The small bowel and functional dyspepsia - peptide hormones and neurotransmitters

Functional dyspepsia (FD) is believed to be caused by pathophysiological changes in the upper gut. Gastro-intestinal motility, epithelial transport and signalling is associated with the metabolism of nutrients and the complex regulation of hunger and satiety. Glucagon-like peptide 1 (GLP-1) and peptide YY (PYY) are considered “hot targets”. Both are anorexigenic, can induce nausea, and are involved in neuronal and hormonal feedback. Epithelial transport and signalling are partly controlled by the action of the neurotransmitter serotonin (5-HT). 5-HT forms the “link” between luminal stimulation and the enteric nervous system. We aimed at investigating if GLP-1, PYY and 5-HT are involved in the pathogenesis of FD. In study I and II healthy subjects were given a radiolabelled omelette during intravenous infusion of saline, PYY1-36, or PYY3-36 (study I) and saline or the GLP- 1 receptor antagonist Exendin(9-39)amide (study II) in a single-blinded, randomized design. Gastric emptying (scintigraphy), appetite ratings (VAS), and plasma concentrations of insulin, glucose, GLP-1, PYY and glucagon were studied. In study III FD patients and controls consumed two liquid meals, first a fixed amount and then until maximal satiety. Gastric emptying (paracetamol absorption test) and plasma concentrations of GLP-1, glucose and insulin were assessed as well as appetite ratings and dyspeptic symptoms. In study IV duodenal mucosal biopsies from FD patients and controls were studied for the number of 5-HT-containing cells (immunohistochemistry) and the expression of different 5-HT receptors by means of PCR. Biopsies were also mounted in Ussing chambers for evaluation of basal and 5-HT-stimulated short-circuit current. In study V duodenal biopsies from non-patients with FD and controls from a population based upper endoscopy study were evaluated immunohistochemically for Chromogranin A (CGA) as endocrine cell marker and 5-HT. Individuals with FD were further divided into epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS). PYY3-36 and PYY1-36 inhibits gastric emptying (PYY3-36 most effectively), and decreased the postprandial rise in insulin. PYY3-36 induced nausea and decreased prospective consumption. GLP-1 was involved in regulation of postprandial gastric motility, in insulin and glucose levels, and restrained glucagon secretion. Gastric emptying was not affected and we conclude that GLP-1 has a role as incretin hormone independent of gastric emptying. FD patients had normal postprandial glucose and GLP-1 concentrations. The FD-EPS subgroup had higher postprandial insulin levels compared to controls. Exogenous 5-HT induced lower short-circuit current and higher electrical resistance in FD. FD patients had higher gene expression of HTR3E and SERT and lower expression of HTR7 and TPH1. The number of 5-HT containing cells in duodenal mucosa was similar in FD patients and controls, and adults with FD had less endocrine cells and a normal number of 5-HT containing cells compared to controls. Endocrine cells was significantly decreased in the duodenal bulb in EPS but not PDS. Our results provide new evidence that altered endocrine secretion in the small bowel is part of the disease mechanism in FD, with PYY and GLP-1 as key candidates. GLP-1 specifically contributes to the development of nausea. Furthermore, FD patients have abnormal 5-HT stimulated electrolyte secretion in the duodenum with possible involvement of the 5-HT receptors 3E and 7

Biodiversity of Spongosorites coralliophaga (Stephens, 1915) on coral rubble at two contrasting cold-water coral reef settings

The authors would like to thank Bill Richardson (Master), the crew of the RRS James Cook, Will Handley and the Holland-I ROV team. We also thank all the specialists in taxonomy that provided important help with identification of species: Professor Paul Tyler (ophiuroids), Dr. Tammy Horton (amphipods), Dr. Graham Oliver (bivalves), Dr. Rob van Soest (sponges), Susan Chambers, Peter Garwood, Sue Hamilton, Raimundo Blanco Pérez (polychaetes). Also we would like to thank Val Johnston (University of Aberdeen) for her contribution to cruise preparations and John Polanski (University of Aberdeen) for his help onboard the RRS James Cook. Special thanks to Dr. Alexios P. Lolas (University of Thessaly, Greece) for all the artwork. Funding for the JC073 cruise was provided by the Natural Environment Research Council (NERC) UK Ocean Acidification (UKOA) research programme’s Benthic Consortium project (NE/H017305/1 to JMR). JMR acknowledges support from Heriot-Watt University’s Environment and Climate Change theme. GK was funded by a Marine Alliance for Science and Technology for Scotland (MASTS) Ph.D. scholarship.Peer reviewedPublisher PD

Transforming Personal Healthcare through Technology - A Systematic Literature Review of Wearable Sensors for Medical Application

Wearable Sensor Health Technology (WSHT) captures, analyzes and aggregates physiological data to improve personal well-being. Recently the technology market is flooded with wearable sensors that measure health-related data and have a high user adoption. Nevertheless, these devices are almost exclusively used for fitness purposes and the healthcare sector still faces the challenge of constantly increasing costs. To respond to the necessary but rare use of WSHT in professional healthcare, we aim to identify the most promising areas for future medical implementation. Therefore, we performed a systematic literature search and reviewed 97 papers with regard to disease treatment, application area, vital parameter measurement and target patient. As a result, we could identify five potential areas for further research: (RA1) concentration on widespread diseases, (RA2) expansion of WSHT’s functionality, (RA3) diversity of vital parameter measurements, (RA4) proactive analysis of sensor data for preventive purposes and (RA5) promoting patient adoption through enhanced usability

Artificial Intelligence: The Future of Sustainable Agriculture? A Research Agenda

Global warming and the increasing food demand are problems of the current generation and require a change towards sustainable agriculture. In recent years, research in the field of artificial intelligence has made considerable progress. Thus, the use of artificial intelligence in agriculture can be a promising solution to ensure sufficient food supply on a global scale. To investigate the state-of-the-art in the use of artificial intelligence-based systems in agriculture, we provide a structured literature review. We show that research has been done in the field of irrigation and plant growth. In this regard, camera systems often provide images as training/input data for artificial intelligence-based systems. Finally, we provide a research agenda to pave the way for further research on the use of artificial intelligence in sustainable agriculture

Design and Development of Virtual Patients for Healthcare Education: State of the Art and Research

The digital transformation of healthcare and the COVID-19 pandemic have accelerated research and deployment of virtual patients (VP), that is, interactive computer simulations used in healthcare education to train students on clinical processes. To help researchers and practitioners understand the state of the art in VP development, we conducted a systematic literature review of 48 papers. Our analysis focused on educational level, medical specialty, competencies, technologies, technical format, and operating systems and tools. We found that VPs are primarily used in the medical field and student education as interactive patient scenarios based on multimedia system technology. VP authoring systems were identified as the primary tool for developing primary clinical reasoning skills. Based on our findings, we suggest implications for medical education research and practice

Vascular risk factors and diabetic neuropathy

Background: Other than glycemic control, there are no treatments for diabetic neuropathy. Thus, identifying potentially modifiable risk factors for neuropathy is crucial. We studied risk factors for the development of distal symmetric neuropathy in 1172 patients with type 1 diabetes mellitus from 31 centers participating in the European Diabetes (EURODIAB) Prospective Complications Study. Methods: Neuropathy was assessed at baseline (1989 to 1991) and at follow-up (1997 to 1999), with a mean (±SD) follow-up of 7.3±0.6 years. A standardized protocol included clinical evaluation, quantitative sensory testing, and autonomic-function tests. Serum lipids and lipoproteins, glycosylated hemoglobin, and the urinary albumin excretion rate were measured in a central laboratory. Results: At follow-up, neuropathy had developed in 276 of 1172 patients without neuropathy at baseline (23.5 percent). The cumulative incidence of neuropathy was related to the glycosylated hemoglobin value and the duration of diabetes. After adjustment for these factors, we found that higher levels of total and low-density lipoprotein cholesterol and triglycerides, a higher body-mass index, higher von Willebrand factor levels and urinary albumin excretion rate, hypertension, and smoking were all significantly associated with the cumulative incidence of neuropathy. After adjustment for other risk factors and diabetic complications, we found that duration of diabetes, current glycosylated hemoglobin value, change in glycosylated hemoglobin value during the follow-up period, body-mass index, and smoking remained independently associated with the incidence of neuropathy. Cardiovascular disease at baseline was associated with double the risk of neuropathy, independent of cardiovascular risk factors. Conclusions: This prospective study indicates that, apart from glycemic control, the incidence of neuropathy is associated with potentially modifiable cardiovascular risk factors, including a raised triglyceride level, body-mass index, smoking, and hypertension

Closing the Gender Gap: Initial Findings and Lessons Learned from a German Medium-Sized IT Services Company\u27s Efforts for Career Changers

Digital transformation is driving demand for information technology (IT) professionals. Addressing the underrepresentation of women in IT is a promising way to expand the pool of potential candidates. This research aims to determine how women without IT-specific knowledge can potentially contribute to reducing the gender gap in the German IT sector, especially for small and medium-sized enterprises. A case study with qualitative interviews within a medium-sized IT service company was conducted to answer the research question. The results reveal that targeted job advertisements can successfully introduce women from other sectors to the possibility of a career change in the IT environment. In this way, new female employees can be recruited, reducing the gender gap

Clinical Effectiveness of a Subperiosteal Anchorage Device

The purpose of this pilot study was to evaluate the clinical efficacy of a subperiosteal anchorage device, the palatal OnPlant™, during orthodontic retraction of protruding anterior teeth in cases requiring maxillary premolar extraction. Seven subjects (5 female, 2 male), ages 13 to 55, were selected for the study. The OnPlant was surgically placed in the mid-palatal region through a well-defined subperiosteal tunnel. Following the manufacturer recommended osseointegration period of four months, the OnPlant was uncovered and attached to the first molars by means of a transpalatal bar. Standard orthodontic treatment then commenced to retract the anterior teeth after the first premolars were extracted. A new volumetric tomography scanner, the NewTom 9000, was used to evaluate the clinical efficacy of the OnPlant. The study design called for records to be taken at two intervals: 1) Following placement of the OnPlant-transpalatal bar, immediately prior to retraction of the anterior dentition and 2) Following completion of retraction as well as any necessary torquing of the maxillary incisors. Limited time allowed only partial treatment for three of the subjects, whose final NewTom records were taken within the retraction phase of treatment. Six of the OnPlants performed without failure, providing absolute anchorage of the molars during treatment. One OnPlant failed near the end of incisor retraction. The NewTom proved to be a consistent and reliable tool for evaluating the OnPlant\u27s clinical performance. Future research into the OnPlant and other such skeletal anchorage devices may continue to expose the orthodontic community to the benefits of such devices in cases requiring maximum anchorage

Flexwork in the context of Burnout-Research

In dieser Arbeit wird das Thema Flexwork im Kontext der Burnout-Forschung vorgestellt. Der Fokus liegt hierbei auf potentiell negativen Folgen des Flexwork. Ziel dieser Ausarbeitung ist es, das Konstrukt des Flexwork konkreter zu fassen und zu untersuchen, ob das Burnout-Syndrom eine spezifische Folge von Flexwork sein kann. Zunächst werden einschlägige theoretische Grundlagen erläutert. Nach einer Einführung in die methodische Vorgehensweise qualitativer und quantitativer Forschungsinstrumente werden die Interviewergebnisse dargestellt. Anschließend wird der Entwurf für einen Fragebogen vorgestellt, der das Ziel hat, zu erfassen, ob und inwiefern Flexwork einen Auslöser für das Burnout-Syndrom darstellt. Im Diskussionsteil dieser Projektarbeit erfolgen eine kritische Betrachtung der methodischen Vorgehensweise sowie eine zusammenfassende Bewertung der Thematik.This research report approaches the subject of Flexwork in the context of Burn-out-Research. The focus lies on the underlying negative effects of Flexwork. The key objective of this paper is to specify the construct of Flexwork and to analyze whether the Burnout-Syndrome can be a specific consequence of Flexwork. Initially, theoretical fundamentals are elucidated. After an introduction into the methodological procedure of qualitative and quantitative instruments of research, the interview-results are illustrated. Subsequently, a blue-print of a questionnaire with the goal of measuring whether or not Flexwork can be seen as an actuator of the Burnout-Syndrome is presented. In the discussion, a critical consideration of the methodological procedures and an overall conclusion is given

Gender and Mobility – A Literature Review on Women\u27s (Non-)Use of Shared Mobility Services

In the context of the development of smart cities, the number and types of shared mobility solutions, such as carsharing and bikesharing, have increased in recent years. While the services are generally becoming more popular, there are comparatively few women among the users. With a view to gender-equitable mobility, this literature review explores gender-specific reasons for this low use of shared mobility solutions. Based on 35 relevant studies from multiple databases and disciplines, we identified four overarching barriers related to: security, availability, simplicity, and costs. By identifying these barriers and the reasons for them, and by linking them in a self-developed conceptual model with starting points for potential actions to address these issues, this literature review contributes to gender-equitable mobility