Epithelial neutrophil localization and tight junction Claudin-2 expression are innovative outcome predictors in inflammatory bowel disease.

BACKGROUND: Patients with inflammatory bowel disease (IBD) in clinical and endoscopic remission may still experience disease relapse. Therefore, there is a need to identify outcome predictors. Recently, the role of neutrophils in predicting outcomes in ulcerative colitis (UC) has been highlighted. Furthermore, the impairment of intestinal barrier plays a key role in forecasting disease outcomes in IBD. OBJECTIVE: This observational study aimed to assess the predictive role of neutrophils according to tissue localization and intestinal barrier protein expression in IBD. METHODS: IBD patients in clinical remission who underwent colonoscopy between January 2020 and June 2022 at two tertiary referral centres were enrolled. Patients with Mayo Endoscopic Score ≤1 (UC) and Simple Endoscopic Score ≤6 (Crohn's disease) were included. Histological activity was assessed using validated scores. Experienced pathologists evaluated neutrophil localization in the epithelium and lamina propria and immunohistochemical expression of Claudin-2 and junctional adhesion molecule A (JAM-A). RESULTS: Of 60 UC and 76 CD patients, 59.7% had histological activity. 25.8% of patients developed an adverse outcome within 12 months. Neutrophils in the epithelium predicted adverse outcomes for UC (hazard ratio [HR] 5.198, p = 0.01) and CD (HR 4.377, p = 0.03) patients in endoscopic remission. Claudin-2 expression correlated with endoscopic and histological activity and predicted outcomes in UC. Similar results were found for JAM-A in CD despite this protein showing less specificity as a barrier predictor of outcome. CONCLUSION: This study highlights the potential role of epithelial neutrophil localization and Claudin-2 'leaky gut' expression as tools for predicting IBD outcomes and guiding further patient-tailored therapy.

Reliability and validation of an electronic penicillin allergy risk-assessment tool in a pregnant population.

BACKGROUND: Penicillin allergy adversely impacts patient care, yet most cases do not have true allergies. Clinicians require efficient, reliable clinical tools to identify low risk patients who can be safely de-labeled. Our center implemented the FIRSTLINE electronic point-of-care decision support tool to help non-allergist practitioners risk stratify patients with penicillin allergy. We sought to explore the reliability and validity of this tool in relation to allergist assessment and actual patient outcomes. We additionally compared it with two other published stratification tools, JAMA and PENFAST, to assess ability to accurately identify low risk patients appropriate for direct oral challenge. METHODS: In this single-center, retrospective, observational study, 181 pregnant females with self-reported penicillin allergy between July 2019 to June 2021 at BC Women's Hospital, Vancouver, Canada were used to assess the reliability and validity of all three tools. Physician-guided history of penicillin use and symptoms were used for scoring. Results and recommendations were compared to actual patient outcomes after clinician decision for direct oral challenge or intradermal tests. We compared the performance of JAMA, PENFAST and FIRSTLINE. RESULTS: 181 patients were assessed. 176/181 (97.2%) patients were deemed not allergic. Each risk stratification tool labelled majority of patients as low risk with 88.4% of patients PENFAST 0-2, 60.2% of patients JAMA low risk, 86.7% of patients FIRSTLINE very low risk. CONCLUSION: We demonstrate that our point-of-care electronic algorithm is reliable in identifying low risk pregnant patients, as compared to an allergist assessment. To our knowledge, this is the first study to provide direct comparison between multiple decision support tools using the same population, minimizing participant bias. Providing clinical algorithms to risk stratify patients, can enable healthcare professionals to safely identify individuals who may be candidates for direct penicillin oral challenges versus needing referral to specialists. This increases the generalizability and efficiency of penicillin allergy de-labeling.

RhoGDI1 regulates cell-cell junctions in polarized epithelial cells.

Cell-cell contact formation of polarized epithelial cells is a multi-step process that involves the co-ordinated activities of Rho family small GTPases. Consistent with the central role of Rho GTPases, a number of Rho guanine nucleotide exchange factors (GEFs) and Rho GTPase-activating proteins (GAPs) have been identified at cell-cell junctions at various stages of junction maturation. As opposed to RhoGEFs and RhoGAPs, the role of Rho GDP dissociation inhibitors (GDIs) during cell-cell contact formation is poorly understood. Here, we have analyzed the role of RhoGDI1/ARHGDIA, a member of the RhoGDI family, during cell-cell contact formation of polarized epithelial cells. Depletion of RhoGDI1 delays the development of linear cell-cell junctions and the formation of barrier-forming tight junctions. In addition, RhoGDI1 depletion impairs the ability of cells to stop migration in response to cell collision and increases the migration velocity of collectively migrating cells. We also find that the cell adhesion receptor JAM-A promotes the recruitment of RhoGDI1 to cell-cell contacts. Our findings implicate RhoGDI1 in various processes involving the dynamic reorganization of cell-cell junctions.

Aligned bodies, united hearts: embodied emotional dynamics of an Islamic ritual.

Collective rituals involve the coordination of intentions and actions and have been shown to promote the alignment of emotional states and social identities. However, the mechanics of achieving group-level synchrony is yet unclear. We report the results of a naturalistic study in the context of an Islamic congregational prayer that involves synchronous movement. We used wearable devices to capture data on body posture, autonomic responses and spatial proximity to investigate how postural alignment and shared arousal intertwine during this ritual. The findings reveal a dual process at play: postural alignment appears to be more localized, with worshippers synchronizing their movements with their nearest neighbours, while physiological alignment operates on a broader scale, primarily driven by the central role of the religious leader. Our findings underscore the importance of interpersonal dynamics in collective gatherings and the role of physical co-presence in fostering connections among participants, with implications extending to our understanding of group dynamics across various social settings.This article is part of the theme issue 'Minds in movement: embodied cognition in the age of artificial intelligence'.

Quality Assessment of TikTok as a Source of Information About Mitral Valve Regurgitation in China: Cross-Sectional Study.

BACKGROUND: In China, mitral valve regurgitation (MR) is the most common cardiovascular valve disease. However, patients in China typically experience a high incidence of this condition, coupled with a low level of health knowledge and a relatively low rate of surgical treatment. TikTok hosts a vast amount of content related to diseases and health knowledge, providing viewers with access to relevant information. However, there has been no investigation or evaluation of the quality of videos specifically addressing MR. OBJECTIVE: This study aims to assess the quality of videos about MR on TikTok in China. METHODS: A cross-sectional study was conducted on the Chinese version of TikTok on September 9, 2023. The top 100 videos on MR were included and evaluated using quantitative scoring tools such as the modified DISCERN (mDISCERN), the Journal of the American Medical Association (JAMA) benchmark criteria, the Global Quality Score (GQS), and the Patient Education Materials Assessment Tool for Audio-Visual Content (PEMAT-A/V). Correlation and stepwise regression analyses were performed to examine the relationships between video quality and various characteristics. RESULTS: We obtained 88 valid video files, of which most (n=81, 92%) were uploaded by certified physicians, primarily cardiac surgeons, and cardiologists. News agencies/organizations and physicians had higher GQS scores compared with individuals (news agencies/organizations vs individuals, P=.001; physicians vs individuals, P=.03). Additionally, news agencies/organizations had higher PEMAT understandability scores than individuals (P=.01). Videos focused on disease knowledge scored higher in GQS (P<.001), PEMAT understandability (P<.001), and PEMAT actionability (P<.001) compared with videos covering surgical cases. PEMAT actionability scores were higher for outpatient cases compared with surgical cases (P<.001). Additionally, videos focused on surgical techniques had lower PEMAT actionability scores than those about disease knowledge (P=.04). The strongest correlations observed were between thumbs up and comments (r=0.92, P<.001), thumbs up and favorites (r=0.89, P<.001), thumbs up and shares (r=0.87, P<.001), comments and favorites (r=0.81, P<.001), comments and shares (r=0.87, P<.001), and favorites and shares (r=0.83, P<.001). Stepwise regression analysis identified "length (P<.001)," "content (P<.001)," and "physicians (P=.004)" as significant predictors of GQS. The final model (model 3) explained 50.1% of the variance in GQSs. The predictive equation for GQS is as follows: GQS = 3.230 - 0.294 × content - 0.274 × physicians + 0.005 × length. This model was statistically significant (P=.004) and showed no issues with multicollinearity or autocorrelation. CONCLUSIONS: Our study reveals that while most MR-related videos on TikTok were uploaded by certified physicians, ensuring professional and scientific content, the overall quality scores were suboptimal. Despite the educational value of these videos, the guidance provided was often insufficient. The predictive equation for GQS developed from our analysis offers valuable insights but should be applied with caution beyond the study context. It suggests that creators should focus on improving both the content and presentation of their videos to enhance the quality of health information shared on social media.

Identification and Validation of JAM-A as a Novel Prognostic and Immune Factor in Human Tumors.

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.

Evaluating the quality and reliability of YouTube videos on myopia: a video content analysis.

PURPOSE: To evaluate the quality and reliability of YouTube videos as an educational resource about myopia. METHODS: The videos were identified by searching YouTube with the keywords 'myopia' and 'nearsightedness', using the website's default search settings. The number of views, likes, dislikes, view ratio, source of the upload, country of origin, video type, and described treatment techniques were assessed. Each video was evaluated using the DISCERN, Journal of the American Medical Association (JAMA), Ensuring Quality Information for Patients (EQIP), Health On the Net Code of Conduct Certification (HONcode), and the Global Quality Score (GQS) scales. RESULTS: A total of 112 videos were included. The classification of videos by source indicated that the top three contributors were health channels (30 videos [26.8%]), physicians (24 videos [21.4%]), and academic centers (19 videos [16.9%]). Most of these videos originated from the United States (74 videos [66.1%]) and focused on the pathophysiology (n = 89, 79.4%) and the treatment (n = 77, 68.7%) of myopia. Statistical comparisons among the groups of video sources showed no significant difference in the mean DISCERN score (p = 0.102). However, significant differences were noted in the JAMA (p = 0.011), GQS (p = 0.009), HONcode (p = 0.011), and EQIP (p = 0.002) scores. CONCLUSIONS: This study underscored the variability in the quality and reliability of YouTube videos related to myopia, with most content ranging from 'weak to moderate' quality based on the DISCERN and GQS scales, yet appearing to be 'excellent' according to the HONcode and EQIP scales. Videos uploaded by physicians generally exhibited higher standards, highlighting the importance of expert involvement in online health information dissemination. Given the potential risks of accessing incorrect medical data that can affect the decision-making processes of patients, caution should be exercised when using online content as a source of information.

Evaluating Turkish Readability and Quality of Strabismus-Related Websites.

Background This cross-sectional study aimed to assess the readability of strabismus-related websites and the quality of their content. Methodology This cross-sectional study evaluated the websites on strabismus disease using Atesman and Bezirci-Yilmaz's readability formulas, which have been scientifically verified to be effective for Turkish people. The study picked texts from the first 50 websites that appeared on the screen after typing "strabismus treatment" into the Google search engine based on their Turkish reading level and information reliability. In this study, 41 of the first 50 websites were reviewed. Furthermore, two separate senior ophthalmologists evaluated the JAMA and DISCERN indexes, as well as the credibility of the content on these sites. Results The Bezirci-Yilmaz readability index indicated that the websites were readable for individuals with an average education level of 10.5 ± 2.3 years. The websites scored an average of 55.2 ± 7.9 on the Atesman readability formula, indicating that they were readable for students in the 11-12th grade. The websites had an average JAMA score of 0.8 ± 0.7 points and a DISCERN score of 34.2 ± 8.6 points, indicating low-quality content. Conclusions The readability of websites providing information regarding strabismus was significantly higher than Turkey's average educational level. Websites should not only be designed to be easy to read so that strabismus patients may learn about their condition but should also provide higher-quality strabismus content.

AI-Enhanced evaluation of YouTube content on post-surgical incontinence following pelvic cancer treatment.

Background: Several pelvic area cancers exhibit high incidence rates, and their surgical treatment can result in adverse effects such as urinary and fecal incontinence, significantly impacting patients' quality of life. Post-surgery incontinence is a significant concern, with prevalence rates ranging from 25 to 45% for urinary incontinence and 9-68% for fecal incontinence. Cancer survivors are increasingly turning to YouTube as a platform to connect with others, yet caution is warranted as misinformation is prevalent. Objective: This study aims to evaluate the information quality in YouTube videos about post-surgical incontinence after pelvic area cancer surgery. Methods: A YouTube search for "Incontinence after cancer surgery" yielded 108 videos, which were subsequently analyzed. To evaluate these videos, several quality assessment tools were utilized, including DISCERN, GQS, JAMA, PEMAT, and MQ-VET. Statistical analyses, such as descriptive statistics and intercorrelation tests, were employed to assess various video attributes, including characteristics, popularity, educational value, quality, and reliability. Also, artificial intelligence techniques like PCA, t-SNE, and UMAP were used for data analysis. HeatMap and Hierarchical Clustering Dendrogram techniques validated the Machine Learning results. Results: The quality scales presented a high level of correlation one with each other (p < 0.01) and the Artificial Intelligence-based techniques presented clear clustering representations of the dataset samples, which were reinforced by the Heat Map and Hierarchical Clustering Dendrogram. Conclusions: YouTube videos on "Incontinence after Cancer Surgery" present a "High" quality across multiple scales. The use of AI tools, like PCA, t-SNE, and UMAP, is highlighted for clustering large health datasets, improving data visualization, pattern recognition, and complex healthcare analysis.

Bioinspired engineering ADSC nanovesicles thermosensitive hydrogel enhance autophagy of dermal papilla cells for androgenetic alopecia treatment.

Androgenic alopecia (AGA) is a highly prevalent form of non-scarring alopecia but lacks effective treatments. Stem cell exosomes have similar repair effects to stem cells, suffer from the drawbacks of high cost and low yield yet. Cell-derived nanovesicles acquired through mechanical extrusion exhibit favorable biomimetic properties similar to exosomes, enabling them to efficiently encapsulate substantial quantities of therapeutic proteins. In this study, we observed that JAM-A, an adhesion protein, resulted in a significantly increased the adhesion and resilience of dermal papilla cells to form snap structures against damage caused by dihydrotestosterone and macrophages, thereby facilitating the process of hair regrowth in cases of AGA. Consequently, adipose-derived stem cells were modified to overexpress JAM-A to produce engineered JAM-A overexpressing nanovesicles (JAM-AOE@NV). The incorporation of JAM-AOE@NV into a thermosensitive hydrogel matrix (JAM-AOE@NV Gel) to effectively addresses the limitations associated with the short half-life of JAM-AOE@NV, and resulted in the achievement of a sustained-release profile for JAM-AOE@NV. The physicochemical characteristics of the JAM-AOE@NV Gel were analyzed and assessed for its efficacy in promoting hair regrowth in vivo and vitro. The JAM-AOE@NV Gel, thus, presents a novel therapeutic approach and theoretical framework for promoting the treatment of low cell adhesion diseases similar to AGA.

The Role of ZO-2 in Modulating JAM-A and γ-Actin Junctional Recruitment, Apical Membrane and Tight Junction Tension, and Cell Response to Substrate Stiffness and Topography.

This work analyzes the role of the tight junction (TJ) protein ZO-2 on mechanosensation. We found that the lack of ZO-2 reduced apical membrane rigidity measured with atomic force microscopy, inhibited the association of γ-actin and JAM-A to the cell border, and instead facilitated p114RhoGEF and afadin accumulation at the junction, leading to an enhanced mechanical tension at the TJ measured by FRET, with a ZO-1 tension probe, and increased tricellular TJ tension. Simultaneously, adherens junction tension measured with an E-cadherin probe was unaltered. The stability of JAM-A and ZO-2 binding was assessed by a collaborative in silico study. The absence of ZO-2 also impacted the cell response to the substrate, as monolayers plated in 20 kPa hydrogels developed holes not seen in parental cultures and displayed a retarded elongation and formation of cell aggregates. The absence of ZO-2 was sufficient to induce YAP and Snail nuclear accumulation in cells cultured over glass, but when ZO-2 KD cells were plated in nanostructured ridge arrays, they displayed an increased abundance of nuclear Snail and conspicuous internalization of claudin-4. These results indicate that the absence of ZO-2 also impairs the response of cells to substrate stiffness and exacerbates transformation triggered by substrate topography.

Suprapubic catheter change: Evaluating YouTube videos as a resource for teaching junior doctors.

Objectives: The objectives of this study are to assess the current level of experience and teaching practices for SPC change at our institution and, second, to assess the quality of YouTube videos as an educational tool for teaching SPC change. Methods: A survey was conducted of 40 JMOs at our institution regarding SPC change. The first 20 YouTube videos on SPC change were included for analysis. A JAMA and DISCERN score was calculated for each video. Using linear regression, the association between collected variables and the assigned JAMA and DISCERN scores were determined. Results: The survey showed that 18 (45%) of JMOs had done an SPC change. None had received formal teaching. The consensus was that the quality of the YouTube videos was poor. There was a statistically significant positive correlation between the score assigned to videos by each scoring system (Pearson's r 0.81, p < 0.001). There was no statistically significant association between video quality as measured by either of the scoring systems and number of views. No association between any video characteristic and JAMA and DISCERN score was found. Conclusion: An SPC change is often a requirement of JMOs; however, this skill is not formally taught. The quality of YouTube videos describing an SPC change is poor.

Quality and comprehensiveness of YouTube videos on back pain during pregnancy.

OBJECTIVES: Back pain during pregnancy is a common issue that impacts the quality of life for many women. YouTube has become an increasingly popular source of health information. Pregnant women often turn to YouTube for advice on managing back pain, but the quality of available videos is highly variable. This study aimed to assess the quality and comprehensiveness of YouTube videos related to back pain during pregnancy. METHODS: A YouTube search was conducted using the keyword "back pain in pregnancy", and the first 100 resulting videos were included in the study. After a thorough review and exclusion of ineligible videos, the final sample consisted of 71 videos. Various parameters such as the number of views, likes, viewer interaction, video age, uploaded source (healthcare or nonhealthcare), and video length were evaluated for all videos. RESULTS: Regarding the source of the videos, 44 (61.9%) were created by healthcare professionals, while 27 (38%) were created by nonprofessionals. Videos created by healthcare professionals had significantly higher scores in terms of DISCERN score, Journal of the American Medical Association (JAMA) score, and Global Quality Scale (GQS) (P < 0.001). Our findings indicate a statistically significant and strong positive correlation among the three scoring systems (P < 0.001). CONCLUSION: Videos created by healthcare professionals were generally of higher quality, but many videos were still rated as low-moderate quality. The majority of videos focused on self-care strategies, with fewer discussing other treatment options. Our findings highlight the need for improved quality and comprehensiveness of YouTube videos on back pain during pregnancy.

Assessing the Quality of YouTube's Incontinence Information after Cancer Surgery: An Innovative Graphical Analysis.

BACKGROUND: Prostate and colorectum cancers rank among the most common cancers, and incontinence is a significant postsurgical issue affecting the physical and psychological well-being of cancer survivors. Social media, particularly YouTube, has emerged as a vital source of health information. While YouTube offers valuable content, users must exercise caution due to potential misinformation. OBJECTIVE: This study aims to assess the quality of publicly available YouTube videos related to incontinence after pelvic cancer surgery. METHODS: A search on YouTube related to "Incontinence after cancer surgery" was performed, and 108 videos were analyzed. Multiple quality assessment tools (DISCERN, GQS, JAMA, PEMAT, and MQ-VET) and statistical analyses (descriptive statistics and intercorrelation tests) were used to evaluate the characteristics and popularity, educational value, quality, and reliability of these videos, relying on novel graphical representation techniques such as Sankey and Chord diagrams. RESULTS: Strong positive correlations were found among quality rating scales, emphasizing agreement. The performed graphical analysis reinforced the reliability and validity of quality assessments. CONCLUSIONS: This study found strong correlations among five quality scales, suggesting their effectiveness in assessing health information quality. The evaluation of YouTube videos consistently revealed "high" quality content. Considering the source is mandatory when assessing quality, healthcare and academic institutions are reliable sources. Caution is advised with ad-containing videos. Future research should focus on policy improvements and tools to aid patients in finding high-quality health content.

IVC filter - assessing the readability and quality of patient information on the Internet.

OBJECTIVE: The internet is an increasingly favorable source of information regarding health-related issues. The aim of this study is to apply appropriate evaluation tools to assess the evidence available online about inferior vena cava (IVC) filters with a focus on quality and readability. METHODS: A search was performed during December 2022 using three popular search engines, namely Google, Yahoo, and Bing. Websites were categorized into academic, physician, commercial, and unspecified websites according to their content. Information quality was determined using Journal of the American Medical Association (JAMA) criteria, the DISCERN scoring tool, and whether a Health On the Net Foundation certification (HONcode) seal was present. Readability was established using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). Statistical significance was accepted as P < .05. RESULTS: In total, 110 websites were included in our study. The majority of websites were categorized as commercial (25%), followed by hospital (24%), academic (21%), unspecified (16%), and physician (14%). Average scores for all websites using JAMA and DISCERN were 1.93 ± 1.19 (median, 1.5; range, 0-4) and 45.20 ± 12.58 (median, 45.5; range, 21-75), respectively. The highest JAMA mean score of 3.07 ± 1.16 was allocated to physician websites, and the highest DISCERN mean score of 52.85 ± 12.66 was allocated to hospital websites. The HONcode seal appeared on two of the selected websites. Physician, hospital, and unspecified websites had a significantly higher mean JAMA score than academic and commercial websites (all with P < .001). Hospital websites had a significantly higher mean DISCERN score than academic (P = .007), commercial (P < .001), and unspecified websites (P = .017). Readability evaluation generated a mean FRES score of 51.57 ±12.04, which represented a 10th to 12th grade reading level and a mean FKGL score of 8.20 ± 1.70, which represented an 8th to 10th grade reading level. Only 12 sources were found to meet the ≤6th grade target reading level. No significant correlation was found between overall DISCERN score and overall FRES score. CONCLUSIONS: The study results demonstrate that the quality of online information about IVC filters is suboptimal, and academic and commercial websites, in particular, must enhance their content quality regarding the use of IVC filters. Considering the discontinuation of the HONcode as a standardized quality assessment marker, it is recommended that a similar certification tool be developed and implemented for the accreditation of patient information online.

An Assessment of the Quality of YouTube Videos as a Resource for Adolescents Experiencing Abnormal Uterine Bleeding.

STUDY OBJECTIVE: YouTube, the largest accessible media-sharing platform, has become an important tool for pursuing health-related information. Adolescents may find it challenging to seek counseling or access adolescent-friendly services for menstruation-related problems, so YouTube may be a useful resource. The aim of this study was to examine the reliability, quality, and accuracy of YouTube videos concerning abnormal uterine bleeding in adolescents. METHODS: A YouTube search using the key words "adolescent, teens, heavy period, abnormal uterine bleeding, heavy menstrual bleeding" yielded 109 videos. Video features (duration, time since upload, likes, views, comments), sources of upload, and content were recorded. All the videos were reviewed by 2 adolescent medicine specialists and scored using the Journal of the American Medical Association, the 5-point modified DISCERN tool, and the Global Quality Scale. RESULTS: Fifty-eight videos met the inclusion criteria. Most (62.1%) were created by non-professionals, and a significant portion (81%) contained general descriptions. On the basis of the DISCERN classification, 50% exhibited poor quality. Similarly, the Journal of the American Medical Association assessment indicated that only 36.2% satisfied the requirements for good quality. The videos uploaded by professionals exhibited notably superior quality in comparison with those uploaded by non-professionals. Additionally, higher-quality videos were longer (P = .040) and more recent (P = .011). CONCLUSION: Mot YouTube videos about adolescent abnormal uterine bleeding provide low-quality information. We believe that increasing the number of videos tailored by health care providers specializing in adolescent gynecology to address the specific physical and psychosocial needs of adolescents with menstrual problems would be beneficial.

Cell Adhesion at the Tight Junctions: New Aspects and New Functions.

Tight junctions (TJ) are cell-cell adhesive structures that define the permeability of barrier-forming epithelia and endothelia. In contrast to this seemingly static function, TJs display a surprisingly high molecular complexity and unexpected dynamic regulation, which allows the TJs to maintain a barrier in the presence of physiological forces and in response to perturbations. Cell-cell adhesion receptors play key roles during the dynamic regulation of TJs. They connect individual cells within cellular sheets and link sites of cell-cell contacts to the underlying actin cytoskeleton. Recent findings support the roles of adhesion receptors in transmitting mechanical forces and promoting phase separation. In this review, we discuss the newly discovered functions of cell adhesion receptors localized at the TJs and their role in the regulation of the barrier function.

How Efficient Is ChatGPT in Accessing Accurate and Quality Health-Related Information?

Background and objective The field of artificial intelligence (AI) is advancing at a rapid pace, impacting all aspects of human life. Chat Generative Pre-trained Transformer (ChatGPT), which represents one of AI's most recent and remarkable achievements, has garnered significant attention and popularity in the academic community. ChatGPT, a language model-based chatbot developed by OpenAI, responds quickly and provides answers to the questions put to it. This chatbot has the ability to gather content from a variety of sources on the internet. However, its success in providing correct information has not yet been comprehensively analyzed. In light of this, this study aimed to engage in a comparative content analysis of health-related information provided by ChatGPT and a few selected websites. Methods We performed a qualitative analysis of data obtained from various information sources by using the DISCERN score and the Journal of the American Medical Association (JAMA) benchmark criteria. In addition, readability levels of the content were measured by using the Flesch-Kincaid grade level, Gunning Fog Index, and Simple Measure of Gobbledygook (SMOG) index. Results Based on our findings, there was no statistically significant difference between the websites and ChatGPT in DISCERN scores. However, the JAMA score was statistically significantly higher for websites. With regard to the Flesch-Kincaid grade level, Gunning Fog Index, and SMOG index values, the data obtained from the websites had higher readability. Conclusion Although AI is starting to play a significant role in our everyday lives, it has yet to surpass traditional methods of accessing information in terms of readability and reliability.

Is Online Patient-Centered Information About Implant Bone Graft Valid?

Background A dental implant is one of the most commonly used treatments to replace missing teeth. A reasonable number of implant cases necessitate using a bone graft before or at the time of implant placement. This study aims to evaluate the quality and readability of online patient-centered information about implant bone grafts. Methodology This cross-sectional study used Google, Yahoo, and Bing search engines. The keywords were entered to screen 900 websites. The DISCERN, Journal of the American Medical Association (JAMA), and Health on the Net (HON) code tools evaluated the included websites for quality. The Flesch reading-ease score (FRES), Flesch-Kincaid grade level, and simple measure of gobbledygook tests measured readability. Statistical analysis was done using SPSS version 25 (IBM Corp., Armonk, NY, USA). Results A total of 161 websites were included; 65 (40.4%) of the included websites belonged to a university or medical center. Only five (3.1%) websites were exclusively related to dental implant treatments. DISCERN showed moderate quality for 82 (50.9%) websites. There was a statistical difference between commercial and non-profit organization websites. In the JAMA evaluation, currency was the most commonly achieved in 67 (41.6%) websites. For the HON code, four (2.5%) websites were certified. Based on FRES, the most common readability category was "fair difficult," accounting for 64 (39.8%), followed by "standard" in 56 (34.8%) websites. Conclusions The study findings suggest that English-language patient-centered information about implant bone grafts is challenging to comprehend and of low quality. Hence, there is a need to establish websites that provide trustworthy, high-quality information on implant bone grafts.

The Readability and Quality of Web-Based Patient Information on Nasopharyngeal Carcinoma: Quantitative Content Analysis.

BACKGROUND: Nasopharyngeal carcinoma (NPC) is a rare disease that is strongly associated with exposure to the Epstein-Barr virus and is characterized by the formation of malignant cells in nasopharynx tissues. Early diagnosis of NPC is often difficult owing to the location of initial tumor sites and the nonspecificity of initial symptoms, resulting in a higher frequency of advanced-stage diagnoses and a poorer prognosis. Access to high-quality, readable information could improve the early detection of the disease and provide support to patients during disease management. OBJECTIVE: This study aims to assess the quality and readability of publicly available web-based information in the English language about NPC, using the most popular search engines. METHODS: Key terms relevant to NPC were searched across 3 of the most popular internet search engines: Google, Yahoo, and Bing. The top 25 results from each search engine were included in the analysis. Websites that contained text written in languages other than English, required paywall access, targeted medical professionals, or included nontext content were excluded. Readability for each website was assessed using the Flesch Reading Ease score and the Flesch-Kincaid grade level. Website quality was assessed using the Journal of the American Medical Association (JAMA) and DISCERN tools as well as the presence of a Health on the Net Foundation seal. RESULTS: Overall, 57 suitable websites were included in this study; 26% (15/57) of the websites were academic. The mean JAMA and DISCERN scores of all websites were 2.80 (IQR 3) and 57.60 (IQR 19), respectively, with a median of 3 (IQR 2-4) and 61 (IQR 49-68), respectively. Health care industry websites (n=3) had the highest mean JAMA score of 4 (SD 0). Academic websites (15/57, 26%) had the highest mean DISCERN score of 77.5. The Health on the Net Foundation seal was present on only 1 website, which also achieved a JAMA score of 3 and a DISCERN score of 50. Significant differences were observed between the JAMA score of hospital websites and the scores of industry websites (P=.04), news service websites (P<.048), charity and nongovernmental organization websites (P=.03). Despite being a vital source for patients, general practitioner websites were found to have significantly lower JAMA scores compared with charity websites (P=.05). The overall mean readability scores reflected an average reading age of 14.3 (SD 1.1) years. CONCLUSIONS: The results of this study suggest an inconsistent and suboptimal quality of information related to NPC on the internet. On average, websites presented readability challenges, as written information about NPC was above the recommended reading level of sixth grade. As such, web-based information requires improvement in both quality and accessibility, and healthcare providers should be selective about information recommended to patients, ensuring they are reliable and readable.