Search Results (2,690)

Background: Gastric cancer survivors frequently encounter a “care gap” after discharge because of complex postgastrectomy syndromes. We evaluated “WECARE,” a bidirectional digital health platform designed to provide real-time symptom monitoring and multidisciplinary support. The primary goal of this study was to assess the efficacy of the platform by measuring the change in the Korean Quality of Life Questionnaire for Gastric Cancer Survivors (KOQUSS-40) total score over a six-month recovery period. Methods: This nationwide, multicenter pilot randomized controlled trial was conducted by the Korean Quality of Life in Stomach Cancer Patients Study Group (KOQUSS) across nine tertiary centers in Korea. A total of 88 patients who underwent curative gastrectomy were enrolled. Following an initial optimization phase involving 22 patients, the remaining 66 patients were randomized at a 1:1 ratio to the WECARE group or the control group. The WECARE group used a platform integrating the KOQUSS-40 algorithm for structured symptom reporting, real-time feedback on nutrition and exercise, and educational content on meal planning, symptom coping, and recovery. Assessments were performed at baseline and at 1, 3, and 6 months after discharge. Results: The WECARE group showed high feasibility and acceptability, with an adherence rate of 86.7% and an 82% satisfaction rate. At 6 months, the KOQUSS-40 total score (primary endpoint) did not differ significantly between the WECARE and control groups (85.3 ± 1.6 vs. 83.8 ± 1.6, p = 0.603). However, the WECARE group showed a numerically favorable recovery trajectory from the acute postoperative phase. Subgroup analysis revealed a positive trend in reflux symptom management in the WECARE group (p = 0.0856). In addition, more than 77% of users reported that the platform improved their self-management capabilities. Conclusions: The WECARE platform is a feasible and acceptable digital intervention for gastric cancer survivors. Although the primary endpoint was not significantly different, the favorable recovery trajectory, high adherence, and patient engagement support further evaluation in larger studies with longer follow-up and broader healthcare settings. Full article

Background and Objectives: Gastric cancer remains a leading cause of cancer-related mortality worldwide and develops through complex interactions between environmental factors, microbial dysbiosis, and host molecular pathways. Although Helicobacter pylori infection is a well-established risk factor, emerging evidence suggests that broader alterations in the gastric microbiome may also contribute to carcinogenesis. However, the associations between gastric cancer-associated microbial taxa and host gene expression profiles remain insufficiently characterized. This study aimed to identify host gene signatures associated with gastric cancer-related microbial taxa through a descriptive analysis integrating microbiome-derived taxa with transcriptome data. Materials and Methods: Microbial taxa associated with gastric cancer were systematically retrieved from the Disbiome database. Taxon set enrichment analysis (TSEA) was performed using the MicrobiomeAnalyst platform to identify host genes associated with gastric cancer-associated taxa. Importantly, TSEA relies on healthy reference data from the Human Microbiome Project and does not establish gastric cancer-specific interactions or causal relationships. Gene expression levels were subsequently evaluated using The Cancer Genome Atlas (TCGA) PanCancer stomach adenocarcinoma (STAD) dataset by comparing tumor and matched normal gastric tissues. Gene interaction network and transcription factor (TF) enrichment analyses were conducted to explore predicted regulatory relationships. Results: Among 64 microbial taxa associated with gastric cancer, 43 were reported as elevated. After removing overlapping taxa across studies, 37 elevated and 21 reduced taxa were retained for analysis. TSEA identified 11 host genes associated with gastric cancer-related microbial taxa. Transcriptomic analysis demonstrated significant downregulation of DPP6 and DLG2, while KDM4D, USP34, and VDR were significantly upregulated in gastric cancer tissues compared with normal controls. Network and TF enrichment analyses revealed predicted co-expression and co-localization patterns among these genes, suggesting their potential involvement in immune-related processes, epigenetic regulation, and cellular organization. Conclusions: This descriptive study identifies distinct host gene expression signatures associated with gastric cancer-associated microbial dysbiosis. This study is purely associative and hypothesis-generating; no causal or mechanistic inferences are made. TSEA used healthy reference data and therefore does not reflect gastric cancer-specific host–microbe interactions. The findings provide a basis for future hypothesis-driven research but require validation in independent cohorts. Full article

Background: Minimal access surgeries are growing more common in neonatal care, but the risk of accidental injury to abdominal wall blood vessels remains a concern. This risk is increased by limited precise anatomical data specific to neonates. Therefore, this study aimed to quantitatively map the superficial and deep blood vessels of the neonatal anterior abdominal wall concerning important surgical landmarks to develop evidence-based recommendations for safer laparoscopic port placement. Methods: Thirty formalin-fixed low-birth-weight neonatal body donations (≤4 weeks old) were dissected. An anatomical grid based on palpable landmarks—including the umbilicus, xiphoid process, and anterior superior iliac spines—was utilised to measure distances to the nearest vessels via digital image analysis. In situ topography of the liver, stomach, and umbilical vessels was also documented. Results: A midline corridor of reduced vascular density was identified; minimum circumferential distances to deep vessels above the umbilicus averaged 6.84–6.88 mm. Conversely, lateral regions were highly vascular, particularly at or below the transumbilical plane, with distances to deep vessels as short as 1.08 ± 0.83 mm. The liver and stomach extended significantly below the costal margin (averaging 20.61 ± 8.29 mm and 34.18 ± 14.44 mm, respectively). Conclusions: The results establish an anatomical foundation for using the reduced vascular midline for port placement and highlight the importance of inserting secondary lateral ports under direct visualisation. Full article

A phage is a virus that targets bacteria with high precision. While phage therapy provides a targeted alternative to broad-spectrum antibiotics, it is not completely free from the challenges of antimicrobial resistance, as phages can facilitate the horizontal transfer of resistance genes through transduction and promote the growth of phage-resistant strains. Nonetheless, within the One Health framework, the strategic use of phages remains a vital and promising tool for addressing the global antimicrobial resistance crisis. This paper reviews current research on phage therapy for gastrointestinal diseases such as cirrhosis, enteritis, and Helicobacter pylori infection. It also details how phages help regulate gut microecological balance and discusses how phage dysbiosis can lead to innate immune dysfunction and worsen conditions like inflammatory bowel disease. The review summarizes both the therapeutic potential and limitations observed in clinical trials and fundamental studies. Transitioning from laboratory research to clinical practice is hindered by multiple complex challenges, including the stomach’s extreme acidity, physical entrapment by the intestinal mucus layer, the rapid co-evolution of bacterial resistance, and ecological risks associated with temperate phages. To overcome challenges like gastrointestinal barrier tolerance and address ethical, technical, and practical hurdles for clinical use, the paper outlines treatment strategies for specific conditions and highlights future directions, providing guidance for employing phages in digestive system disease management. These future innovations focus on integrating artificial intelligence-driven precision matching, advanced bioengineering for durable delivery systems, and multimodal combination therapies to safely modulate the intestinal microecology. Full article

Background/Objectives: Non-variceal upper gastrointestinal bleeding (NVUGIB) remains a major clinical emergency, particularly among patients receiving antiplatelet or anticoagulant therapy, whose use has increased substantially in recent years. This study aimed to evaluate the clinical characteristics, endoscopic findings, risk stratification, and outcomes of NVUGIB in patients receiving antithrombotic therapy, and to compare the predictive performance of commonly used prognostic scores. Methods: This prospective cohort study included 89 patients receiving antithrombotic therapy who presented with NVUGIB at Beni-Suef University Hospitals between March 2023 and March 2025. Clinical presentation, laboratory findings, and endoscopic characteristics were recorded. Risk stratification was assessed using Glasgow–Blatchford (GBS), Rockall, Baylor, AIMS65, ABC, and PNED scores. The optimal cut-off values for prediction of rebleeding and mortality were determined using receiver operating characteristic (ROC) analysis and the Youden index. Area under the curve (AUC) values were reported with 95% confidence intervals. Results: Endoscopy revealed that peptic ulcers were the most common lesion (41/89, 46%), followed by erosive disease (27/89, 30%), with the stomach being the most frequently involved site (76.5%). Rebleeding occurred in 16 patients (18.0%), while mortality was observed in 2 patients (2.2%). The Glasgow–Blatchford score demonstrated the most consistent performance for predicting rebleeding, with an optimal cutoff value of 5.5 (derived using the Youden index), yielding 92.9% sensitivity and 78.8% specificity. For mortality prediction, AIMS65, ABC, and PNED scores showed very high AUC values, although these findings should be interpreted cautiously due to the small number of mortality events (n = 2). No statistically significant difference in rebleeding or mortality was observed between single and dual antithrombotic therapy, although patients receiving dual therapy required longer hospitalization and more transfusion units. Conclusions: In patients with antithrombotic-related GI bleeding, ulcers and erosions predominate, with minimal differences between single and dual therapy outcomes. Concomitant NSAID use trends toward higher mortality. Glasgow–Blatchford score offers optimal performance for both rebleeding and mortality prediction, with a cutoff of 5.5 providing excellent sensitivity (92.9%) and specificity (78.8%) for rebleeding risk assessment. Full article

This experiment evaluated the effects of pellet diameter on growth performance and intestinal health of piglets during the creep feeding stage. A total of 144 7-day-old suckling piglets (body weight of 2.2 ± 0.3 kg) were randomly assigned to four groups and fed the same formula as meal feed and pellets of 2 mm, 4 mm, and 8 mm in diameter, respectively. Each treatment consisted of six replicates of six piglets. The trial was divided into two phases by weaning time: 7–21 days (breast milk + creep feed) and 21–35 days (creep feed only). After the feeding trial, piglets from the meal feed group and the 8 mm pellet group were selected for slaughter and sampling. The results showed that before weaning, average daily feed intake (ADFI) increased significantly with increasing pellet diameter (p < 0.001). Post-weaning, piglets fed 8 mm pellets presented significantly higher final body weight (FBW) and average daily gain (ADG) than those in the meal group (p < 0.05). Apparent nutrient digestibility (ATTD) in pellet groups was significantly higher than that in the meal feed group and rose with increasing pellet diameter (p < 0.001). The organ indices of the stomach and large intestine in the 8 mm group of piglets were significantly lower than those of the meal group. The jejunal villus height (VH) in the 8 mm group showed a trend toward an increase (p = 0.066), and the ileal crypt depth (CD) was significantly lower (p = 0.004), with significantly higher digestive enzyme activities in the jejunum and ileum (p < 0.05). In the 8 mm group, the relative abundances of Bacteroidetes in the jejunum and Actinobacteriota in the cecum and colon increased, while those of Pseudomonadota decreased; jejunal microbial relative richness increased significantly, while the ileal microbial operational taxonomic unit (OTU) richness decreased obviously. In conclusion, pellets improved the growth performance of creep feeding piglets. Compared with meal, 8 mm pellets can significantly enhance intestinal health level and nutrient digestion and absorption capacity by optimizing intestinal morphology, boosting digestive enzyme activities, and improving flora structure. Full article

Corn, paddy, wheat, sorghum, and cassava serve as the primary energy sources in both human and animal diets. This study aimed to evaluate their nutrient release patterns in a simulated gastrointestinal environment and to assess the in vitro biological activity of the metabolites produced during digestion. The results showed that wheat exhibited the highest dry matter degradation in the stomach–jejunum–ileum digestion stage, while wheat and paddy showed the highest crude protein degradation compared with the other starch sources. In addition, wheat had a higher total free sugar concentration than paddy, sorghum, and cassava. Among the individual free sugars, such as D-sorbitol and D-(+)-trehalose, were found to have the highest concentrations in wheat, whereas cassava had the highest D(−)-fructose concentration. Several differential metabolites, including valeric acid, caproic acid, octanoic acid, and azelaic acid were highly released in paddy, whereas glucaric acid, threonic acid, phenylacetic acid, and shikimic acid were highly released in cassava, and 4-hydroxycinnamic acid was highly released in paddy and sorghum. Four unique metabolites were identified during the digestion process of five starch sources. Particularly, isocitric acid and trans-Cinnamic acid were released only from cassava; caffeic acid was released only from sorghum and corn; and pimelic acid was released only from paddy and wheat. Furthermore, cassava was distinct from the other starch sources, displaying a higher abundance of differential metabolites within the glucagon signaling pathway as mapped in KEGG pathway analysis. In summary, compared with other starch sources, wheat provides more dry matter, protein, and sugars for the body. Cassava is unlikely to offer any advantage in glycemic regulation, while paddy and cassava possess stronger biological activity in terms of differential metabolites. Full article

Ayu (Plecoglossus altivelis) is an East Asian amphidromous river fish, yet seasonal microbiota dynamics remain unclear. We investigated ayu in the Dajing Stream (Zhejiang Province, China) by synchronously sampling water microbiota (H), gut content microbiota (N), and gut tissue-associated microbiota (C) across four seasons. Each season, four fish were collected, and an overlapping pooling strategy (abc/abd/bcd) generated three composite replicates for C and N (n = 3 composites/season); water was collected as three field replicates (n = 3/season), yielding 36 samples (12 per niche). Using 16S rRNA amplicon sequencing and COI barcoding of stomach contents, we observed the clearest seasonal differentiation in H and seasonal variation in N consistent with diet shifts, whereas C was comparatively stable. COI signals indicated a diet dominated by aquatic insects in spring/summer, which shifted toward smaller prey (e.g., rotifers) in winter. Together, these results highlight strong niche partitioning and season-linked shifts in water and gut content communities relative to the more stable tissue-associated microbiota. These findings should be interpreted as exploratory and require validation in larger individual-level studies. Full article

Saponins, the primary bioactive constituents with immunomodulatory activities in Baoyuan decoction—a traditional Chinese medicine formula composed of ginseng, astragalus, licorice, and cinnamon—are limited by low extraction yield, poor stability, and easy degradation. In this study, cellulase and pectinase were used for the extraction of saponins from Baoyuan decoction and optimized by response surface methodology. Subsequently, the optimal extracts were microencapsulated by spray drying with soy protein isolate (SPI) or high-oleic acid soy protein isolate (HOSPI) and pectin (PE) as composite wall materials, followed by application evaluation in gummies and in vitro digestion. After optimization, the total saponin yield was 63.68 ± 0.15 mg/g. HOSPI-PE microcapsules (HBP) had a higher encapsulation efficiency (90.38%), smaller particle size, and lower hygroscopicity than SPI-PE ones (SBP). Furthermore, both microcapsules showed good stability during storage and controlled release, with 60.9% of saponins in SBP and 65.8% in HBP being delivered to the intestinal phase during in vitro digestion of microparticles. When applied in gummies, microcapsule gummies retained satisfactory sustained-release in vitro digestion (23.0% released in the stomach and 66.2% in the small intestine). In contrast, the unencapsulated gummies exhibited a burst release (74.4%) at 30 min in gastric digestion. This study provides theoretical and technical insights into the development of plant-derived functional foods and promotes the practical application of microencapsulation in functional gummy candies. Full article

Background/Objectives: Enteric drug forms are developed to delay drug release to avoid drug degradation in the acidic environment of the stomach or to prevent irritation of the stomach mucosa. The bioavailability of posaconazole (POS) after oral administration depends on stomach pH and food intake. Delayed-release tablets and unmodified oral suspension are the POS formulations currently available on the market. The oral suspension formulation is characterized by highly variable bioavailability, which may significantly affect therapy effectiveness. Methods: In this study, multi-unit drug forms with delayed and sustained POS release were designed. Polymeric microparticles consisting of sodium alginate (ALG), methacrylic acid–ethyl acrylate copolymer (EUD), or both, were prepared using the spray-drying technique. The formulations that met the pharmacopoeia enteric release standards in the in vitro dissolution test were subjected to further in vitro evaluation via swelling and mucoadhesion assays, an antifungal activity test, attenuated total reflectance–Fourier transform infrared spectroscopy (ATR-FTIR), and thermal analysis. Results: It was shown that EUD formulations at concentrations of 5% and 6% provided enteric release, whereas ALG at 1.5% concentration exhibited a sustained, although not delayed, POS release profile. The optimal blended formulations (EAP15–EAP18), comprising 4% EUD with 1.5–2.0% ALG and either 1% or 4% POS, met the pharmacopoeia criteria for enteric dosage forms. Furthermore, these blends demonstrated the most favorable sustained-release profiles in the buffer phase, ranging from 2 to 3 h. The microparticles exhibited beneficial swelling and mucoadhesive properties, which are essential for prolonging contact with the intestinal mucosa; combined with antifungal properties. Conclusions: Obtained carrier may provide a promising preliminary basis for developing a multi-unit, sustained-release enteric dosage form for POS and future in vivo investigations. Full article

Currently, GLP-1RAs are peptide drugs, typically administered by injection due to insufficient absorption, and only one GLP-1RA, semaglutide, is available as an orally administered drug. To overcome the absorption challenges of oral peptides, this drug product contains the absorption enhancer SNAC. As the tablet is eroded in the stomach, SNAC neutralizes the acidic gastric environment, thereby protecting the semaglutide from enzymatic degradation. Then, SNAC fluidizes the stomach lipidic membrane to increase semaglutide transcellular permeability across the gastric epithelium. It is necessary to realize that the use of such a unique drug product, that relies solely on the stomach for absorption, is expected to be affected by the extreme gastric anatomy/physiology changes post-MBS. Hence, we analyzed the key mechanisms that may affect the bioavailability of oral semaglutide post-MBS. Several mechanisms appear to potentially reduce oral semaglutide absorption post-MBS, including decreased inner gastric surface area, decreased gastric contractility, and faster gastric emptying. Hence, the effectiveness of the complex formulation, that relies solely on the stomach for the SNAC activity and semaglutide absorption, may be severely hampered post-MBS; clinicians should be aware of the potential malabsorption of oral GLP-1RA post-MBS, and preferably consider subcutaneous therapy until specific pharmacokinetic/clinical data are available. Full article

The presence of microplastics (<5 mm) has become a major threat to marine ecosystems and the organisms inhabiting them. This issue affects a wide range of animals, including commercially important marine fish, whose ingestion of microplastics can cause mechanical and metabolic damage. This study aimed to characterize the main types of microplastic-like particles ingested by Centropomus viridis, Cynoscion othonopterus, Pomadasys macracanthus, Diapterus peruvianus, Lutjanus colorado, and Scomberomorus sierra, important commercial fish species in northwestern Mexico. Four sampling events were conducted over an annual cycle (November to August) in the lagoon and insular systems of Navachiste and Ohuira, Sinaloa, Mexico (RAMSAR sites 1826 and 2025). A total of 556 individuals were captured, and their stomach contents were analyzed using stereoscopic microscopy. Systematic sediment sampling was also performed at each capture site (El Coloradito, El Caracol, El Huitussi, El Aparecido, El Cerro Cabezón, Topolobampo, El Cerro Partido, and El Tortugo) by examining the upper 30 cm of sediment to ensure representativeness of the particle inventory. Four of the six analyzed species (C. viridis, C. othonopterus, P. macracanthus, and D. peruvianus) contained microplastic-like particles (MP-p), totaling 163 items, with an average ingestion rate of 0.29 items individual⁻¹. The omnivorous species D. peruvianus showed the highest ingestion (0.52 items individual⁻¹; 0.0029 items g⁻¹ wet weight). Five categories of MP-p were distinguished based on morphology and fluorescence; however, their polymeric identity cannot be confirmed without spectroscopic analyses. Sediment results showed that most microplastic-like fragments occurred at site 2025 during autumn, spring, and summer, while levels at site 1826 did not differ significantly. This study provides the first evidence of microplastic contamination in these fish species and in this region of northwestern Mexico. Full article

Background: Gliomas are the most common primary malignant tumors of the central nervous system. Accurate preoperative grading is essential for individualized surgical planning and treatment selection; however, reliable non-invasive prediction tools integrating multimodal preoperative data remain limited. This study aimed to develop and internally validate an interpretable machine-learning model for non-invasive glioma grading. Methods: Clinical and imaging data from 400 patients with pathologically confirmed gliomas were retrospectively collected. Twenty-four preoperative variables were analyzed. The dataset was randomly divided into training and validation cohorts (7:3). Feature selection was performed using a combination of the Boruta algorithm and logistic regression analyses, followed by correlation filtering. Seventeen machine-learning algorithms were benchmarked using five-fold cross-validation, and the optimal model was evaluated in the independent validation cohort using ROC analysis, calibration assessment, precision–recall curves, and decision curve analysis. Model interpretability was examined using SHAP. Results: Eight key predictors were identified, including age, focal neurological deficits, midline shift, tumor laterality, tumor lobar location, enhancing tumor volume, and MRS-derived Cho/NAA and Cho/Cr ratios. The Random Forest model achieved an area under the ROC curve of 0.946 (95% CI: 0.902–0.989) in the validation cohort. Calibration analysis demonstrated reasonable agreement between predicted and observed outcomes, and the precision–recall curve yielded an average precision of 0.98. Decision curve analysis indicated net clinical benefit across relevant probability thresholds. Conclusions: A multimodal machine-learning model integrating clinical, structural imaging, and MRS-derived metabolic features was developed and internally validated for non-invasive preoperative glioma grading. The model showed good discrimination and calibration and provided individualized probability estimates, suggesting potential value for preoperative risk stratification. However, clinical deployment remains premature, and further external validation is required. Full article

Compared to antennas bearing a single port, MIMO antennas with several ports enable higher data throughput by exploiting spatial diversity. This capability is essential for next-generation implantable medical devices, where high channel capacity is a key requirement. A quad-element implantable MIMO antenna is designed and practically validated at 1420 MHz in this paper. It occupies a compact volume of $7\times 8\times 0.1 {\mathrm{mm}}^3$ ($5.6 {\mathrm{mm}}^3$). The compactness is realized by combining high-permittivity substrate (Rogers 3010 with relative permittivity of 10.2) with meandered radiator paths, which increase the effective current length while maintaining a small physical size. All antennas have very small mutual coupling with isolation of more than $31.78$ dB, which is mainly due to the spacing of 1 mm between the elements and the substrate, which is thin. The peak realized gain for each antenna element is $-27.3$ dBi. The simulation is performed within a capsule-like structure, which is embedded in the stomach tissue model. The experimental verification is carried out by embedding antenna within minced meat. The ECC, channel capacity, and link margin are also evaluated and found to be satisfactory. The proposed antenna ensures reliable communication performance, with the transmission range being as high as $2.5$ m, link margin being 15 dB, and the data rate being 120 Mb/s. The proposed antenna ensures a good level of ECC, which is less than $0.1$. The SAR is $52.3$ W/kg at 1420 MHz. This design is favorable for implants because of the small size, good impedance matching, high isolation, low correlation, good level of gain, and good link performance. Full article

Liraglutide (Lira), a glucagon-like peptide-1 (GLP-1) receptor agonist, has demonstrated substantial efficacy in improving glycemic control and reducing body weight. However, subcutaneous injection is poorly adherent for patients. To improve treatment compliance, we developed a poly(lactic-co-glycolic acid) (PLGA)-based nanovesicle (PLGA-Lira-NV) system for the oral delivery of Lira using a double-emulsion solvent evaporation technique. The optimized formulation yielded a narrow size distribution and high encapsulation efficiency (>95%). In vitro release studies showed that PLGA-Lira-NVs remained relatively stable under acidic conditions (pH 1.2 to 6.8) and exhibited sustained drug release in a neutral environment (pH 7.4), enabling protection of the fragile peptide in the stomach and controlled release after crossing the intestine. Following oral administration to obese mice (10 mg/kg), PLGA-Lira-NVs achieved prolonged glycemic control for up to 72 h. Notably, body weight decreased to 83% of baseline after 12 days, outperforming the subcutaneous injection (free Lira) group (88%). The consistent trend toward weight reduction confirms the sustained-release properties of PLGA nanocarrier for Lira, highlighting its potential to reduce dosing frequency and improve patient compliance. Collectively, these findings underscore the promising potential of PLGA nanovesicles as an oral delivery platform for peptide therapeutics. Full article