inflammatory bowel disease (IBD) is a paradigm for such an approach: this is a chronic disease that usually affects young and technologically literate patient population, who are motivated to be involved in their own care. A range of eHealth technologies are available for IBD. This review considers the strengths and weaknesses of 7 platforms that focus on patient-provider interaction. These have been developed in Denmark, United States, the Netherlands, and the United Kingdom, demonstrating an international interest in this form of technology and interaction. Not only do these technologies aim to improve care but they also have the potential to collect large amounts of information. Information includes demographics and patient reported outcomes (symptoms, quality of life), quality of care (steroid use, among other metrics) and outcomes such as hospitalization. These data could inform quality improvement programmes to improve their focus. eHealth technology is also open to machine learning to analyze large data sets, through which personalized algorithms may be developed.
Biomedical Technology* ; Chronic Disease ; Data Collection ; Dataset ; Demography ; Denmark ; Electronic Health Records ; Great Britain ; Hospitalization ; Humans ; Inflammatory Bowel Diseases* ; Machine Learning ; Mobile Applications ; Netherlands ; Quality Improvement ; Telemedicine ; United States

Circulating concentrations of thyrotropin (TSH) and thyroxine (T4) are tightly regulated. Each individual has setpoints for TSH and free T4 which are genetically determined, and subject to environmental and epigenetic influence. Pituitary-thyroid axis setpoints are probably established in utero, with maturation of thyroid function continuing until late gestation. From neonatal life (characterized by a surge of TSH and T4 secretion) through childhood and adolescence (when free triiodothyronine levels are higher than in adults), thyroid function tests display complex, dynamic patterns which are sexually dimorphic. In later life, TSH increases with age in healthy older adults without an accompanying fall in free T4, indicating alteration in TSH setpoint. In view of this, and evidence that mild subclinical hypothyroidism in older people has no health impact, a strong case can be made for implementation of age-related TSH reference ranges in adults, as is routine in children.

This pilot study evaluated the effect of manuka honey as a subgingival adjunct to scaling and root surface debridement in the treatment of periodontitis. This study used a split-mouth design with a 3-month follow-up in seven participants diagnosed with periodontitis Stage III Grade B or C. Root surface debridement was performed on one side of the mouth (control); the other side received debridement plus manuka honey application (test). Clinical parameters were recorded at baseline, 6- and 12-weeks. Gingival crevicular fluid and subgingival plaque were sampled. Microbiological outcomes were analysed using benzoylarginine pnitroanilide assay and polymerase chain reaction assay. Single application of manuka honey to periodontal pockets did not result in additional reduction of pocket depth, improvement of attachment levels or changes in p-nitroaniline enzymes when compared with root surface debridement alone. However, test sites exhibited greater reduction in bleeding than control sites, mean differences 1.3 (95%CI 1.2-1.5) and 1.7 (95%CI 1.5-1.9) at 6-weeks and 12-weeks, respectively. The proportion of mutans streptococci decreased at 6-weeks in test sites but increased at 12-weeks in control sites. Adjunctive application of manuka honey to periodontal pockets improved gingival inflammation but did not demonstrate significant clinical benefits compared with root surface debridement alone.

OBJECTIVE: To investigate the differences in oral health-related quality of life (OHRQoL) and self-reported jaw function between patients with hyperdivergent and normodivergent facial types. METHODS: Eighty patients with a distinctively hyperdivergent facial type (mandibular plane angle greater than 2 standard deviations, or 42°) and 80 controls were individually matched according to age, sex, ethnicity, and treatment stage. Data were collected using self-report questionnaires such as the Oral Health Impact Profile (OHIP-14) and Jaw Functional Limitation Scale (JFLS-8). RESULTS: The mean age of the patients was 17.2 ± 4.6 years (range, 12–9 years), with most (65.0%) being female and of New Zealand European origin (91.3%). Individuals with hyperdivergent facial types had higher overall and social domain scores on the OHIP-14 (p < 0.05) than did the ones with normodivergent facial types. However, the intergroup differences in JFLS-8 scores were not significant (p > 0.05). CONCLUSIONS: Jaw function appears to be similar in individuals with hyperdivergent and normodivergent facial morphologies. However, those with hyperdivergent facial types are more likely to self-report poorer OHRQoL than are those with normal faces, especially in relation to social aspects.
Female ; Humans ; Jaw* ; New Zealand ; Oral Health ; Quality of Life*

Plant Dicer-like (DCL) and Argonaute (AGO) are the key enzymes involved in anti-virus post-transcriptional gene silencing (AV-PTGS). Here we show that AV-PTGS exhibited nucleotide preference by calculating a relative AV-PTGS efficiency on processing viral RNA substrates. In comparison with genome sequences of dicot-infecting Turnip mosaic virus (TuMV) and monocot-infecting Cocksfoot streak virus (CSV), viral-derived small interfering RNAs (vsiRNAs) displayed positive correlations between AV-PTGS efficiency and G+C content (GC%). Further investigations on nucleotide contents revealed that the vsiRNA populations had G-biases. This finding was further supported by our analyses of previously reported vsiRNA populations in diverse plant-virus associations, and AGO associated Arabidopsis endogenous siRNA populations, indicating that plant AGOs operated with G-preference. We further propose a hypothesis that AV-PTGS imposes selection pressure(s) on the evolution of plant viruses. This hypothesis was supported when potyvirus genomes were analysed for evidence of GC elimination, suggesting that plant virus evolution to have low GC% genomes would have a unique function, which is to reduce the host AV-PTGS attack during infections.
Arabidopsis ; enzymology ; genetics ; virology ; Base Composition ; Dactylis ; enzymology ; genetics ; virology ; Genes, Plant ; Genes, Viral ; Models, Genetic ; Mustard Plant ; enzymology ; genetics ; virology ; Plant Diseases ; genetics ; virology ; Plant Proteins ; metabolism ; Plant Viruses ; genetics ; pathogenicity ; Plants ; enzymology ; genetics ; virology ; Potyvirus ; genetics ; pathogenicity ; RNA Interference ; RNA, Plant ; genetics ; RNA, Small Interfering ; chemistry ; genetics ; metabolism ; RNA, Viral ; chemistry ; genetics ; metabolism ; RNA-Induced Silencing Complex ; metabolism ; Ribonuclease III ; metabolism ; Selection, Genetic ; Substrate Specificity

BACKGROUND/AIMS: TrueColours ulcerative colitis (TCUC) is a comprehensive web-based program that functions through email, providing direct links to questionnaires. Several similar programs are available, however patient perspectives are unexplored. METHODS: A pilot study was conducted to determine feasibility, usability and patient perceptions of real-time data collection (daily symptoms, fortnightly quality of life, 3 monthly outcomes). TCUC was adapted from a web-based program for patients with relapsing-remitting bipolar disorder, using validated UC indices. A semi-structured interview was developed and audio-recorded face-to-face interviews were conducted after 6 months of interaction with TCUC. Transcripts were coded in NVivo11, a qualitative data analysis software package. An inductive approach and thematic analysis was conducted. RESULTS: TCUC was piloted in 66 patients for 6 months. Qualitative analysis currently defies statistical appraisal beyond “data saturation,” even if it has more influence on clinical practice than quantitative data. A total of 28 face-to-face interviews were conducted. Six core themes emerged: awareness, control, decision-making, reassurance, communication and burden of treatment. There was a transcending overarching theme of patient empowerment, which cut across all aspects of the TCUC experience. CONCLUSIONS: Patient perception of the impact of real-time data collection was extremely positive. Patients felt empowered as a product of the self-monitoring format of TCUC, which may be a way of improving self-management of UC whilst also decreasing the burden on the individual and healthcare services.
Automatic Data Processing ; Bipolar Disorder ; Colitis, Ulcerative ; Data Collection ; Delivery of Health Care ; Electronic Mail ; Humans ; Patient Participation ; Pilot Projects ; Quality of Life ; Self Care ; Statistics as Topic ; Ulcer

Objective To characterize the bacteriocin-like inhibitory-substances (BLIS) activity of Streptococcus macedonicus MBF10-2 [named BLIS(MBF10-2)], a bacteriocinogenic strain isolated from an Indonesian tofu byproduct. Methods BLIS(MBF10-2) was obtained by culturing the bacterium, and standard deferred antagonism assays were used to demonstrate its activity. The antibacterial testing of fractions collected by filtration using 3–30 kDa cut-off membrane sizes were carried out by performing well diffusion method. Results The growth of Micrococcus luteus, Streptococcus pyogenes, Lactococcus lactis, Leuconostoc mesenteroides and Weissella confusa were inhibited by BLIS(MBF10-2). Interestingly, BLIS-containing fractions obtained from sequential application on ultrafiltration membranes indicated that this bacterium Streptococcus macedonicus MBF10-2 could produces at least two antimicrobial peptides activities, one of which is likely to be a lantibiotic peptide. Potential synergistic activity against certain Gram-positive (but not Gram-negative) species when partnered with antibiotics (ampicillin, tetracycline or kanamycin) were observed. Conclusion Combination of some BLIS(MBF10-2) active fractions with antibiotics (ampicillin, tetracycline or kanamycin) could demonstrate synergistic activities against certain Gram-positive species.

Non-specific spinal pain is a leading cause of disability worldwide and traditional approaches to management have failed to address the societal burden of spinal pain. This narrative review describes the shift in approach to the management of non-specific spinal pain over the past two decades and outlines key recommendations in modern practice guidelines that are informed by these changes. Implementation of evidence-based practice for spinal pain remains a challenge.
Models, Biopsychosocial

INTRODUCTION: Three doses of SARS-CoV-2 mRNA vaccines have been recommended for cancer patients to reduce the risk of severe disease. Anti-neoplastic treatment, such as chemotherapy, may affect long-term vaccine immunogenicity. METHOD: Patients with solid or haematological cancer were recruited from 2 hospitals between July 2021 and March 2022. Humoral response was evaluated using GenScript cPASS surrogate virus neutralisation assays. Clinical outcomes were obtained from medical records and national mandatory-reporting databases. RESULTS: A total of 273 patients were recruited, with 40 having haematological malignancies and the rest solid tumours. Among the participants, 204 (74.7%) were receiving active cancer therapy, including 98 (35.9%) undergoing systemic chemotherapy and the rest targeted therapy or immunotherapy. All patients were seronegative at baseline. Seroconversion rates after receiving 1, 2 and 3 doses of SARS-CoV-2 mRNA vaccination were 35.2%, 79.4% and 92.4%, respectively. After 3 doses, patients on active treatment for haematological malignancies had lower antibodies (57.3%±46.2) when compared to patients on immunotherapy (94.1%±9.56, P<0.05) and chemotherapy (92.8%±18.1, P<0.05). SARS-CoV-2 infection was reported in 77 (28.2%) patients, of which 18 were severe. No patient receiving a third dose within 90 days of the second dose experienced severe infection. CONCLUSION This study demonstrates the benefit of early administration of the third dose among cancer patients.
Humans ; SARS-CoV-2 ; COVID-19/prevention & control* ; Treatment Outcome ; Neoplasms/drug therapy* ; Hematologic Neoplasms ; Vaccination ; RNA, Messenger ; Antibodies, Viral ; Immunogenicity, Vaccine