Search Results (10)

Background/Objectives: Chronic constipation is a prevalent gastrointestinal (GI) disorder among individuals with diabetes mellitus (DM), occurring more often than in healthy subjects. This review provides a systematic overview of this often-underestimated clinical condition in people with DM. Methods: A narrative review of literature up to 30 May 2025 was conducted, focusing on studies regarding the pathogenesis of constipation in DM, the correlation with GLP-1 RAs treatment, and the diagnostic-therapeutic framework. Results: The mechanisms underlying constipation in DM remain largely unclear; however, a multifactorial etiology has been proposed, involving structural changes in various tissues within the GI tract wall, as well as functional abnormalities, often secondary to hyperglycemia. It is noteworthy that the use of GLP-1 RAs, a class of medications crucial for managing glycemic control and reducing cardiovascular and renal risk in type 2 DM, is another cause of constipation. The diagnosis of constipation is typically based on clinical evaluation, as validated methods for assessing colonic transit are invasive and available only in specialized centers. Treatment objectives include alleviating symptoms and restoring bowel function. The primary strategy for management involves dietary changes and physical activity. If the clinical response is inadequate, the use of laxatives is recommended. Finally, newer agents and mechanical methods may be considered for scenarios that are particularly severe. Conclusions: Given the increasing global prevalence of DM, healthcare professionals must recognize the clinical problem constituted by the occurrence of chronic constipation, especially considering the use of medications such as GLP-1 RAs that may induce this clinical condition. Full article

Neuronal ceroid lipofuscinoses (NCLs) are paediatric neurodegenerative disorders that primarily affect the central nervous system (CNS). The high prevalence of gastrointestinal (GI) symptoms has prompted researchers and clinicians to move beyond an exclusively “brain-centric” perspective. At the molecular level, mutations in CLN genes lead to lysosomal dysfunction and impaired autophagy, resulting in intracellular accumulation of storage material that disrupts both central and enteric neuronal homeostasis. To systematically examine current clinical and preclinical knowledge on gut involvement in NCLs, with a focus on recent findings related to the enteric nervous system and gut microbiota. We conducted a systematic review following the PRISMA guidelines using PubMed as the sole database. Both clinical (human) and preclinical (animal) studies were included. A total of 18 studies met the inclusion criteria, focusing on gastrointestinal dysfunction, nervous system involvement, and gut microbiota. We found that the nature of GI symptoms was multifactorial in NCLs, involving not only the CNS but also the autonomic and enteric nervous systems, which were affected early by lysosomal deposits and enteric neuron degeneration. Of note, preclinical studies showed that gene therapy could improve not only CNS manifestations but also GI ones, which may have beneficial implications for patient care. While the role of the ENS seems to be clearer, that of gut microbiota needs to be further clarified. Current evidence from preclinical models highlighted alterations in the composition of the microbiota and suggested a possible influence on the progression and modulation of neurological symptoms. However, these results need to be confirmed by further studies demonstrating the causality of this relationship. GI involvement is a key feature of NCLs, with early impact on the enteric nervous system and possible links to gut microbiota. Although preclinical findings—particularly on gene therapy—are encouraging due to their dual impact on both CNS and GI manifestations, the causal role of the gut microbiota remains to be fully elucidated. In this context, the development of sensitive and specific outcome measures to assess GI symptoms in clinical trials is crucial for evaluating the efficacy of future therapeutic interventions. Full article

As a crucial component of the Beijing–Hangzhou Grand Canal’s hydraulic engineering, the Jiangnan Canal has historically played a pivotal role in China’s development as a key hydraulic infrastructure. This water conservancy project, connecting northern and southern water systems, not only facilitated regional economic integration but also nurtured unique cultural landscapes along its course. The Jiangnan Canal and its adjacent cities were selected as the study area to systematically investigate 334 tangible cultural heritage (TCH) sites and 420 intangible cultural heritage (ICH) elements. Through integrated Geographical Information System (GIS) spatial analyses—encompassing nearest neighbor index, kernel density estimation, standard deviation ellipse assessment, multi-ring buffer zoning, and Geodetector modeling, the spatiotemporal distribution features of cultural heritage were quantitatively characterized, with a focus on identifying the underlying driving factors shaping its spatial configuration. The analysis yields four main findings: (1) both TCH and ICH exhibit significant spatial clustering patterns across historical periods, with TCH distribution displaying an axis-core structure centered on the canal, whereas ICH evolved from dispersed to clustered configurations. (2) The center of gravity of TCH is primarily around Taihu Lake, while that of ICH is mainly on the south side of Taihu Lake, and the direction of distribution of both is consistent with the direction of the canal. (3) Multi-ring buffer analysis indicates that 77.2% of TCH and 49.8% of ICH clusters are concentrated within 0–10 km of the canal, demonstrating distinct spatial patterns: TCH exhibits a gradual canal-dependent density decrease with distance, whereas ICH reveals multifactorial spatial dynamics. (4) Human activity factors, particularly nighttime light intensity, are identified as predominant drivers of heritage distribution patterns, with natural environmental factors exerting comparatively weaker influence. These findings provide empirical support for developing differentiated conservation strategies for canal-related cultural heritage. The methodology offers replicable frameworks for analyzing heritage corridors in complex historical landscapes, contributing to both applied conservation practices and theoretical advancements in cultural geography. Full article

Objectives: The aims of this study were to (1) evaluate if there were any significant differences in gastrointestinal (GI) and/or feeding symptoms for infants with tethered oral tissues (TOTs) pre-frenotomy compared to infants with untreated TOTs and infants without TOTs, and (2) evaluate if treatment via frenotomy led to improvements in symptoms that more closely align with GI and/or feeding symptoms in infants with untreated TOTs and/or infants without (TOTs). Methods: This study utilized a pretest-only control group design. The Infant Eating Assessment Tool (InfantEAT) and Gastrointestinal and Gastroesophageal Reflux (GIGER) Scale were used to evaluate infant feeding and GI symptoms, respectively. Multiple linear regression was used to compare scores between the three groups at baseline, controlling for age and gestational age at birth. Treatment group’s average score after intervention was compared to the mean baseline score of the other two groups. For the treatment group, paired t-test was used to evaluate changes in scores before and after the treatment. Results: All subscales of both the InfantEAT and GIGER demonstrated statistically significant differences for infants with TOTs before intervention when compared with infants with TOTs who did not undergo treatment and infants without TOTs. Conclusion: This study demonstrates the importance of considering structure along with function for infants with tongue- and/or lip-tie. Clinicians must evaluate maternal symptoms alongside infant factors. The decision to treat TOTs via frenotomy is multifactorial and is not necessary in every mother-infant dyad. Full article

Crohn’s disease (CD) is a progressive, multifactorial, immune-mediated disease characterized by chronic inflammation of any part of the gastrointestinal (GI) tract. Pediatric patients present with a more extensive form of the disease, especially in the upper GI tract with various histopathological inflammatory patterns. Our study aims to analyze the clinical, laboratory, endoscopic, and histopathological findings in children with diagnosed CD and compare results on the initial and follow-up tests. We have included 100 children and adolescents with CD, with performed endoscopic and histopathological (HP) procedures. The results of multiple biopsies executed in these 8 years were matched and compared. We found a statistically significant frequency reduction in stool changes (65.52% to 18.18%), weight loss (35.24% to 4%), and abdominal pain (41.86% to 6.67%) as presenting symptoms. There was an improvement in all laboratory values: fecal calprotectin (1000 to 60,8 μg/g), C-reactive protein (12.2 to 1.9 mg/L), and albumin (36 to 41 g/L). On esophagogastroduodenoscopy and ileo-colonoscopy 36.59% and 64.86% patients had specific findings, respectively. A total of 32 patients had evidence of Crohn’s disease in the upper GI tract. Non-caseating granulomas were found on 9% of oesophageal, 18% of gastric, and 12% of duodenal biopsies. In the lower GI tract, we have observed a disease progression in the rectum (72.29 to 82.22%) and descending colon (73.49 to 80%). There was no registered disease progression in the upper GI tract. Our study demonstrated a significant decline in the frequency of symptoms and an improvement in laboratory values on the follow-up examinations. More than a third of our patients had specific endoscopic and HP findings in the upper GI tract, and an additional 23% had HP findings highly suggestive of CD. We demonstrated the importance of regular clinical, laboratory, endoscopic, and histopathological assessments of pediatric CD patients. Full article

The contribution of biodiversity to the global economy, human survival, and welfare has been significantly increasing. However, nature reserves have long been subject to a sequence of ecological environmental issues caused by human activities. Therefore, quantitatively assessing the spatiotemporal evolution characteristics of habitat quality due to land use changes and exploring the mechanisms of potential influencing factors can provide a scientific basis for the stable and sustainable development of natural ecosystems. This study aims to analyze 18 nature reserves in Hubei Province to identify the spatiotemporal evolution of habitat quality within these reserves and to explore the influence of multifactorial dynamics from nature, humanity, and policy on this evolution. Initially, the study utilizes land use transition matrices and land use dynamic degree methods to understand the spatiotemporal characteristics of land conversion within the study area. Subsequently, it analyzes the spatiotemporal changes in habitat quality from 2000–2020 based on the InVEST model and tools like spatial autocorrelation (Moran’s I) in ArcGIS. Finally, 14 potential influencing factors are selected from natural environment, socio-human, and policy regulation aspects and analyzed in the Geodetector software to understand the factors affecting the spatiotemporal evolution of habitat quality. The results show that, during the study period, the land area of 18 nature reserves in Hubei Province increased from 2000 to 2020, while the water area decreased. There were slight increases in farmland, construction land, and forest land, with significant decreases in grassland and water areas. This reveals the erosion of water bodies due to artificial lake filling during rapid urbanization, leading to a decline in overall habitat quality within the reserves and a gradual increase in spatial heterogeneity. Among the influencing factors, single-factor influences such as land use intensity and distance to county roads and slopes have a strong negative linear relationship with habitat quality, with land use intensity being the most significant human activity factor. The interaction strength among different types of influencing factors in the bivariate interaction detection results is ranked as follows: the interaction between natural geographical and socio-human factors > the interaction within socio-human factors > the interaction within natural geographical factors. This study has diverged from the past focus on the selection of a single continuous natural reserve as the empirical subject. Consequently, it allows for an integrated analysis of physical geographical dimensions such as locational topography with socio-cultural and policy elements including land use and transportation facilities, thereby facilitating a multifactorial assessment of the interactive impacts on habitat quality. Full article

The emergence of post-COVID-19 syndrome (PCS), a complex and multifactorial condition that follows the acute COVID-19 infection, has raised serious concerns within the global medical community. Concurrently, Irritable Bowel Syndrome (IBS), a widespread chronic gastrointestinal (GI) dysfunction, is considered to be one of the most common disorders of gut–brain interaction (DGBI) that significantly affects the quality of life and social functioning of patients. PCS presents a wide range of symptoms and GI manifestations, including IBS. This review aims to analyze the GI involvement and the prolonged symptoms of COVID-19 infection as part of PCS, in order to explore the potential development of post-infection IBS (PI-IBS) in COVID-19 patients. Irritating factors such as enteric infection, psychosocial conditions, food antigens, and antibiotics may lead to abnormalities in the physiological function of the GI system and could be involved in the development of PI-IBS. Through the presentation of the pathophysiological mechanisms and epidemiological studies that assessed the prevalence of IBS as part of PCS, we attempted to provide a better understanding of the long-term consequences of COVID-19 and the pathogenesis of PI-IBS. Even though PI-IBS is becoming a global challenge, there are only a few studies about it and therefore limited knowledge. Currently, the majority of the existing treatment options are referred to non-COVID-19-associated DGBIs. Forthcoming studies may shed light on the mechanisms of PI-IBS that could be targeted for treatment development. Full article

Background: Gastrointestinal (GI) symptoms are very common in subjects with eating disorders (EDs). This study aimed to (a) investigate the prevalence of gut–brain interaction disorders (DGBIs) in anorexia nervosa (AN) patients, according to ROME IV criteria; and (b) explore AN psychopathological assets and disgust that might impact GI symptoms. Methods: Thirty-eight female patients consecutively diagnosed with untreated AN (age 19.32 ± 5.59) in an outpatient clinic devoted to EDs underwent Eating Disorder Inventory—3 (EDI-3), Hospital Anxiety and Depression Scale (HADS), Social Phobia Anxiety Scale (SPAS), Body Uneasiness Test (BUT), and Disgust Scale (DS) questionnaires. The presence of DGBIs was evaluated and GI symptoms were assessed using a standardized intensity–frequency questionnaire. Results: A total of 94.7% of our sample met the diagnostic criteria for functional dyspepsia (FD), of which 88.8% presented the postprandial distress syndrome (PDS) subtype and 41.6% presented the epigastric pain syndrome (EPS) subtype. In addition, 52.6% of the sample met the diagnostic criteria for irritable bowel syndrome (IBS), while for functional constipation (FC), prevalence reached 7.9%. All participants presented a pathological score on the disgust scale. Significant correlations were found between several GI symptoms and psychopathological asset and disgust. Conclusions: AN is a multifactorial disorder. It is necessary to implement studies with an integrated approach, taking into account DGBIs, as well as to monitor the emotional–cognitive structure that acts as a factor in maintaining the disorder. Full article

A comprehensive evaluation is important for the sustainable development of entrepreneurship education in colleges and universities. Specifically, evaluating entrepreneurship education in colleges and universities from the perspective of teachers, as stakeholders of entrepreneurship education in colleges and universities, can provide a basis for decision making to improve the quality of entrepreneurship education. Using the improved entropy–TOPSIS method, this study selects 35 indicators from five aspects, namely, curriculum systems, organizational leadership, faculty construction, teaching management, and an institutional guarantee, to establish a sustainable and comprehensive evaluation framework for entrepreneurship education in colleges and universities. Survey data from a questionnaire of college teachers in 11 provinces (cities) in China’s Yangtze River economic zone are used. The objective is to propose a framework that enables a comprehensive evaluation of the sustainability of entrepreneurship education and to develop a new evaluation method that highlights the challenges in evaluating the sustainability of entrepreneurship education, including the selection and effective measurement of the evaluation criteria. The study provides a scientific basis and support for decision making on the optimal reform of entrepreneurship education, faculty allocation, and education methods in Chinese universities and contributes to the realization of the goal of sustainable development of entrepreneurship education in universities. Full article

The evaluation of scale management suitability provides a comprehensive assessment of the various factors driving farmland management conditions. This research objectively evaluated the conditions for scale management suitability by applying the entropy-TOPSIS method with the aim of effectively balancing the space for agricultural production, the development of towns, and ecological protection. First, to ensure a balance between agricultural production, urban development, and ecological protection, 13 indexes were selected to represent the following three areas: natural factors, socioeconomic factors, and characteristics of cultivated land factors. The original matrix was standardized to evaluate the suitability of natural resources, the social economy, and cultivated land conditions, and a comprehensive suitability evaluation of scale management in the Jiangjin District of Chongqing was conducted. The research results divide the study area into four regions based on the level of scale management suitability. Examining the spatial distribution, the level of scale management suitability decreased gradually from north to south, regions at the high and middle levels of scale management suitability were concentrated in the northern area beside the Yangtze river, and the regions at a low level were concentrated in the southern mountain area. This research can provide a reference for the rational utilization of land resources and land use policymaking. Full article