Association Between Irritable Bowel Syndrome and Lower Urinary Tract Symptomatology: A Cross-sectional Study in Mexican Population.

GOALS: This study aimed to investigate the clinical phenotype of urinary symptoms in patients diagnosed with irritable bowel syndrome, the factors associated with this overlap, and the impact of urinary symptoms on their quality of life. BACKGROUND: Irritable bowel syndrome is a common disorder, affecting up to 3.8% of the population. The overlap with other disorders of the gut-brain interaction, psychiatric disorders, and other somatic disorders is common. Moreover, the association between irritable bowel syndrome and urinary symptoms has been recognized, but the clinical phenotype remains unclear. STUDY: This cross-sectional study involved patients with irritable bowel syndrome according to Rome IV. Lower urinary tract symptoms were classified using the International Continence Society's classification. Data on demographics, medical history, medication use, anxiety, depression, and quality of life were collected and analyzed using logistic regression analysis. RESULTS: The study included 428 subjects, 86 diagnosed with irritable bowel syndrome. Patients exhibited a higher prevalence of lower urinary tract symptoms (60.5%, 95% CI: 50.5-71.9). Multivariate analysis revealed associations between irritable bowel syndrome and lower urinary tract symptoms (OR: 2.49, 95% CI: 1.48-4.18, P=0.001), particularly storage urinary symptoms (OR: 1.94, 95% CI: 1.10-3.40, P=0.021). Patients with urinary symptoms reported significantly lower quality of life compared with those without these symptoms (50.8±17.2 vs. 76.7±21.8, P<0.001). CONCLUSIONS: Irritable bowel syndrome is associated with lower urinary tract symptoms, contributing to a significant reduction in quality of life. Clinicians should consider referring patients with irritable bowel syndrome and lower urinary tract symptoms to experts in urodynamics to provide targeted management.

FORWARD: Building a Model to Hold Schools of Public Health Accountable for Antiracism Work.

Schools of public health have increasingly adopted programs, praxis, and competencies for antiracist work. Fighting Oppression, Racism and White Supremacy through Action, Research and Discourse (FORWARD) was founded to accelerate antiracist work at the Columbia University Mailman School of Public Health in New York City. Seven action corps reporting to an accountability cabinet were established with 183 participants. FORWARD achieved progress across five core pillars. We describe how an iterative, dynamic structure and explicit framework for accountability can guide future antiracism work. (Am J Public Health. 2023;113(10):1086-1088. https://doi.org/10.2105/AJPH.2023.307356).

Exploring barriers and enablers to the delivery of Making Every Contact Count brief behavioural interventions in Ireland: A cross-sectional survey study.

OBJECTIVES: The public health impact of the Irish Making Every Contact Count (MECC) brief intervention programme is dependent on delivery by health care professionals. We aimed to identify enablers and modifiable barriers to MECC intervention delivery to optimize MECC implementation. DESIGN: Online cross-sectional survey design. METHODS: Health care professionals (n = 4050) who completed MECC eLearning were invited to complete an online survey based on the Theoretical Domains Framework (TDF). Multiple regression analysis identified predictors of MECC delivery (logistic regression to predict delivery or not; linear regression to predict frequency of delivery). Data were visualized using Confidence Interval-Based Estimates of Relevance (CIBER). RESULTS: Seventy-nine per cent of participants (n = 283/357) had delivered a MECC intervention. In the multiple logistic regression (Nagelkerke's R2  = .34), the significant enablers of intervention delivery were 'professional role' (OR = 1.86 [1.10, 3.15]) and 'intentions/goals' (OR = 4.75 [1.97, 11.45]); significant barriers included 'optimistic beliefs about consequences' (OR = .41 [.18, .94]) and 'negative emotions' (OR = .50 [.32, .77]). In the multiple linear regression (R2  = .29), the significant enablers of frequency of MECC delivery were 'intentions/goals' (b = 10.16, p = .02) and professional role (b = 6.72, p = .03); the significant barriers were 'negative emotions' (b = -4.74, p = .04) and 'barriers to prioritisation' (b = -5.00, p = .01). CIBER analyses suggested six predictive domains with substantial room for improvement: 'intentions and goals', 'barriers to prioritisation', 'environmental resources', 'beliefs about capabilities', 'negative emotions' and 'skills'. CONCLUSION: Implementation interventions to enhance MECC delivery should target intentions and goals, beliefs about capabilities, negative emotions, environmental resources, skills and barriers to prioritization.

Developing a standardized national undergraduate curriculum for future healthcare professionals on self-management support for chronic conditions.

This is a report on the development of the second part of a national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland; National Undergraduate Curriculum for Chronic Disease Prevention and Management Part 2: Self-management Support for Chronic Conditions. The development processes involved in Part 1, Making Every Contact Count for Health Behavior Change, were described earlier. This report presents an overview of the development of a national self-management support curriculum and barriers and enablers encountered. The curriculum was developed by a National Working Group, with interprofessional representation from each of the Higher Education Institutions (HEIs) in Ireland and the national health service, i.e. the Health Service Executive (HSE). All phases of the project were overseen by a Steering Group and supported in each HEI by a local working group. The aim of the curriculum is to introduce standardized self-management support education across all undergraduate and graduate entry healthcare programmes nationally to prepare future healthcare professionals with knowledge, skills and attitudes to support individuals to self-manage their chronic conditions.

Enhancing the implementation of the Making Every Contact Count brief behavioural intervention programme in Ireland: protocol for the Making MECC Work research programme.

Background: Brief behavioural interventions offered by healthcare professionals to target health behavioural risk factors (e.g. physical activity, diet, smoking and drug and alcohol use) can positively impact patient health outcomes. The Irish Health Service Executive (HSE) Making Every Contact Count (MECC) Programme supports healthcare professionals to offer patients brief opportunistic behavioural interventions during routine consultations. The potential for MECC to impact public health depends on its uptake and implementation.   Aim: This protocol outlines the 'Making MECC Work' research programme, a HSE/Health Behaviour Change Research Group collaboration to develop an implementation strategy to optimise uptake of MECC in Ireland. The programme will answer three research questions: (1) What determines delivery of MECC brief interventions by healthcare professionals at individual and organisational levels? (2) What are patient attitudes towards, and experiences of, receiving MECC interventions from healthcare professionals? (3) What evidence-informed implementation strategy options can be consensually developed with key stakeholders to optimise MECC implementation? Methods: In Work Package 1, we will examine determinants of MECC delivery by healthcare professionals using a multi-methods approach, including: (WP1.1) a national survey of healthcare professionals who have participated in MECC eLearning training and (WP1.2) a qualitative interview study with relevant healthcare professionals and HSE staff. In Work Package 2, we will examine patient attitudes towards, and experiences of, MECC using qualitative interviews. Work Package 3 will combine findings from Work Packages 1 and 2 using the Behaviour Change Wheel to identify and develop testable implementation strategy options (WP 3.1). Strategies will be refined and prioritised using a key stakeholder consensus process to develop a collaborative implementation blueprint to optimise and scale-up MECC (WP3.2). Discussion: Research programme outputs are expected to positively support the integration of MECC brief behaviour change interventions into the Irish healthcare system and inform the scale-up of behaviour change interventions internationally.

Developing a national undergraduate standardized curriculum for future healthcare professionals on "Making Every Contact Count" for chronic disease prevention in the Republic of Ireland.

This report describes the development of the first national undergraduate interprofessional standardized curriculum in chronic disease prevention for healthcare professionals in the Republic of Ireland. This project brought together for the first time all higher education institutions nationwide in a novel collaboration with the national health service i.e. the Health Service Executive (HSE), to develop a standardized national curriculum for undergraduate health care professions. The curriculum sits within the framework of Making Every Contact Count, the goal of which is to re-orientate health services to embed the ethos of prevention through lifestyle behavior change as part of the routine care of health professionals. The core focus of Making Every Contact Count is chronic disease prevention, targeting four main lifestyle risk factors for chronic disease; tobacco use, alcohol consumption, physical inactivity and unhealthy eating. Making Every Contact Count is a key component of Healthy Ireland, the Irish national framework for health and wellbeing. The aim of the curriculum is to prepare newly qualified health professionals with the skills needed to support patients to achieve lifestyle behavior change delivered as part of routine clinical care.

Perforating Freestanding Molybdenum Disulfide Monolayers with Highly Charged Ions.

Porous single-layer molybdenum disulfide (MoS2) is a promising material for applications such as DNA sequencing and water desalination. In this work, we introduce irradiation with highly charged ions (HCIs) as a new technique to fabricate well-defined pores in MoS2. Surprisingly, we find a linear increase of the pore creation efficiency over a broad range of potential energies. Comparison to atomistic simulations reveals the critical role of energy deposition from the ion to the material through electronic excitation in the defect creation process and suggests an enrichment in molybdenum in the vicinity of the pore edges at least for ions with low potential energies. Analysis of the irradiated samples with atomic resolution scanning transmission electron microscopy reveals a clear dependence of the pore size on the potential energy of the projectiles, establishing irradiation with highly charged ions as an effective method to create pores with narrow size distributions and radii between ca. 0.3 and 3 nm.

Optimized single-layer MoS2 field-effect transistors by non-covalent functionalisation.

Field-effect transistors (FETs) with non-covalently functionalised molybdenum disulfide (MoS2) channels grown by chemical vapour deposition (CVD) on SiO2 are reported. The dangling-bond-free surface of MoS2 was functionalised with a perylene bisimide derivative to allow for the deposition of Al2O3 dielectric. This allowed the fabrication of top-gated, fully encapsulated MoS2 FETs. Furthermore, by the definition of vertical contacts on MoS2, devices, in which the channel area was never exposed to polymers, were fabricated. The MoS2 FETs showed some of the highest mobilities for transistors fabricated on SiO2 with Al2O3 as the top-gate dielectric reported so far. Thus, gate-stack engineering using innovative chemistry is a promising approach for the fabrication of reliable electronic devices based on 2D materials.

Grain boundary-mediated nanopores in molybdenum disulfide grown by chemical vapor deposition.

Molybdenum disulfide (MoS2) is a particularly interesting member of the family of two-dimensional (2D) materials due to its semiconducting and tunable electronic properties. Currently, the most reliable method for obtaining high-quality industrial scale amounts of 2D materials is chemical vapor deposition (CVD), which results in polycrystalline samples. As grain boundaries (GBs) are intrinsic defect lines within CVD-grown 2D materials, their atomic structure is of paramount importance. Here, through atomic-scale analysis of micrometer-long GBs, we show that covalently bound boundaries in 2D MoS2 tend to be decorated by nanopores. Such boundaries occur when differently oriented MoS2 grains merge during growth, whereas the overlap of grains leads to boundaries with bilayer areas. Our results suggest that the nanopore formation is related to stress release in areas with a high concentration of dislocation cores at the grain boundaries, and that the interlayer interaction leads to intrinsic rippling at the overlap regions. This provides insights for the controlled fabrication of large-scale MoS2 samples with desired structural properties for applications.

High-Performance Hybrid Electronic Devices from Layered PtSe2 Films Grown at Low Temperature.

Layered two-dimensional (2D) materials display great potential for a range of applications, particularly in electronics. We report the large-scale synthesis of thin films of platinum diselenide (PtSe2), a thus far scarcely investigated transition metal dichalcogenide. Importantly, the synthesis by thermally assisted conversion is performed at 400 °C, representing a breakthrough for the direct integration of this material with silicon (Si) technology. Besides the thorough characterization of this 2D material, we demonstrate its promise for applications in high-performance gas sensing with extremely short response and recovery times observed due to the 2D nature of the films. Furthermore, we realized vertically stacked heterostructures of PtSe2 on Si which act as both photodiodes and photovoltaic cells. Thus, this study establishes PtSe2 as a potential candidate for next-generation sensors and (opto-)electronic devices, using fabrication protocols compatible with established Si technologies.

Mapping of Low-Frequency Raman Modes in CVD-Grown Transition Metal Dichalcogenides: Layer Number, Stacking Orientation and Resonant Effects.

Layered inorganic materials, such as the transition metal dichalcogenides (TMDs), have attracted much attention due to their exceptional electronic and optical properties. Reliable synthesis and characterization of these materials must be developed if these properties are to be exploited. Herein, we present low-frequency Raman analysis of MoS2, MoSe2, WSe2 and WS2 grown by chemical vapour deposition (CVD). Raman spectra are acquired over large areas allowing changes in the position and intensity of the shear and layer-breathing modes to be visualized in maps. This allows detailed characterization of mono- and few-layered TMDs which is complementary to well-established (high-frequency) Raman and photoluminescence spectroscopy. This study presents a major stepping stone in fundamental understanding of layered materials as mapping the low-frequency modes allows the quality, symmetry, stacking configuration and layer number of 2D materials to be probed over large areas. In addition, we report on anomalous resonance effects in the low-frequency region of the WS2 Raman spectrum.

Atomic layer deposition on 2D transition metal chalcogenides: layer dependent reactivity and seeding with organic ad-layers.

This commmunication presents a study of atomic layer deposition of Al2O3 on transition metal dichalcogenide (TMD) two-dimensional films which is crucial for use of these promising materials for electronic applications. Deposition of Al2O3 on pristine chemical vapour deposited MoS2 and WS2 crystals is demonstrated. This deposition is dependent on the number of TMD layers as there is no deposition on pristine monolayers. In addition, we show that it is possible to reliably seed the deposition, even on the monolayer, using non-covalent functionalisation with perylene derivatives as anchor unit.

Direct Observation of Degenerate Two-Photon Absorption and Its Saturation in WS2 and MoS2 Monolayer and Few-Layer Films.

The optical nonlinearity of WS2 and MoS2 monolayer and few-layer films was investigated using the Z-scan technique with femtosecond pulses from the visible to the near-infrared range. The nonlinear absorption of few- and multilayer WS2 and MoS2 films and their dependences on excitation wavelength were studied. WS2 films with 1-3 layers exhibited a giant two-photon absorption (TPA) coefficient as high as (1.0 ± 0.8) × 10(4) cm/GW. TPA saturation was observed for the WS2 film with 1-3 layers and for the MoS2 film with 25-27 layers. The giant nonlinearity of WS2 and MoS2 films is attributed to a two-dimensional confinement, a giant exciton effect, and the band edge resonance of TPA.

Transition metal dichalcogenide growth via close proximity precursor supply.

Reliable chemical vapour deposition (CVD) of transition metal dichalcogenides (TMDs) is currently a highly pressing research field, as numerous potential applications rely on the production of high quality films on a macroscopic scale. Here, we show the use of liquid phase exfoliated nanosheets and patterned sputter deposited layers as solid precursors for chemical vapour deposition. TMD monolayers were realized using a close proximity precursor supply in a CVD microreactor setup. A model describing the growth mechanism, which is capable of producing TMD monolayers on arbitrary substrates, is presented. Raman spectroscopy, photoluminescence, X-ray photoelectron spectroscopy, atomic force microscopy, transmission electron microscopy, scanning electron microscopy and electrical transport measurements reveal the high quality of the TMD samples produced. Furthermore, through patterning of the precursor supply, we achieve patterned growth of monolayer TMDs in defined locations, which could be adapted for the facile production of electronic device components.

Heterojunction hybrid devices from vapor phase grown MoS2.

We investigate a vertically-stacked hybrid photodiode consisting of a thin n-type molybdenum disulfide (MoS2) layer transferred onto p-type silicon. The fabrication is scalable as the MoS2 is grown by a controlled and tunable vapor phase sulfurization process. The obtained large-scale p-n heterojunction diodes exhibit notable photoconductivity which can be tuned by modifying the thickness of the MoS2 layer. The diodes have a broad spectral response due to direct and indirect band transitions of the nanoscale MoS2. Further, we observe a blue-shift of the spectral response into the visible range. The results are a significant step towards scalable fabrication of vertical devices from two-dimensional materials and constitute a new paradigm for materials engineering.

Molybdenum disulfide/pyrolytic carbon hybrid electrodes for scalable hydrogen evolution.

The electrochemical generation of hydrogen fuel via the proton reduction in the Hydrogen Evolution Reaction (HER) in aqueous media is currently dependent on the use expensive noble metal catalysts for which alternatives must be sought. Molybdenum disulfide (MoS2) has shown great promise as a suitable electrocatalyst in this regard. While many lab-scale experiments on the HER activity of this material have demonstrated its viability and explored some fundamental mechanistic features of HER at MoS2, these experimental techniques are often ill-suited to large scale production of such electrodes. In this study we present work on the fabrication of MoS2/pyrolytic carbon (PyC) electrodes via vapour phase sulfurization of Mo thin films. These hybrid electrodes combine the catalytic activity of MoS2 with the conductivity and stability of PyC, whilst using industrially compatible processing techniques. Structural defects in the sulfur lattice were found to be key catalytically active sites for HER and thinner MoS2 films displayed a higher quantity of these defects and, hence, an improved HER activity. The observed Tafel slope of 95 mV decade(-1) is comparable to previous literature works on MoS2 HER performance.

Vitamin D status of 51-75-year-old Irish women: its determinants and impact on biochemical indices of bone turnover.

OBJECTIVES: To assess the vitamin D status of Irish postmenopausal women during wintertime, and to examine its relationship with serum parathyroid hormone (PTH) and biochemical markers of bone turnover. In addition, the determinants of wintertime serum 25-hydroxyvitamin D (25OH-D) levels in these women were investigated. DESIGN: A cross-sectional observational study. SETTING: Cork City, Ireland (52 degrees N). SUBJECTS: Ninety-five apparently healthy, free-living postmenopausal women (aged 51-75 years), not taking any medication and free from any condition likely to affect vitamin D status or calcium/bone metabolism. RESULTS: Forty-eight per cent and 7% of women had serum 25OH-D levels <50 nmol l(-1) and <25 nmol l(-1), respectively. 25OH-D levels in these women were positively associated with dietary calcium intake (P = 0.0002) and use of vitamin D-containing supplements (P = 0.031), and negatively associated with cigarette smoking (P = 0.027) and body mass index (BMI) (P = 0.030). Low serum 25OH-D levels (<50 nmol l(-1)) were associated (P < 0.01) with elevated serum PTH levels. There were no significant differences in urinary pyridinium crosslinks or serum osteocalcin, biochemical indices of bone turnover, between subjects with serum 25OH-D levels above or below 50 nmol l(-1). CONCLUSION: A high proportion of Irish postmenopausal women had low vitamin D status (<50 nmol l(-1)) during late wintertime, which appeared to lead to elevated levels of serum PTH but not of bone turnover markers. Use of regular low-dose supplemental vitamin D, meeting daily calcium recommendations, cessation of smoking and maintaining BMI in the normal range are important factors that could help maintain adequate vitamin D levels during wintertime in these women.

Vitamin K status in patients with Crohn's disease and relationship to bone turnover.

BACKGROUND: There is a high prevalence of osteopenia among patients with Crohn's disease (CD). There is some evidence that a deficiency of certain bone-active nutrients (including vitamins K and D) may have a partial role in this bone loss. AIMS: To compare the intake and the status of vitamin K in CD patients, currently in remission, with age- and sex-matched controls, and furthermore to investigate the relationship between vitamin K status and bone turnover in these patients. SUBJECTS: CD patients (n = 44; mean age: 36.9 yr) and matched controls (n = 44) were recruited from the Cork University Hospital and Cork City area, respectively. METHODS: Bloods were analyzed for the total and undercarboxylated (Glu)-osteocalcin and urine analyzed for cross-linked N-telopeptides of type I collagen (NTx). Vitamin K(1) intake was estimated by food frequency questionnaire. RESULTS: Vitamin K(1) intake in CD patients tended to be lower than that of controls (mean (SD), 117 (82) vs 148 (80) mug/d, respectively; p= 0.059). Glu and NTx concentrations in CD patients were higher than controls (mean (SD), 5.1 (3.1) vs 3.9 (2.1) ng/ml, respectively; p= 0.03 for Glu; and 49 (41) vs 25.8 (19.5) nM BCE/mM creatinine, respectively; p= 0.001 for NTx). In CD patients, Glu was significantly correlated with NTx (r= 0.488; p < 0.001), even after controlling for age, gender, vitamin D status, calcium intake, and corticosteroid use. CONCLUSION: Vitamin K status of CD patients was lower than that of the healthy controls. Furthermore, the rate of bone resorption in the CD was inversely correlated with vitamin K status, suggesting that it might be another etiological factor for CD-related osteopenia.