Search Results (77)

Background/objectives: Social media has significantly enhanced access to medical knowledge by enabling rapid information sharing. With YouTube being the second-most popular website, we intended to evaluate the quality of its content as a source of information for patients and relatives for information about cerebral palsy. Methods: The first 30 videos for search terms “Cerebral palsy”, “Spastic cerebral palsy”, “Dyskinetic cerebral palsy”, “Worster-Drought syndrome”, and “Ataxic cerebral palsy” were selected for inquiry. Out of 150 films, a total of 83 were assessed with a mixed method approach by two independent raters utilizing evidence-based quality scales such as Quality Criteria for Consumer Health Information (DISCERN), the Journal of the American Medical Association instrument (JAMA), and the Global Quality Score (GQS). Furthermore, audience engagement was analyzed, and the Video Power Index (VPI) was calculated for each video. Results: The mean total DISCERN score excluding the final question (subjective assessment of the video) was 30.5 ± 8.7 (out of 75 points), implying that the quality of the videos was poor. The global JAMA score was 2.36 ± 0.57 between the raters. The mean GQS score reached 2.57 ± 0.78. The videos had statistically higher DISCERN scores when they included treatment options, risk factors, anatomy, definition, information for doctors, epidemiology, doctor as a speaker, and patient experience. Conclusions: YouTube seems to be a poor source of information for patients and relatives on cerebral palsy. The analysis can contribute to creating more engaging, holistic, and informative videos regarding this topic. Full article

Background: Lactate dehydrogenase (LDH) activity, producing high levels of lactate from pyruvate in cancer cells, is often associated with poor patient prognosis. We previously showed enhanced LDH/lactate levels in estrogen receptor (ER) compared to ER + breast cancer cells; lactate or pyruvate supplementation to ER + cells significantly enhanced their motile ability, while LDHB gene knockout (KO) or treatment with LDH inhibitors reduced the motility of the highly aggressive ER breast cancer cells. Aims: To investigate the molecular mechanisms by which lactate, LDHB KO, or treatment with LDH inhibitors can modulate the motile capabilities of breast cancer cell lines. Methods: KO experiments were performed using siRNA, and global expression was determined by proteomic profiling with Proteome Profiler Human XL Oncology arrays, Western blot, and immunofluorescence. Results: Lactate supplementation to ER + breast cancer cells enhanced expression of vimentin, N-cadherin, and snail, while reducing the expression of JAM-A, E-cadherin, and nectin-4. This expression profile was reversed with LDHB KO in ER cells. LDHB KO, or treatment with LDH inhibitors in ER cells, also reduced the expression of IL-6, IL-8, and MMP-2. The expressions of other markers such as PECAM-1, CCL20, and ENPP-2 were differentially modulated with LDH B KO in de novo ER cells (MDA-MB-231) vs. those that had ER knockout (pII). Conclusions: Our data show a novel role for lactate in modulating the EMT status in breast cancer cells and highlight the important role of lactate in breast cancer motility in part through modulating EMT status and the expression profile of cytokines, adhesion molecules, MMP-2, and nectin-4. Full article

This study examines speleothems, sediments, rock, and water to assess geochemical and mineralogical processes in deep karst systems. Focusing on Slovačka jama cave (−1320 m deep) and the Velebita cave system (−1026 m deep), we identify elemental and mineralogical anomalies that provide valuable records of element transport, mineral formation, and paleoenvironmental changes. Heavy metal anomalies (Al, B, Co, Mn, Na, Tl, Ba, Be, Cr, Cu, Fe, K, Pb, Rb, Ti, U, Zn) at 300–400 m of depth in Slovačka jama indicate a complex interplay of geological conditions, geomorphological processes, atmospheric deposition, and potential anthropogenic influences. Factor analysis reveals two elemental associations: (1) Fe, Pb, Cu, and Zn, linked to terrigenous aluminosilicates, and (2) Cd, Cr, Mo, and Ni, suggesting airborne or geological sources. Mineralogical analysis confirms the dominance of calcite, with quartz, clay minerals, feldspars, magnetite, and goethite also detected. High magnetic susceptibility values in sediment-rich samples suggest Fe-rich mineral inputs from weathering, biogenic activity, or industrial sources. Ba anomalies in feldspar-rich samples and Sr accumulation at depth indicate distinct geochemical processes. These findings enhance our understanding of deep karst geochemistry, crucial for paleoenvironmental reconstructions and groundwater protection. Full article

Insulin is an important component of stem cell cultures; however, its role in the proliferation of avian primordial germ cells (PGCs) is unknown. The proliferation of PGCs in cultures varies and the growth factors and signaling pathways necessary to induce the proliferation of PGCs in chickens are unknown. Therefore, we conducted the present study to investigate the effect of insulin on the survival and proliferation of PGCs. In this study, we observed that under this culture system, PGCs proliferate in the presence of insulin, but do not proliferate in the absence of insulin. Furthermore, in insulin-lacking media, the expression of pluripotency genes, including LIN28, NANOG, POUV, and SOX2, was markedly decreased. Similarly, the expression of cell adhesion proteins ZO-1, Occludin, and JAM-A was significantly reduced. Elevated levels of ROS, GSSG, and MDA reduced the redox capacity of the cells and induced apoptosis. Subsequent transcriptome analyses revealed that insulin is one of the key factors in the proliferation of chicken PGCs through the regulation of downstream genes by PI3K/AKT, ECM–receptor interaction, Wnt, and P53 signaling, and that these downstream genes may be important for PGCs’ proliferation and survival. Full article

Highly Urbanized Cities (HUCs) in the Philippines were at the forefront of public health surveillance and response during the COVID-19 pandemic. With the rapid spread of COVID-19 to Philippine cities, local government units continuously assessed, adapted, and implemented public health interventions (PHIs) and depended on available open-source government data (OSGD). This study consolidated PHIs in selected HUCs in the Philippines using high-quality OSGD to create a timeline of interventions and document good practices in local COVID-19 control. OSGD resources were collected from February 2020 to January 2023, and the data quality of OSGD was evaluated using the Journal of the American Medical Association (JAMA) benchmarks. A total of 180 metadata sources that met at least two core standards (Authorship and Currency) were included in the analysis. COVID-19 control strategies were analyzed vis-à-vis the rise of COVID-19 cases and types of PHIs, including the control of imported cases, case management, contact management, behavioral modification, and pharmaceutical intervention. Travel bans and hard lockdowns in Luzon early in the pandemic delayed the introduction of COVID-19 to other parts of the country. Good practices of LGUs for local COVID-19 control, such as quarantine passes, curfews and liquor bans, using QR-based contact tracing, massive community testing in high-risk communities, and free public swabbing centers, were implemented to slow down the local spread of COVID-19. With the evolving scenarios in city-level COVID-19 epidemics, local risk assessments based on available OSGD drove the adoption of relevant and innovative control strategies in HUCs in the Philippines. Lessons learned must be integrated into epidemic preparedness and response programs against future emerging or re-emerging infectious diseases. Full article

Although rare, the ability to produce surface S-layer proteins is beneficially associated with particular Lactobacillus strains being investigated as probiotics. Therefore, this work aimed to study specific probiotic functionalities of selected Levilactobacillus brevis strains MB1, MB2, MB13 and MB20, isolated from human milk microbiota, and to assess the contribution of S-proteins. Firstly, Rapid Annotation using Subsystem Technology revealed that cell wall-related genes were abundant in analysed L. brevis genomes. Furthermore, the results demonstrated that S-proteins mediate aggregation capacity and competitive exclusion of selected pathogens by L. brevis strains. The improvement of Caco-2 epithelial monolayer barrier function was demonstrated by the increase in JAM-A and occludin expressions when L. brevis strains or S-proteins were added, with the effect being most pronounced after treatment with MB2 and S-proteins of MB1. L. brevis strains, especially MB20, exerted the potential to adhere to recombinant human ZG16. Strain MB2 and MB20-S-proteins improved the barrier function of HT29 epithelial monolayer, as evidenced by increased ZG16 expression. Analysed L. brevis strains and S-proteins differentially affected the protein expression of IL-1β, IL-6 and IL-8, and IL-10 cytokines. The most prominent effect was observed by S-proteins of MB20, since IL-1β production was decreased while IL-10 production was significantly increased. Full article

This study aimed to assess the quality of YouTube (YT) videos providing medical information on cervical spine fractures; secondly, a comparison of two timeframes has been conducted. Using Google Chrome with privacy settings to minimize personalization, two searches were conducted on 20 July 2021 and the second one on 10 April 2024 using various terms related to cervical spine injuries. Videos were evaluated using the DISCERN (Quality Criteria for Consumer Health Information), GQS (Global Quality Score), and JAMA scoring systems. In total, 91 videos were included. Mechanisms of injury were the most frequent video content (n = 66), and postoperative pain occurred the least (n = 6). The mean DISCERN score of 43.26 (std = 11.25), mean GQS of 2.67 (std = 0.74), and mean JAMA score was 2.2 (std = 0.68). Inclusion of treatment options had an odd ratio of 21.72 for a better-quality video. The largest number of videos was provided by physicians (n = 24). In DISCERN, risks of treatment were graded lowest = 1.9. Newer videos achieved higher scores in the DISCERN, GQS, and JAMA scoring systems reaching 52.5, 3, and 2.75, respectively. These scores suggest inadequate information provision in the videos, hindering patients’ understanding of their condition. Due to insufficient information presented in current videos, patients are not fully informed. Full article

Background: This study evaluates the ability of six popular chatbots; ChatGPT-3.5, ChatGPT-4.0, Gemini, Copilot, Chatsonic, and Perplexity, to provide reliable answers to questions concerning keratoconus. Methods: Chatbots responses were assessed using mDISCERN (range: 15–75) and Global Quality Score (GQS) (range: 1–5) metrics. Readability was evaluated using nine validated readability assessments. We also addressed the quality and accountability of websites from which the questions originated. Results: We analyzed 20 websites, 65% “Private practice or independent user” and 35% “Official patient education materials”. The mean JAMA benchmark score was 1.40 ± 0.91 (0–4 points), indicating low accountability. Reliability, measured using mDISCERN, ranged from 42.91 ± 3.15 (ChatGPT-3.5) to 46.95 ± 3.53 (Copilot). The most frequent question was “What is keratoconus?” with 70% of websites providing relevant information. This received the highest mDISCERN score (49.30 ± 4.91) and a relatively high GQS score (3.40 ± 0.56) with an Automated Readability Level Calculator score of 13.17 ± 2.13. Moderate positive correlations were determined between the website numbers and both mDISCERN (r = 0.265, p = 0.25) and GQS (r = 0.453, p = 0.05) scores. The quality of information, assessed using the GQS, ranged from 3.02 ± 0.55 (ChatGPT-3.5) to 3.31 ± 0.64 (Gemini) (p = 0.34). The differences between the texts were statistically significant. Gemini emerged as the easiest to read, while ChatGPT-3.5 and Perplexity were the most difficult. Based on mDISCERN scores, Gemini and Copilot exhibited the highest percentage of responses in the “good” range (51–62 points). For the GQS, the Gemini model exhibited the highest percentage of responses in the “good” quality range with 40% of its responses scoring 4–5. Conclusions: While all chatbots performed well, Gemini and Copilot showed better reliability and quality. However, their readability often exceeded recommended levels. Continuous improvements are essential to match information with patients’ health literacy for effective use in ophthalmology. Full article

Since orthopedic surgery has been slower to acknowledge the rise of social media for distributing medical information, this study aims to evaluate TikTok videos’ quality and educational value in relation to carpal tunnel syndrome treatment exercises. TikTok was searched using the hashtags “#carpaltunnelexercises”, “#carpaltunnelremedies”, “#carpaltunnelrehab”, and “#physicaltherapyforcarpaltunnel”. The engagement indicators were documented and the video content quality was assessed using the DISCERN, CTEES, JAMA, and GQS grading scales. There were 101 videos included, which accumulated 20,985,730 views. The videos received 1,460,953 likes, 15,723 comments, 243,245 favorites, and 159,923 shares. Healthcare professionals were responsible for 72% of the video uploads, whereas general users contributed 28%. More healthcare professionals’ videos were graded as “poor” (79%) compared to general users (21%). General users received slightly more video grades of “very poor” (52%) than healthcare professionals (48%). For the DISCERN grading, the videos by healthcare professionals were significantly better than those by general users in terms of reliability, achieving aims, and relevancy. They were also superior in the overall composition of the health information derived from the total DISCERN score. However, no significant differences were found between the two groups when using the CTEES, JAMA, and GQS grading scales. Overall, despite the emergence of TikTok as a medical information tool, the quality and educational value of the carpal tunnel syndrome exercise videos were poor. Full article

Background: Fractures of the distal radius are among the most common bone injuries, and their frequency is constantly increasing, leading to an elevated need for subsequent rehabilitation. This growing need has led to the emergence of online content aimed at providing guidance on rehabilitation. Nonetheless, unreviewed online content raises concerns about its reliability; therefore, the objective of this study was to evaluate the quality, reliability, and comprehensiveness of online videos concerning rehabilitation following a distal radius fracture. Methods: A total of 240 YouTube videos were screened, identifying 33 videos that met the inclusion criteria. These selected videos were evaluated by five independent experts from various professional groups, using the Global Quality Scale, the DISCERN reliability tool, and the JAMA Benchmark Score, as well as a structured set of questions to assess their comprehensiveness and coverage of pertinent aspects. Results: The observers’ assessment of the Global Quality Scale exhibited a broad spectrum of viewpoints, indicating considerable variability in evaluations. In most cases, therapy aligned well with the diagnosed condition, and most raters deemed the indication and instruction in the videos acceptable. A proportion of 87% of the videos was deemed suitable for home training by at least three raters. However, a concerning trend emerged, as potential risks and pitfalls were scarcely addressed. Conclusions: The moderate overall quality of the videos and the divergence in expert opinions highlight the need for a regulatory authority to ensure adherence to guidelines and maintain high-quality content. Additionally, our results raise concerns about the applicability of established assessment tools in this context. Full article

Background: Hyperbilirubinemia is a common condition in newborns. While mild cases of jaundice are common and typically resolve spontaneously, severe hyperbilirubinemia can lead to serious neurologic complications if left untreated. With the constant adaptation of guidelines, clinical management has significantly improved, and treatment has become routine for pediatricians. However, for parents of affected children, managing the condition is not routine. In today’s digital age, parents often seek additional information by accessing a wide range of medical resources on the internet. While this can be empowering, it also presents challenges, as the quality and accuracy of online medical information can vary widely. Therefore, we analyzed the current quality of information on jaundice found on the internet by parents. Methods: A simulated internet search (using the Google search engine) was conducted from a layperson’s perspective using German (“Neugeborenes Gelbsucht”, “Baby Gelbsucht”) and English (“jaundice newborn”, “jaundice baby”) search terms. Subsequently, the quality of the search results was assessed by two independent neonatologists based on the DISCERN Plus Score, HONcode certification, and the JAMA criteria. Results: Websites targeting non-medical laypersons exhibited significant variability in quality. Notably, the content of English websites was superior to that of websites in the German language. The majority of English sites were predominantly institutional, whereas most German sites were commercially oriented. Conclusions: Although information on jaundice is readily accessible online for non-medical individuals, there were notable differences in quality based on language and significant variability in the quality of information warranting attention from healthcare professionals. Furthermore, German websites providing information on jaundice were often hosted by commercial organizations. We propose that pediatric societies engage in developing and maintaining organization-based medical information to improve online resources for parents. Full article

The Internet is the most used source of HIV information second to information received from healthcare professionals. The aim of this study was to assess the quality of Internet information about periodontitis in people living with HIV (PLWH). An Internet search was performed on 18 April 2024 using the search terms “Periodontitis”, “Periodontal disease”, and “Gum disease” in combination with “HIV” in the most popular search engines (Google™, Bing™, and YAHOO!^®). The first 20 results from each search term engine were pooled for analysis. Quality was assessed by JAMA benchmarks. Readability was assessed using the Flesch reading ease score (FRES). Origin of the site, type of author, and information details were also recorded. The quality of Internet information about periodontitis in PLWH varied. The mean JAMA score was 2.81 (SD = 1.0). The websites were generally fairly difficult to read (mean FRES = 57.1, SD = 15.0). Most websites provided some advice about self-treatment of oral problems, accompanied by a strong recommendation to seek professional dental care. In conclusion, advanced reading skills on periodontitis in PLWH were required and quality features were mostly not provided. Therefore, healthcare professionals should be actively involved in developing high-quality information resources and direct patients to evidence-based materials on the Internet. Full article

Junctional adhesion molecule-A (JAM-A), also known as F11 receptor (F11R), is a transmembrane glycoprotein that is involved in various biological processes, including cancer initiation and progression. However, the functional characteristics and significance of JAM-A in pan-cancer remain unexplored. In this study, we used multiple databases to gain a comprehensive understanding of JAM-A in human cancers. JAM-A was widely expressed in various tissues, mainly located on the microtubules and cell junctions. Aberrant expression of JAM-A was detected in multiple cancers at both mRNA and protein levels, which can be correlated with poorer prognosis and may be attributed to genetic alterations and down-regulated DNA methylation. JAM-A expression was also associated with immune infiltration and may affect immunotherapy responses in several cancers. Functional enrichment analysis indicated that JAM-A participated in tight junction and cancer-related pathways. In vitro experiments verified that JAM-A knockdown suppressed the proliferation and migration abilities of breast cancer cells and liver cancer cells. Overall, our study suggests that JAM-A is a pan-cancer regulator and a potential biomarker for predicting prognosis and immune-therapeutic responses for different tumors. Full article

Objective: To assess the quality and readability of online information on holmium laser enucleation of the prostate in managing benign prostate hyperplasia using the most-used search engine worldwide, Google. Methods: Google search terms “Holmium laser surgery” and “enlarged prostate” were used to generate 150 search results. Two independent authors (i) excluded any paywall, scientific literature, or advertisement and (ii) conducted an independent assessment on information quality, which was based on DISCERN, QUEST, and JAMA criteria, and readability, which was based on the FKG, GFI, SMOG, and FRE scores on qualified webpages. A third author was involved if there were any discrepancies between the assessments. Results: 107 qualified webpages were included in the data analysis. The median DISCERN score was 42 out of 80 (IQR 35–49). The median JAMA score was 0 out of 4 (IQR 0–1). The median QUEST score was 9 out of 28 (IQR 9–12). Using the non-parametric ANOVA and post hoc Games–Howell test, significant differences were identified between rankings of webpages. Sponsorship had no influence on the quality of webpages. The overall readability level required a minimum reading level of grade 11. Linear regression analysis showed that a higher ranked webpage is a positive predictor for all three quality assessment tools. Conclusions: The overall quality of online information on HoLEP is poor. We identify that the top-ranked google searches have a higher DISCERN score and are a positive predictor for DISCERN/QUEST/JAMA. Quality online information can benefit patients but should be used in conjunction with professional medical consultation. Full article

The Biospeleological Station (BS) in Postojna Cave, with a volume of 36,000 m³, has served as an underground biological laboratory since 1931, receiving 100,000 visitors annually. Historical cave micro-climate monitoring was performed in 1933 and 1963, and continuous monitoring of cave air temperature and carbon dioxide concentration at hourly intervals started in 2015. Micro-climatic data collected between 2015 and 2024 has helped us to understand the relationship between natural underground environment and anthropogenic impact, thereby aiding expert recommendations to cave managers for the mitigation of anthropogenic micro-climatic effects. Results strongly support the policy that, during summer, when outdoor temperatures are higher than in the cave, solid metal doors connecting the BS with the rest of the cave (Stara Jama) should be kept open. Such a simple mitigation act helps to decrease anthropogenically increased air temperature and carbon dioxide concentrations, thereby maintaining suitable micro-climatic conditions for the exhibition of cave animals. Closure during the COVID-19 pandemic (2020–2021) resulted in the lowest temperatures recorded. BS visitation increases air temperature by 1 °C, highlighting the need for management strategies to maintain suitable conditions for cave fauna exhibition. Full article