An important question in mental healthcare for children is whether treatments are effective and safe in the long run. Here, we comment on a recent editorial perspective by Roest et al. (2022), who argue, based on an overview of systematic reviews, ‘that there is no convincing evidence that interventions for the most common childhood disorders are beneficial in the long term’. We believe that the available evidence does not justify this conclusion and express our concern regarding the harmful effects of their message. We show that there is evidence to suggest beneficial longer term treatment effects for each of the disorders and explain why evidence‐based treatment should be offered to children with mental disorders. 10.1111/jcpp.13677.Read the full article at doi:  Journal of Child Psychology and Psychiatry on 29 August 2022. We appreciate the authors' discussion of a topic of large clinical relevance. However, we believe that the authors' conclusion ‘that there is no convincing evidence that interventions for the most common childhood disorders are beneficial in the long term’ is misguided.With much interest we read the recent editorial perspective by Roest, de Vries, Wienen, and de Jonge  who aimeThe authors searched for systematic reviews of long‐term (in their definition over 2 years) outcomes of treatment for attention‐deficit/hyperactivity disorder (ADHD), behavioral disorders, anxiety, and depression for children between 6 and 12 years old. They identified five systematic reviews, all on ADHD or behavioral disorders, of which three focused on pharmacological treatments. We argue that the authors' conclusion is a classical misinterpretation of absence of evidence as evidence of absence. Moreover, the authors failed to discuss important findings that contradict their conclusion. We illustrate this by briefly reviewing the missed literature. As long‐term effects of healthcare are inherently multi‐factorial, and to a substantial degree influenced by non‐medical factors , generalizing claims regarding the effects – or absence thereof – are hazardous and potentially harmful if policymakers use this to reduce the availability of mental healthcare services for the current generation of vulnerable children.Evidence‐based clinical practice guidelines for the treatment of children with ADHD recommend behavioral parent training and/or stimulant medication. In addition to the numerous studies on short‐term benefits of these interventions  within‐group long‐term effects (>2 years). This is consistent with an earlier review showing long‐term outcomes  and selective serotonin reuptake inhibitor medication have considerable empirical support for treating children and adolescents with anxiety disorders  should weigh heavily in making treatment decisions. We appreciate that Roest et al. stress the methodological problems of examining long‐term outcomes of treatments in mental health for children, such as loss of randomization, variability in the natural course of mental disorders and general time‐related factors. Importantly, however, these problems should not be used as an argument against treatment. For example, the fields of adult psychosis and suicidality suffer from the same methodological problems in examining long‐term effects, but there is clear consensus about the importance of providing evidence‐based treatment.Second, any definition of ‘long‐term’ is arbitrary and the authors' choice for 2 years is no exception. Numerous studies  show sustained treatment effects up to 12–18 months post intervention, suggesting that treatment effects are relatively stable over time. Given the current situation in which outcomes beyond 2 years have been less studied, information about any Third, even if the current treatments would benefit families for ‘only’ 2 years, then 2 years of reduced suffering is valuable. Moreover, evidence‐based treatment reduces costs , as indicated by several cost‐effectiveness studies . M.L. has co‐developed a self‐help teacher training program, without financial interests. She has received research grants from ZonMw and was an advisor of the Dutch ADHD guideline groups. P.J.H. has been a member of an advisory board meeting of Takeda. G.O. was supported by a grant from the Dutch Science Council (016.vici.185.063) in the preparation of this manuscript. E.S. was supported by a grant from the Dutch Science Council (VI.vidi.195.041) in the preparation of this manuscript. B.v.d.H. has received royalties as one of the editors of Sociaal Onhandig (published by Van Gorcum), a Dutch book for parents that can be used in parent training. She has been involved in the development and evaluation of several parent and teacher training programs, without financial interests; she has been a member of Dutch ADHD guideline and practice standard groups. S.v.d.O. has co‐developed a planning‐focused and solution‐focused treatment and other behavioral treatments but has no financial interest in any of these. She has received research grants from ZonMw and the Research Foundation Flanders (FWO); she was an advisor of the Dutch ADHD guideline groups and is a member of a working group on ADHD of the Superior Health Council of Belgium. P.L. was supported by a grant from the Dutch Science Council (VI.Vidi.201.065) in the preparation of this manuscript. None of the funders or other parties mentioned here had any involvement in the current commentary. The remaining authors have declared that they have no competing or potential conflicts of interest.


Digital Native, a term first coined in 2001 by the US author Marc Prensky to describe young people born after 1980 who have been surrounded by mobile phones, computers, and other digital devices their entire lives. The objective of this paper is to explore the concept of the Digital Native and how it influences undergraduate nursing education. Materials and Methods: A pragmatic approach was used for this narrative review, working forward from Prensky’s definition of the Digital Native and backward from contemporary sources of information extracted from published health, education and nursing literature. Results: The findings from this narrative review will inform further understanding of digital literacy beliefs and how these beliefs influence undergraduate nursing education. Recommendations for enhancing the digital literacy of undergraduate nursing students are also discussed. Conclusions: Digital literacy is an essential requirement for undergraduate nursing students and nurses and is linked with safe, evidence-based patient care. The myth of the Digital Native negates the reality that exposure to digital technologies does not equate digital literacy and has resulted in deficits in nursing education programs. Digital literacy skills should be a part of undergraduate nursing curricula, and National Nursing Digital Literacy competencies for entry into practice as a Registered Nurse should be developed and contextualised to individual jurisdictions.Background and Aims: Nurses are increasingly engaging with digital technologies to enhance safe, evidence-based patient care. Digital literacy is now considered a foundational skill and an integral requirement for lifelong learning, and includes the ability to search efficiently, critique information and recognise the inherent risk of bias in information sources. However, at many universities, digital literacy is assumed. In part, this can be linked to the concept of the  Technical dimensions include technical skills for using digital technologies in everyday living and learning  and t Prensky  to descrDigital Natives, Digital Immigrants, there has been debate over whether it presents a false dichotomy [Digital immigrants, who are exposed to digital technologies later in life [Since Prensky’s seminal work , Digitalichotomy ,13 that  in life ,14. Deba in life . Despite in life .Therefore, this narrative review will examine the history of the Digital Native, the arguments for and against this terminology, and how these beliefs influence the digital literacy of undergraduate nursing students. Recommendations for enhancing the digital literacy of undergraduate nursing students are also discussed. A pragmatic approach was used for this narrative review, working forward from Prensky’s definition of the Digital Native and backward from contemporary sources of information extracted from the published health, education, and nursing literature. “Narrative reviews describe published articles to inform debate, appraise research and identify gaps in current knowledge”  (p. 109)Scale for the Assessment of Narrative Review Articles (SANRA), which consists of six items: (1) a justification of the article’s importance for the readership, (2) a statement of concrete/specific aims or the formulation of questions, (3) a description of the literature search, (4) referencing, (5) scientific reasoning, and (6) an appropriate presentation of data , but it is necessary to specify search terms, and the types of literature included” . A detaieducation AND nursing”, “digital literacy” and “Digital Native”. Additional search terms of “Net generation”, “Generation Y” and “Google generation” were then applied, as identified by the ECDL (European Computer Driving Licence) [Digital Native.A literature search of English-language peer-reviewed and full-text articles was conducted using the search terms “Licence)  in “The Inclusion criteria included: articles that were peer-reviewed and available as a full-text article, described Digital Natives , related to digital literacy, related to undergraduate nursing education, were published between January 2001 and January 2023 and were published in English.Exclusion criteria included: articles that were not peer-reviewed, not available as a full-text article, not related to Digital Natives , not related to digital literacy, not related to undergraduate nursing education or nursing education, not published between January 2001 and January 2023, not available in English, duplicate articles and articles for which the authors were unable to access the full text.ProQuest Central was searched to identify potentially relevant sources, including scholarly journals, books, reports, conference papers and proceedings. A total of 4084 sources of evidence were identified. A snowball technique was employed, and 13 additional sources of information were obtained from the reference lists of selected sources. In total, 4097 sources of evidence were uploaded to Covidence, an online collaboration platform that facilitates the preparation of literature reviews, aids in uploading search results, the screening abstracts and full texts, completing data collection, review by two or more reviewers and exporting data . FollowiTitle and abstract screening and Full-text screening. A total of 3837 sources of evidence progressed to Title and abstract screening, and 364 sources of evidence progressed to Full-text screening. To arrive at a consensus, review meetings were held, and emails were exchanged between the researcher and the PhD supervisors. For visual reinforcement and to enhance the trustworthiness of the findings, a flowchart was developed to depict the phases of the screening process , study settings, aim or purpose of the study, study design, sampling procedure and a synopsis of content related to the inclusion criteria. The data extraction template was used in the data analysis and synthesis phase.Following the completion of the screening process, 29 sources of evidence were moved to the In a narrative review, the analysis and synthesis of data requires all the information retrieved in the literature search to be synthesised into comprehensive paragraphs . Green eReferences section.Comprehensive referencing, including evidence for all arguments stated in the review, supports the validation of the trustworthiness of the findings . ReferenThis item requires evidence for arguments, study designs of selected sources of information and, where applicable, levels of evidence . EvidencThe final requirement is concerned with the correct presentation of data from the selected sources of information . AccordiTo be included in this review, sources of evidence needed to include education for undergraduate nursing students in a Bachelor of Nursing program . The Australian Nursing and Midwifery Federation  define uDigital technologies used in undergraduate nursing education were explored in the sources of evidence. Cremin  (p. 153)Digital literacy has been defined as “the ability to use information and communication technologies to find, evaluate, create, and communicate information, requiring both technical and cognitive skills” . “DigitaDigital Native, stating “Our students today are all ‘native speakers’ of the digital language of computers, video games and the Internet”. In a subsequent publication, Prensky suggested that the brains of Digital Natives could also be physically different due to the input of digital technologies [Net Generation in 1998. However, Prensky’s Digital Native gained traction, particularly in academia, and has been present in the literature and public discourse ever since [In 2001, Prensky  first usnologies . The connologies , with Tanologies  identifyer since .Digital Natives were defined by Prensky [Generation Y or Millennials, born between 1981 and 1995 [The Net Generation or Net Set, born between 1980 and 2001 [the Google Generation, born after 1993 [Generation Z, born between 1996 and 2010. Prensky  as anyon Prensky , with Geand 1995 , The Netand 2001 , the Gooter 1993 , and GenTwenty-nine sources of evidence were selected following full-text screening and data extraction. The characteristics of these sources and their relevance to the inclusion criteria are presented in For the purpose of this review, undergraduate nursing students were defined as individuals undertaking a three-year Bachelor of Nursing program at a university. Equivalent definitions were also identified in the sources of evidence, including Bachelor of Science Nursing ,37,38, nFor the purpose of this review, digital technologies used in (or recommended for use in) undergraduate nursing education were identified. They included computer-based or device-based applications ,55,56,57Faculty knowledge has been identified as a barrier to the integration of digital technologies into undergraduate nursing curricula . The knoThroughout the sources of evidence, digital literacy was consistently identified as a critical component of success . Some soThe discussion on the development of undergraduate nursing students’ digital literacy was noted to be limited in some of the sources of evidence. As previously illustrated, some authors made assumptions about generational differences and inherent digital literacy, and therefore subsequent development of digital literacy skills was not addressed. However, studies identified the importance of promoting critical thinking and clinical reasoning ,60,63,64Digital Native [Generation Y [Millennials [Net Generation [Net Set [Google Generation [Generation Z [the next generation.In a large proportion of the sources of evidence, the term l Native ,58,59,63ration Y ,45,46,60lennials ,52,59,61neration ,52,53,60neration  and Generation Z ,43,44,58ration Z  avoided Generation Y was described as “a unique and truly Digital Native generation” [The Net Generation was described as having unique learning styles [Generation Z was identified as being uniquely diverse, tech-savvy and self-motivated [Digital Natives were noted to require flexible, collaborative and individualised learning [Assumptions about the specific attributes of different generations and their engagement with digital technologies were evident in a number of sources of evidence. eration”  (p. 180)eration”  due to ag styles  and infog styles . Generatotivated , hypercootivated  and compotivated . Overalllearning , were colearning  and souglearning .Generation Y Health Professional Students’ Preferred Teaching and Learning Approaches, concluded that the review could “neither confirm nor refute taking a generational perspective to explore teaching and learning preferences” and noted that “Preferences among generational groups were not consistent”.The debate surrounding the Digital Native has been described as an academic form of a moral panic, with suggestions that the education system must be fundamentally changed to meet the need of a new generation of students . Brown aEvans and Robertson  agreed tRegarding nursing education, this review found that over 22 of the 31 articles reviewed were still using the term digital native ,57,58,63The results evidenced that nursing education is embracing a wide variety of digital technologies to meet the learning needs of students. However, the review also found that nursing educators are still not being supported with appropriate, accessible professional development opportunities to overcome their lack of confidence in using digital technologies in their teaching ,40,55. TThere was confusion among some of the authors of the reviewed articles who incorrectly assumed that increased exposure time to technology equated to increased digital literacy skills ,53,60,61Growing up digital: The rise of the net generation, stating “…it is through the use of digital media that the N-Generation will develop and superimpose its culture on the rest of society…they are a force for social transformation”. Several years later, Prensky [Digital Natives, Digital Immigrants and exclaimed that there was a radical change seen in the students of today, declaring that they were no longer compatible with the education system designed to teach them. As the literature conceptualised a generation who inherently knew how to use digital technologies to such an extent, it was suggested this could result in physical changes in the brain [In sociology, Generational Theory was developed as a mechanism to explain differences between population cohorts . It was  Prensky  publishehe brain ,29. Thishe brain , resonathe brain  and, deshe brain ,75,76. Digital Native was first described in 2001 [Since the term  in 2001 , the met in 2001  describe in 2001 ,29,77. T in 2001 ,65,66,76 in 2001 ,79,80,81 in 2001 ,82, the  in 2001 ,15,82, o in 2001 ,65,82, a in 2001 ,83 and r in 2001 ,65,81,83Digital Wisdom, indicating that as generations increasingly move into the 21st century, everyone will have grown up with digital tools and technologies, blurring the distinction between Digital Natives and digital immigrants. He also acknowledged that digital literacy and the ability to critique and evaluate digital technologies was an essential skill [Digital Divide, described as the gap between those people with access to easy-to-use digital technologies and the Internet and those without this access [In 2009, Prensky  moved awal skill . One isss access . Populats access ,86, low-s access ,87, peops access ,88 and ts access ,90, withs access . Despites access , and pros access .The responses by tertiary institutions to the Digital Native debate have been mixed. Smith , in notiuniversal literacy—a baseline literacy embracing a critical stance towards all digital technologies; creative literacy—emphasising the technical skills of digital content production; and literacy across disciplines—a diffusion of digital literacy across the education curriculum which reflects different learning contexts. Digital literacy remains a contested concept, and its use has been inconsistent in the literature [As innovations in digital technologies have evolved, the language used to describe the knowledge, skills and attitudes required to use these technologies has also changed . Boechleterature ,96. Digiterature  (pp. 66–terature  (p. 3) aterature . This prGlobally, institutional responses to digital literacy have been diverse. In Global diffusion of eHealth: Making universal health coverage achievable, the World Health Organization (WHO)  identifiInformation Literacy—the capability to find, critique and manage information;ICT Literacy—the capability to adopt, adapt and use digital technologies;Learning Skills—the capability to learn and study in a digital technology environment;Digital Scholarship—the capability to participate in academic, research and professional environments that use digital technologies;Media Literacy—the capability to critique and create academic and professional information using digital technologies;Communications and collaboration—the capability to participate in digital environments for education and research;Career and identity management—the capability to develop and manage a professional digital identity [identity .Established in 1993, Jisc is a not-for-profit digital, data and technology agency providing support for higher education institutions within the United Kingdom . The ageDigital Natives, Digital Immigrants. A recent Horizon Report on higher education identified the “solvable challenge” of improving digital literacy, noting the current deficits in the promotion of digital literacy in higher education and advocating for the changing roles of educators to have more personal connections with students [Since 2004, the New Media Consortium (NMC) has been responsible for publishing the Horizon Reports , which rstudents . Howeverstudents , it was Whilst it has long been acknowledged that students require digital literacy skills to effectively engage with digital technologies ,9,98,105As the largest healthcare workforce , nurses A global set of core Nurse Educator Digital Literacy competencies are identified that can be contextualised to individual jurisdictions;National Nursing Accreditation agencies adopt and contextualise National Nurse Educator Digital Literacy competencies and require all nurse academics to demonstrate their digital literacy competency accordingly;Nurse Educator Digital Literacy competencies are recognised and aligned with existing national digital health competency frameworks;National Nursing Digital Literacy competencies for entry into practice as a Registered Nurse are developed and adopted and are cognisant of the existing global efforts and frameworks to inform undergraduate nursing curricula;National Nursing Accreditation and registration agencies update undergraduate course accreditation guidelines that reflect the development and assessment of the National Nursing Digital Literacy competencies.Digital literacy is an essential requirement for undergraduate nursing students as they prepare to enter the workforce. However, this review has demonstrated that the continued dissemination of the myth of the Digital Native, which is accompanied by the perception that students arrive at university with digital literacy capabilities, is impacting students’ abilities to search efficiently, critique information and recognise the inherent risk of bias in information sources. From this study, the following recommendations are proposed:Implementing the five recommendations above could involve addressing potential barriers, including (1) systemic, with jurisdictional policy and regulatory hurdles to tackle; (2) organisational, with challenges faced in resourcing and a supportive change environment; (3) professional, with challenges in leadership and the recognition of a digital-first mindset; and (4) individual, with required changes in work practice reform and a supportive work environment .It is important to note some limitations associated with a narrative review. The researchers have a background in nursing education and health care management and are based in Australia. The focus on ProQuest Central as the searched database, in addition to the use of the snowball technique to identify additional publications from the reference lists of selected sources as part of the literature search, limits the generalisability of the results, though it is in line with the narrative review approach taken . TherefoThis review has shown the dilemma facing today’s students and educators when relying on assumptions about digital capabilities, which can unwittingly perpetuate the myth of the Digital Native. The implications of this are profound for undergraduate nursing education.The literature presented in this review supports the contention that digital literacy is an essential requirement for undergraduate nursing students and nurses and is associated with safe, evidence-based practice. The myth of the Digital Native presents a challenge to educators and curricula alike, as exposure to digital technologies does not necessarily equate with digital literacy. This assumption must be continually tested to ensure that nursing education programs are reflective of required practice in a digital world.The five recommendations established from this research should inform future discussions and studies that investigate, substantiate and further encourage discourse throughout nursing education and digital health community. Digital literacy skills must be a part of undergraduate nursing curricula.


Biogenic amines (BAs) were presented as significant markers for the evaluation of the spoilage of meat and meat products. In this work, a colorimetric sensor array was developed for the discrimination and detection of spermine (SP), spermidine (SD), histamine (HS), and tryptamine (TP) as important BAs in food assessment. For this aim, two important spherical plasmonic nanoparticles, namely gold nanoparticles (AuNPs) and silver nanoparticles (AgNPs), were utilized as the sensing elements of the probes. The cross-reactive interaction of the target biogenic amines and the plasmonic nanoparticles caused the aggregation-induced UV–Vis spectra changes, which were accompanied by visual color variation in the solution. The collected responses were analyzed by principal component analysis-linear discrimination analysis (PCA-LDA) to classify the four BAs. This colorimetric sensor array can also discriminate between the individual BAs and their mixture accurately. Partial least squares regression (PLS-R) was also utilized for quantitative analysis of the BAs. The wide linear concentration ranges of 0.1–10.0 µM for the four BAs and desirable figures of merits (FOMs) showed the potential of the developed sensor for quantitative detection of the BAs. Finally, the practical ability of the developed probe was studied by the determination of the BAs in the meat samples, which successfully proved the potential of the colorimetric sensor array in a food sample. The safety and quality control of food products are one of the most important concerns for food consumers and health organizations all around the world . The WorA vast number of studies have been presented for the detection of BAs in different types of food samples . Most of4·3H2O) (99.5%), trisodium citrate, silver nitrate, sodium borohydride, spermine, spermidine, histamine, and tryptamine were purchased from Sigma-Aldrich . Milli-Q grade water with a resistivity of 18.2 MΩ was used in all experiments.All materials were analytical reagent grade and were utilized without any purification. Hydrogen tetrachloroaurate (III) trihydrate (HAuClA Perkin Elmer (Lambda25) spectrophotometer was utilized for recording absorbance spectra with a 1.0 cm glass cell. Photographic images were captured by the Samsung A70 smartphone. Controlling of pH was performed with a Denver Instrument Model of 270 pH meters with a Metrohm glass electrode. It is noteworthy that all measurements were obtained at room temperature.−1) were added to the 50 mL of boiled HAuCl4 solution (1.0 mmol L−1) under vigorous stirring. Then, the solution was mixed for an additional 30 min under reflux condition. The solution was allowed to cool at room temperature and was stored at 4 °C for future use. The prepared AuNPs with the average size of 13 nm showed a plasmonic peak at 520 nm.Citrate-capped AuNPs were synthesized previously by the Turkevich method . Typical3 (100 mM), 250 μL trisodium citrate (100 mM), and 100 mL of DI water was prepared. Then, 1 mL of ice-cold NaBH4 (5 mM) was added to the prepared solution dropwise under vigorous stirring. The color of the solution was converted to pale yellow and stirred additionally for 30 min. Finally, the synthesized AgNPs were stored at 4 °C in a dark place for 24 h before use. The prepared AgNPs with the average size of 15 nm showed a plasmonic peak at 390 nm.Citrate-capped AgNPs were synthesized based on the previous procedure . BrieflyUnmodified AuNPs and AgNPs were utilized as two sensor elements to produce a colorimetric sensor array for the discrimination of BAs. For each of these sensor elements, a 5.0 mL solution containing 350 µL of AuNPs (700 µL of AgNPs) and citrate buffer pH 6.5 with a final concentration of 1.0 mM was prepared. Then, 50 µL of different concentrations of SP, SD, HS, and TP was added to the AuNPs or AgNPs containing solution and it was mixed well. The absorbance spectra were recorded after 10 min.To check the practical capability of the developed colorimetric sensor array in a real sample, the target BAs were determined in a meat sample. For this purpose, five pieces of fresh meat (1.0 g) were washed and transferred to five separate 5.0 mL centrifuge tubes. Then, 500 µL of SP, SD, HS, and TP (0.6 mM) was added to four tubes and one tube was considered as a reference sample. The samples were soaked in 5.0 mL of ethanol and shacked by hand for 1 min. In the next step, the samples were centrifuged at 100,000 rpm for three minutes . FinallyThe statistical data analysis was conducted by Originpro 2018 and MATLAB R2019b. For the qualitative and quantitative detection of the target BAs, principal component analysis-linear discrimination analysis (PCA-LDA) was used to discriminate between the target BAs, and partial least squares regression (PLS-R) was considered to detect the concentration of the target BAs analytes. PLS-toolbox version 7.8  was employed for PLS-R analysis. The prediction accuracy of the models was evaluated using test-set validation. In this regard, the dataset was divided into categories including calibration set  and test set  using a duplex algorithm. MVC1 toolbox in MATLAB R2019b was exploited for conducting PLS-R analyses and calculating the analytical figures of merit.We focused on developing colorimetric sensor array for evaluation of meat freshness by monitoring four important BAs. For this purpose, two important plasmonic nanoparticles (AuNPs and AgNPs) were synthesized. The result of the ultraviolet–visible (UV–Vis) spectroscopy with the plasmon absorption band centered at 520 nm (AuNPs) and 390 nm (AgNPs), along with the TEM images of dispersed synthesized AuNPs and AgNPs, confirmed the formation of monodispersed plasmonic gold and silver nanoparticles . For somAs shown in It is not clear if the interactions of the BAs to the plasmonic NPs are based on electrostatic interaction between amines and carboxylic acid or the chemical binding of amine to the Au or Ag. The electrostatic interaction, including the protonated amino group of BAs and the negatively charged carboxylic acid on the NPs, should be pH dependent. Therefore, the aggregation behaviors of the two sensing elements in the presence of the four target BAs were studied at three pH regimes, namely acidic (4.5), neutral (6.5), and basic (8.5) . Accordi650/A520 in AuNPs and A500/A390 in AgNPs) were completed within 10 min. A650/A520 and A500/A390 were defined as the ratio of the aggregated peak to the plasmon peak of the AuNPs and AgNPs, respectively, which were increased by completing the aggregation of the NPs  at optimum conditions  were recorded from 350 to 800 nm in the presence of the wide concentration (0.1 µM–10 µM) of the four BAs . RepreseThe discrimination and regression analysis were applied to a data matrix that is constructed based on the variation of UV–Vis spectra of the AuNPs and AgNPs after the addition of different concentrations of the target analytes. The row and columns of this data matrix are the sample and wavelengths, respectively (156 × 902). It is worth noting that there is a common problem in the LDA model, in which the number of variables should be equal to or less than the number of samples. Therefore, PCA was employed to reduce the high dimensional data of the developed colorimetric sensor (902 variables: 451 wavelengths and 2 NPs) into 20 PCs prior to performing LDA. Thus, PCA-LDA was utilized to analyze the corresponding multidimensional data matrix (156 × 20) to discriminate the four target BAs and as well as their mixtures. 2), the root-mean-square-error of prediction (RMSEP), sensitivity (SEN), analytical sensitivity , limit of detection (LOD), and limit of quantification (LOQ).For quantitative analysis, PLS regression (PLS-R) was performed on the data matrix to verify that the developed colorimetric sensor array can predict the concentration of BAs after their recognition. As shown in After evaluating the ability of the developed sensor to discriminate the singular analytes in a wide concentration range from their mixtures , the abiTo investigate the feasibility of the developed colorimetric sensor array for the determination of the target BAs in real practical applications, the response absorption of the two sensing elements in the presence of some amino acids and ions, which might be in the meat sample, was evaluated for selectivity purpose . In addiIn summary, a colorimetric sensor array was proposed for the determination of four important BAs  as significant chemical indicators of the meat freshness evaluation. In this colorimetric sensor, applying two unmodified plasmonic NPs (AgNPs and AuNPs) improved the expansion of the color variation in the sensing elements’ responses. The results show that the constructed plasmonic sensor array could successfully detect or distinguish the BAs in a wide concentration range. In view of simplicity, sensitivity, and visual readout, our developed sensor can be utilized for the discrimination of the BAs and their mixture by the use of two sensing elements. The results show that this simple colorimetric sensor array can identify the BAs in meat samples, which verifies the ability of this probe in the real samples and the meat freshness analysis. Without using bioenzymes or modifications of the NPs, this simple and cost-effective colorimetric sensor array can be used to verify the quality of meat. Providing portable probes by immobilizing the unmodified NPs on such paper-based substrates can help the researcher for rapid and on-site verification of the quality and health of food products in the near future.


N = 8) as a prokinetic were analyzed for both bacteriome and mycobiome. Age-matched children with similar clinical characteristics but without EES therapy were included as controls (N = 20). Results: In both groups, Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant bacterial phyla. Ascomycota was the most abundant fungal phyla, followed by Basidiomycota. There were no significant differences in richness between the groups for both bacterial and fungal microbiome. Alpha diversity (at genus and species levels) and beta diversity (at the genus level) were not significantly different between the groups for both bacterial and fungal microbiome. At the species level, there was a significant difference between the groups for fungal microbiota, with a p-value of 0.029. We also noted that many fungal microorganisms had significantly higher p-values in the EES group than controls at both genera and species levels. Conclusions: In this observational case-control study, the prokinetic use of EES was associated with changes in beta diversity between the groups for mycobiome at the species level. Many fungal microorganisms were significantly higher in the EES group when compared to the controls. Confirmation of these results in larger trials will provide further evidence regarding the impact of EES on gut microbiota when utilized as a prokinetic agent.Background: Studies have demonstrated that the gut microbiome changes upon exposure to systemic antibiotics. There is a paucity of literature regarding impact on the gut microbiome by long-term usage of erythromycin ethyl succinate (EES) when utilized as a prokinetic. Methods: Stool samples from pediatric patients with feeding intolerance who received EES ( Clostridioides difficule infection, and the development of resistant organisms.Antibiotics have been widely used in many sectors, such as livestock farms, veterinary medicine, agriculture, hospitals, and industries . Since tBoth short- and long-term use of antimicrobials have a profound impact on the gut microbiome ,3. EvideMacrolide antibiotics (erythromycin and azithromycin) at lower doses are often used off-label for their prokinetic action to enhance feeding tolerance in neonates and infants ,17,18. TMost studies evaluating the impact of antibiotics on gut microbiota have been performed in adults and there is a paucity of pediatric literature ,34,35. SInfants with feeding intolerance have been noted to have altered gut microbiota ,42. Hu aEight patients in the EES group and 20 in the control group were included after the quality control for the analysis. The clinical characteristics were similar and not significantly different between the EES and control groups . Eight pOn stool microbiome analysis, we compared the bacterial and fungal composition between the EES (cases) and control groups. We utilized 16S rRNA (16S) for bacteriome and internal transcribed spacer (ITS) sequencing for mycobiome. In both groups, Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant phyla , followed by Actinobacteria and Verrucomicrobia, and there were no significant differences noted between the groups A. Among Bacteroides, Faecalibacterium, Escherichia, Ruminococcus, and Citrobacter were the most abundant genera for both groups. Among the fungal genera, Galactomyces, Candida, and Clavispora were the abundant genera for both groups  was not significantly different between the groups for both bacterial and fungal microbiota, with a sum test .p-values were 0.6 and 0.35 (Wilcoxon rank-sum test) for bacterial and fungal microbiota, respectively  based on the EES therapy for bacteriome. Meanwhile, a p-value of 0.0297 was noted for the mycobiome at the species level, indicating a significant difference between the two clusters based on EES  for both bacteriome and mycobiome between the two groups . The betd on EES .p-values were also noted between the EES and control groups. At the genus level, the prevalence and relative abundance of Prevotella increased with EES usage and, meanwhile, for Clostridium, the prevalence and relative abundance decreased , which allowed us to evaluate the long-term effects. We noted that diversity  and richness were not significantly different between EES and control groups for bacteriome. For mycobiome, the alpha diversity, beta diversity (only at the genus level), and richness were not significantly different between the groups. We did not observe an association between the duration of EES therapy and diversity and richness in both bacteriome and mycobiome. Further, we noted an increase in the relative abundance and prevalence of many fungi, both at species and genus levels, with EES exposure.Prevotella with EES usage, and, meanwhile, for Clostridium, the prevalence and relative abundance decreased. Animal experiments serve as excellent models to evaluate the effects of systemic antibiotics. In mice, exposure to erythromycin or penicillin G, or a mixture of both, swiftly resulted in altered microbial composition and took a long time to revert to preexposure composition [The impact of antibiotics on the gut microbiome is complex and variable, based on multiple factors such as patient characteristics and antibiotic details . The majposition .Low-dose, long-term macrolide antibiotics are often utilized in chronic respiratory disorders for their anti-inflammatory action, and their impact on oropharyngeal and respiratory microbiome has been previously documented. Burr et al. investigated the impact of long-term (4-week) exposure to EES and azithromycin therapies on oropharyngeal microbiome . Both anOryzias latipes), chronic exposure to minimal concentrations of EES and ampicillin demonstrated significantly increased Proteobacteria and reduced Fusobacteria [In our study, Proteobacteria, Firmicutes, and Bacteroidetes were the most abundant phyla, and no significant differences were noted between the groups. Interestingly, we found an increased relative abundance of Proteobacteria in both groups, which has been previously reported in young children with functional GI disorders and patients with many systemic diseases ,48. The bacteria .Haemophilus influenzae noted compared to the placebo [Similar to our study results, Firmicutes, Bacteroidetes, Fusobacteria, Proteobacteria, and Actinobacteria were the most abundant phyla in oropharyngeal microbiome of people with asthma, and there were no significant differences between participants who received azithromycin or a placebo . On the  placebo . Segal a placebo . Here, i placebo .These variations in inferences between different microbiome studies are likely due to differences in the methodology utilized, different doses and durations of antibiotics, and also due to the differences in the underlying patient population . AnotherBacteroides, Faecalibacterium, Escherichia, Ruminococcus, and Citrobacter were the most abundant genera for both groups, and no significant differences were noted in bacteriome. In other words, we did not find any specific bacterial signatures identified in our patient population compared to prior reported pediatric studies [In the present study,  studies ,58,59.Galactomyces, Candida, and Clavispora were the abundant genera for both groups. Among the control group, Galactomyces was the most predominant genera, but in the EES group, Candida dominated, followed by Galactomyces. Even though Candida is part of normal human mycobiota, its expansion has been noted in many inflammatory conditions [p-value—0.0297). This difference is likely due to the smaller sample size in the EES group rather than true clustering patterns noted between the groups  growth may increase and, at times, could predispose the host to systemic fungal infections [Candida following ingestion of antibiotics [Candida albicans, decreased cecal anaerobic bacteria correlated with intestinal mucosal surface adhesion, colonization, and further dissemination of fungi from the GI tract, underscoring the relationship between bacterial and fungal microbial changes upon exposure to antibiotics [In our study, we noted an increase in the relative abundance and prevalence of many fungi, both at the species and genus levels, with EES exposure. Generally, the commensal bacteria predominate in gut microbiota and mitigate the fungal overgrowth and invasive fungemia . When thfections ,69,71. Pibiotics ,73. Variibiotics ,73. Bactibiotics ,74,75. Iibiotics . When inibiotics .We recognize several limitations of this study. This pilot study involved a small sample in a single center, which affects the generalizability of the results. Studies with small sample sizes are inevitable in pediatric microbiome studies focusing on a specific patient population, such as ours . Also, tThe definition of feeding intolerance was also entirely clinical, which might have introduced some confounding in the recruitment of controls. Also, other important clinical characteristics known to influence the gut microbiome, such as delivery method, gestational age, diet (history of breastfeeding vs. formula), and neurodevelopmental status were not evaluated between the groups. As the majority of participants were less than three years of age, the normal age-dependent maturation of the microbiota might have confounded our interpretation. We recruited age-matched controls to minimize this confounding factor. Further, we did not recruit age-matched healthy children as controls. Under ideal circumstances, age-matched healthy children may better serve as controls and might have demonstrated a healthy microbial pattern.Despite the above limitations, we have numerous strengths as well. This prospective observational pediatric study is the first of its kind to evaluate the effects of long-term effects EES as a prokinetic in patients with feeding intolerance. The median duration of EES therapy was 12 weeks (range 4–32 weeks), which allowed us to evaluate the long-term effects. Our strict inclusion criteria helped us to minimize many confounders. Additionally, we also recruited controls with similar clinical characteristics who were age-matched for the study population in an approximately 2:1 ratio. Further, we analyzed the mycobiome in addition to the bacteriome. Mycobiome studies in pediatrics remain very sparse and this study provides useful insights into the gut microbiota in children on long-term EES. Further prospective studies with larger samples are needed to elucidate the changes in gut bacteria and fungi and their complex interactions after long-term use of EES as a prokinetic ,78.This prospective observational case-control study was conducted at the University Hospitals (UH) Rainbow Babies & Children’s Hospital and Case Western Reserve University, Cleveland, Ohio and the protocol was approved by the Institutional Review Board (study number 20200634).Inclusion criteria: Potential study participants between 2 months and 18 years of age were prescreened and identified at clinic visits for eligibility. Children with feeding intolerance who were already prescribed EES for at least four weeks for prokinetic indication constituted the EES group . Eleven patients on EES were successfully enrolled in this group. The decision to initiate EES therapy was entirely decided by the primary pediatric gastroenterologist without input from the research team. Gastroparesis (either confirmed or suspected) was the indication for initiating EES. Gastroesophageal reflux disease, cow milk allergy, constipation, and aspiration of feeds were comorbid diagnoses. Twenty-two age-matched patients with feeding intolerance with similar clinical profiles but not on EES were recruited as controls.Exclusion criteria: Patients with a recent episode of bacterial or viral illness in the preceding 12 weeks were excluded. Also, patients who received antibiotics other than EES and/or exposure to probiotics in the preceding 12 weeks were excluded to minimize confounding effects on gut microbiota. Patients with known immunodeficiency disorders, malignancies, systemic inflammatory disorders, autoimmune conditions, and mucosal GI disorders were also excluded.Participants were enrolled after informed consent from their parents or legal guardians. An assent was obtained from children between 7–18 years of age. A stool sample kit  was provided, along with instructions, to the participant’s families. Stool specimens were collected in a consistent way to minimize confound effects and were stored in the Integrated Microbiome Core Laboratory at the Case Western Reserve University and University Hospitals Cleveland Medical Center, Cleveland, OH, USA.® tubes  containing 500 μL of glass beads  and 1 mL ASL™ lysis buffer . To reduce batch effect, all samples were stored at −20 °C, then processed and analyzed concurrently for microbial composition. The methodology, including DNA extraction, PCR amplification, library preparation, and sequencing, is detailed in All collected stool samples were instantly placed in FastPrepRaw data of the microbial (both 16S and ITS data) read counts were loaded to R version 4.0.3. Sample metadata was further processed using R-package microbiome 1.12.0 and phyloseq 1.34.0, a phyloseq object with a read count matrix (species-level identification), taxonomic table (kingdom to species), and metadata, was generated. When processing 16S (for the bacteriome) and ITS (for the mycobiome) data, each of them was processed separately and later combined after the read counts were normalized and transformed to relative abundance.Before creating the phyloseq object for the 16S and ITS data, the taxonomic table was evaluated to eliminate species and phyla which were annotated as “unidentified” or lacking identification at a species level with an annotation “empty cell”. This elimination ensured only identifiable species were utilized in the bioinformatic analysis. With regards to total read counts per sample, a cutoff of 500 read counts was utilized as the minimum needed read count. For the final analysis, only 8 samples in the EES group and 20 in the control group were utilized after this quality control.Separate composition bar graphs were developed on 16S and ITS relative abundance after aggregating the data to the phyla level and filtering on phyla prevalence of 10% amongst all samples. Ordinate analysis/principal component analysis (PCA) was performed on bacterial microbiome and mycobiome data separately, after aggregating data to the phyla level as a means to reduce complexity. Ordinate analysis was performed using the “ordinate” function part of microbiome R-package version 1.12.0, with this method utilized as “multidimensional scaling” (MDS) and distances using the “Bray–Curtis” method for beta diversity. Bar plots were created using 16S and ITS based on relative abundance. The data were first filtered on species with a prevalence of 20% within all samples, and then the corresponding phyloseq objects were merged.Given the nonparametric nature of the data, the Wilcoxon rank-sum test was utilized to evaluate for significantly different species between the two groups, and the foldchange was measured using the mean relative abundance of a species within each group, utilizing the foldchange function from the R-package. Box plots were constructed to estimate diversity and richness. In the box plots, the central rectangle spans the first to third quartiles , the central line inside the rectangle shows the median, and the whiskers above and below the box indicate the variability outside the upper and lower quartiles. Alpha diversity was estimated using the Shannon diversity index and richness was measured using the observed taxon richness index.In this pilot study, long-term exposure to EES treatment at the prokinetic dosage did not have significant changes in alpha diversity and richness in either the bacteriome or mycobiome in children with feeding intolerance. We noted that the relative abundance and prevalence of many fungal genera were significantly higher in the EES group when compared to the controls. A very similar trend was also noted at the species level. Prospective clinical trials with larger samples are needed to confirm or refute our preliminary data in this clinical setting.


To understand the status and influencing factors of Kyrgyz chronic disease prevention literacy, and to explore the impact of chronic disease prevention literacy on behavior and living habits.Using stratified sampling method, Kyrgyz residents aged ≥ 18 years in Artush City, Aheqi County and Ucha County were surveyed by questionnaire.P < 0.05). Residents with chronic disease prevention literacy were more inclined to not smoke, not drink alcohol, drink milk every day, eat soy products every month, eat whole grains every day (P < 0.05).A total of 10,468 subjects were investigated, and the literacy rate of chronic disease prevention in Kyrgyz was 11.2%. The results of Logistic regression analysis showed that the literacy rate of chronic disease prevention was low among people with low education level, herdsmen, low income, urban and chronic disease (The literacy level of chronic disease prevention of Kyrgyz residents in Kezhou has been improved, but it is still at a low level compared with another subcategories. The behavioral lifestyle is related to the literacy level of chronic disease prevention. Therefore, local health promotion strategies should be developed to improve the literacy level of chronic disease prevention and promote the formation of good behavioral and living habits.The online version contains supplementary material available at 10.1186/s12889-023-16884-1. Chronic diseases have become the leading cause of human death . Since mIn this study, the Permanent residents of the Kyrgyz ethnic group in Artush City, Aheqi County and Ucha County in Kezhou Region of Xinjiang from July to December 2021 were selected as the study subjects. Inclusion criteria: Permanent residents aged ≥ 18 years old who lived in Kezhou for more than 6 of the previous 12 months at the time of the survey; Exclusion criteria: those who do not meet the age, those who cannot cooperate with the survey normally, and those who are not residents. This study has been approved by the Ethics Committee of the First Affiliated Hospital of Xinjiang Medical University (20160317-02), and the participants have signed informed consent.Sampling was carried out using the stratified sampling method. Referring to the 2018 health literacy monitoring results of Chinese residents, the health literacy level of residents in the central and western regions was 13.23%, the 95% confidence interval was taken, and the allowable error was calculated according to 0.02, and the sample size α coefficient of the questionnaire was 0.834, the validity was 0.821 [The Questionnaire of this study-Xinjiang Ethnic Minority Areas Health Culture Survey Questionnaire, which is suitable for ethnic minority areas, is designed through literature research method, field research, and reference to the contents of the “National Residents Health Literacy Monitoring Questionnaire (2015 Edition)”  by extraas 0.821 , 13. QueThe questions of health literacy were divided into six subcategories: scientific view of health, health information literacy, infectious disease prevention literacy, chronic disease prevention literacy, safety and first aid literacy and basic medical literacy. The questionnaire consisted of 68 questions (43 single-answer and 25 multiple-answer), with a full score of 93: single-answer ; multiple-answer , no-response questions were counted by 0 points. A respondent is defined as having adequate health literacy if their total score is at least 80% of the full score.Content related to chronic disease prevention literacy serves as a data source for this study. Among them, there are 7 questions in chronic disease prevention literacy , which are divided into 2 single-answer and 5 multiple- answer, with a total of 12 points. If the questionnaire score is more than 80% of the total score, that is, the total score ≥ 9 points, it is deemed that the respondent has the literacy of chronic disease prevention, otherwise it is regarded as not having the literacy of chronic disease prevention.Our study also collected basic information on the subjects` demographic characteristics, lifestyle and eating habits and health status. We retrieved information on age, gender, education, occupation, marital status, household income etc. Health status-related content includes whether suffering from chronic diseases, as well as the type of disease, the number of years of illness, and the evaluation of self-health status.α = 0.05.Establish a database and double entry through Epidata3.1, and use SPSS23.0 for statistical analysis. Descriptive analysis of the basic situation of residents, t-test, analysis of variance and chi-square test was used for the inter group comparison of measurement data and counting data. First, logistic regression analysis with chronic disease prevention literacy as the dependent variable was used to test the correlation with socio-demographic characteristics. Then, a multivariate logistic regression model was constructed with different behaviors, lifestyles and eating habits as dependent variables, and whether people had chronic disease prevention literacy as independent variables. In the model, the effects of gender, age, education, occupation, marital status, family per capita monthly income, region and family size were controlled. The test level is Among the 10,468 survey respondents, 54.0% were women, the average age was 47.28 ± 18.97, junior high school education accounted for 39.9%, livestock residents accounted for 26.9%, married 68.9%, rural residents accounted for 78.4%, and the per capita monthly household income was 1000 ~ 1999 yuan and 2000 ~ 4999yuan, accounting for 27.4% and 29.4% respectively, as shown in Table Among these six categories, the literacy rate of chronic disease prevention is the lowest, which is 11.2%, as shown in Table P < 0.001). In the population with chronic diseases, there was no significant difference in the level of chronic disease prevention and control literacy between the number of chronic diseases and the number of years of illness (P > 0.05), as shown in Table The chi-square test showed that the residents with chronic diseases had a lower rate of chronic disease prevention literacy (7.6%) than the residents without chronic diseases (12.7%). The self-assessed health status with poor (5.7%) and relatively poor (11.4%) had a low rate of chronic disease prevention literacy than the relatively good (14.2%) group, and the difference was statistically significant  more likely to have chronic disease prevention literacy than junior high school and below; Herders and others were 1.46 times  and 1.80 times  less likely to have chronic disease prevention literacy than those working in government agencies, respectively; The per capita monthly household income with 2000–4999 yuan and with 5000–9999 yuan were 2.48 times  and 1.77 times  more likely to have chronic disease prevention literacy than the average household monthly income of < 500 yuan; Family size of 4–6 and ≥ 7 persons were 1.35 times  and 1.43 times  less likely to have chronic disease prevention literacy than that in a family size of 1–3 persons, respectively; Rural populations were 1.39 times  more likely to have chronic disease prevention literacy than urban population; People without chronic diseases were 1.71 times  more likely to have chronic disease prevention literacy than those with chronic diseases, see Table The results of binary logistic regression analysis showed that people with high school and above were 1.26 times (P < 0.05), see Table Among the survey respondents, most people slept ≥ 7 h a day, accounting for 52.6%; smokers account for 20.7%, non-smokers account for 47.1%; drinkers account for 25.2%, non-drinkers account for 74.8%; 78.1% of the population exercised for more than 3 times a week; The population with a light diet accounted for 38.8%, see Table The results of this study show that the chronic disease prevention literacy level of Kyrgyz residents in Kezhou, Xinjiang was 11.2%, which was higher than the 2018 Kyrgyz chronic disease prevention literacy in Kezhou (7.13%) . TherefoIn the relationship between chronic disease prevention literacy and health status of the Kyrgyz people, it was found that people with chronic diseases have lower chronic disease prevention literacy than those without chronic diseases, and the self-assessed groups of poor and relatively poor health status have a lower rate of chronic disease prevention literacy than those with relatively good health status, which is consistent with the findings of Liu L et al. . This isBinary logistic regression in our study did not show an association between age and chronic disease prevention literacy. However, other studies have reported that age is an important factor affecting health literacy , 19. ThiInterestingly, this study found that rural residents have higher rates of chronic disease prevention literacy than urban residents, which contradicts previous research results , 19, 25.Research shows that chronic disease prevention literacy is closely related to personal health-related behaviors and lifestyles, as well as health status . People Although this study did not show that exercise, light diet, and daily consumption of vegetables and fruits are associated with chronic disease prevention and control literacy, it is still recognized as a healthy lifestyle and eating habit.To the best of our knowledge, this is the first time to conduct a systematic study between health literacy on chronic disease prevention and behavior and lifestyle of the Kyrgyz people, which provides inspiration for future work in related fields. A clear strength of this study is the large sample size, which allowed us to conduct a broad survey of health literacy across demographic, socioeconomic, and health-related indicators. Another strength of the study is that our questionnaire is reliable. The questionnaire was formulated according to the “Chinese Resident Health Literacy Manual” and the culture and living habits of ethnic minorities in Xinjiang.However, our work it is based on cross-sectional data, so the causal inferences should be viewed with caution. Future intervention studies can be conducted to improve the health knowledge level and health status of patients, and appropriate measures can be taken to address the contributing factors. Secondly, the chronic diseases of the residents involved in the health literacy questionnaire were self-reported by the survey subjects, which could result in imprecision and biased results. Thirdly, because of the large number of questions in our questionnaire, some respondents may lose their patience, leading to selection bias in the results.The literacy level of chronic disease prevention among Kyrgyz residents in Kezhou has improved compared with 2018. The literacy of chronic disease prevention and treatment is an influencing factor for the healthy behavior and lifestyle of the Kyrgyz residents. Government departments and social organizations should combine the work and life characteristics of the Kyrgyz residents to carry out health education on chronic diseases in a targeted manner. At the same time, combined with national health examinations and national health literacy promotion actions, a healthy and supportive environment is created, which can improve the enthusiasm of residents and encourage residents to form healthy lifestyles and eating habits.Below is the link to the electronic supplementary material.Supplementary Material 1


Dihydromyricetin (DMY) is a natural flavonoid with anti-nonalcoholic steatohepatitis (NASH) activity. However, the effects of DMY on the composition of lipids and bile acids (BAs) in serum, and gut microbiota (GM) in ileum of mice with NASH are not clear.After male C57BL/6 mice was fed with methionine and choline deficiency (MCD) diet and simultaneously administered with DMY (300 mg/kg/day) by gavage for 8 weeks, the pathological changes of liver tissue were observed by Oil Red O, hematoxylin eosin and Masson staining, the levels of serum alaninea minotransferase, aspartate aminotransferase and liver triglyceride, malonic dialdehyde were detected by the detection kits, the composition and contents of serum lipids and BAs were detected by Liquid Chromatograph-Mass Spectrometry, the mRNA levels of hepatic BAs homeostasis-related genes were detected by RT-qPCR, and microbiological diversity in ileum was analyzed by 16S rDNA sequencing.Mrp2 and Oatp1b2) and 8 GMs between MCD and DMY groups. Among them, DMY treatment significantly down-regulated 21 lipids, 4 BAs mentioned above, the ratio of Firmicutes/Bacteroidota and the abundance of Erysipelotrichaceae, Faecalibacuium, significantly up-regulated 8 lipids and 5 GMs .The results showed that the significant changes including 29 lipids, 4 BAs , 2 BA transporters  and inhibiting intestinal harmful bacteria .The results suggested that DMY may alleviate MCD diet-induced NASH through decreasing the serum levels of toxic BAs which regulated by liver The online version contains supplementary material available at 10.1186/s12944-023-01871-7. Non-alcoholic steatohepatitis (NASH) is a common chronic liver disease, characterized by bullae steatosis, hepatocellular balloonlike degeneration, lobular inflammation and varying degrees of fibrosis –3. AbnorIt has been reported that bile acids (BAs)—gut microbiota (GM) axis plays an important role in the pathogenesis of NAFLD/NASH . BAs areAmpelopsis grossedentata (Hand.-Mazz.) and traditionally used to treat fever or cough , decreased harmful lipids  and harmful BAs (23-DCA and CA), and so it is for the regulatory trends of harmful bacteria   in ileum and beneficial lipids  in serum, decreased the levels of harmful bacteria  and harmful lipids -HDHA, 9, 10-DIHOME and LPC 14:1/0:0, etc.) and harmful BAs (23-DCA and CA). These changes should be conducive to the ameliorative effect of DMY on MCD mice. DMY can be used as a functional food for for NASH prophylaxis in daily life and clinical practice.In summary, DMY treatment increased the levels of probiotics .


We evaluated 11 patients with hematological malignancies who underwent allo-HSCT [five with peripheral blood stem cell transplantation (PBSCT) and six with unrelated cord blood transplantation (UCBT)]. Before allo-HSCT, 18F-FLT uptake did not differ between the two groups. At day 50, 18F-FLT uptake in the spleen was significantly greater in the UCBT group than in the PBSCT group (p = 0.0043), with no difference in whole-body bone marrow. At day 180, the differences in spleen uptake had diminished, and there were no differences between groups in whole-body bone marrow or the spleen, except for the sternum. The persistence of splenic hematopoiesis after engraftment in the UCBT group may reflect the complex systemic homing and proliferation mechanisms of cord blood hematopoietic cells.Cord blood is an important donor source for allogeneic hematopoietic stem cell transplantation , with its unique composition and quality of hematopoietic cells. The proliferation site and potency of infused hematopoietic stem cells in humans may vary between stem cell sources. We investigated this possibility in a prospective, exploratory study to assess hematopoietic dynamics using the radiopharmaceutical 3′-deoxy-3′- Unrelated cord blood transplantation (UCBT) is a valuable alternative donor source when a suitable related donor is unavailable for allogeneic hematopoietic stem cell transplantation  . HoweverThe composition, quantity, and characteristics of cord blood cells differ from those observed in peripheral blood or bone marrow –11. CordDuring BMT/PBSCT, transplanted hematopoietic stem cells (HSCs) participate in extramedullary hematopoiesis in the hepatic and splenic regions during the initial phase of transplantation, before the onset of hematopoiesis in the bone marrow –21. Howe18F-fluorothymidine (18F-FLT), a thymidine analog used in positron emission tomography (PET) imaging, is a surrogate indicator of deoxyribonucleic acid synthesis . B-lymphocyte count was significantly higher in the UCBT group than in the PBSCT group at day 100 , and at day 180 .Neutrophil, platelet, and reticulocyte counts, CD4 and CD8 lymphocyte counts, IgG levels, and bone marrow nuclear cell count did not change significantly between the two groups at days 50, 100, and 180 Table . Eosinop18F-FLT uptake in the spleen, with a mean SUV comparable to that of the thoracic spine, where uptake was strongest throughout the body. The increased uptake in the spleen was not observed in the PBSCT group at day 50, and the increased uptake in the spleen disappeared by day 180 in the UCBT group.On day 50 after allo-HSCT, the UCBT group showed high 18F-FLT uptake in the spleen increases in the early post-transplant period (day 5) and decreases subsequently [18F-FLT uptake occurs predominantly in the sternum, thoracolumbar spine, and pelvic region, returning to the normal adult human hematopoietic state [18F-FLT uptake in the spleen is enhanced in UCBT even at approximately day 50 post-transplant, the period of immune reconstitution.Hematopoiesis occurs in the spleen during the process leading to engraftment in mouse models of hematopoietic stem cell transplantation , 21, 29.equently . After eic state . This pa18F-FLT PET detects extramedullary hematopoietic activity in the spleen [18F-FLT uptake in whole bone marrow tended to be lower in the UCBT group compared to the PBSCT group. This suggests that in the UCBT group, hematopoiesis in the spleen compensates for the lack of hematopoiesis in the systemic bone marrow after transplantation, and that recovery of the bone marrow niche may be more gradual in the UCBT group than in the PBSCT group. It is known that infusion of mesenchymal stem cells or endothelial progenitor cells induces recovery of the damaged bone marrow niche and promotes hematopoiesis [The spleen generates extramedullary hematopoiesis –32, and e spleen , 25. Thee spleen –35. Highe spleen . Restorae spleen , 37, 38.e spleen . In thisopoiesis –43. The opoiesis –47.18F-FLT in the spleen, a secondary lymphoid organ for B cells, after engraftment may be associated with the immune reconstitution that is unique to this transplantation modality.In addition, eosinophils and B lymphocytes increase during UCBT in the early post-engraftment phase –53; in t18F-FLT is trapped in the liver because of glucuronidation [18F-FLT uptake based on donor type; however, we failed to account for differences in conditioning regimen, primary disease, GVHD prophylaxis, or the presence of PIR/GVHD due to the small number of cases. Furthermore, the temporal progression of increased and decreased 18F-FLT uptake within the spleen during UCBT, before and after day 50, remains unclear. The relationship between peripheral blood chimerism and splenic hematopoiesis also remains undefined. These concerns require further investigation in an expanded patient cohort to determine the relationship between 18F-FLT uptake, various patient background determinants, and transplantation prognosis.This study has several limitations. First, the accuracy of extramedullary hematopoiesis within the hepatic domain was not investigated, as nidation , 58. SecWe have demonstrated that hematopoietic kinetics after allo-HSCT vary in the localization of hematopoiesis and its intensity when UCBT is contrasted with PBSCT. In particular, while hematopoiesis in the spleen before engraftment has been known, our study shows that the spleen plays an important role in maintaining systemic hematopoiesis after engraftment in UCBT. This may be due to the unique characteristics of the splenic niche. We believe that our findings provide valuable insights for the design of pre-transplant conditioning protocols that take into account the effects of the spleen and bone marrow on the niche, and for the development of novel therapies aimed at promoting niche recovery.


Background: Infodemic is a neologism of ‘information’ and ‘epidemic’ coined in the year 2003. Evidence mapping is a technique to appraise the literature which enables the extent of research activity in a specific area to be discovered. The main objective of this evidence synthesis presents the outcomes of an evidence map that was directed to know the extent of Infodemics and its effects on public health.  Methods: The following methods were used to construct this evidence synthesis: Phase I. Construct a Broad Question Referring to the Field of Analysis. Phase II; Defining Key Variables to Be Mapped, identifying the characters of each variable and Outline Inclusion and Exclusion Criteria for the variables. Phase III: Literature search. Phase IV: Screening and Charting the Appropriate Evidence within the Synthesis.  Results:  Authors identified 55 records through database searching, after screening for duplicates, 53 records screened at title/abstract level of which, 16 records were removed because of lack of complete article or articles were not in English. 37 articles were eligible for full text screening, 37 full-text articles were than assessed for eligibility and only 22 articles were included as per inclusion criteria with an interrater Outcome Kappa value: 0.91. The strength of agreement was considered to be 'excellent'.  Conclusions: This synthesis focused majorly on the gaps in the research focused on infodemic. The two main gaps identified were lack of systematically conducted research and poor digital health literacy. As infodemic is a new phenomenon with respect to the COVID-19 pandemic it was an eye opener at different levels of public health, furthermore this evidence map points out areas for further research on the impact of infodemic. Social media plays a pivotal role in dissemination of information. This information is always not credible, as it is believed to spread misinformation and disinformation. The spread of misinformation is not a new phenomenon but the magnitude of its spread was a concern during the COVID-19 pandemic. An infodemic means an excessive amount of information of which some are accurate and some inaccurate, usually occurring during a pandemic/epidemic. Similar to the pattern of spread of a pandemic, an infodemic spreads in the same mode, but through digital or/physical information systems, making it more complex for people to isolate a solid and reliable source of information.,The portmanteau word Infodemic is a neologism of ‘information’ and ‘epidemic’ coined in the year 2003.Infodemics have been one of the most virulent phenomena known to humankind, capable of transiting the world instantly. In every possible aspect they mimic a disease, with an epidemiology of its own, symptoms similar to a disease. Sadly it is one of the most highly neglected and underestimated problems.The spread of COVID-19 correlated to the spread of misinformation, in terms of circulating conspiracy theories, often dispersed through social media platforms. This constituted a risk to the public and presented a major global health hazard. Delivering a vital source of evidence-based information to the general public during an outbreak of a pandemic aids in quick act of managing the disaster. Evidence synthesis are formulated on an explicit research question concerning the field of interest, which are not in depth analysis of a question but rather a systematic accumulation of topics of interest., The evidence synthesis initiates search, and collation of, suitable evidence making use of clear and replicable methods at every step. The synthesis includes clear definition of components, evolution of a detailed and reproducible search strategy, development of clear exclusion and inclusion criteria, and clear conclusions about the level of evidence to be obtained from individual study.Evidence synthesis is a technique to appraise the literature which enables the extent of research activity in a specific area to be discovered. Systematic reviews usually detail a specific clinical question and seek to answer the question. Evidence mapping on the other hand provides a brief summary of the range, distribution and scope of evidence in a field of interest broadly. CADIMA is outlined to offer substantial evidence to users in the structure of prompts, that majorly differentiates between a meticulous systematic review and a quality literature review, this feature substantially reduces the difficulty in assimilation of evidence for new research.For the present evidence synthesis an open access online tool CADIMA was used for management of evidence that was established by Julius Kühn-Institut (JKI) during a EU-funded project called GMO Risk Assessment and Communication of Evidence (GRACE). CADIMA is a free web tool guiding the conduct and furnishing the documentation of systematic reviews, systematic maps and further literature reviews.The main objective of this evidence synthesis presents the outcomes of an evidence map that was directed to know the extent of infodemics and its effects on public health during the ongoing pandemic and attempts to explore the nature of evidence present in literature. The process assures a procedure of ‘stocktaking’ of the evidence as vital gateway in providing a sketch of the extensiveness of research activities in the field of infodemics. After consulting experts in Public Health (community medicine), Public Health Dentistry and also the nodal Covid officers of COVID 19, a relevant question was framed and the scope and frame of the was chalked out. The process disclosed two domains, mainly the causes of Infodemics and the effects of infodemics on public health, as the first question was the primary focus of the evidence synthesis two secondary questions were included to widen the scope of this evidence. The objectives of the present review were to screen for good-quality evidence on the effects of infodemics on public health during the Covid-19 pandemic and to know the impact of infodemics and various strategies to manage infodemics in public health during the Covid-19 pandemic. The other key variables included COVID 19 defined as Coronavirus disease (COVID-19) which is an infectious disease caused by the SARS-CoV-2 virus and public health as the topic is novel we included all the available evidence present from Ramdomised control trail, non-randomised controlled trials, systematic reviews, overviews and meta-analyses, as the reviewers wanted to know the range of evidence that would be available for conducting a map for a template for future investigations to be carried out in the field of infodemics. Explanations of the type of review were not definable or are consistently explained as numerous differing terms are used, and many a times interchangeably, therefore only those reviews were included which used a simple methodical search strategy but were systematic in search strategies. There were no restrictions for year of publication but complete articles published in English or with an English translation were included.The authors established a baseline for defining variables for the literature search. The definition of infodemic was established from the World Health Organisation guidelines as ‘infodemic’- is too much information including false or misleading information in digital and physical environments during a disease outbreak’..with the following key words Infodemic AND Public AND Health AND Covid-19 NOT Vaccine.The authors designed a search strategy using medical subject headings and specific keywords. There was no restriction on publication date but the language was restricted to English. A search was conducted in two databases namely MEDLINE and Scopus. The reference lists of the included studies were also searched for potential evidenceThe search criteria for MEDLINE and Scopus were devised as they are the two most commonly used databases for medical literature searches. Multiple databases were not screened because this was an evidence synthesis.Infodemic AND Public AND Health AND Covid-19 NOT Vaccine. Filters were used for Abstract, Clinical Trial, Meta-Analysis, Randomized Controlled Trial, Review, Systematic Review.The search included the keywordsTitles and abstracts of all articles deemed important and relevant were recognised by the searches of the two databases. Two reviewers separately selected all the evidence. The search outcomes were screened. Inclusion and exclusion criteria were applied with interrater Outcome Kappa value: 0.91. The strength of agreement was considered to be ‘excellent’.The reviewers deliberated all studies, regardless of design, as eligible for inclusion. A population and outcome (PO) search strategy that was wide enough to cover all topics was developed for categorizing potentially significant studies in any topic area. We excluded review articles that did not have any systematic search strategies but scrutinized the bibliography for identifying other potentially appropriate evidence. There were no restrictions for year of publication but the articles published in English or with an English translation were included.Underlying data.The selection of the retrieved articles involved the authors (MP and AS) independently and solved disagreements by consensus or consultation with a third reviewer (SY) Each time the title or abstract reported a keyword of relevance appearing to be eligible for the inclusion, the full article was obtained. All references were retained post the initial screening and later assessed for the inclusion and exclusion criteria the following information was extracted: (i) title, (ii) author, (iii) journal, (v) publication year, (vi) location of key words, (vii) type of article/study and (viii) comments based upon the full texts. all the articles were charted in a standard Excel format. The data extraction sheet can be found underThe present review drives past the scope of only ‘evidence mapping’ if a systematic review was obtainable than that was inserted into the mapping process and can be considered as an umbrella review and evidence mapping and a brief qualitative explanation of the key results have been considered and each theme is described below .The authors identified 55 records through database searching, after screening for duplicates, 53 records were screened at title/abstract level of which, 16 incomplete or non-English articles were removed and 37 were eligible for full text screening. 37 full-text articles were then assessed for eligibility and only 22 articles were included as per the inclusion criteria with an interrater Outcome Kappa value: 0.91. The strength of agreement was considered to be: ‘excellent’.impact of infodemic followed byeffect of infodemic andmanagement in infodemic during the covid-19 pandemic. The studies explicitly mentioned the psychological impacts on infodemics, the health care burden, low digital health literacy, economic burden, financial losses, and desensitization of the public towards infodemics.The majority of the studies focused on the first domainduring the covid 19 pandemic. A review article by Khan Set al. and Sharma DC elucidated some factors that contributed to the impact of infodemics on health care workers. They found that low immunity due to stress and drop in intellectual capacity due to inadequate resting time led to risk of acquiring infection and psychological traumas.The studies failed to include some vital aspects such as ways to manage and overcome the infodemic As this phenomenon spread at a faster rate, health professionals had to come up with a solution and very few health care workers came on social media to clarify this publicly  knowledge of the disease to be increased by digital health literacy, 2) to manage and cope with new practices and changes from the routine, 3) to overcome anxiety and fear regarding the disease (COVID 19), 4) to overcome the barriers to health literacy and 5) increase the acceptance to technology. A study by Li X revealed that during the COVID-19 pandemic the main barrier for cohorts with HIV/AIDS to understand their individual health, illness and treatment was considered to be poor health literacy.A review by ChoukouSocial media as a preventive approach could help in circulating the authentic news and information on diseases. This could help the public in adopting the necessary measures for control of the disease. Lack of digital equipment in vulnerable groups is the basis for poor digital health literacy in population, and resolving this situation through health care organisations reaching out to such groups and enabling access to an electronic source for information and health care of these groups should remain a priority. The increased circulation of misinformation in social media platforms during the accelerated health emergency has led to a cataclysmal infodemic.A systematic review conducted to assess the media sources of information and knowledge levels about COVID-19 revealed that 40% of the population depended on social media as their primary source of information regarding the disease. Implementing artificial intelligence to tackle this will help publish evidence based and systematically conducted research and filter out the biased publications during a pandemic. The quality of research published should be evaluated critically for any misinformation. Hence researchers have to comply with publishing and reporting strong scientific evidence.Researchers have the advantage and the right medium to hold back this tide of infodemic and any paucity in conducting the research process could lead to either insufficient information or could be interpreted insufficiently. The rapid spread in false medical cures or false remedies was noticed during the pandemic in large populations. The examples for such false remedies include smelling spices and inhalation of steam with salt could kill COVID 19 before it reached the lower respiratory system.This review has exposed certain definite evidence gaps in the field of infodemics and the ways to manage infodemics during a pandemic. In this unprecedented world with many unexpected situations, infodemics will be a common phenomenon, hence studies on health literacy, and identification of cohorts at high risk of this phenomenon will be a way forward.Our evidence synthesis was conducted systematically, with inclusion of appropriate literature based on the study objective. The study highlighted the impact and effects of infodemics on public health and ways to manage this phenomenon. The study focused on research gaps in the field of infodemics and has paved way for further research by finding evidence gaps in literature for the same. The major limitation of the study was that we included data from only two databases as the focus was just on finding evidence gaps and exploring further avenues for new research.This synthesis focused mostly on the gaps in the field of infodemics and public health. The two main gaps identified were lack of systematically conducted research and poor digital health literacy. As infodemics are a new phenomenon with respect to the COVID-19 pandemic, it was an eye opener at different levels of public health, furthermore this evidence map highlights the need for further research on the impact of infodemics and prevention of their spread. Hence further studies are required to strengthen public health infrastructure and prevent this digital virus.It has been recommended that the application of Artificial intelligence (AI) in assisting to screen the data available for accurate translation, summarization, simplification and content filtering should be the immediate approach to address this catastrophe. This is a well-written manuscript that only needs to undergo a few minor changes. This review article focused mostly on the gaps in the field of infodemic and public health. It has recommended the improvement of digital health literacy and use of artificial intelligence as an immediate approach to address this catastrophe. The COVID-19 pandemic had massive consequences not only on the societies and health systems across the world, but also has contributed to the development of ‘Infodemic’ to manage the crisis. Although one to one consultation between the doctor and the patient remains the gold standard in Medical Care, Infodemic has taken an upper hand during the pandemic. This has enabled simplified access to healthcare, reduction in distance between the patient and doctor, especially where health care is not accessible. However, it also has certain challenges like surplus information from various sources, which may be misinformation or disinformation. This misleads the users, affecting the decision making process thereby delaying health care. Hence an immediate, and collaborative effort is required to  maintain the integrity and credibility of professional expertise and rebuild public trust. This is an interesting and unique topic which is well structured and well written. However, I have provided few remarks based on my observation.Title: Kindly specify if the focus is of the impact of COVID-19 related infodemic on Public Health or Infodemic  on Public health.Abstract: The objective could be made more specific as in the manuscript the focus is on COVID -19 related infodemic and its impact on Public Health.Introduction:Page 3, L 33-34: Kindly Rephrase the sentence.Page 3, L 36: Kindly mention the secondary questions.Page 3, L 38-39: Please be more specific.Methods:Page 3: Kindly indicate if a review protocol exists the web address where it can be accessed , registration information along with the registration number.Page 4: Kindly mention if any attempts were made to confirm the data from the investigators.Page 5: Kindly correct the number of studies included in the flow diagram.Page 6: Please provide the citations in Table 2.Discussions:.Page 7:Kindly suggest the other strategies to manage infodemics as mentioned in the introductionPage 7:Please address the first domain, i.e the cause of infodemics.Page 7: Please consider providing information regarding the management of Psychological disturbance due to the impact of Infodemic.Are the rationale for, and objectives of, the Systematic Review clearly stated?YesIs the statistical analysis and its interpretation appropriate?YesAre sufficient details of the methods and analysis provided to allow replication by others?YesAre the conclusions drawn adequately supported by the results presented in the review?YesReviewer Expertise:Dental Public Health, Bioethics,I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard. Talk more about annotators/reviewers biases, their demographics and how authors dealt with that. to support these definitions for citations.Differentiate between misinformed vs biased information - may see Raza & Ding (2022)The contents of table 2 should be mentioned in intro, for clarity (1-2 lines maybe).Is 53 and then 27 not a small number for such research (figure 1), also since no time limit is on search strategy, is anything missed? Or so what is the strict criteria?How much time did the study take for all this?Mention theoretical implication of this study a bit more.The paper is very interesting and well written, the conciseness of the paper is impressive. A few suggestions:Are the rationale for, and objectives of, the Systematic Review clearly stated?YesIs the statistical analysis and its interpretation appropriate?Not applicableAre sufficient details of the methods and analysis provided to allow replication by others?YesAre the conclusions drawn adequately supported by the results presented in the review?PartlyReviewer Expertise:NLP, Informatics, public health, information retrievalI confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.