The Effectiveness of Patient Training in Inflammatory Bowel Disease Knowledge via Instagram: Randomized Controlled Trial.

BACKGROUND: Patients' knowledge was found to be a key contributor to the success of therapy. Many efforts have been made to educate patients in their disease. However, research found that many patients still lack knowledge regarding their disease. Integrating patient education into social media platforms can bring materials closer to recipients. OBJECTIVE: The aim of this study is to test the effectiveness of patient education via Instagram. METHODS: A randomized controlled trial was conducted to test the effectiveness of patient education via Instagram among patients with inflammatory bowel disease. Participants were recruited online from the open Instagram page of a patient organization. The intervention group was educated via Instagram for 5 weeks by the research team; the control group did not receive any educational intervention. The knowledge about their disease was measured pre- and postintervention using the Inflammatory Bowel Disease Knowledge questionnaire. Data were analyzed by comparing mean knowledge scores and by regression analysis. The trial was purely web based. RESULTS: In total, 49 participants filled out both questionnaires. The intervention group included 25 participants, and the control group included 24 participants. The preintervention knowledge level of the intervention group was reflected as a score of 18.67 out of 24 points; this improved by 3 points to 21.67 postintervention. The postintervention difference between the control and intervention groups was 3.59 points and was statistically significant (t32.88=-4.56, 95% CI 1.98-5.19; P<.001). Results of the regression analysis, accounting for preintervention knowledge and group heterogeneity, indicated an increase of 3.33 points that was explained by the intervention (P<.001). CONCLUSIONS: Patient education via Instagram is an effective way to increase disease-related knowledge. Future studies are needed to assess the effects in other conditions and to compare different means of patient education. TRIAL REGISTRATION: German Clinical Trials Register DRKS00022935; https://tinyurl.com/bed4bzvh.

Mechanistic inquiry and scientific pursuit: The case of visual processing.

Why is it rational for scientists to pursue multiple models of a phenomenon at the same time? The literatures on mechanistic inquiry and scientific pursuit each develop answers to a version of this question which is rarely discussed by the other. The mechanistic literature suggests that scientists pursue different complementary models because each model provides detailed insights into different aspects of the phenomenon under investigation. The pursuit literature suggests that scientists pursue competing models because alternative models promise to solve outstanding empirical and conceptual problems. Looking into research on visual processing as a case study, we suggest an integrated account of why it is rational for scientists to pursue both complementary and competing models of the same mechanism in scientific practice.

The Enigmatic Metallothioneins: A Case of Upward-Looking Research.

In the mid-1950s, Bert Lester Vallee and his colleague Marvin Margoshes discovered a molecule referred to today as metallothionein (MT). Meanwhile, MTs have been shown to be common in many biological organisms. Despite their prevalence, however, it remains unclear to date what exactly MTs do and how they contribute to the biological function of an organism or organ. We investigate why biochemical research has not yet been able to pinpoint the function(s) of MTs. We shall systematically examine both the discovery of and recent research on Dr. Vallee's beloved family of MT proteins utilizing tools from philosophy of science. Our analysis highlights that Vallee's initial work exhibited features prototypical of a developing research tradition: it was upward-looking, exploratory, and utilized mere interactions. Since the 1960s, MT research has increasingly become intervention- and hypothesis-based while it remained largely upward-looking in character. Whilst there is no reason to think that upward-looking research cannot successfully yield structure-function mappings, it has not yet been successful in the case of MTs. Thus, we suggest it might be time to change track and consider other research strategies looking into the evolution of MTs. Recent studies in mollusks render research in this direction worthy of pursuit.

Integrating mechanistic explanations through epistemic perspectives.

Talk of levels is ubiquitous in philosophy, especially in the context of mechanistic explanations spanning multiple levels. The mechanistic conception of levels, however, does not allow for the kind of integration needed to construct such multi-level mechanistic explanations integrating observations from different scientific domains. To address the issues arising in this context, I build on a certain perspectival aspect inherent in the mechanistic view. Rather than focusing on compositionally related levels of mechanisms, I suggest analyzing the situation in terms of epistemic perspectives researchers take when making scientific observations. Characterizing epistemic perspectives along five dimensions allows for a systematic analysis of the relations the scientific observations made from these different epistemic perspectives. This, in turn, provides a solid foundation for integrating the mechanistic explanations that are based on the scientific observations in question.

Good things come in threes: Communicative acts comprise linguistic, imagistic, and modifying components.

Gesture and sign form an integrated communication system, as do gesture and speech. Communicative acts in both systems combine categorical linguistic (words or signs) with imagistic (gestures) components. Additionally, both sign and speech can employ modifying components that convey iconic information tied to a linguistic base morpheme. An accurate analysis of communicative acts must take this third category into account.

Monitoring Different Phonological Parameters of Sign Language Engages the Same Cortical Language Network but Distinctive Perceptual Ones.

The study of signed languages allows the dissociation of sensorimotor and cognitive neural components of the language signal. Here we investigated the neurocognitive processes underlying the monitoring of two phonological parameters of sign languages: handshape and location. Our goal was to determine if brain regions processing sensorimotor characteristics of different phonological parameters of sign languages were also involved in phonological processing, with their activity being modulated by the linguistic content of manual actions. We conducted an fMRI experiment using manual actions varying in phonological structure and semantics: (1) signs of a familiar sign language (British Sign Language), (2) signs of an unfamiliar sign language (Swedish Sign Language), and (3) invented nonsigns that violate the phonological rules of British Sign Language and Swedish Sign Language or consist of nonoccurring combinations of phonological parameters. Three groups of participants were tested: deaf native signers, deaf nonsigners, and hearing nonsigners. Results show that the linguistic processing of different phonological parameters of sign language is independent of the sensorimotor characteristics of the language signal. Handshape and location were processed by different perceptual and task-related brain networks but recruited the same language areas. The semantic content of the stimuli did not influence this process, but phonological structure did, with nonsigns being associated with longer RTs and stronger activations in an action observation network in all participants and in the supramarginal gyrus exclusively in deaf signers. These results suggest higher processing demands for stimuli that contravene the phonological rules of a signed language, independently of previous knowledge of signed languages. We suggest that the phonological characteristics of a language may arise as a consequence of more efficient neural processing for its perception and production.

Disambiguating "Mechanisms" in Pharmacy: Lessons from Mechanist Philosophy of Science.

Talk of mechanisms is ubiquitous in the natural sciences. Interdisciplinary fields such as biochemistry and pharmacy frequently discuss mechanisms with the assistance of diagrams. Such diagrams usually depict entities as structures or boxes and activities or interactions as arrows. While some of these arrows may indicate causal or componential relations, others may represent temporal or operational orders. Importantly, what kind of relation an arrow represents may not only vary with context but also be underdetermined by empirical data. In this manuscript, we investigate how an analysis of pharmacological mechanisms in terms of producing and underlying mechanisms-as discussed in the contemporary philosophy of science-may shed light on these issues. Specifically, we shall argue that while pharmacokinetic mechanisms usually describe causal chains of production, pharmacodynamics tends to focus on mechanisms of action underlying the in vivo effects of a drug. Considering the action of thyroid gland hormones in the human body as a case study, we further demonstrate that pharmacodynamic schemes tend to incorporate entities and interactions on multiple levels. Yet, traditional pharmacodynamic schemes are sketched "flat", i.e., non-hierarchically. We suggest that transforming flat pharmacodynamic schemes into mechanistic multi-level representations may assist in disentangling the different kinds of mechanisms and relations depicted by arrows in flat schemes. The resulting Baumkuchen model provides a powerful and practical alternative to traditional flat schemes, as it explicates the relevant mechanisms and relations more clearly. On a more general note, our discussion demonstrates how pharmacology and related disciplines may benefit from applying concepts from the new mechanist philosophy to guide the interpretation of scientific diagrams.

Neural Networks Supporting Phoneme Monitoring Are Modulated by Phonology but Not Lexicality or Iconicity: Evidence From British and Swedish Sign Language.

Sign languages are natural languages in the visual domain. Because they lack a written form, they provide a sharper tool than spoken languages for investigating lexicality effects which may be confounded by orthographic processing. In a previous study, we showed that the neural networks supporting phoneme monitoring in deaf British Sign Language (BSL) users are modulated by phonology but not lexicality or iconicity. In the present study, we investigated whether this pattern generalizes to deaf Swedish Sign Language (SSL) users. British and SSLs have a largely overlapping phoneme inventory but are mutually unintelligible because lexical overlap is small. This is important because it means that even when signs lexicalized in BSL are unintelligible to users of SSL they are usually still phonologically acceptable. During fMRI scanning, deaf users of the two different sign languages monitored signs that were lexicalized in either one or both of those languages for phonologically contrastive elements. Neural activation patterns relating to different linguistic levels of processing were similar across SLs; in particular, we found no effect of lexicality, supporting the notion that apparent lexicality effects on sublexical processing of speech may be driven by orthographic strategies. As expected, we found an effect of phonology but not iconicity. Further, there was a difference in neural activation between the two groups in a motion-processing region of the left occipital cortex, possibly driven by cultural differences, such as education. Importantly, this difference was not modulated by the linguistic characteristics of the material, underscoring the robustness of the neural activation patterns relating to different linguistic levels of processing.