In recent years, the gut microbiota has become an integral research topic in human health owing to its impact on digestion, immunity, metabolic processes, and mental health. The possibilities of microbiome treatment have increased interest in dietary approaches, with a special focus on the intake of fermented foods. This has revived some of the most profound and practical constructs derived from food therapy in Chinese medicine (CM), where food therapy, along with fermented options, actively preserves health and prevents disease. In CM, the spleen and stomach system refers to the postnatal foundation of the body, which controls the processes of chewing, nutrient assimilation, and energy production (qi). The balance between intestinal and overall health is the foundation of psychosomatic well-being and is of utmost importance. Fermented foods can boost the spleen, alleviate stagnant food syndrome, dispel excess fluids, enhance protective functions, and strengthen the immune system. This review aimed to integrate the conceptual and clinical paradigms of CM with those of Western medicine, focusing on the role of fermented foods in gut microbiota regulation. This article discusses prominent fermented foods in CM and their classical functions, alongside the currently available peer-reviewed literature (published within the last 7 years) on their impact on gut flora and other clinical outcomes. Mechanistic considerations regarding the production of probiotics and other active metabolites, such as short-chain fatty acids, and the modulation of the intestinal barrier are discussed. This review also examines multidisciplinary approaches to dietary customs worldwide and outlines the clinical applications of these findings in the context of chronic disease management and gastrointestinal health.

Bacterial Infections ; Humans ; Lymphoma, Large B-Cell, Diffuse/diagnosis* ; Mucormycosis/diagnosis* ; Respiratory Sounds ; Thyroid Gland

Objective: This study aimed to evaluate the reliability and validity of the Korean version of the Pornography Craving Questionnaire (K-PCQ) using classical test theory and item response theory. Methods: The goodness of fit test and differential item functioning (DIF) analysis based on the Rasch model, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and correlation analysis were used to test its reliability and validity. Results: Response data from 226 students were analyzed. According to the goodness of fit test, the outfit mean square value of only one item, Item 11, was greater than 2. The CFA results revealed that all items of the K-PCQ measured a single construct. The EFA results revealed that the K-PCQ had excellent internal reliability. The DIF analysis results showed that the measurement of pornography craving using the K-PCQ did not differ based on gender. The result of Poly-DIMTEST supported the unidimensionality of the K-PCQ. The cut-off value of pornography craving was suggested as a measure of -0.0908 which corresponds to 46 (54.8%) out of a maximum score of 84. Conclusion The items of the K-PCQ are unidimensional and have good reliability and validity. The K-PCQ will be useful in clinical practice and research as a screening tool for pornography craving.

Management of complicated massive infective endocarditis (IE) in patients who are contraindicated for surgical valve replacement has long been a dilemma for many clinicians. Studies have shown that massive IE patients who were treated conservatively generally result in poorer prognosis. We report two cases of massive native valve infective endocarditis with severe mitral valve regurgitation and septic emboli that has been successfully treated conservatively. Interestingly, despite having a large vegetation and multiple septic emboli complications, none of these two cases had any positive culture or serology. Managing culture negative IE without surgical intervention pose an even greater challenge to the choice and duration of antibiotics with further long-term plans. We hope to share these case series to aid in the management dilemma of similar cases in the future.

COVID-19 ; Heart Diseases ; Humans ; Incidence ; SARS-CoV-2 ; Singapore/epidemiology*

Objective: This study aimed to evaluate the reliability and validity of the Korean version of the Pornography Craving Questionnaire (K-PCQ) using classical test theory and item response theory. Methods: The goodness of fit test and differential item functioning (DIF) analysis based on the Rasch model, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and correlation analysis were used to test its reliability and validity. Results: Response data from 226 students were analyzed. According to the goodness of fit test, the outfit mean square value of only one item, Item 11, was greater than 2. The CFA results revealed that all items of the K-PCQ measured a single construct. The EFA results revealed that the K-PCQ had excellent internal reliability. The DIF analysis results showed that the measurement of pornography craving using the K-PCQ did not differ based on gender. The result of Poly-DIMTEST supported the unidimensionality of the K-PCQ. The cut-off value of pornography craving was suggested as a measure of -0.0908 which corresponds to 46 (54.8%) out of a maximum score of 84. Conclusion The items of the K-PCQ are unidimensional and have good reliability and validity. The K-PCQ will be useful in clinical practice and research as a screening tool for pornography craving.

INTRODUCTION: A voluntary cerebral palsy (CP) registry was established in 2017 to describe the clinical characteristics and functional outcomes of CP in Singapore. METHODS: People with CP born after 1994 were recruited through KK Women's and Children's Hospital, National University Hospital and Cerebral Palsy Alliance Singapore. Patient-reported basic demographics, service utilisation and quality of life measures were collected with standardised questionnaires. Clinical information was obtained through hospital medical records. RESULTS: Between 1 September 2017 and 31 March 2020, 151 participants were recruited. A majority (n=135, 89%) acquired CP in the pre/perinatal period, where prematurity (n=102, 76%) and the need for emergency caesarean section (n=68, 50%) were leading risk factors. Sixteen (11%) of the total participants had post-neonatally acquired CP. For predominant CP motor types, 109 (72%) had a spastic motor type; 32% with spastic mono/hemiplegia, 41% diplegia, 6% triplegia and 21% quadriplegia. The remaining (42, 27.8%) had dyskinetic CP. Sixty-eight (45.0%) participants suffered significant functional impairment (Gross Motor Functional Classification System levels IV-V). Most participants (n=102, 67.5%) required frequent medical follow-up (≥4 times a year). CONCLUSION Optimisation of pre- and perinatal care to prevent and manage prematurity could reduce the burden of CP and their overall healthcare utilisation.

Background: Interscalene brachial plexus block (ISB) provides excellent analgesia for arthroscopic shoulder surgeries but is associated with adverse effects including hemidiaphragmatic paresis. We aimed to compare the respiratory effects, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) between suprascapular nerve block (SSB) and ISB. Methods: Sixty patients were recruited and randomized into ISB, anterior SSB, and posterior SSB groups. FVC, FEV1, and diaphragmatic excursion were evaluated at baseline and 30 minutes after intervention. Blocks were performed under ultrasound guidance with 15 ml of 0.5% ropivacaine. Pain scores were assessed at 6, 12, and 24 hours postoperatively. Results: The ISB group showed a reduced FVC of 31.2% ± 17.5% (mean ± SD), while the anterior and posterior SSB groups had less reduction of 3.6% ± 18.6% and 6.8% ± 6.5%, respectively (P < 0.001). The ISB group showed more reduction in diaphragmatic excursion than the anterior and posterior SSB groups (median [IQR]): −85.7% (−95.3% to −63.3%) vs. −1.8% (−13.1% to 2.3%) and −1.2% (−8.8% to 16.8%), respectively (P < 0.001). The median pain scores (IQR) in the ISB and anterior SSB groups were lower than those in the posterior SSB group at 6 hours on movement: 0 (0–2), 1.8 (0–4.5) vs. 5 (2.5–8), respectively (P = 0.002). There was no significant difference in oxycodone consumption postoperatively. Conclusions Anterior SSB preserves lung function and has a comparable analgesic effect as ISB. Thus, it is recommended for arthroscopic shoulder surgeries, especially in patients who have reduced lung function.

The hepatitis C virus (HCV) consists of eight genotypes and 90 subtypes, with genotype (GT) 3 being the second most common globally and is linked to higher incidences of steatosis and rapid development of fibrosis and cirrhosis. The NS3/4A serine protease, a heterodimer complex of two HCV non-structural proteins, is an effective target for pharmaceutical intervention due to its essential roles in processing HCV polyproteins and inhibiting innate immunity. This study combines structure-based virtual screening (SBVS) of predefined compound libraries, pharmacokinetic prediction (ADME/T) and in vitro evaluation to identify potential low molecular weight (<500 Dalton) inhibitors of the NS3/4A serine protease (GT3). In silico screening of ZINC and PubChem libraries yielded five selected compounds as potential candidates. Dose-dependent inhibition of the NS3/4A serine protease and HCV replication in HuH-7.5 cells revealed that compound A (PubChem ID No. 16672637) exhibited inhibition towards HCV GT3 with an IC50 of 106.7µM and EC50 of 25.8µM, respectively. Thus, compound A may be developed as a potent, low molecular weight drug against the HCV NS3/4A serine protease of GT3.