To conduct a successful geomechanical characterization of rock masses, an appropriate interpretation of lithological heterogeneity should be attained by considering both the geological and geomechanical data. In order to clarify the reliability and applicability of geological surveys for rock mechanics purposes, a geomechanical characterization study is conducted on the heterogeneous rock mass of Niobec Mine , by considering the characteristics of its various identified lithological units. The results of previous field and laboratory test campaigns were used to quantify the variability associated to intact rock geomechanical parameters for the different present lithological units. The interpretation of geomechanical similarities between the lithological units resulted in determination of three main rock units . Geomechanical parameters of these rock units and their associated variabilities are utilized for stochastic estimation of geomechanical parameters of the heterogeneous rock mass using the Monte Carlo Simulation method. A comparison is also made between the results of probabilistic and deterministic analyses to highlight the presence of intrinsic variability associated with the heterogeneous rock mass properties. The results indicated that, for the case of Niobec Mine, the carbonatite-syenite rock unit could be considered as a valid representative of the entire rock mass geology since it offers an appropriate geomechanical approximation of all the present lithological units at the mine site, in terms of both the magnitude and dispersion of the strength and deformability parameters.Evaluating the reliability and applicability of geological survey outcomes for rock mechanics purposes.A geomechanical characterization study is conducted on the heterogeneous rock mass by considering the various identified rock lithotypes.The geomechanical parameters of intact units and their associated variabilities are used to stochastically estimate the geomechanical parameters of the heterogeneous rock mass by employing the Monte Carlo Simulation.A comparison is also made between the results of probabilistic and deterministic geomechanical analyses.The results indicate that, in the case of Niobec Mine, the combined syenite-carbonatite rock unit could be considered as a valid representative of the entire rock mass. Site characterization is an essential preliminary phase for implementing a successful rock mechanics program in any underground mining activity. As part of an underground mining plan, site characterization facilitates the subsequent geomechanical classifications by determining the geological settings and lithological characteristics of the area in which the mining activity is taking place. Aside from determining the geological settings and/or hydrogeological characteristics of the mining environment, site characterization contributes in estimation of the strength and deformability parameters of the numerous lithological units identified within the rock mass at the mine site , 2. In fFrom a geological perspective, various intact lithological units can be distinguished based on their lithological and petrographic differences. In some cases, numerous units could be identified within the rock having slight differences in mineral assemblage or alteration intensity , 6. ThisLithological heterogeneity should be considered when estimating the geomechanical parameters of rock masses. Variable lithological compositions along with the presence of geological structures would result in anisotropy and heterogeneity in rock mass properties. Heterogeneity and anisotropy in rock mass geomechanical characteristics, originate from the presence of multiple rock formations having horizons with different alternations , 5. The Different methods for estimating the strength and deformability parameters have been used in geomechanical characterization of rock masses. However, employment of the empirical Hoek–Brown failure criterion in conjunction with the Geological Strength Index (GSI) classification system has been reported to be the most common method for estimation of rock mass properties –11. Convmi values of heterogeneous rock masses. Sari et al. .To eliminate generation of negative and/or false values, the normal PDFs were truncated by using the actual reported minimum and maximum values. Figures D represents the degree of disturbance of the rock mass (ranging from 0 to 1 for undisturbed in-situ rock masses to highly disturbed rock masses) [D is considered equal to 0 for this study.Subsequently, the MCS method was applied to calculate the Hoek–Brown strength and deformability parameters of each rock mass type through Eqs. Each output parameter was generated from 10,000 iterations of randomly selected combinations of input parameters in accordance with their assigned PDF using Latin hypercube sampling algorithm (LHS). The advantage of LHS is that it provides smoother resulting PDFs with fewer iterations by using stratified sampling models. For the sake of simplicity, all the input parameters were assumed as independent variables. Although the dependence of the Hoek–Brown parameters could jeopardize the probabilistic estimation of the output parameters, Sari et al.,  stated tBy the aim of MCS, the variability associated to the output geomechanical parameters were quantified and the Kolmogorov–Smirnov test determined the best-fitted distribution function for each parameter. The mean, standard deviation and best-fitted PDF of strength and deformability parameters for each rock mass type are reported in Table Figures The results of rock mass geomechanical characterization indicated that, similar to the intact properties, the obtained values for syenite and carbonatite rock masses show slight differences and the carbonatite rock mass quality was estimated to be higher than syenite. However, estimated geomechanical parameters for the carbonatite-syenite rock mass were fairly close to the values calculated only for the carbonatite.RocData 5.0 software [D was considered equal to 0 [The software , was useual to 0 . The faiStudying the results of geological and geomechanical characterizations, emphasizes the necessity of adopting an accurate interpretation of data considering both lithological and geomechanical descriptions of a rock mass. In fact, lithological heterogeneity shouldn’t provide a misleading indication on the presence of geomechanical variety throughout that rock mass.In this regard, studying the field and laboratory tests results of different test campaigns at the Niobec Mine, revealed that lithological heterogeneity rather than depth was responsible for the variation in geomechanical properties of the three main identified rock units. Studying the results proved that the largest variations in geomechanical parameters belong to the carbonatitic lithological units either with maximum separation from the syenitic lithological units or with intense alteration to chlorite. In fact, the resulted variability in strength and deformability parameters of intact samples was determined to be significantly defined by the degree of carbonatite alteration. Furthermore, geomechanical characterization of intact samples identified the carbonatitic units with a better quality than syenitic units. Determination of the Mohr–Coulomb and Hoek–Brown failure parameters for each constituent lithological unit and subsequently each rock unit Tables  and 8, rHowever, in geomechanical perspective, the observed difference between the calculated strength and deformability parameters of carbonatite and syenite units, wouldn’t be sufficient enough to justify the assumption of considering them as distinguished units within the intact rock; however, the carbonatite-syenite rock unit provided a quite reasonable approximation of geomechanical properties of the two aforementioned units. Besides, findings of local site characterization programs during the deposit exploitation phases, demonstrated that the nature of rock mass at the Niobec Mine is too complex to be discretized geomechanically and the captured irregularities in the quality of intact rock units are considered to occur in local scales , 35. The89 conversion method. It should be noted that even though this conversion method has been conventionally used in many similar studies, it can be unreliable, particularly for poor quality rock masses and for rocks with lithological peculiarities that cannot be easily incorporated in the RMR calculations. Therefore, it is recommended to estimate the GSI directly and not from the RMR classification. Moreover, due to the lack of data, a same value of GSI had to be considered for all the three identified rock mass units which imposed a limit upon the accuracy of the obtained results through oversimplifying the calculation of rock mass geomechanical parameters for different units.In the rock mass scale, estimation of geomechanical parameters separately for syenite, carbonatite and carbonatite-syenite rock units also determined the quality of carbonatite rock mass to be slightly higher than syenite but fairly close to the quality of the carbonatite-syenite rock mass. Even the dispersions of the estimated strength and deformability parameters, were obtained to be very similar between carbonatite and carbonatite-syenite rock masses Table . The obtUltimately, comparison between the results of deterministic and probabilistic estimation of geomechanical parameters for the particular case of carbonatite-syenite rock mass, proved the significant presence of variability associated to each parameter and inability of conventional deterministic approaches to address them entirely Table . ConventThe results of previously conducted geomechanical and geological field and laboratory tests at the Niobec Mine  were combined to characterize the heterogeneous rock mass by considering the lithological and mechanical properties of identified lithological units’ constituents. The aim of this study was to find a reasonable agreement between the geomechanical parameters in relation to the extensive lithological variability for describing the rock mass properties.The results of intact rock characterization indicated that the carbonatite-syenite rock unit could be considered as an appropriate representative lithology to define the rock mass geomechanical properties. Furthermore, estimated rock mass geomechanical parameters for syenitic, carbonatitic and carbonatitic-syenitic units also indicated that considering the carbonatite-syenite rock mass instead of trying to distinguish the syenite and the carbonatite as separate units provide a reasonable and reliable approximation of the geomechanical quality of rock mass at the Niobec Mine. Moreover, consideration of the carbonatite-syenite rock unit to represent the entire rock mass provides a good agreement between both the geomechanical and geological perspectives. Finally, the use probabilistic approaches instead of conventional deterministic methods in rock mass geomechanical characterization programs are highly recommended since a more realistic portray of the intrinsic nature of rock materials is depicted by considering the inherent variability associated to the geomechanical parameters.


Diagnostics and assessment of the structural performance of collectors and tunnels require multi-criteria as well as comprehensive analyses for improving the safety based on acquired measurement data. This paper presents the basic goals for a structural health monitoring system designed based on distributed fiber optic sensors (DFOS). The issue of selecting appropriate sensors enabling correct strain transfer is discussed hereafter, indicating both limitations of layered cables and advantages of sensors with monolithic cross-section design in terms of reliable measurements. The sensor’s design determines the operation of the entire monitoring system and the usefulness of the acquired data for the engineering interpretation. The measurements and results obtained due to monolithic DFOS sensors are described hereafter on the example of real engineering structure—the Burakowski concrete collector in Warsaw during its strengthening with glass-fiber reinforced plastic (GRP) panels. Aging of the existing infrastructure and dynamic development of new infrastructure in the cities are becoming a growing environmental threat to people. The development of large-scale infrastructure, including deep-founded buildings, is causing constant changes in the groundwater regime, which often intensifies their negative impact on susceptible structures. Conversely, urban areas are exposed to a number of additional factors that shorten the operational life of installations, such as stray currents. All these aspects have a negative impact on the condition of water and sewage infrastructure, especially those components of these systems that were built in the previous century, sometimes using low-quality materials. Leaks and failures may result in contamination of the ground around sewage collectors, as well as contamination of underground and inland waters . It is nThe article describes the concrete sewage collector originally constructed in 1964 and now reinforced with Glass–fiber Reinforcement Plastic (GRP) panels. Such structural components are made of glass fiber reinforced polyester resins. This technology allows to obtain any shape, fitting it to an existing pipeline or sewer cross section .The space between the panels mounted inside and the existing inner walls of the collector was filled with a cement grout. Fitting self-supporting GRP panels inside the existing concrete structure is a process that completely cuts off any access to the original collector structure, making it difficult to assess the phenomena occurring in the original structure and at the interface between different materials. To better understand the complex state of stresses occurring during the retrofit and further operation, a decision was made to use comprehensive structural health monitoring (SHM), which allows to obtain measurement data and to assess the structural performance of the sewage collector—without the need for additional inspections.Warsaw’s sewer network is currently nearly 4200 km long, most of which will require renovation in the coming years. The owner of the network is interested in finding modern monitoring solutions which would make it possible to supervise the process of modernizing the network and its future operation. This will allow more effective quality control of the network, reduce the number of potential failures and extend the life of the renovated collectors.DFOS-based structural health monitoring is pretending to meet the above goals and that is why the pilot installation was conducted within the modernized section of the “Burakowski” sewer collector in Warsaw, Poland.3/s .The Burakowski sewage collector is an important element of the Warsaw sewage system. It was built in the 1960s using the mining method in a concrete casing, with segments of lengths from 2 to 3 m and an internal diameter of approximately 3 m, buried under the ground surface at a depth of 4.5 to 7.5 m . Its purThere are a number of unfavorable external factors in the collector area. The most important ones include the location near the edge of the high bank of the Vistula River and the vicinity of subway and tram lines and stations. A number of modern, high and deep-founded buildings have also been built in the area over the past 15 years. Moreover, in mid-2015, the construction of a new Burakowski Bis collector was completed in the immediate vicinity, along the existing Burakowski collector, which resulted in a number of changes in the environment of the existing collector compared to when it was originally constructed.In 2019, a decision was made to retrofit a 4.8 km long section of the collector using non-circular GRP modules and relining technology . The intassessment of the structural performance of the retrofitted collector structure;tracking the development of cracks identified during the inspection of the existing concrete casing of the collector;behavior of the original collector structure during the renovation works, in particular behavior of the identified cracks and detecting the new ones that occur at key stages of works, i.e., placement of GRP panels inside the collector, gap grouting process, grout setting process;monitoring the mating of GRP modules with concrete casing after completed renovation and during the operation of the renovated section, e.g., in extreme operating conditions (when completely filled).Because of the importance of the Burakowski collector in Warsaw’s sewage distribution system and the applied method of its renovation using standard and split self-supporting GRP panels, the following issues requiring verification were identified:monitor the collector strains along its entire length );locate and monitor the development of cracks and fractures (large measuring range);fully integrate sensors to the monitored object, i.e., concrete collector casing and grout;ensure a possibly high ease of installation, high resistance to the mounting stress as well as harsh environmental conditions.Identification of the abovementioned issues shows the need of application the measurement technique that allows to:The objectives established for monitoring the collector’s longitudinal strain dictated the need for geometrically continuous, distributed fiber optic measurements using DFOS sensors. Fiber optic-measurement technology allows to use Rayleigh, Brillouin or Raman scattering-based techniques for measurement. As a result, it is possible to measure both temperature changes (Raman scattering)  and straThe key task preceding construction of the monitoring system was to select fiber optic elements used to measure strains. A popular and widely used market solution is layered sensing cables. A common feature of all commercially available solutions is their multi layered designs .The need for an operating principle of coatings in sensing cables is explained in a patent application filed by F. Ravet from Omnisens in 2014 (US 2014/0033825 A1—Method And Assembly For Sensing Permanent Deformation Of a Structure). The patent application provides a description and principle of operation for most of the commercially available sensing cable designs. The primary purpose of the coatings in a sensing cable is to protect the optical fiber from rupture. When the fiber reaches the strain assumed at the cable design stage, particular layers of the sensing cable start to slip against each other. The layers split and shift in relation to each other. This behavior of the sensing cable protects the optical fiber from breakage by reducing its strain and, at the same time, it mechanically records the occurring event. Mechanical shifting of the layers sustains the tension of the fiber when external impacts cease, which makes it possible to detect exceeding of the assumed strain threshold at any time . In order for layered sensing cables to fulfill their role, they must be designed and manufactured individually for each system, considering the location of sensors and the expected strain level such that the slippage between the layers of the sensing cable occurs at a precisely defined strain value. This means that it is not possible to use general purpose layered cables for different applications.Layered design of sensing cables allows these layers to slip uncontrolled in relation to each other; thus, it is not possible to unambiguously transfer strain to the internal measuring fiber in the desired strain range. An intuitive example showing the influence of layer slippage effect on the final strain results is presented in Plastic (nonlinear) effects including slippage between intermediate layers but also yielding of steel components in the cable  make it impossible to monitor the current deformation state of the structure, e.g., closing of cracks under the impact of external factors. Such characteristics of layered cables prevent their application for monitoring the strengthened collector described hereafter in the article.The other possible solution is distributed fiber optic sensors (DFOS) designed specially to measure strains of the monitored structure. The sensors consist of a monolithic, composite core in which a measuring optical fiber in its primary coating is integrated during production process (pultrusion). There are no intermediate layers or external coatings, what allows for unambiguous, predictable transmission of strain from the surrounding material  to the measuring fiber inside the core. Additional advantages of the DFOS fiber optic sensors include a wide measurement range of up to ±4%, ribbed or braided external surface that ensures good integration of the sensor and the surrounding concrete as well as a high resistance to the installation process and environmental conditions.Given the requirements: unambiguous strain measurement, no slippage between layers, possibly wide measurement range and resistance to sewage collector operating conditions, monolithic composite DFOS sensors have been selected for the system.The monitoring covered the renovated segment of the Burakowski sewage collector, specifically the section where the structural damage was most significant. The length of the pilot section equipped with sensors was about 146 m . The senTwo types of sensors were installed in the monitored section—see The sensor locations were determined by reference to similar sewage collector and tunnel monitoring systems, including those performed in 2016 as a part of the Grand Paris Express  project All sensors with appropriate lengths were delivered to the site in coils a. Three Sensors installed in grooves are protected from mechanical damage during installation of the GRP modules and properly integrated with the existing concrete casing.The other type of sensor—EpsilonSensor (B)—was used to measure circumferential strains between 120–125 m of the monitored section, where diagonal cracks in the collector walls were visible with an unarmed eye . EpsilonThe measurement sessions were performed using an optical backscatter reflectometer (OBR) from Luna Innovations. This device is based on Rayleigh scattering . The reaStrain measurements were taken during the strengthening works, including the stage before GRP modules were placed inside the collector (zero reading), after the GRP modules were placed (before grout injection) and finally after grout injection. DFOS monitoring allowed to observe structural response of the collector under gradual load changes.A particularly significant effect observed due to the DFOS measurements was revealing the original structure of the concrete collector casing, related to technological breaks during its construction. Increasing load on the concrete casing during the renovation works revealed cracks caused by technological breaks and changes in their widths were carefully analyzed during this process . ConcretBased on the strain measurements acquired from three lines of EpsilonRebars, vertical displacements of the collector caused by the strengthening works (including dead weight of the composite panels and mortar injection) were determined. The analysis was based on the trapezoidal method ,14,15,16The mid-length displacement (settlement) of the collector determined after the grout injection process relative to its ends was about 1 mm, as shown in Identify discontinuities of the collector’s concrete casing (cracks) and observe their development over time. In the analyzed case study, deformations were caused by the dead weight of GRP segments, grout injection used to fill the gap between the new composite panels and old collector, as well as the thermal-shrinkage effect of the cement grout;Determine relative displacements (changes in shape) of the collector along the whole measured section, both in the vertical and horizontal plane. The relative displacements determined in the vertical plane after strengthening were about 1 mm;Measure the temperature distribution along the entire length of the collector. Such measurements can be used to detect leaks through the collector casing. They are also used for thermal compensation, which is one of the key aspects during long term structural health monitoring. In the presented case study, thermal compensation was performed due to two approaches:application of additional optical device based on Raman scattering to obtain temperature profiles along the entire collector. EpsilonRebars were used simultaneously as the temperature sensors;application of additional spot measurements at the start and end point of the collector to obtain reference temperature readings.The application of fiber optic measurements using DFOS sensors with a monolithic core allowed to create an effective monitoring system for a concrete collector reinforced with GRP panels, operating in difficult and variable ground and water conditions. A wide spectrum of information acquired from the sensors may, in the future, contribute to the reduction of required functional inspections carried out directly by the operator. In particular, the system allowed to:In addition, the analysis of changes in the collector strains along its length recorded using distributed fiber optic sensors (DFOS) can provide important information on the structural performance of the collector. An indication of change in tendency (even if changes are minor) at the initial stage of operation helps to plan and carry out remedial work as soon as possible. The ultimate goal is to create a situation where a properly designed, constructed and operated structural health monitoring system will enable an objective assessment of the technical condition of a facility over its entire service life, and inform the users of any abnormalities. The application of distributed fiber optic sensors is a promising solution for these purposes. DFOS can be successfully used to detect and observe phenomena that are typically local in nature, such as steel yielding, junction cracking, concrete cracking, leakages etc. None of the commercially available, conventional spot techniques provide similar capabilities.


The COVID-19 pandemic has impacted all of our lives, but the population most at risk are older adults. Canadians over the age of 60 account for 36% of all COVID-19 cases but 95% of the deaths, and over two-thirds of ICU admissions. Older adults with chronic health conditions are especially at risk. Prior to COVID-19, family caregivers (FCGs) for older adults were managing their caregiving duties at the limits of their emotional, physical and financial capacity. As such, FCGs need special consideration during these times of uncertainty to support them in their role and enable the continuation of care for their older adult family members. This symposium will report on independently conducted studies from across Canada that have examined how the pandemic and associated public health measures have influenced resource utilization by FCGs and the older adults for whom they provide care. McAiney et al’s study examines the deleterious effect of reduced services on community dwelling FCGs and the wellbeing of their family member with dementia. Parmar & Anderson examined the effect of pandemic restrictions on FCGs of frail older adults and found they were experiencing increased distress and decreased wellbeing. Flemons et al report on the experiences of FCGs managing caregiving without critical services and the effect of restrictive visiting policies and the well-being of the caregiving dyad (FCGs and family member with dementia). Finally, McGhan et al will share how FCGs evaluated the efficacy of public health measures and the public health messaging about the pandemic.


The endogenous microbiome of the oral cavity plays an essential role in the development of periodontal disease. It also has a significant pathogenic effect on the inner-vation of the oral cavity organs. The experimental determination of the effectiveness of various drugs is required for the effective treatment of periodontal disease, and this involves the creation of a model of experimental periodontitis. The objective of this series of studies was to determine the possibility of reproduction of the experimental model of periodontitis and the study of the effects of anticholinergic drugs on the development of an experimental periodontitis model. The reproduction of the experimental model of periodontitis was performed by injecting the gums of rats with solutions of pathogenic factors: lipopolysaccharide, hyaluronidase and trypsin. We aimed to study the effect of anticholinergic drugs (pilocarpine and atropine) on the development of an experimental model of periodontitis after the injection of a hyaluronidase solution (2 mg/ml) into the rats' gums. The study was performed on white Wistar rats. Elastase activity, malonic dialdehyde content, urease activity , lysozyme activity (an indicator of nonspecific immunity), and catalase activity (an antioxidant enzyme) were determined in the homogenate of the studied tissues. The results of a comparative study of the effect of three pathogenic factors  on the activity of elastase in different tissues of experimental animals  showed that hyaluronidase has the greatest proinflammatory effect. The action of pilocarpine and atropine was determined with an underline experimental periodontitis model. It was shown that both anticholinergic drugs stimulate the inflammatory process in the periodontium and that anticholinergic drugs enhance the proinflammatory effect of hyaluronidase. According to the literature, the microbiome of the oral cavity occupies an important place in the development of periodontal disease –4. This Other pathogenic factors of microbes are proteolytic enzymes that cause degradation of the protein base  of vascular walls –21. For The objective of this series of studies was to determine the possibility of reproduction of an experimental periodontitis model and the study of anticholinergic drugs effect on the development of an experimental periodontitis model.The reproduction of the experimental model of periodontitis was performed by injecting the rats’ gums with solutions of pathogenic factors: lipopolysaccharide, hyaluronidase and trypsin. The drugs were in the form of solutions of 0.9 % NaCl lipopolysaccharide (1 mg/ml), hyaluronidase (2 mg/ml) and trypsin (5 mg/ml), which were injected into the gums in the molar area in an amount of 0.2 ml per rat.The study was performed on white Wistar rats . We aimed to study the effect of anticholinergic drugs (pilocarpine and atropine) on the development of an experimental model of periodontitis after the injection of hyaluronidase solution (2 mg/ml) into the gums of rats. In order to achieve this, the rats were previously given oral applications of gels with pilocarpine (2 mg/ml) or atropine (0.2 mg/ml) for two days. The rats were euthanized under thiopental anesthesia (20 mg/kg). Three hours after hyaluronidase injection, the gums and dental pulp were isolated, and blood serum was obtained.The level of biochemical markers of inflammation was determined in the homogenate of the isolated mucosa: elastase activity and malondialdehyde content, urease activity , lysozyme activity (an indicator of nonspecific immunity), and catalase activity (antioxidant enzyme) . AccordiAll the results of experimental studies were processed using standard statistical techniques .Previous experiments have shown that significant pathological manifestations of pathogenic factors are detected after 3 hours. The activity of the proteolytic enzyme elastase was chosen as an indicator of inflammation. It is produced by leukocytes, and the increase of its activity indicates leukocyte infiltration of the studied tissue, which is an important pathogenetic sign of the inflammatory process.The results of a comparative study of the effect of three pathogenic factors  on the activity of elastase in different tissues  are presented in The results of this series of experiments became the basis of the hyaluronidase use for the experimental periodontitis model.The effect of modulators of the autonomic nervous system (pilocarpine and atropine) on the development of acute experimental periodontitis after the injection of a hyaluronidase solution (2 mg/ml) into the rats' gums was studied in the next series of experiments (15 rats). To perform this, the rats were previously given oral applications of gels with pilocarpine (2 mg/ml) or with atropine (0.2 mg/ml) for two days. Rats were euthanized 3 hours after the hyaluronidase injection, and gums and dental pulp were isolated, and serum was obtained. The biochemical parameters of the rats' gums were determined, and the results are presented in The presence of an inflammatory process in the periodontium is evidenced by a significant increase in the activity of elastase (by 22.5%). Applications of gels with pilocarpine or atropine slightly reduce elastase activity, but it remains significantly higher compared to intact rats. Both anticholinergic drugs (pilocarpine and atropine) significantly increase the malondialdehyde content compared to its level in rats with an experimental periodontitis model (control).Applications of gel with pilocarpine significantly reduced catalase activity and the API index. Gel applications with the proposed drugs did not reduce catalase activity. However, they reduced the API index to some extent. As for the levels of urease and lysozyme, they were not significantly reduced in the experimental periodontitis model after the application of anticholinergic drugs.We performed a comparative study of the effect of three pathogenic factors  on elastase activity in different tissues of experimental animals , and we found that hyaluronidase has the greatest proinflammatory effect. It has been established that hyaluronidase exceeds the proinflammatory activity of trypsin and even intestinal endotoxin lipopolysaccharide. We also found that anticholinergic drugs enhance the proinflammatory effect of hyaluronidase: they increase elastase activity, malondialdehyde content and significantly reduce catalase activity, API index, alkaline phosphatase activity, and increase acid phosphatase and lysozyme activity.As a result of the first series of experimental studies, an experimental model of periodontitis was developed using one of the pathogenic effectors of bacteria, namely hyaluronidase, which can significantly increase the permeability of bacteria and their toxins into periodontal tissues.


Research on intergroup contact suggests that negative contact experiences affect cognitive representations such as stereotypes more strongly than positive contact experiences. To comprehensively examine the full effect of intergroup contact, the valence of the contact experience as well as the affective and cognitive dimensions of prejudice should be assessed. In ageism research, previous studies typically focused only on contact of positive valence and were limited to the perspectives of younger individuals on older adults. Primary objective of this study is to examine both positive and negative contact frequency and their relation to affective and cognitive dimensions of ageism from the perspectives of younger adults between the age of 18 and 25 (study 1) and older adults between the age of 60 and 92 (study 2). Consistent with previous research on intergroup contact, our results confirm that both types of contact were similarly predictive of affective facets of prejudice. However, only in study 2 that assessed older adults’ agreement with contemporary stereotypes about young men and women, negative compared to positive contact frequency proved to be a stronger predictor of the cognitive dimension of ageism. Our findings emphasize the importance of focusing on all dimensions of prejudice and highlight the need to consider the perspectives of young and old in ageism research.


This special issue was inspired by Grigoryev et al.  on ethniWhile many of the papers in this volume incorporate these cognitive functions of stereotypes, they go beyond these basic acts of perception, categorization, attribution, and generalization that give meaning to intercultural interaction and intergroup anxiety. They deal also with the processes of evaluating members of the groups , and then to acts ranging from discrimination to inclusion as the static and dynamic aspects of intercultural relationships. All these individual psychological processes are embedded in the general sociopolitical group contexts that incorporate the history of intergroup relations, their mutual images, the extant institutional and systemic values, and the established collective practices that may act against some groups but privilege others.This special issue consists of 13 articles by 46 scholars from 15 countries that address both personal and cultural stereotypes for which insights from the Stereotype Content Model  of locals in Portugal and the US.The first three articles include an examination of the cognitive sphere of non-dominant groups . Lutterbach and Beelmann addressed personal stereotypes by refugees toward host society members and their perceptions of discrimination provoked by host society members to analyze their associations with the refugees' shared reality and acculturation orientations in Germany. The article claims that contextual and everyday discrimination experiences prevent integration because they reduce the motivation to adopt aspects of the host culture, reduce the perception of shared reality between the cultural groups, and increase the motivation to maintain one's own culture among refugees holding strong positive sociability stereotypes toward the host society members. Hence, increased discrimination experiences are likely to lead to a disillusioning effect included separation acculturation strategies among refugees who actually had the potential to integrate into the host society.Urbiola et al. investigated the relationships between personal stereotypes and the acculturation preferences of Spanish and Moroccan origin adolescents in Spain. The article claims that it connects the literature of acculturation and intergroup relations in an interactive way instead of studying the predictive role of stereotypes or acculturation perceptions in isolation. For example, stereotypes would play an important role in majority members' acculturation preferences when they perceived that minority youth were not adopting the host culture because it is a more threatening situation than when minority group members are adopting the host culture. Moreover, this work illustrates the importance of the concept of mutuality in the study of acculturation  and negative  appraisal of immigrants, and contact. The article shows how the relationships between variables differed by immigrant groups based on cultural stereotypes that were related to the social structural characteristics of these groups. The results strengthen a theoretical conceptualization that posits an indirect relationship between individual value preferences and behavior through both positive and negative group appraisal. We find this as a good example of the group-specific approach within the SCM for how, considering threats (and benefits as well) separately, one can form a consistent threat profile for each target group  based on the Justification-Suppression Model. The article considers the full path from the ideologies to the expression of stereotypes by investigating how the Laïcité norms can set the stage for specific regulatory strategies: (1) to prevent prejudicial attitudes but which can lead to unexpected consequences on stereotyping within the Historic Laïcité context  and (2) to help realize prejudice within the New Laïcité context . This analysis expands our understanding of the functioning of intergroup ideologies in specific cultural contexts . The results supported their hypothesis that compared to low-attitude-strength networks; high-attitude-strength networks of evaluations had a stronger degree of global connectivity, i.e., the higher connectivity between the evaluations on different aspects of anti-Roma bias .Javakhishvili et al. applied the SCM and the BIAS map in Georgia (the former Soviet Union republic from the South Caucasus) to evaluate English and German speakers globally. The article shows some features of evaluation of representatives of large and powerful countries by people from small countries, including the implication of a unique set of perceived socio-structural variables  and culturally specific meaning of emotions.Hakim et al. experimentally examined the stereotype of Muslims as being either moderate or radical to add the findings of these subtyping to the adverse implications of concepts with positive guises. The article claims that the endorsement of these Muslim subtyping  can be translated into support for aggressive military and social policies toward Muslims in the US.Findor et al. used a representative sample of ethnic Slovaks and two target ethnic minority groups (stigmatized: Roma vs. non-stigmatized Hungarians), whereas, Bye used the data from the Norwegian Citizen Panel and asylum seekers as the target group to experimentally examine the effect of response instruction . The results of both highlight the importance of the distinction between cultural stereotypes, which are shared by members of a particular society, and personal stereotypes, which are beliefs of individuals about groups. Social perceivers can recognize a common belief about groups, even if they do not personally endorse it  and systematic patterns of stereotype content and ingroup favoritism.Further, the methodological contribution continues due to the appeal to an issue of non-Western face perception. Knutson integrated the scientific study of stereotypes within the SCM with a literary-theatrical exploration of stereotyping. The article demonstrates how theater performance can sometimes embody the dynamic for Jew stereotype traced by the BIAS map, from cognition to affect to behavior.Finally, We hope that the collection facilitates wide interest in stereotypes as the heart of intercultural relations and as the ways individuals grapple with the many different kinds of knowledge they have about cultures and of their understandings of communication.DG wrote the first draft of this paper. JB and AZ reviewed and edited the draft to finalizing it. All the authors approved the submitted version of this paper.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


The declaration of any public health emergency in the Democratic Republic of Congo (DRC) is usually followed by the provision of technical and organizational support from international organizations, which build a parallel and short-time healthcare emergency response centered on preventing the extension of health emergencies across the countries and over the world. Previous Ebola virus disease (EVD) outbreaks have highlighted the need to reinforce the healthcare sector in different countries.Based on the difficulty to implement the International Health Regulations (2005) to the local level of affected countries including the DRC, this paper proposes a multidisciplinary model based on the health zones through the strengthening of preparedness and response structures to public health emergencies vis-à-vis the existing weak health systems existing in DRC. A commitment to integrating the emergency response in the existing health system should work to reduce the tension that exists between local recruitment and its impact on the quality of daily healthcare in the region affected by EVD outbreak on one hand, and the involvement of international recruitment and its impact on the trust of the population on the emergency response on the other. This paper highlights the provision of a local healthcare workforce skilled to treat infectious diseases, the compulsory implementation of training programs focused on the emergency response in countries commonly affected by EVD outbreaks including the DRC. These innovations should reduce the burden of health problems prior to and in the aftermath of any public health emergency in DRC hence increasing the wellbeing of the community, especially the vulnerable people as well as the availability of trained healthcare providers able to early recognize and treat EVD. The declaration of any public health emergency is followed by the provision of technical support from international organizations to individual countries to limit the widespread of infectious diseases , 2. As aEVD outbreak is associated with important implications in concerning countries such as lack of trust in the government, food insecurity, loss of domestic income, stigmatization, impaired provision of healthcare, and disruption of school activities . During While conducting the analysis and reviewing the challenges identified during the tenth EVD outbreak in DRC, this paper proposes an alternative model based on a health system able to respond to future outbreaks that involve community engagement, the provision of skilled healthcare workers, and perform the quality of healthcare during outbreaks. Similar to the EVD outbreaks in the West-African region which caused 11,310 deaths and produced more than 17,300 orphans, the tenth EVD outbreak in DRC was marked by the declaration delay of a public health emergency, the contact tracing in an insecure setting, the lack of funds, the overwhelmed healthsystems, and the disruption of preventive interventions including immunization, HIV/AIDS, and tuberculosis prevention .The Health System in the DRC is based on three levels namely the central, intermediate, and operational levels Fig. . The impThe DRC healthcare system is affected by the impoverishment of nearly 70 % of the population including health workers; poor adoption of the Health System Strengthening Strategy adopted in 2005, unequipped infrastructure, impaired supply of drugs into health facilities, multiples labor strikes motivated by poor salary, as well as the paucity of trained health workers . This heThe history of emergency response to outbreaks has been linked to the early attempts to implement a commitment focused on anticipatory actions and the performance of the health system . In the Instead of recruiting the local healthcare workers as the emergency responders in an outbreak situation, international response staff was used during the tenth EVD outbreak. The massive participation of international staff workers involved in the emergency response team and their increased salary compared to local health workers lead to increased community resistance illustrated by the burns of Ebola treatment facilities and the murder of Richard Valery Mouzoko, a WHO staff on April 19, 2019, in Butembo city, located in North-Kivu province . AlthougA functional health system focused on the preparedness and response services in health emergencies  should bThe tenth EVD outbreak has constituted a clear opportunity to build the capacity of a strong health system in DRC via the training of a local healthcare task force , and theThe management of the tenth EVD outbreak in DRC has tinted the reinforcements of the health systems by enhancing primary and specialized healthcare capacities either during a global crisis or in normal conditions. This sustained approach Fig.  may provFirst, the emergency response against EVD outbreaks is usually impaired by community resistance. However, the experience of global health security in the previous public health problems showed that community resistance is encouraged by the non-recruitment of local practitioners and the lack of funds . In UganSecondly, the lack of local healthcare workers trained to manage a public health emergency in North-Kivu and Ituri has affected the EVD outbreak, called for international healthcare workers, and increased community resistance . BuildinThirdly, monitoring, contact tracing, and supervision have been criticized over the years in their methods of handling infectious disease outbreaks. However, the close monitoring and the recruitment of local healthcare workers and community leaders have shown a positive result during the response against the tenth EVD outbreak. Also, trained staff should be encouraged to conduct continuous monitoring and supervision of health facilities with special attention to the cause of outbreaks. Given that the communication is impaired between the health facilities of different levels of the ministry of health and the community, the use of available means of communication such as community radios and community outreach programs could promote awareness of health problems and quick health communication. The extension of the job description of community health workers to address public health challenges and to support the appropriate management of many diseases at the community level should be supported .The lack of ambulances and means of communication especially in rural health zones impaired the chain of early treatment from the community, primary health facilities, and the Ebola treatment center.The occurrence of EVD outbreaks in DRC, commonly in rural and armed conflict settings, demonstrated the role of delayed consultation of health facilities by patients in the early recognition of outbreaks. This delay is caused by the lack of money for the affected patients. Therefore, the promotion of a free-of-charge healthcare service should be promoted up in health zones with a high risk of outbreaks, during or out of global health crisis.This paper proposes a multidisciplinary model made to increase the health system capacity in regions concerned with public health emergencies including DRC, especially in North Kivu and Ituri provinces. This model will be applied by the Ministry of Health and other related agencies involved in public health emergencies including WHO, especially in armed conflict and developing settings. This model is based on two main assumptions: firstly, the model centered on the IHR 2005) may increase the community resistance; modulates the worseness of the health system during the outbreaks, and impaired the management of common health problems [ may incrThe integrative model may reduce the delay of outbreak recognition and modulates the early contact tracing and contention of an outbreak in an efficient way. Therefore, the shift from a model based on a short-term parallel health system into an emergency response model integrated into the existing health systems could accelerate the elaboration of this model . Given tThe tenth EVD outbreak in DRC has revealed the need for new approaches to strengthen the weak health systems in developing countries. The lessons from previous outbreaks have emphasized the integration of the emergency response into the existing health system. There is a need to set up the reinforcement of the operational health level to perform the readiness and preparedness against any public health emergency. Therefore, the multidisciplinary model centered on the health zone is proposed to fight infectious diseases that cause outbreaks. The trained health workers on providing emergency health care services are required as well as support from international organizations for effective management of health emergencies and disease outbreaks the first time. Finally, a monitoring system by the central and intermediary level of the ministry of health in these countries must be instituted, which should be supported and supervised by the WHO.


Introduction: Nowadays, the final success of implantation is not only based on obtaining osseointegration of the implant but is also determined by achieving a satisfactory aesthetic effect of the soft tissues surrounding the implant, which can be defined as an aesthetic integration. The process of obtaining this aesthetic integration already begins at the stage of placing the healing abutment, which allows us to obtain the emergence profile necessary for our prosthetic reconstruction. Materials and Methods: The study used cone-beam computer tomography (CBCT) scans of 51 patients. The measurements of the maxillary teeth  were performed from cross-sections of the individual teeth at the transition zone to design a custom anatomic healing abutment milled from zirconium and luted to the non-index Ti-base. Results: The obtained results allowed to design and create the shape of the anatomic healing abutment. Conclusions: The use of laboratory-produced anatomical healing abutments is possible and may allow to obtain the desired and planned emergence profiles of prosthetic restorations. In addition, it might be a method of reducing work time at the dental chair but further clinical trials are necessary. One of the greatest challenges of modern implantology is to achieve beautiful and natural aesthetic results. The key to achieving this is the maximum preservation or reconstruction of hard and soft tissues around the implant.Current guidelines for successful therapeutic implantology treatment are based on the evaluation of the implant and restoration survival, dento-gingival aesthetics, rate of mechanical complications, and the bone levels and health of surrounding soft tissues ,2,3. TheThe soft tissues at the implant have the characteristics of scar tissue, which is the cause of reduced resistance to damaging factors such as the inflammation due to bacterial plaque. This characteristic feature makes it very important to produce the corresponding anatomical structure of the soft tissue around the implant as well as the corresponding shape of crowns and bridges capable of maintaining a high standard of oral cavity hygiene . This prPrefabricated standard healing abutments have a circular cross-section. They are produced in various sizes and heights, and are usually made of titanium ,20. The The healing response around abutments can be evaluated and the soft tissue around the fixtures can heal according to the contours of the definitive prosthesis . The cirIn this study, randomly selected CBCT scans of patients from the database were used regardless of the gender and age of the patient. In the research group, CBCT scans were from 30 women aged from 19 to 65 years and 21 men aged 18 to 69 years, and were randomly selected by two independent researchers. The scans of patients with tooth shape disorders, numerous fillings, and metal scattering problems were disqualified. The scans were originally made for diagnostic purposes due to planned dental treatment. The study had the consent of the bioethical commission at the Regional Medical Chamber in Gdańsk (registration number KB-13/18 approved 25May 2018). The commission operates in accordance with the principles of good clinical practice.To analyze anatomic crown ratios, the measurements were taken from CBCT scans of the maxillary teeth: central incisor, lateral incisor, canine, first premolar, and first molar made on cross-sections of individual teeth at the place where the tooth comes from bone tissue into the soft tissue (transition zone). Four measurements were made in millimetres on each cross-section . Two independent researchers made the measurements . The L1 At total of 51 patients were included in this study. Out of 51 patients, 59% (30) were females and 41% (21) were males .The received results allowed to design the shape of the individualized anatomical healing abutment for each group of the teeth mentioned . The ariIn order to achieve success in implantology treatment, it is highly beneficial to understand the importance of proper designing and the obtaining of the emergence profile. The aim of this study was to design an anatomically stock-healing abutment. We can manage the healing of tissues around the implant by using customized prosthetic elements such as healing abutments or connectors between the implant and the crown. Due to the use of such solutions, the tissue healing process is possible to plan and is more predictable, which results in a better aesthetic effect ,2,3.When striving to obtain the best fitting natural representation, we should come as close as possible to the physiological anatomy of the dental and surrounding structures. The use of standard prefabricated implant prostheses such as the healing abutment to shape the emergence profile is an unpredictable procedure. These screws are made in a shape of which the cross-section is circular: in no way does this shape mimic the natural anatomy of the crown and the root of the tooth ,30, whicThe use of existing CBCT scans taken from the research group allowed us to obtain a cross-section of dimensions needed to obtain average values in four dimensions  at the entry of the tooth into the bone structure (transition zone) for the central incisor, lateral incisor, canine, first premolar, and first molar in the upper jaw. The obtained results allowed to design the shape of the individualized anatomical healing abutment for each group of teeth mentioned. None of the profiles received were of a rounded profile due to the detailed measurements, making it feasible to get as close to the natural anatomy as possible. Having such an anatomically shaped healing abutment offers the possibility to control the process of soft tissue healing around the implant either immediately after implantation or after the integration period and after unveiling the implant without the necessity to establish additional visits with the patient or long procedures involving the use of additional materials needed for standard healing abutmentThe material from which the implant and prosthetic components are made should be mechanically stable (abutments) and maximally biocompatible . In the studies by Abrahamsson et al. performed on animals, materials for making abutments were tested . The abuWhile selecting material for customized implant abutments, recent advances in milling technology recommend two materials: zirconium and titanium . TitaniuThe meta-analysis by Linkevicus et al. showed statistically significant superiority of Zr abutments over Ti abutments in developing natural soft tissue colour and a superior aesthetic PES score . When deNowadays, this material is also relatively inexpensive, thanks to which it is possible to create a highly biocompatible and economic implant-prosthetic solution that is an individualized anatomical pre-fabricated healing abutment.The present study is a preliminary report on an innovative method of using clinical data for the construction of anatomical healing abutments made of biocompatible material, namely zirconium and available chairside without additional time-consuming visits or protocols. Further clinical trials, which are currently underway, are needed to determine the results of the study and compare its effectiveness with other solutions practiced so far.The use of dental implants in the treatment of missing teeth is a predictable treatment at the osseointegration stage. The use of individualized healing abutment allows to achieve this predictability in the healing process of soft tissues surrounding the implant and in the formation of the emergence profile. The obtained CBCT measurement results allowed to design and create the shape of the anatomic healing abutment, milled from biocompatible zirconium and luted to the non-hexed Ti-base.The use of laboratory-produced anatomical healing abutments is possible and may allow to obtain the desired and planned emergence profile of prosthetic restoration. It might also be a method of reducing work time at the dental chair but further clinical trials are necessary.


The long road of establishing an accreditation entity began in August 2010 when the AGHE Accreditation Task Force was convened. After numerous meetings complete with loud and vigorous debates, AGEC, the Accreditation for Gerontology Education Council emerged in 2016. Over the subsequent years, the Standards hit the hard road of reality leading to various revisions to the Handbook. The symposium’s first presentation concerns the history of AGEC and its further development into an independent entity. The key purpose of AGEC is assuring gerontology programs educational quality and enhancement governed by the principle of self-evaluation and peer review that engenders trust. The next presentation discusses the marketing aspect of AGEC built on getting feedback from the public. One of the outcomes of conducting focus groups and surveying the public is the discovery that prospective students really see the value of accreditation. The penultimate presentation focuses on refinements to procedures alluded to in the first presentation in response to the feedback received in meeting with institutions and faculty about what accreditation offers to students, stake-holders, and ultimately the older adults served by the graduates in the work force. The key goal is to clarify the expectations and simplify the application process. On no other issue has more time been spent than on the assessment of students’ competency. Our last presentation explains competency-based education consisting of well-articulated student learning outcome measures that are consonant with the program’s mission that lead to "closing the loop" of continuous and durable improvements in the learning environment.


The surgical management of Laryngeal webs is challenging and is associated with a high recurrence rate due the presence of opposing raw mucosal surfaces of the vocal cords, especially near the anterior commissure which causes re-scarring. We describe an endoscopic technique of mucosal flap lateralization (MFL) with ultrasound guidance, which prevents the apposition of the anterior raw surfaces of the vocal cords after web incision, thus avoiding recurrence. Congenital Laryngeal webs (LWs) are rare entities and are classified based on the percentage of vocal cord involvement and the presence of subglottic extension as given by Cohen –3. PreseWe describe an endoscopic technique of mucosal flap lateralization (MFL) with ultrasound guidance, which prevents the apposition of the anterior raw surfaces of the vocal cords after web incision, thus avoiding recurrence.The present surgical technique is described in a 15-month-old otherwise healthy child with Type 2 Laryngeal web  who presThe surgical technique can be viewed in the The surgery is performed with the patient under spontaneous ventilation using a combination of propofol and sevoflurane. After direct laryngoscopy and rigid bronchoscopy, an appropriately sized Benjamin Lindholm laryngoscope  is introduced for laryngeal exposure which is placed in suspension with the aid of a self-retaining laryngoscope holder  secured to a Mayo stand. A vocal fold spreader is placed in order to completely expose the anterior glottic web till the anterior commissure. The microscope is then brought into the field and after implementation of all laser safety precautions, a straight handheld CO2 laser set at 2W, 20mj ultrapulse repeat mode  is used to incise the laryngeal web close to the edge of the right vocal fold .The thin mucosal flap is then subsequently wrapped on to the left vocal fold which is then lateralized using an ultrasound guided exo-endolaryngeal technique of suture lateralization, which we have described in detail previously . In brieA 2 months follow up, revealed no evidence of recurrence of the laryngeal web with significant subjective improvement in voice . The resThe biggest challenge in the endoscopic management of LWs is to prevent apposition of the anterior vocal folds to avoid rewebbing. The present technique of mucosal flap lateralization provides a method of maintaining distance between the anterior vocal cords, preventing contact of raw mucosal surfaces. The use of ultrasound guidance for accurately predicting the trajectory of the needle assists in precise placement of the endolaryngeal stitch avoiding multiple passes and preventing injury to the delicate laryngeal mucosa.A multitude of surgical techniques have been described for avoiding juxtaposition of the anterior vocal cords after LW excision. The most widely used is endoscopic excision and placement of a silicon keel. However, keel placement has been associated with a high recurrence rate of 10–30% . Also, kThe present technique provides a way of keeping the anterior vocal fold raw mucosal surfaces separated till complete healing has taken place of the contralateral vocal cord. The ultrasound guided exo-endolaryngeal technique of suture lateralization has been previously described by our team for the management of bilateral vocal cord paralysis . We haveThe authors preference is to use flexible fiber CO2 laser for the incision of the LW, however cold steel microlaryngeal instrumentation can also be used to achieve similar result. The ultrapulse mode of laser emission provides control and precision while reducing the damage to the surrounding tissues. The flexible fiber laser helps in greater maneuverability in the limited space of the pediatric larynx. Preloading the needles with sutures and making sure that they can easily slide through the needles will ensure that the surgical procedure runs smoothly. The external puncture site is critical and should be 1.5 cm lateral to the midline at the level of the vocal cords which can be determined with the help of ultrasound guidance. The ultrasound probe is used in the axial plane with an in-line axis needle approach which allows for visualization of the whole trajectory of the needle, accurately placing the needle in the anterior part of the vocal cord, while preventing repeated passes. The suture is tightened over a silastic button to avoid cutting through the soft tissue and buried underneath the strap muscles to avoid extrusion and stitch abscess. While tightening the suture it is important that the stitch is being visualized endolaryngeally to achieve minimal laterization to avoid increased separation of the vocal cord which might lead to aspiration. For LWs with greater glottic involvement multiple sutures can be placed in order to achieve mucosal flap lateralization. The simplicity of the technique makes it an option for management of children with predominant voice symptoms rather than waiting in this subset of patients till school age.The major drawback of the technique is the possibility of producing aspiration. In the present case transient choking was noticed which resolved after adequate pain management. Even if postoperative aspiration is noticed, it will be transitory, as the suture is cut within a week of placement. Another surgical risk is the possibility of glottic and subglottic trauma secondary to multiple needle passes. However, with the assistance of ultrasound, we were able to complete the procedure in a single needle pass. The technique is also a two-stage procedure and warrants a second stage to take down the suture and excise the redundant mucosa on the left vocal fold. However, most techniques described for the management of LWs require a second stage for removal of an endoscopically placed keel. Also, the technique is of limited value in case of subglottic extension and hence is not an option for Type 4 LWs.Future studies using a larger sample size and outcome analysis regarding the tissue impact, and technical ease should be undertaken to demonstrate the effectiveness of this technique.We propose an ultrasound guided mucosal flap lateralization technique for management of laryngeal webs which is a simple way of avoiding vocal cord apposition and preventing recurrence of LWs.The original contributions presented in the study are included in the article/The studies involving human participants were reviewed and approved by University of Iowa IRB No: 20210205. Written informed consent to participate in this study was provided by the participants' legal guardian/next of kin.SK contributed to the idea, writing of the manuscript, and final approval.The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


Female infertility is the main reason for involuntary childlessness nowadays. The overall trend toward postponing parenthood toward a more advanced female age in most of the economically developed countries is certainly partly, though not exclusively, responsible for this trend. A number of age-independent factors, related to professional gametotoxic exposures and other independent environmental factors can also come into play. The impact of all these factors in each individual woman is conditioned by her genetic and epigenetic background.Apart from the known genetic  and epigUnlike the most studied mammalian models, the maternal-to-embryonic developmental control transition occurs later in humans. The first signs of embryonic RNA synthesis (transcription) were observed in the nucleoli of four-cell human embryos , while eThe relatively late onset of embryonic gene expression in human embryos underscores the importance of the molecular events taking place during oogenesis, so as to endow the future embryos with an appropriate stock of maternal mRNAs as well as of the molecules controlling their coordinated translation before, during, and after the embryonic genome’s activation . These mThe oocyte-derived epigenetic patterns controlling early embryonic development are no less important than the genetic ones . In factThe information derived from the studies focused on the above aspects of the relationship between oogenesis and the early embryogenesis can serve as a guide for further in-depth analysis of the molecular particularities that can guide a doctor to design the optimal diagnostic and treatment strategies for each individual patient. A failure of implantation and early pregnancy loss, independent of embryo quality, is another possible cause of female infertility . In addiPreserving genome integrity during the cleavage stage of early embryogenesis is another essential goal to be achieved by the embryo, with regard to its potential to generate multiple, distinct cell lineages . A mammaThe ability of the oocyte to repair sperm-derived DNA damage represents another challenge for future research. Sperm DNA damage is known to cause genomic instability in early embryonic development . HoweverWe still need more high-quality studies to suggest ways to improve female fertility status by increasing the quality of oocytes in women of any age. The mechanisms responsible for both the physiological  and premThis Special Issue aims at advancing our knowledge and understanding of how to design molecular studies in both humans and animal models and to use and interpret their results to improve different aspects of oocyte quality related to the success of both natural and assisted reproduction outcomes. The data obtained from both humans and different animal models will be used to predict the risk of premature ovarian decay and the ways to prevent it, the molecular diagnostic of the existing issues, and the ways to act in each individual case, also taking into account the condition of the male partner. The synthesis of these analyses will serve to determine (1) the need for taking therapeutic actions, (2) the degree of urgency of the actions to be taken, and (3) the possibility of adopting a wait-and-see approach in patients who either do not have a stable male partner or in whom immediate action is not currently necessary.


The lack of transparency in the methodology of unit cost estimation and the usage of confidential or undisclosed information prevents cost comparisons and makes the transferability of the results across countries difficult. The objective of this article is to compare the methodologies used in the estimation of the cost of a day case cataract extirpation that are described in the official and publicly available sources and to study how these translate into different unit cost estimates.A literature review was conducted to identify the main sources of unit costs of cataract extirpation. A semi-structured questionnaire to obtain information on national costing methodologies was developed and sent to consortium partners in nine European countries. Additionally, publicly available sources of unit cost of cataract surgery in those countries included in the European Healthcare and Social Cost Database (EU HCSCD) were analysed.The findings showed a considerable diversity across countries on unit costs varying from 432.5€ in Poland (minor degree of severity) to 3411.96€ in Portugal (major degree of severity). In addition, differences were found in the year of cost publication and on the level of detail of different types of cataract surgery. The unit of activity were Diagnosis-Related Groups in all countries except Slovenia. All unit costs include direct costs and variable overheads (except Germany where nursing costs are financed separately). Differences were identified in the type of fixed overheads included in unit costs. Methodological documents explaining the identification, measurement and evaluation of resources included in the unit costs, as well as use of appropriate cost drivers are publicly available only in England, Portugal and Sweden.We can conclude that while unit costs of cataract extirpation are publicly available, the information on methodological aspects is scarce. This appears to pose a significant problem for cross-country comparisons of costs and transferability of results from one country to another.The online version contains supplementary material available at 10.1186/s12962-022-00346-3. Untreated cataracts are the leading cause of blindness worldwide and the second leading cause of visual impairment. It causes the opacity of the eye lens leading to blurred or reduced vision. The only effective intervention is a surgical operation that involves the removal of the blurred lens and subsequent implantation of a lens . CataracEconomic evaluation is an important tool for adoption and reimbursement of health technologies. The lack of transparency in the methodology of unit cost estimation and the usage of confidential or undisclosed information prevent cost comparison, which, in turn, makes the transferability of the results across countries difficult. The European Commission (Horizon 2020) project IMPACT-HTA aimed to understand the variation of costs across European countries. One of the outcomes of this project was the European Healthcare and Social Cost Database (EU HCSCD), a minimum common dataset of international costs  which can feed into health-economic evaluations and enable transfer of models across countries . All cosThe objective of this article is to analyse and compare official and publicly available sources of cost of cataract extirpation in nine European countries included in the EU HCSCD.A literature review was carried out consulting PubMed and Scopus databases to identify articles estimating the cost of cataract extirpation that were published after 2005 in English, Spanish and French. This search was completed with an additional search on Google Scholar. The search terms used were: . The literature search was verified by a librarian with an extensive experience in the field of public health. The reference lists of relevant studies identified from the search were also reviewed. The objective of the literature review was to identify the sources of costs and/or tariffs of cataract surgery and ensure that there were no additional publicly available sources to those included in the EU HCSCD.The methodology used to construct DRG costs has been described in some detail by previous EC projects HealthBASKET  and EuroNo ethical approval was required since we were not dealing with patient data.The literature review retrieved 54 articles; five articles were based on unit costs obtained from publicly available databases. A PRISMA diagram is provided as Additional file Table Significant variability in the level of detail of different types of cataract surgery was observed. Thus, there were countries that showed up to 9 different costs depending on type of the procedure or degree of complexity (England), while; other countries published a single cost of the procedure . The unit of activity was DRG in all countries except in Slovenia, where the estimation of cost was based on the breakdown of various cost items  included in the procedure . The DRGAgence Technique de l’Information sur l’Hospitalization; ATIH) from the social health insurance point of view. The health insurer in France does not reimburse the hospital for the full DRG tariff; a proportion of the tariff must be paid by the patient or by an additional insurance [Another important finding relates to the differences between DRG costs and DRG tariffs. In England, each cataract surgery subtype has both DRG costs (referred in England as reference costs)  and DRG nsurance . No offinsurance . Spain hOne of the findings of this study is that detailed documents explaining how the resources are identified, measured and valued, what type of cost drivers were used in estimation of costs and what type of resources were included in calculation of unit costs are missing in most countries except England, Portugal and Sweden. This suggests that there is a lack of transparency in the costing methodology used in estimating costs and setting public prices and/or tariffs for different procedures carried out by health systems. This result is more striking considering that the economic evaluation guidelines of the different countries mention the need for an adequate identification of all resources included in the final unit costs.Fattore and Torbica  comparedThe results of the study described in this article demonstrate the need for the authorities of the European countries to include detailed information on the estimation of the costs/tariffs in the official sources, which can ensure the transferability of the results across countries. Geissler et al. (2015) mentions the idea of ‘a common European DRG system to define homogeneous groups of patients across different countries’ . This woThe result of standardized economic evaluation is that it would be transferable from country A to country B without having to develop the same economic model from scratch in country B.The study has several limitations. First, the year of cost publication varies among countries, so the costs do not refer to the same year. However, costs inflated to 2019 prices using both Consumer Price Index and Gross Domestic Product can be found at the EU HCSCD webpage . Second,This study highlights the need of methodological documents describing the resources included in the estimation of unit costs to be publicly available. Enhancing transparency in and accessibility of methodological costing documents will improve the transferability of economic evaluations across countries.Additional file 1. Questionnaire General.Additional file 2. Responses to questionnaire.Additional file 3. PRISMA flow diagram.


The Journal and Authors retract the 14 January 2021 article cited above for the following reasons provided by the Authors:Following publication, concerns were raised regarding the integrity of the images in the published figures. The authors failed to provide a satisfactory explanation during the investigation, which was conducted in accordance with Frontiers’ policies.This retraction was approved by the Chief Editors of Frontiers in Oncology and the Chief Executive Editor of Frontiers. The authors agree to this retraction.


The emergence of multicellular organisms was, perhaps, the most spectacular of the major transitions during the evolutionary history of life on this planet ,2. DespiResearch into the evolution of multicellularity tends to involve either studies that attempt to understand transitions from unicellularity to multicellularity or studies that focus on the subsequent step, corresponding to the emergence of complex multicellularity . Kin and Schaap  argue thExtracellular matrices (ECMs) have played key roles in the evolution of multicellularity. They not only carry out the basic physical role of binding cells together but also influence development and morphology, protect cells from the external environment and represent an important a source of molecules involved in intercellular communication, all essential functions for a multicellular organism. Kloareg et al.  provide Transcription-associated proteins  play a central role in mediating and modulating the expression of the genome in the different cell types of a multicellular organism. In this Special Issue, Petroll et al.  focus onAn opinion article by Patthy  focuses Finally, the article by Isaksson et al.  considerIn conclusion, this Special Issue brings together articles that address several of the important outstanding questions in multicellularity research and should be of interest to a broad audience interested in both the experimental and theoretical aspects of this exciting field of research.


The presence of maternal emotions towards the offspring resulting from assisted reproductive techniques (ART) has been previously reported in oocyte donors. However, there is limited information about the presence of these emotions in oocyte donors during the ART process and before pregnancy. The aim of this study was to evaluate the emotions of oocyte donor women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes.A cross-sectional study was conducted on 100 women who were divided into two groups of oocyte donors and those treated with ART and using autologous oocyte. At the time of oocyte retrieval. Using a validated questionnaire, the emotions toward potential offspring (EPO) resulting from ART and its three dimensions  were measured and compared in two groups.Comparison of the EPO in the two groups showed that the emotions in all three dimensions were lower in oocyte donors than the other group (p < 0.001). Moreover, in oocyte donors, the mean score of the scale of the importance of treatment outcome dimension was higher than the other two scales (p < 0.001).The results of the study showed that there is a significant emotion toward the potential offspring in oocyte donors. The presence of these emotions thus should be considered in formulating the ethical charter of ART by using oocyte donation. There is limited information about the presence of maternal emotions in egg donor women during the assisted reproductive techniques (ART) process and before pregnancy. The aim of this study was to evaluate these emotions of women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes. A cross-sectional study was conducted on 100 women who were divided into two groups of egg donor and those treated with ART and using autologous oocyte. At the time of oocyte retrieval and using a validated questionnaire, the emotions toward potential offspring (EPO) resulting from ART and its three dimensions  were measured and compared in two groups. Out of 100 women. Comparison of the EPO in the two groups showed that the emotions in all three dimensions were lower in egg donors than the other group. Moreover, in egg donors, the mean score of the scale of the importance of treatment outcome dimension was higher than the other two scales. The results of the study showed that there is a significant emotion toward the potential offspring in oocyte donors. The presence of these emotions thus should be considered in formulating the ethical charter of ART by using oocyte donation. The widespread use of the third party in assisted reproductive techniques (ART) and the success of infertility treatment following its use has led to an increased number of women volunteers who enter the oocyte donation process , mainly Willingness to connect with the born offspring in some gamete donors , oocyte It is believed that genetic relationships form the basis of the parent–child relationship . In thisAlthough evaluation of oocyte donors' experiences in qualitative studies has shown the presence of emotional responses in donors, the presence of these emotions in oocyte donors towards the potential offspring has not been reported during the ART process and before the confirmation of the clinical pregnancy. However, the recognition of these emotions at the time of the donor's participation in ART allows the development of ethical charter for using a third party in ART. Therefore, the aim of this study was to evaluate the emotions of oocyte donor women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes.To evaluate the emotions of oocyte donors to the potential offspring this cross-sectional study was performed on 50 oocyte donors and 50 women under ART through using own oocyte with the approval of the ethics committee of Isfahan University in 2019–2020 Isfahan, Iran. A necessary sample size was 50 women in each group in order to achieve a 95% confidence interval and 80% test power to identify significant differences in means values at the 5% level and a significance level alpha of 0.05.Inclusion criteria in the two groups consisted of having no history of major psychological disorders, sexually transmitted diseases and hepatitis B and C based on the documents recorded in their medical file. For oocyte donor women previous complication with ovarian stimulation and history of genetic diseases were other inclusion criterion. ART cycle cancellation was exclusion criteria for both groups.Using convenience sampling method, sampling was performed in Isfahan Fertility and Infertility Center before ovarian stimulation among the oocyte donor women and the women who were candidate for ART due to male factor infertility. After obtaining informed consent, the baseline characteristics were recorded and, then, the EPO was measured on the day of oocyte reception and after the operation by using the self-report 12-item emotions towards the potential offspring questionnaire , while they had lower education level and most of them were employed (Table Comparison of the mean scores of the three dimensions of EPO shown in the donor women showed that the mean score of importance of treatment outcome dimension was higher than the mean score of imagination dimension (p < 0.001). Also, the mean score of importance of treatment outcome was higher than the mean score of the sense of ownership dimensions in the donor women (p < 0.001).Also, in the own oocyte women the mean score of importance of treatment outcome dimension was higher than the imagination (p < 0.001) and sense of ownership dimensions (p < 0.001). The mean scores of imagination and sense of ownership did not differ in the oocyte donor women; but in women treated with own oocytes, the mean score of imagination was significantly higher than that of sense of ownership (p = 0.02).In oocyte donor women, independent of the age, monthly income and educational level, the sense of ownership score was related to the number of children inversely and decreased with the increase of number of children (p-0.005). Additionally, the scores of sense of ownership p = 0.04) and the importance of treatment outcome (p < 0.001) had a significant inverse relationship with the economic level of the oocyte donor women (Table  and the The aim of this study was to evaluate the emotions of oocyte donor women towards the potential genetic offspring and to compare them with women treated with ART by using own oocytes. The results showed that oocyte donor women had a relatively significant emotion towards the potential genetic offspring. Furthermore, while these women were younger and less literate than those treated with ART through using own oocytes, their emotions toward potential offspring response were lower than those of the women undergoing ART with own oocytes.The results showed that the individual characteristics of the participants were different in the two groups. In ART through using donated oocytes, oocyte donors are selected from among young women in order to obtain an appropriate number of oocytes with high fertility potential and increase the treatment success. Moreover, as studies have shown that the oocyte donor’s participation in ART is mainly because of financial motivations , 3, 11, The finding suggests that prior to embryo formation; the oocyte donor women were somewhat emotionally involved with the potential genetic offspring, reflecting maternal attitudes toward the offspring resulting from the ART. The emotions of the oocyte donor women after the end of the participation in ART and the occurrence of pregnancy have been reported in previous studies. According to these studies, before starting the oocyte donation process, some women have expressed their concerns about the possibility of an emotional bond with the resulting offspring and their fondness for it . Some coImagination of the offspring is one of the events that take place during the bonding of the mother with the fetus . AdditioThe higher level of the dimension of the importance of treatment outcome compared to the other two dimensions of imagination, sense of ownership of the potential offspring, shows that the condition in which the child will grow up and the future that awaits him are so important for the oocyte donors. This research finding is in line with a study by Purewal et al. suggesting that it is important for the oocyte donors to have access to the information such as the number of the children, the history of divorce and socio-economic status of recipient couples .Another finding of the study showed that women with lower economic status and more children experience fewer emotions when participating in ART. Other studies have shown that financial incentives for oocyte donation are significantly related to the low economic status . TherefoAlthough the results of the present study indicated the presence of maternal emotions of oocyte donors towards potential genetic offspring, its limitations should be considered in interpreting the results of the present study. The first limitation of the study was related to the time of assessing the emotions of the donors. Owing to the researcher's lack of access to the donors, this assessment was performed after their participation in the treatment process on the day of ovulation and before sperm insemination and embryo formation.Also, in this study the results have been adjusted for some potential confounding factors which may influence the overall score of EPO, however there could still be residual variables which are not considered. Therefore, in-depth understanding on the emotional aspects can be investigated further through qualitative approach. Not following-up of the donors and evaluating their changes over time was another limitation of the present research. Furthermore, since the sampling method wasn’t a random sampling, the sample to generalize to the population might not accurately represent the population.Another limitation of the study was using a forced Likert scale and limitations of this method to deal the neutral value among respondents who don't have clear response to the item. Despite the limitations of the present study, its results can be helpful in development of the ethical charter in providing ART services through using donated oocytes. It is also suggested that the motivation and emotions of the oocyte donor towards the resulting offspring be considered before they enter the treatment process. Moreover, for a deeper understanding of these emotions in oocyte donors, it is suggested that future researchers compare the emotions of oocyte donors with that of the oocyte recipients.The results of the present study showed that albeit the EPO score in oocyte donor women was lower than women treated with own oocyte, the donor group score was high, This results revealed that the oocyte donors were involved in significant emotions towards the potential genetic offspring who does not belong to them and should be taken into account to develop the ethical charter in providing ART services through using donated oocytes.