1.Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?
Linxin LI ; Vasileios-Arsenios LIOUTAS ; Ralph K. AKYEA ; Stefan GERNER ; Kui Kai LAU ; Emily RAMAGE ; Aristeidis H. KATSANOS ; George HOWARD ; Philip M. BATH
Journal of Stroke 2025;27(1):41-51
Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the “less traditional” designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.
2.Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment
Hee Kyong NA ; Andrew A. LI ; Andres GOTTFRIED-BLACKMORE ; Alexander J. PODBOY ; Micaela M. ESQUIVEL ; Abel A. JOSEPH ; Linda NGUYEN ; Joo Ha HWANG
Gut and Liver 2025;19(3):327-345
Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature.
3.Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment
Hee Kyong NA ; Andrew A. LI ; Andres GOTTFRIED-BLACKMORE ; Alexander J. PODBOY ; Micaela M. ESQUIVEL ; Abel A. JOSEPH ; Linda NGUYEN ; Joo Ha HWANG
Gut and Liver 2025;19(3):327-345
Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature.
4.Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment
Hee Kyong NA ; Andrew A. LI ; Andres GOTTFRIED-BLACKMORE ; Alexander J. PODBOY ; Micaela M. ESQUIVEL ; Abel A. JOSEPH ; Linda NGUYEN ; Joo Ha HWANG
Gut and Liver 2025;19(3):327-345
Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature.
5.Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?
Linxin LI ; Vasileios-Arsenios LIOUTAS ; Ralph K. AKYEA ; Stefan GERNER ; Kui Kai LAU ; Emily RAMAGE ; Aristeidis H. KATSANOS ; George HOWARD ; Philip M. BATH
Journal of Stroke 2025;27(1):41-51
Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the “less traditional” designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.
6.Factors associated with anxiety symptoms among Filipino farmers in Central Luzon: An analytical cross-sectional study.
Har-li T. YOUNG ; Dina Marie YALONG ; Vinace S. GUINGGUING ; Van Irish S. VENTILACION ; Merimae S. VILLAMAYOR ; Peter Verona G. VILLANGCA ; William M. MANENGYAO JR. ; Ma. Beatrice M. VEGA ; Alina Marea C. ZAÑO ; Maria Teresa SANCHEZ-TOLOSA
Acta Medica Philippina 2025;59(Early Access 2025):1-11
BACKGROUND AND OBJECTIVE
Filipino farmers face unique occupational challenges that increase the risk of mental health issues, particularly anxiety. This study aims to determine the different personal, environmental, socioeconomic, occupational, and psychosocial factors associated with anxiety symptoms among Filipino farmers in Central Luzon.
METHODSChain referral sampling method was used to recruit participants for the study, who underwent screening based on the eligibility criteria. Eligible participants were then asked about anxiety symptoms using the Generalized Anxiety Disorder-7 (GAD-7), while the validated, researcher-constructed Data Collection Tool for Factors Associated with Anxiety Symptoms (DCFAAS) was used to determine the farmers’ exposure to a variety of factors. Microsoft Excel was utilized in computing for frequency and percent distribution of participants, in each factor. Binary logistic regression was used to compute crude and adjusted odds ratio of each factor thru IBM SPSS Statistics®.
RESULTSAmong the 113 eligible farmers enrolled in the study, only 19 (16.8%) experienced anxiety symptoms, with excessive worrying, which was seen among 45 participants (39.8%). The mental health of Filipino farmers was significantly affected by the presence of physical illness (OR = 10.70 [95% CI 1.367, 83.773]) and having relatives affecting work completion (OR = 6.45 [95% CI 1.346, 30.896]).
CONCLUSIONDespite the low prevalence of anxiety symptoms in this study, the findings suggest government policies to improve mental health service access to farmers, to integrate psychosocial support into agricultural programs, and to address family-related work pressures. By addressing these factors, it can improve farmer productivity and promote overall well-being, putting emphasis on the mental health of the Filipino farmers.
Human ; Farmers ; Agriculture ; Generalized Anxiety Disorder ; Gad-7 ; Patient Health Questionnaire
7.Pyloric Dysfunction: A Review of the Mechanisms, Diagnosis, and Treatment
Hee Kyong NA ; Andrew A. LI ; Andres GOTTFRIED-BLACKMORE ; Alexander J. PODBOY ; Micaela M. ESQUIVEL ; Abel A. JOSEPH ; Linda NGUYEN ; Joo Ha HWANG
Gut and Liver 2025;19(3):327-345
Pyloric dysfunction is defined as hypertonia or spasm of the pyloric sphincter. The pylorus plays a key role in gastric emptying, but its function remains incompletely understood. Most studies have focused on gastroparesis regardless of the underlying pathophysiology. Few studies have reported pyloric dysfunction in patients with gastroparesis, and the diagnostic and treatment modalities for pyloric dysfunction are not well established. Recently developed diagnostic modalities assessing pyloric function, such as high-resolution antroduodenal manometry and endoluminal functional lumen imaging, are currently being evaluated. A variety of therapeutic interventions targeting the pylorus, including pharmacologic agents, intrapyloric botulinum injection, endoscopic balloon dilation, stent insertion, surgical pyloroplasty, and gastric peroral endoscopic pyloromyotomy, have been proposed. Among these, gastric peroral endoscopic pyloromyotomy has emerged as a novel, minimally invasive therapy with demonstrated efficacy and safety for refractory gastroparesis. This article reviews the pathophysiology of pyloric dysfunction and the potential diagnostic and therapeutic modalities based on the latest literature.
8.Non-Inferiority Trials in Stroke Research: What Are They, and How Should We Interpret Them?
Linxin LI ; Vasileios-Arsenios LIOUTAS ; Ralph K. AKYEA ; Stefan GERNER ; Kui Kai LAU ; Emily RAMAGE ; Aristeidis H. KATSANOS ; George HOWARD ; Philip M. BATH
Journal of Stroke 2025;27(1):41-51
Randomized clinical trials are important in both clinical and academic stroke communities with increasing numbers of new design concepts emerging. One of the “less traditional” designs that have gained increasing interest in the last decade is non-inferiority trials. Whilst the concept might appear straightforward, the design and interpretation of non-inferiority trials can be challenging. In this review, we will use exemplars from clinical trials in the stroke field to provide an overview of the advantages and limitations of non-inferiority trials and how they should be interpreted in stroke research.


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