233 research outputs found
Stool Microbiota Diversity Analysis of Blastocystis-Positive and Blastocystis-Negative Individuals
Blastocystis is a unicellular eukaryote found in the gastrointestinal tract of both human and other animal hosts. The clinical significance of colonic Blastocystis colonization remains obscure. In this study, we used metabarcoding and bioinformatics analyses to identify differences in stool microbiota diversity between Blastocystis-positive and Blastocystis-negative individuals (n = 1285). Alpha diversity was significantly higher in Blastocystis carriers. At phylum level, Firmicutes and Bacteroidetes were enriched in carriers, while Proteobacteria were enriched in non-carriers. The genera Prevotella, Faecalibacterium, Flavonifracter, Clostridium, Succinivibrio, and Oscillibacter were enriched in carriers, whereas Escherichia, Bacteroides, Klebsiella, and Pseudomonas were enriched in non-carriers. No difference in beta diversity was observed. Individuals with Blastocystis-positive stools appear to have gut microbiomes associated with eubiosis unlike those with Blastocystis-negative stools, whose gut microbiomes are similar to those associated with dysbiosis. The role of Blastocystis as an indicator organism and potential modulator of the gut microbiota warrants further scrutiny.publishedVersio
A Systematic Review of Neuropsychological Tests for the Assessment of Dementia in Non-Western, Low-Educated or Illiterate Populations
Objective:Neuropsychological tests are important instruments to determine a cognitive profile, giving insight into the etiology of dementia; however, these tests cannot readily be used in culturally diverse, low-educated populations, due to their dependence upon (Western) culture, education, and literacy. In this review we aim to give an overview of studies investigating domain-specific cognitive tests used to assess dementia in non-Western, low-educated populations. The second aim was to examine the quality of these studies and of the adaptations for culturally, linguistically, and educationally diverse populations.Method:A systematic review was performed using six databases, without restrictions on the year or language of publication.Results:Forty-four studies were included, stemming mainly from Brazil, Hong Kong, Korea, and considering Hispanics/Latinos residing in the USA. Most studies focused on Alzheimer's disease (n = 17) or unspecified dementia (n = 16). Memory (n = 18) was studied most often, using 14 different tests. The traditional Western tests in the domains of attention (n = 8) and construction (n = 15), were unsuitable for low-educated patients. There was little variety in instruments measuring executive functioning (two tests, n = 13), and language (n = 12, of which 10 were naming tests). Many studies did not report a thorough adaptation procedure (n = 39) or blinding procedures (n = 29).Conclusions:Various formats of memory tests seem suitable for low-educated, non-Western populations. Promising tasks in other cognitive domains are the Stick Design Test, Five Digit Test, and verbal fluency test. Further research is needed regarding cross-cultural instruments measuring executive functioning and language in low-educated people
A weak scientific basis for gaming disorder: let us err on the side of caution
We greatly appreciate the care and thought that is evident in the 10 commentaries that discuss our debate paper, the
majority of which argued in favor of a formalized ICD-11 gaming disorder. We agree that there are some people
whose play of video games is related to life problems. We believe that understanding this population and the nature
and severity of the problems they experience should be a focus area for future research. However, moving from
research construct to formal disorder requires a much stronger evidence base than we currently have. The burden of
evidence and the clinical utility should be extremely high, because there is a genuine risk of abuse of diagnoses. We
provide suggestions about the level of evidence that might be required: transparent and preregistered studies, a better
demarcation of the subject area that includes a rationale for focusing on gaming particularly versus a more general
behavioral addictions concept, the exploration of non-addiction approaches, and the unbiased exploration of clinical
approaches that treat potentially underlying issues, such as depressive mood or social anxiety first. We acknowledge
there could be benefits to formalizing gaming disorder, many of which were highlighted by colleagues in their
commentaries, but we think they do not yet outweigh the wider societal and public health risks involved. Given the
gravity of diagnostic classification and its wider societal impact, we urge our colleagues at the WHO to err on the side
of caution for now and postpone the formalization
Peripheral nerve block anaesthesia and postoperative pain in acute ankle fracture surgery:the AnAnkle randomised trial
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