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The use of neuromodulators is prevalent in various functional gastrointestinal disease. However, data concerning the outcomes of these treatments in functional esophageal disorders (FED) remains limited and inadequate. The aim of the present study is to examine the efficacy of central neuromodulators in FED. We searched PubMed, EMBASE, and the Cochrane library databases from inception to April 2023. Randomized controlled trials that compared the effects of neuromodulators and placebos on FED are included. Primary outcome is the symptom improvement, and Rome IV criteria is used to assess eligible studies. Eleven randomized controlled studies (three for functional chest pain, four for reflux hypersensitivity/functional heartburn, three for globus, and one for functional dysphagia) were included in the final analysis. Neuromodulators reduced chest pain by 52%–71% in patients with functional chest pain, and alleviated symptom by 46%–75% in patients with globus (n = 3, Odds ratio 6.30, 95% confidence interval 4.17–9.50). However, the results were inconsistent for reflux hypersensitivity and functional heartburn. There was a lack of convincing evidence to support the use of neuromodulators for functional dysphagia. The use of neuromodulators did not have a significant impact on the quality of life. Functional chest pain and globus may potentially benefit from the use of neuromodulators, but their effectiveness for functional dysphagia, functional heartburn and reflux hypersensitivity remains controversial. More controlled trials are needed to confirm the therapeutic effects on these conditions. [ABSTRACT FROM AUTHOR]

Owing to their limited accuracy and narrow applicability, current antimicrobial peptide (AMP) prediction models face obstacles in industrial application. To address these limitations, we developed and improved an AMP prediction model using Comparing and Optimizing Multiple DEep Learning (COMDEL) algorithms, coupled with high-throughput AMP screening method, finally reaching an accuracy of 94.8% in test and 88% in experiment verification, surpassing other state-of-the-art models. In conjunction with COMDEL, we employed the phage-assisted evolution method to screen Sortase in vivo and developed a cell-free AMP synthesis system in vitro , ultimately increasing AMPs yields to a range of 0.5–2.1 g/L within hours. Moreover, by multi-omics analysis using COMDEL, we identified Lactobacillus plantarum as the most promising candidate for AMP generation among 35 edible probiotics. Following this, we developed a microdroplet sorting approach and successfully screened three L. plantarum mutants, each showing a twofold increase in antimicrobial ability, underscoring their substantial industrial application values. This study establishes an AI-based AMPs prediction model named COMDEL for effectively mining edible AMPs and probiotics, which are subsequently synthesized and directly evolved for industrial application, respectively. [Display omitted] [ABSTRACT FROM AUTHOR]

• Learning caregiving skills via online platform is important for caregivers. • Family caregivers and professionals held different views on online-learning platform. • Professionals see family caregivers as incapable of independent learning. To compare perspectives of family and professional caregivers regarding an online self-learning platform. Family and professional caregivers were interviewed separately. A thematic analysis was conducted with 12 family caregivers and 13 professional caregivers of people living with dementia in Macao using six semi-structured focus group interviews. Family and professional caregivers had different perspectives regarding the application of online learning program Four main themes emerged from the focus groups, including similarities and differences, namely 1) Need for services; 2) Accessibility to services; 3) Barriers to online learning; 4) Adjustments to the platform. The psychological assurance offered by an online learning program is imperative to the well-being of family caregivers. By identifying the gap between the needs and abilities of family caregivers and those imagined by professional caregivers, it allows for the development of support programs and interventions tailored to meet the specific needs of family caregivers. [ABSTRACT FROM AUTHOR]

To investigate the predictive value of a novel posterior circulation score (novel-PC score) based on baseline posterior circulation diffusion-weighted imaging (DWI) for functional independence after endovascular treatment (EVT) in patients with acute vertebral-basilar artery occlusion (VBAO). The baseline DWI brain stem score (BSS), posterior circulation Alberta Stroke Program Early CT Score (pc-ASPECTS), and the novel-PC score were evaluated separately. A modified Rankin scale (mRS) ≤2 at 90 days was defined as a prognostic indicator of functional independence. Modified Thrombolysis in Cerebral Infarction grade 2b or 3 was defined as surgical success. A total of 64 eligible patients were enrolled and divided into good and poor functional prognosis groups based on the mRS. The novel-PC score, BSS, and pc-ASPECTS (all P ≤.001) were significantly better in the good functional prognosis group. The novel-PC score had a higher predictive value than BSS and pc-ASPECTS for 90-day functional independence (area under the receiver operating characteristic curve, 0.87 vs. 0.73 vs. 0.71; P <.05). Univariate binary logistic regression analysis showed that age (P =.006), Posterior National Institutes of Health Stroke Scale ≤18 (P <.001), BSS ≤2 (P =.008), pc-ASPECTS >7 (P =.002), and novel-PC score ≤5 (P =.001) were independently associated with function. Our novel-PC score, based on DWI, can independently predict functional prognosis in patients with acute VBAO after EVT. The novel-PC score based on baseline DWI was shown to be an independent predictor of function in patients with acute BVAO who are treated with EVT. • Acute vertebrobasilar artery occlusion is often identified late, and accurately selecting patients for endovascular treatment is challenging. • Our novel posterior circulation score comprehensively considers the areas of lesion involvement and complete infarction. • The proposed score has a higher predictive value for 90-day functional independence after endovascular treatment than other commonly used scores. [ABSTRACT FROM AUTHOR]