bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of HM-Exos on the migration and inflammatory response of LPS-exposed dental pulp stem cells
Authors: Azaryan Ehsaneh , Karbasi Samira , Saharkhiz Mansoore , Hanafi-Bojd Mohammad Yahya , Zarban Asghar , Emadian Razavi Fariba , Naseri Mohsen
Published: February 2023

Aim

The purpose of this study was to investigate the effects of human milk exosomes (HM-Exos) on the viability, migration, and inflammatory responses of lipopolysaccharide (LPS)-exposed human dental pulp stem cells (HDPSCs) in vitro.

Methods

HM-Exos were isolated, and dynamic light scattering (DLS), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) were used to analyze their physical properties (size and shape). To construct an in vitro inflammation model, HDPSCs were exposed to LPS. The MTT test and migration assay were used to investigate the effect of HM-Exos on cell proliferation and migration, and the quantitative polymerase chain reaction (qPCR) was used to assess the expression of inflammatory genes in HDPSCs. Data were analyzed using a one-way analysis of variance (ANOVA) with Tukey's post-test.

Results

DLS measurement revealed that HM-Exos were 116.8 ± 3.6 nm in diameter. The SEM and TEM images revealed spherical shapes with diameters of 97.2 ± 34.6 nm. According to the results of the cell viability assay, the nontoxic concentration of HM-Exos (200 µg/ml) was chosen for the subsequent investigations. The migration assay results showed that HM-Exos improved the potential of LPS-exposed HDPSCs to migrate. The qPCR results indicated that HM-Exos significantly reduced the expression of inflammatory cytokines such as TNF-α, IL-1β, and IL-6 in HDPSCs after LPS stimulation.

Conclusions

HM-Exos increased LPS-exposed HDPSCs migration and proliferation and reduced gene expression of inflammatory cytokines. They may be a viable candidate for pulpitis therapy.
Association between self-reported sedentary behavior and health-related quality of life among infertile women with polycystic ovary syndrome
Authors: Cao Yanjun , Li Guopeng , Ren Yanbei
Published: February 2023

Background

High sedentary behavior and poor health-related quality of life (HRQoL) were common among women with polycystic ovary syndrome (PCOS). However, the association of sedentary behavior with HRQoL among infertile women with PCOS is still unknown. This study aimed to investigate the association of sedentary behavior with HRQoL among them.

Methods

A cross-sectional study was conducted with 283 participants recruited from infertility outpatient clinic. A self-administered, structured questionnaire including the modified PCOS health-related QoL questionnaire (MPCOSQ), the International Physical Activity Questionnaire short form (IPAQ-SF), the Patient Health Questionnaire-9 (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) was used. Anthropometric and laboratory indictors related to PCOS were also collected. Multivariable linear regression analyses were performed to identify the associations. Bonferroni correction was utilized for multiple testing correction.

Results

Sedentary behavior was associated with reduced HRQoL among this group. Specifically, over seven hours per day of sedentary behavior was strongly associated with total and several aspects of HRQoL (β ranged from − 0.378 to − 0.141, all P < 0.0063) after adjusting for physical activity, anxiety and depression. In addition, elevated BMI (β = − 0.407, P < 0.001) and anxiety (β ranged from − 0.410 to − 0.245, all P < 0.0063) were associated with poor HRQoL, while physical activity and depression were not.

Conclusion

Sedentary behavior is an important behavior among infertile women with PCOS as it was associated with poorer HRQoL. Future interventions seeking to improve HRQoL should be considered to reduce sedentary behavior and psychological burden as primary intervention targets.
Maternal pre-pregnancy body mass index is associated with newborn offspring hypothalamic mean diffusivity: a prospective dual-cohort study
Authors: Rasmussen Jerod M. , Tuulari Jetro J. , Nolvi Saara , Thompson Paul M. , Merisaari Harri , Lavonius Maria , Karlsson Linnea , Entringer Sonja , Wadhwa Pathik D. , Karlsson Hasse , Buss Claudia
Published: February 2023

Background

An extensive body of animal literature supports the premise that maternal obesity during pregnancy can alter the development of the fetal hypothalamus (HTH, a critical regulator of energy balance) with implications for offspring obesity risk (i.e., long-term energy imbalance). Yet, the relationship in humans between maternal overweight/obesity during pregnancy and fetal hypothalamic development remains largely unknown. Here, using an international (Finland and California, USA) multi-site diffusion tensor imaging (DTI) dataset, we test the hypothesis that maternal pre-pregnancy BMI is associated with newborn offspring HTH mean diffusivity (HTH MD, a replicable neural correlate of BMI in adults).

Methods

HTH MD was independently quantified in two separate BMI-matched cohorts (up to class II obesity; BMIRange = 17–35) using a high-resolution atlas-based definition of HTH. A total of n = 231 mother-child dyads were available for this analysis (nSite,1 = 152, age at MRI = 26.7 ± 8.1 days, gestational age at birth = 39.9 ± 1.2 weeks, nM/F = 82/70, BMI = 24.2 ± 3.8; nSite,2 = 79, age at MRI = 25.6 ± 12.5 days, gestational age at birth = 39.3 ± 1.5 weeks, nM/F = 45/34, BMI = 25.1 ± 4.0). The association between maternal pre-pregnancy BMI and newborn offspring HTH MD was examined separately in each cohort using linear regression adjusting for gestational age at birth, postnatal age at scan, sex, whole white matter mean diffusivity, and DTI quality control criteria. In post hoc analyses, additional potentially confounding factors including socioeconomic status, ethnicity, and obstetric risk were adjusted where appropriate.

Results

The distribution of maternal pre-pregnancy BMI was comparable across sites but differed by ethnicity and socioeconomic status. A positive linear association between maternal pre-pregnancy BMI and newborn offspring HTH MD was observed at both sites ($$\hat{\beta}$$

β
^

Site,1 = 0.17, pSite,1 = 0.01; $$\hat{\beta}$$

β
^

Site,2 = 0.22, pSite,2 = 0.03) and remained significant after adjusting for cohort-relevant covariates.

Conclusions

These findings translate the preclinically established association between maternal obesity during pregnancy and offspring hypothalamic microstructure to the human context. In addition to further replication/generalization, future efforts to identify biological mediators of the association between maternal obesity and fetal HTH development are warranted to develop targeted strategies for the primary prevention of childhood obesity.
Worsening of asthma control after recovery from mild to moderate COVID-19 in patients from Hong Kong
Authors: Kwok Wang Chun , Tam Terence Chi Chun , Lam David Chi Leung , Leung Jackson Ka Chun , Chan King Pui Florence , Chan Shung Kay Samuel , Chiang Ka Yan , Ip Mary Sau Man , Ho James Chung Man
Published: February 2023

Background

While there are postulations that asthma is potentially associated with severe coronavirus disease 2019 (COVID-19), there has been conflicting results from studies on the impact mild-to-moderate COVID-19 on asthma control after recovery.

Methods

A case control study on the association between mild-to-moderate COVID-19 and asthma control post infection was conducted. The primary outcome was a reduction in Asthma Control Test (ACT) score by ≥ 3 points post-COVID infection. The secondary outcomes included the change in ACT score, the proportion of patient with ACT score who dropped to ≤ 15 on enrolment visit and the need for escalation of asthma maintenance therapy.

Results

Out of the total of 221 adult patients with asthma recruited, 111 had mild-to-moderate COVID-19 within 30 to 270 days prior to study enrolment. The adjusted odds ratio (aOR) for a reduction in ACT score by ≥ 3 points after COVID-19 was 3.105 (95% CI = 1.385–6.959, p = 0.006). The odds of escalation of asthma maintenance therapy by at least 1 Global Initiative for Asthma (GINA) step was 4.733 (95% CI = 1.151–19.467, p = 0.031) and asthma patient are more likely to become uncontrolled after COVID-19 [aOR = 5.509 (95% CI = 1.061–28.600, p = 0.042)].

Conclusion

Mild-to-moderate COVID-19 among asthma patients, upon recovery, was associated with worsening of asthma symptom, lower ACT score, a higher need for escalation of asthma maintenance therapy and more uncontrolled asthma.
Drivers and barriers of international migration of doctors to and from the United Kingdom: a scoping review
Authors: Brennan N. , Langdon N. , Bryce M. , Burns L. , Humphries N. , Knapton A. , Gale T.
Published: February 2023

Background

Many high-income countries are heavily dependent on internationally trained doctors to staff their healthcare workforce. Over one-third of doctors practising in the UK received their primary medical qualification abroad. Simultaneously, an average of around 2.1% of doctors leave the UK medical workforce annually to go overseas. The aim of this study was to identify the drivers and barriers of international migration of doctors to and from the UK.

Methods

A scoping review was conducted. We searched EMBASE, MEDLINE, CINAHL, ERIC and BEI in January 2020 (updated October 2021). Grey literature and citation searching were also carried out. Empirical studies reporting on the drivers and barriers to the international migration of doctors to and from the UK published in the English language from 2009 to present were included. The drivers and barriers were coded in NVivo 12 building on an existing framework.

Results

40 studies were included. 62% were quantitative, 18% were qualitative, 15% were mixed-methods and 5% were literature reviews. Migration into and out of the UK is determined by a variety of macro- (global and national factors), meso- (profession led factors) and micro-level (personal factors). Interestingly, many of the key drivers of migration to the UK were also factors driving migrationfromthe UK, including: poor working conditions, employment opportunities, better training and development opportunities, better quality of life, desire for a life change and financial reasons. The barriers included stricter immigration policies, the registration process and short-term job contracts.

Conclusions

Our research contributes to the literature by providing a comprehensive up-to-date review of the drivers and barriers of migration to and from the UK. The decision for a doctor to migrate is multi-layered and is a complex balance between push/pull at macro-/meso-/micro-levels. To sustain the UK’s supply of overseas doctors, it is vital that migration policies take account of the drivers of migration particularly working conditions and active recruitment while addressing any potential barriers. Immigration policies to address the impact of Brexit and the COVID-19 pandemic on the migration of doctors to and from the UK will be particularly important in the immediate future.

Trial registrationPROSPERO CRD42020165748.
Factors related to the implementation and scale-up of physical activity interventions in Ireland: a qualitative study with policy makers, funders, researchers and practitioners
Authors: Murphy Joey , Mansergh Fiona , O’Donoghue Grainne , van Nassau Femke , Cooper Jemima , Grady Caera , Murphy Niamh , Bengoechea Enrique Garcia , Murphy Marie H. , Cullen Benny , Woods Catherine B. ,   the I-PARC
Published: February 2023

Background

Current literature reports a gap between development of effective interventions to promote physical activity and the systematic uptake into real-world settings. Factors relating to implementation and scale-up of physical activity interventions have been examined, however the perspectives of multiple stakeholders from different domains are not well researched. The purpose of this study was to examine the perceived factors related to physical activity intervention implementation and scale-up in different domains from different stakeholders on the island of Ireland.

Methods

Practitioners, researchers, funders and policy makers in Ireland were invited to take part in a semi-structured interview exploring factors related to the implementation and scale-up of eleven different physical activity interventions. A thematic analysis was conducted to identify factors related to the implementation and scale-up of the included interventions. The data collection and analysis were guided by the Consolidated Framework for Implementation Research.

Results

Thirty-eight participants took part in the interviews which identified factors related to 1) intervention planning and practical considerations; 2) organisational structures, staffing and resources related to delivery; 3) reflection, evaluation and updating of the intervention; and 4) practical consideration related to scale-up. Furthermore, participants referred to the ongoing commitment, engagement, and support needed throughout the implementation process.

Conclusions

Future research and practice needs to consider how different factors are experienced at different implementation stages and by the different stakeholder groups involved. The findings highlight multiple inter-related factors that influence the implementation and scale-up of physical activity interventions, but also identifies many strategies that can be utilised to aid future successes.
α-Synuclein induces prodromal symptoms of Parkinson’s disease via activating TLR2/MyD88/NF-κB pathway in Schwann cells of vagus nerve in a rat model
Authors: Cheng Yue , Tong Qing , Yuan Yongsheng , Song Xinna , Jiang Wenwen , Wang Yueping , Li Wenjie , Li Yangxia , Zhang Kezhong
Published: February 2023

Background

Increasing evidence suggests that patients with Parkinson's disease (PD) present with peripheral autonomic dysfunction (AutD) that even precedes motor deficits, through which α-synuclein can spread to the central nervous system. However, the pathological mechanisms underlying AutD in prodromal PD remain unclear. Here, we investigated the role of α-synuclein and its interplay with the activation of Schwann cells (SCs) of the vagus nerve in AutD.

Methods

Rats were subjected to injection with adeno-associated viruses containing the human mutated A53T gene (AAV-A53T) or an empty vector into the left cervical vagus nerve and evaluated for gastrointestinal symptoms, locomotor functions, intestinal blood flow, and nerve electrophysiology. Further, we examined the impact of α-synucleinopathy on vagus nerves, SCs, and central nervous system neurons using electron microscopy, immunofluorescence, immunohistochemistry, and western blot. Finally, the role of Toll-like receptor 2 (TLR2) in regulating the neuroinflammation in the vagus nerve via MyD88 and NF-κB pathway was determined using genetic knockdown.

Results

We found that rats injected with AAV-A53T in the vagus nerve exhibited prominent signs of AutD, preceding the onset of motor deficits and central dopaminergic abnormalities by at least 3 months, which could serve as a model for prodromal PD. In addition, reduced intestinal blood flow and decreased nerve conduction velocity were identified in AAV-A53T-injected rats, accompanied by disrupted myelin sheaths and swollen SCs in the vagus nerve. Furthermore, our data demonstrated that p-α-synuclein was deposited in SCs but not in axons, activating the TLR2/MyD88/NF-κB signaling pathway and leading to neuroinflammatory responses. In contrast, silencing the TLR2 gene not only reduced inflammatory cytokine expression but also ameliorated vagal demyelination and secondary axonal loss, consequently improving autonomic function in rats.

Conclusions

These observations suggest that overexpression of α-synuclein in the vagus nerve can induce symptoms of AutD in prodromal PD, and provide support for a deeper understanding of the pathological mechanisms underlying AutD and the emergence of effective therapeutic strategies for PD.
Surgical treatment of thoracic aortic pseudoaneurysm caused by Brucella melitensis
Authors: Guo Hong-Wei , Sun Yang-Xue , Sun Jing , Qian Xiang-Yang
Published: February 2023

Thoracic aortic pseudoaneurysm caused by Brucella melitensis is extremely rare with extremely few cases reported to date. Herein, we present the case of a 65 year-old man with a huge pseudoaneurysm of the proximal descending thoracic aorta, involving the left subclavian artery and distal arch. Surgery was performed to replace the proximal descending aorta with a self-made bovine pericardial duct and the left subclavian artery with a 10 mm artificial vessel under deep hypothermic circulatory arrest; the patient recovered uneventfully. However, continued follow-up is required for long-term results.
Association between social support for mothers of patients with eating disorders and mothers’ active listening attitude: a cohort study
Authors: Katsuki Fujika , Yamada Atsurou , Kondo Masaki , Sawada Hanayo , Watanabe Norio , Akechi Tatsuo
Published: February 2023

Background

Family members of patients with eating disorders, especially their mothers, experience heavy caregiving burdens associated with supporting the patient. We predict that increasing caregivers’ support will have a positive effect on their active listening attitudes, mental health, loneliness, and self-efficacy. This study aimed to investigate differences in mothers’ active listening attitudes, mental health, loneliness, and self-efficacy improvements between mothers who did and did not experience increased perceived social support.

Main body

Participants were mothers of patients with eating disorders. Questionnaires for this cohort study were sent to the participants’ homes at three time points (baseline, 9 months, and 18 months). The Japanese version of the Social Provision Scale (SPS-10) was used to evaluate social support, the Active Listening Attitude Scale (ALAS) for listening attitude, the UCLA Loneliness Scale (ULS) for loneliness, the General Self-Efficacy Scale (GSES) for self-efficacy, the Beck Depression Inventory (BDI-II) for depression symptoms, and the K6 for psychological distress. An unpaired t-test was used to determine whether participants’ status differed between the groups that did and did not experience increased perceived social support. The mean age of the participants was 55.1 ± 6.7 (mean ± SD) years. The duration of their children’s eating disorders was 7.6 ± 5.5 years. The degree of improvement for each variable (active listening attitude, loneliness, self-efficacy, depressive symptoms, and mental health) was the difference in each score (ALAS, ULS, GSES, BDI-II, and K6) from T1 to T3. The degree of improvement in active listening attitude and loneliness was significantly greater in the improved social support group than in the non-improved social support group (p < 0.002 and p < 0.012, respectively).

Conclusions

Our findings indicate that increasing mothers’ perceptions of social support will be associated with improving their active listening attitudes and loneliness.
Adverse drugs reactions to paracetamol and ibuprofen in children: a 5-year report from a pediatric poison control center in Italy
Authors: Marano Marco , Roversi Marco , Severini Flavia , Memoli Claudia , Musolino Antonio , Pisani Mara , Cecchetti Corrado , Villani Alberto
Published: February 2023

Background

This study aimed to analyze all the patients who contacted the hospital’s pediatric poison control center (PPCC) for exposure to ibuprofen and acetaminophen, in order to assess the incidence of any adverse reactions.

Methods

We retrospectively reported the clinical data of children who accessed the PPCC of the Bambino Gesù Children’s Hospital, IRCCS, Rome, from January 1, 2018 to September 30, 2022 due to wrong, accidental or intentional intake of inappropriate doses of acetaminophen and/or ibuprofen. In addition, we compared patients according to the intake of one of the two drugs and reported the trimestral distribution of cases during the study period.

Results

A total of 351 patients accessed the PPCC during the study period. The median age was 3.0 years. Most patients were females (57.8%). The most common reason for inappropriate oral intake of paracetamol or ibuprofen was a wrong use or an accidental intake (78.6%), with a fifth of patients taking the drug with suicidal intent (21.1%). According to the PPCC evaluation, most patients were not intoxicated (70.4%). Hospitalization was required for 30.5% of patients. Adverse reactions were reported in 10.5% of cases, with a similar incidence in patients who took paracetamol or ibuprofen. Nausea and vomiting were the most commonly reported adverse reactions. A higher frequency of moderate intoxication was found in patients who took paracetamol compared to ibuprofen (p = 0.001). The likelihood of intoxication was also higher in the paracetamol cohort. A spike of cases was registered at the end of 2021.

Conclusions

We analyze exposures to the two most commonly used pediatric molecules, paracetamol and ibuprofen, to assess the frequency of adverse reactions. We demonstrated that these relatively “safe” drugs may be associated with intoxications and adverse reactions when inappropriately administered.
Development and evaluation of a simple PCR assay and nested PCR for rapid detection of clarithromycin-resistant Helicobacter pylori from culture and directly from the biopsy samples in India
Authors: Karmakar Bipul Chandra , Paul Sangita , Basak Surajit , Ghosh Manisha , Mukherjee Piyali , Das Rajashree , Chaudhuri Sujit , Dutta Shanta , Mukhopadhyay Asish Kumar
Published: February 2023

Background

Eradication of Helicobacter pylori provides the most effective treatment for gastroduodenal diseases caused by H. pylori infection. Clarithromycin, a member of the macrolide family, still remains the most important antibiotic used in H. pylori eradication treatment. But the increasing prevalence of clarithromycin resistant H. pylori strains due to point mutations in the V region of the 23S rRNA, poses a great threat in treating the ailing patients. So, we aimed for PCR-mediated rapid detection of the point mutation at 2143 position of 23S rRNA gene in H. pylori that is relevant to clarithromycin resistance from culture and simultaneously from biopsy specimens to avoid the empirical treatment.

Results

Newly developed PCR assay using DNA of pure culture detected point mutation in 23S rRNA gene in 21 (8.04%) of 261 clinical strains tested. The agar dilution method showed that all these 21 strains were resistant to clarithromycin indicating the perfect match of the PCR based results. Additionally, the sequencing study also identified the A to G mutation at 2143 position in 23S rRNA gene of the resistant strains only. Consequently, the newly developed Nested-ASP-PCR dealing directly with 50 biopsy specimens demonstrated 100% sensitivity and specificity with the findings of agar dilution method taken as Gold standard. Bioinformatics based analysis such as accessibility analysis and dot plot clearly stated that the base pairing probability has increased due to mutation. Computational studies revealed that the point mutation confers more stability in secondary structure due to conversion of loop to stem. Furthermore, interaction studies showed binding affinity of the CLR to the mutant type is weaker than that to the wild type.

Conclusion

This assay outlines a rapid, sensitive and simple approach to identify point mutation that confers clarithromycin resistance as well as clarithromycin sensitive strains, providing rapid initiation of effective antibiotic treatment. Additionally, it is simple to adopt for hospital based diagnostic laboratories to evaluate the degree of regional clarithromycin resistance from biopsy specimens itself. Furthermore, in silico studies provide evidence or a signal that the prevalence of clarithromycin resistance may rise in the near future as a result of this point mutation.
Endothelial colony forming cell administration promotes neurovascular unit development in growth restricted and appropriately grown fetal lambs
Authors: Bell Alexander , Watt Ashalyn P. , Dudink Ingrid , Pham Yen , Sutherland Amy E. , Allison Beth J. , McDonald Courtney A. , Castillo-Melendez Margie , Jenkin Graham , Malhotra Atul , Miller Suzanne L. , Yawno Tamara
Published: February 2023

Background

Fetal growth restriction (FGR) is associated with deficits in the developing brain, including neurovascular unit (NVU) dysfunction. Endothelial colony forming cells (ECFC) can mediate improved vascular stability, and have demonstrated potential to enhance vascular development and protection. This investigation examined whether ECFCs from human umbilical cord blood (UCB) enhanced NVU development in FGR and appropriate for gestational age (AGA) fetal sheep.

Methods

Twin-bearing ewes had surgery performed at 88–90 days’ gestation, inducing FGR in one fetus. At 113 days, ECFCs (1 × 107 cells) cultured from human UCB were administered intravenously to fetal sheep in utero. At 127 days, ewes and their fetuses were euthanised, fetal brains collected, and NVU components analysed by immunohistochemistry.

Results

Twenty-four fetal lambs, arranged in four groups: AGA (n = 7), FGR (n = 5), AGA + ECFC (n = 6), and FGR + ECFC (n = 6), were included in analyses. FGR resulted in lower body weight than AGA (P = 0.002) with higher brain/body weight ratio (P = 0.003). ECFC treatment was associated with increased vascular density throughout the brain in both AGA + ECFC and FGR + ECFC groups, as well as increased vascular–astrocyte coverage and VEGF expression in the cortex (P = 0.003, P = 0.0006, respectively) and in the subcortical white matter (P = 0.01, P = 0.0002, respectively) when compared with the untreated groups.

Conclusions

ECFC administration enhanced development of NVU components in both the AGA and FGR fetal brain. Further investigation is required to assess how to optimise the enhanced angiogenic capabilities of ECFCs to provide a therapeutic strategy to protect the developing NVU against vulnerabilities associated with FGR.
Prioritization of head and neck cancer patient care during the COVID-19 pandemic: A retrospective cohort study
Authors: Psycharis Samuel S. , Salameh Samer , Turkdogan Sena , Razzaq Saad , Zhao Kevin , Mascarella Marco A. , Richardson Keith , Mlynarek Alex M. , Hier Michael P. , Sadeghi Nader
Published: February 2023

Background

The COVID-19 pandemic placed considerable strain on the healthcare system, leading to the re-allocation of resources and implementation of new practice guidelines. The objective of this study is to assess the impact of COVID-19 guideline modifications on head and neck cancer (HNC) care at two tertiary care centers in Canada.

Methods

A retrospective cohort study was conducted. HNC patients seen at two tertiary care centers before and after the onset of the COVID-19 pandemic (pre-pandemic: July 1st, 2019, to February 29th, 2020; pandemic: March 1st, 2020, to October 31st, 2020) were included. The pre-pandemic and pandemic cohorts were compared according to patient and tumor characteristics, duration of HNC workup, and treatment type and duration. Mean differences in cancer care wait times, including time to diagnosis, tumor board, and treatment as well as total treatment package time and postoperative hospital stay were compared between cohorts. Univariate and multivariate analyses were used to compare characteristics and outcomes between cohorts.

Results

Pre-pandemic (n = 132) and pandemic (n = 133) patients did not differ significantly in sex, age, habits, or tumor characteristics. The percentage of patients who received surgery only, chemo/radiotherapy (CXRT) only, and surgery plus adjuvant CXRT did not differ significantly between cohorts. Pandemic patients experienced a significant time reduction compared to pre-pandemic patients with regards to the date first seen by a HNC service until start of treatment ([Formula: see text] [Formula: see text]  = 48.7 and 76.6 days respectively; p = .0001), the date first seen by a HNC service until first presentation at tumor board ([Formula: see text] [Formula: see text]  = 25.1 and 38 days respectively; p = .001), mean total package time for patients who received surgery only ([Formula: see text] [Formula: see text]  = 3.7 and 9.0 days respectively; p = .017), and mean total package time for patients who received surgery plus adjuvant CXRT ([Formula: see text] [Formula: see text]  = 80.2 and 112.7 days respectively; p = .035).

Conclusion

The time to treatment was significantly reduced during the COVID-19 pandemic as compared to pre-pandemic. This transparent model of patient-centered operative-room prioritization can serve as a model for improving resource allocation and efficiency of HNC care during emergency and non-emergency scenarios.
Factors associated with the severity of premenstrual symptoms in women with central obesity: a cross-sectional study
Authors: Sharifan Payam , Jafarzadeh Esfehani Ali , Zamiri Amir , Ekhteraee Toosi Mansoureh Sadat , Najar Sedgh Doust Fatemeh , Taghizadeh Niloufar , Mohammadi-Bajgiran Maryam , Ghazizadeh Hamideh , Khorram Rouz Fatemeh , Ferns Gordon , Ghayour-Mobarhan Majid
Published: February 2023

Introduction

Premenstrual syndrome (PMS) is a common condition that affects social and psychological well-being of women. The risk of PMS is higher among obese women. The aim of this study was to identify the factors that influence the severity of PMS in women with central obesity.

Materials and methods

This cross-sectional study was performed on 30–50 year-old women with abdominal obesity (waist circumference > 80 cm). The following data were collected: demographic data, anthropometric measurements, premenstrual symptoms screening tools, semi-quantitative food frequency questionnaire, 42-item depression, anxiety, and stress questionnaire (DASS-42), as well as serum vitamin D, and renal function tests.

Results

A total of 139 women (mean age of 41.40 ± 7.39 years old) participated in the study. The prevalence of mild, moderate and severe premenstrual symptoms was 38.7% (55/142), 31.7% (45/142) and 27.5% (39/142), respectively. There was no significant difference between the groups in terms of anthropometric measurements and energy-adjusted nutrient intakes (p > 0.05). There was a significant relationship between moderate PMS and energy-adjusted saturated fatty acid (SFA) (p = .018, OR = .010 and 95% CI for OR: < .001 and .452), and energy-adjusted riboflavin (p = .042, OR = .005, 95% CI for OR: < .001 and .821), and between severe PMS and age (p = .034, OR = .906, 95% CI for OR: .826 and .993), and energy-adjusted monounsaturated fatty acid (MUFA) intake (p = .041, OR = 23.789, 95% CI for OR: 1.138 and 497.294).

Conclusion

High intakes of MUFA and younger age were associated with a greater severity of PMS, while riboflavin intake was associated with reduced PMS severity.
IMplementing Predictive Analytics towards efficient COPD Treatments (IMPACT): protocol for a stepped-wedge cluster randomized impact study
Authors: Michaux Kristina D. , Metcalfe Rebecca K. , Burns Paloma , Conklin Annalijn I. , Hoens Alison M. , Smith Daniel , Struik Laura , Safari Abdollah , Sin Don D. , Sadatsafavi Mohsen ,   IMPACT Study Group, Bansback Nick , Barn Prabjit , Bottorff Joan L. , Bryan Stirling , Carlsten Chris , De Vera Mary , Gershon Andrea , Gupta Samir , Gustafson Paul , Mokhtaran Mehrshad , Johnson Jim , Joshi Phalgun , Leung Janice , Lynd Larry D. , Simmers Brian , Sutherland Janet , Vinay Dhingra
Published: February 2023

Introduction

Personalized disease management informed by quantitative risk prediction has the potential to improve patient care and outcomes. The integration of risk prediction into clinical workflow should be informed by the experiences and preferences of stakeholders, and the impact of such integration should be evaluated in prospective comparative studies.

The objectives of the IMplementing Predictive Analytics towards efficient chronic obstructive pulmonary disease (COPD) treatments (IMPACT) study are to integrate an exacerbation risk prediction tool into routine care and to determine its impact on prescription appropriateness (primary outcome), medication adherence, quality of life, exacerbation rates, and sex and gender disparities in COPD care (secondary outcomes).

Methods

IMPACT will be conducted in two phases. Phase 1 will include the systematic and user-centered development of two decision support tools: (1) a decision tool for pulmonologists called the ACCEPT decision intervention (ADI), which combines risk prediction from the previously developed Acute COPD Exacerbation Prediction Tool with treatment algorithms recommended by the Canadian Thoracic Society’s COPD pharmacotherapy guidelines, and (2) an information pamphlet for COPD patients (patient tool), tailored to their prescribed medication, clinical needs, and lung function. In phase 2, we will conduct a stepped-wedge cluster randomized controlled trial in two outpatient respiratory clinics to evaluate the impact of the decision support tools on quality of care and patient outcomes. Clusters will be practicing pulmonologists (n ≥ 24), who will progressively switch to the intervention over 18 months. At the end of the study, a qualitative process evaluation will be carried out to determine the barriers and enablers of uptake of the tools.

Discussion

The IMPACT study coincides with a planned harmonization of electronic health record systems across tertiary care centers in British Columbia, Canada. The harmonization of these systems combined with IMPACT’s implementation-oriented design and partnership with stakeholders will facilitate integration of the tools into routine care, if the results of the proposed study reveal positive association with improvement in the process and outcomes of clinical care. The process evaluation at the end of the trial will inform subsequent design iterations before largescale implementation.

Trial registration

NCT05309356.
New opportunities for the early detection and treatment of cognitive decline: adherence challenges and the promise of smart and person-centered technologies
Authors: He Zhe , Dieciuc Michael , Carr Dawn , Chakraborty Shayok , Singh Ankita , Fowe Ibukun E. , Zhang Shenghao , Lustria Mia Liza A. , Terracciano Antonio , Charness Neil , Boot Walter R.
Published: February 2023

Early detection of age-related cognitive decline has transformative potential to advance the scientific understanding of cognitive impairments and possible treatments by identifying relevant participants for clinical trials. Furthermore, early detection is also key to early intervention once effective treatments have been developed. Novel approaches to the early detection of cognitive decline, for example through assessments administered via mobile apps, may require frequent home testing which can present adherence challenges. And, once decline has been detected, treatment might require frequent engagement with behavioral and/or lifestyle interventions (e.g., cognitive training), which present their own challenges with respect to adherence. We discuss state-of-the-art approaches to the early detection and treatment of cognitive decline, adherence challenges associated with these approaches, and the promise of smart and person-centered technologies to tackle adherence challenges. Specifically, we highlight prior and ongoing work conducted as part of the Adherence Promotion with Person-centered Technology (APPT) project, and how completed work will contribute to the design and development of a just-in-time, tailored, smart reminder system that infers participants’ contexts and motivations, and how ongoing work might build toward a reminder system that incorporates dynamic machine learning algorithms capable of predicting and preventing adherence lapses before they happen. APPT activities and findings will have implications not just for cognitive assessment and training, but for technology-mediated adherence-support systems to facilitate physical exercise, nutrition, medication management, telehealth, and social connectivity, with the potential to broadly improve the engagement, health, and well-being of older adults.
Somatic FGFR2 is Required for Germ Cell Maintenance in the Mouse Ovary
Authors: Bird Anthony D , Frost Emily R , Bagheri-Fam Stefan , Croft Brittany M , Ryan Janelle M , Zhao Liang , Koopman Peter , Harley Vincent R
Published: February 2023

During sex determination in the mouse, fibroblast growth factor 9 signals through the fibroblast growth factor receptor 2c isoform (FGFR2c) to trigger Sertoli cell and testis development from 11.5 days post coitum (dpc). In the XX gonad, the FOXL2 and WNT4/RSPO1 pathways drive granulosa cell and ovarian development. The function of FGFR2 in the developing ovary, and whether FGFR2 is required in the testis after sex determination, is not clear. In fetal mouse gonads from 12.5 dpc, FGFR2 shows sexually dimorphic expression. In XX gonads, FGFR2c is coexpressed with FOXL2 in pregranulosa cells, whereas XY gonads show FGFR2b expression in germ cells. Deletion of Fgfr2c in XX mice led to a marked decrease/absence of germ cells by 13.5 dpc in the ovary. This indicates that FGFR2c in the somatic pregranulosa cells is required for the maintenance of germ cells. Surprisingly, on the Fgfr2c-/- background, the germ cell phenotype could be rescued by ablation of Foxl2, suggesting a novel mechanism whereby FGFR2 and FOXL2 act antagonistically during germ cell development. Consistent with low/absent FGFR2 expression in the Sertoli cells of 12.5 and 13.5 dpc XY gonads, XY AMH:Cre; Fgfr2flox/flox mice showed normal testis morphology and structures during fetal development and in adulthood. Thus, FGFR2 is not essential for maintaining Sertoli cell fate after sex determination. Combined, these data show that FGFR2 is not necessary for Sertoli cell function after sex determination but does play an important role in the ovary.
Trans-Interhemispheric Stereoelectroencephalography Depth Electrode Placement for Mesial Frontal Lobe Explorations in Medically Refractory Epilepsy: A Technical Note and Case Series
Authors: Sharma Nikhil , Mallela Arka N. , Abou-Al-Shaar Hussam , Aung Thandar , Gonzalez-Martinez Jorge
Published: February 2023

BACKGROUND:

Stereoelectroencephalography (SEEG) is an established and safe methodology for extra-operative invasive monitoring in patients with medical refractory epilepsy. SEEG has several advantages such as the ability to record deep cortical structures, mapping the epileptogenic zone in a three-dimensional manner, and analyze bihemispheric regions without the need for bilateral craniotomies. In patients with bilateral hemispheric hypotheses, especially the mesial surface of frontal lobes, bilateral lead placement is compulsory to further define and localize the epileptogenic zone. In this particular cohort of patients, bilateral monitoring may be accomplished from a single entry point using trans-interhemispheric placement of the electrodes. The use of trans-interhemispheric monitoring offers several advantages including sparing the need for additional leads.

OBJECTIVE:

To test the hypothesis that, given the lack of the falx as a limiting structure in the ventral and mesial frontal lobe regions, trans-interhemispheric SEEG placement is feasible and a potential benefit for the SEEG method.

METHODS:

We report on 6 patients who underwent bilateral monitoring using trans-interhemispheric SEEG lead placement and discuss the operative technique.

RESULTS:

Six patients underwent trans-interhemispheric monitoring, with a median of 3 leads per patient (19 total). Trajectory error was minimal (<0.3 mm), and operating room time was comparable with that in previous reports. All leads were placed without adverse events, mislocalization, electrode hemorrhages, or any other complications. All patients had successful localization of the epileptogenic zone.

CONCLUSION:

Trans-interhemispheric SEEG to monitor the mesial wall of frontal lobe regions is technically feasible. No adverse events were observed, suggesting a favorable safety profile.
The baseless mutant links protein phosphatase 2A with basal cell identity in the brown alga Ectocarpus
Authors: Godfroy Olivier , Zheng Min , Yao Haiqin , Henschen Agnes , Peters Akira F. , Scornet Delphine , Colin Sebastien , Ronchi Paolo , Hipp Katharina , Nagasato Chikako , Motomura Taizo , Cock J. Mark , Coelho Susana M.
Published: February 2023

The first mitotic division of the initial cell is a key event in all multicellular organisms and is associated with the establishment of major developmental axes and cell fates. The brown alga Ectocarpus has a haploid-diploid life cycle that involves the development of two multicellular generations: the sporophyte and the gametophyte. Each generation deploys a distinct developmental programme autonomously from an initial cell, the first cell division of which sets up the future body pattern. Here, we show that mutations in the BASELESS (BAS) gene result in multiple cellular defects during the first cell division and subsequent failure to produce basal structures during both generations. BAS encodes a type B″ regulatory subunit of protein phosphatase 2A (PP2A), and transcriptomic analysis identified potential effector genes that may be involved in determining basal cell fate. The bas mutant phenotype is very similar to that observed in distag (dis) mutants, which lack a functional Tubulin-binding co-factor Cd1 (TBCCd1) protein, indicating that TBCCd1 and PP2A are two essential components of the cellular machinery that regulates the first cell division and mediates basal cell fate determination.
A Group-Based, Videoconference-Delivered Physical Activity Program for Cancer Survivors
Authors: Leach Heather J. , Crisafio Mary E. , Howell Matthew J. , Nicklawsky Andrew , Marker Ryan J.
Published: February 2023

Introduction/Purpose

Virtually supervised, group-based exercise presents an innovative way to expand the reach of exercise-oncology programs and help cancer survivors increase physical activity (PA) and connect with other participants. This study examined the feasibility, acceptability, and preliminary effects of a group-based PA program delivered exclusively using videoconferencing software.

Methods

This study used a single-group pre–post design. The 8-wk program consisted of aerobic and resistance exercise sessions once per week and three PA behavior change discussion sessions in groups of four to six. Feasibility was determined by enrollment, retention, safety, and adherence. Postprogram surveys evaluated acceptability using a Likert scale and open-ended responses. Changes in PA (Godin Leisure-Time Exercise Questionnaire), quality of life (QOL; Functional Assessment of Cancer Therapy—General), and upper and lower body muscular endurance (bicep curl and sit-to-stand test) were also evaluated.

Results

Enrollment was feasible (n = 61 of 65 who expressed interest in the program), and retention (86.9%) and adherence (88% for exercise, 91% for discussion) were high; no adverse events were reported. Participants (mean age, 59.9 ± 10.1 yr; 96.2% female; 64.2% ovarian cancer, 28.3% breast cancer, 7.5% other cancer) reported they enjoyed the program (median, 7 of 7), and videoconferencing software was easy to use and had good video and audio quality (median, 5 of 5). From preprogram to postprogram, participants increased their weekly minutes of aerobic (mean (SD) change, 82.4 (144.2)) and resistance (mean (SD) change, 31.9 (42.7)) PA; sit-to-stand (mean (SD) change, 1.4 (3.9)) and bicep curl (mean (SD) change, 5.3 (6.8)) repetitions; and emotional (mean (SD) change, 0.82 (2.3) points), functional (mean (SD) change, 1.2 (3.6) points), and total QOL (mean (SD) change, 3 (7.9) points; all P < 0.05).

Conclusions

A group-based PA program delivered using videoconference technology is feasible and acceptable for cancer survivors, and may increase PA and improve physical fitness and some aspects of QOL. A larger, controlled intervention is needed to determine efficacy, as well as pragmatic studies to directly compare this approach with conventional strategies (i.e., face-to-face programs).
Salário digno e saúde mental: por que se engajar?
Authors: Spinelli Mário
Published: February 2023

As empresas têm papel de relevância em implementar e pagar uma remuneração que possibilite aos trabalhadores não só sobreviverem, como gozarem de uma vida plena em sociedade e com qualidade em aspectos relacionados a questões psicossociais.
Combatendo a corrupção
Authors: Maura Costa Ligia , Stocco Betiol Luciana , Antonio Carvalho Teixeira Marco
Published: February 2023

Agir contra práticas ilícitas é fundamental para alcançar os Objetivos de Desenvolvimento Sustentável, e estão surgindo oportunidades para que as empresas cumpram seu papel nesse sentido.
Uma questão de gênero
Authors: Tonelli Maria José
Published: February 2023

Apesar de as metas do Objetivo de Desenvolvimento Sustentável 5 ainda estarem distantes da realidade, crescem iniciativaspara ajudar as organizações a promoverem igualdade entre homens e mulheres no ambiente de trabalho.
Como remunerar o trabalho?
Authors: Cavalcanti Boucinhas Filho Jorge
Published: February 2023

Salário digno não é apenas salário mínimo, precisa suprir as necessidades vitais dos trabalhadores e de sua família e cumprir indicadores de equidade e de mérito.
Como as empresas cuidam da saúde mental dos seus funcionários?
Authors: Ferreira Paul , Chiodi Appel Taynã , Hungerbühler Ines
Published: February 2023

Pesquisa mostra alta incidência de transtornos mentais entre profissionais no Brasil, mas ações insuficientes para lidar com o problema, e aponta caminhos para mudar tal cenário.
Passo a passo até o impacto
Authors: Rodrigues Juliana , Adriana de Melo Aurélia
Published: February 2023

Propomos adotar a avaliação de impacto como um mecanismo de gestão de empreendimentos sociais, com o uso de indicadores em cada etapa, desde o planejamento de atividades até a obtenção de resultados de longo prazo.
É possível construirmos negócios de mais impacto?
Authors: Wilner Adriana
Published: February 2023

Será que os empreendedores sociais estão conseguindo contribuir para atenuar ou resolver os principais problemas do Brasil?
Large–scale monitoring campaigns of contaminants of emerging concern in the environment employing high-resolution mass spectrometry
Authors: Γαλάνη Αικατερίνη
Published: February 2023

Χιλιάδες Αναδυόμενοι Ρύποι (ΑΡ) απελευθερώνονται από, σημειακές και μη, πηγές ρύπανσης στα επιφανειακά ύδατα. Οι σημειακές πηγές αποτελούν μέσο εναπόθεσης υψηλών φορτίων ΑΡ στο περιβάλλον, διότι οι διεργασίες που εφαρμόζονται στα Κέντρα Επεξεργασίας Λυμάτων (ΚΕΛ) δεν επιτρέπουν την πλήρη απομάκρυνσή τους. Συνεπώς, οι πιο ανθεκτικοί καταλήγουν σε δεξαμενές γλυκού νερού, υπόγεια ύδατα, στο πόσιμο νερό και εισέρχονται στην τροφική αλυσίδα. Η παρουσία τους στην πανίδα απειλεί τη σταθερότητα των οικοσυστημάτων λόγω της τοξικότητας και της βιοσυσσώρευσης σε ζωικούς οργανισμούς που βρίσκονται σε υψηλότερα τροφικά επίπεδα. Παρ’ όλο που ο αριθμός των ερευνών για τους ΑΡ συνεχώς αυξάνεται, η μελέτη της συμπεριφοράς τους στα οικοσυστήματα και το πλήθος των φυσικών και μη διεργασιών που πραγματοποιούνται παραμένει πρόκληση. Ως γνωστόν, οι ΑΡ δημιουργούν σύνθετες μήτρες άγνωστης σύστασης, γεγονός που καθιστά την παρακολούθησή τους πρόκληση, εκτός αν χρησιμοποιούνται προηγμένες μέθοδοι σάρωσης και όργανα τελευταίας τεχνολογίας.Η παρούσα διατριβή διακρίνεται σε τρεις εργασίες που στοχεύουν (i) στον χαρακτηρισμό ΑΡ σε οικοσυστήματα υψηλής περιβαλλοντικής σημασίας (ποταμός Δούναβης) χρησιμοποιώντας προηγμένες αναλυτικές μεθόδους και εργαλεία επεξεργασίας δεδομένων, (ii) στην εκτίμηση κινδύνου και τοξικότητας όσων ταυτοποιηθούν στα δείγματα και (iii) στην εκτίμηση των επιπέδων συγκέντρωσης των ΑΡ σε δείγματα εισροών λυμάτων με τη χρήση Επιδημιολογίας Λυμάτων, ένα χημικό εργαλείο που αντικατοπτρίζει τις συνήθειες και τη δημόσια υγεία του πληθυσμού που εξυπηρετείται από το ΚΕΛ. Λόγω της εν εξελίξει πανδημίας που οφείλεται στη νόσο Corona Virus Disease 2019 (COVID-19) και των μεταλλάξεων του αρχικού στελέχους, θα αναπτυχθεί και επικυρωθεί αναλυτικό πρωτόκολλο που περιλαμβάνει τρία στάδια (προσυγκέντρωση, απομόνωση και ανίχνευση) με σκοπό την εκτίμηση του ιικού φορτίου σε δείγματα εισροών αστικών λυμάτων από την Αθήνα και την ανάπτυξη ενός συστήματος έγκαιρης προειδοποίησης για την εξέλιξη της πανδημίας.