Patient decision aid for trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery: a quasi-experimental pre-post study.

OBJECTIVE: To assess the impact of a web-based decision aid on patient-centered decision making outcomes among women considering a trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery. METHODS: The Birth Decision Aid Study (B-READY) was a quasi-experimental pre-post study of two sequential cohorts. From June 18, 2018 to July 31, 2019, 50 women were enrolled in routine care, followed by 50 women who were enrolled in the decision aid group. Inclusion criteria were singleton pregnancies between 19/0 to 36/6 weeks, ≤2 prior cesareans, and no contraindications to TOLAC. The decision aid group viewed the online Healthwise® "Pregnancy: Birth Options After Cesarean" program. Both groups received the same birth options counseling and completed the same online assessment. Primary patient-centered outcomes were knowledge about birth options and shared decision making at online assessment, and informed, patient-centered decision making about her preferred mode of delivery at delivery admission. RESULTS: Among 100 women participated in this study (50 per group), the mean gestational age at enrollment was 31 weeks, and 71% or 63/89 women who consented to delivery data abstraction had a cesarean delivery. Women in the patient decision aid group gained more knowledge (defined as score ≥ 75%) about birth options compared to those in the routine care group (72% vs. 32%; adjusted odds ratio, AOR: 6.15 [95% CI: 2.34 to 16.14]), and were more likely to make an informed, patient-centered decision (60% vs. 26%; AOR: 3.30 [95% CI: 1.20 to 9.04]. Women in both groups reported similar involvement in shared decision making, as well as satisfaction and values. More than 90% of decision aid users reported it was a useful tool and would recommend it to other TOLAC-eligible women. CONCLUSIONS: A web-based birth options patient-centered decision aid for TOLAC eligible women can be integrated into prenatal Telehealth and may improve the quality of decision making about mode of delivery. TRIAL REGISTRATION: The study was registered with ClinincalTrials.gov and the ID# was NCT04053413 . Registered 12 August 2019 - Retrospectively registered.

Acute Effects of High-Intensity Interval Training on Brain-Derived Neurotrophic Factor, Cortisol and Working Memory in Physical Education College Students.

High-intensity interval training (HIIT) is considered one of the most effective methods for improving cardiorespiratory and metabolic functions. However, it is necessary to clarify their effects on neurophysiological responses and coginitive functioning. Thus, this study aimed to determine the effects of an acute bout of HIIT on neurocognitive and stress-related biomarkers and their association with working memory (WM) capacity in healthy young adults. Twenty-five male college students performed a single bout of HIIT consisting of 10 × 1 min of cycling at their VO2 peak power output. Plasma Brain-Derived Neurotrophic Factor (BDNF) and cortisol (CORT) levels, and WM (Digit Span Test (DST)), were assessed pre-, post- and 30 min post-intervention. Significant post-exercise increases in circulating BDNF and CORT levels were observed coinciding with the highest DST performance; however, no statistical associations were found between cognitive and neurophysiological variables. Moreover, DST scores obtained 30 min after exercise remained higher than those assessed at pre-exercise. In conclusion, the stress induced by a single bout of HIIT induces a remarkable response of BDNF and CORT boosting WM capacity in healthy young males. Future research should clarify the association between cognitive and neurobiological markers during intense exercise stimulation.

Study of the physical and chemical changes during the maturation of three cocoa clones, EET8, CCN51, and ICS60.

BACKGROUND: Colombia is known for its production of fine and aromatic cocoa; however, the lack of homogeneity in the ripeness stage of cocoa fruit affects the final quality of cocoa beans. Therefore, the aim of this work was to identify parameters that can be use as indicators of ripeness in cocoa fruit in order to homogenize the characteristics of raw cocoa used in the production of cocoa-products industry. The parameters evaluated were fruit, seed and pod weight, firmness, color, polar and equatorial diameters of the fruit, seed moisture content, total titratable acidity, pH, and total soluble solids of pulp. RESULTS: Factors such as seed weight, firmness, diameters, total soluble solids, pH, and acidity were affected by the clone factor, whereas seed weight, pH, and total titratable acidity were affected by ripeness stage. CONCLUSION: Identification of indicators of ripeness for cocoa fruit is a complex task due to the influence of the clone on the evolution of the physicochemical characteristics of cocoa fruit during its maturation process. Thus, indicators must be developed for each clone, and at least two parameters among color, pH, and total titratable acidity should be used to determine the ripeness stage of cocoa fruit. © 2019 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Anticoccidial efficacy of Canary rue (Ruta pinnata) extracts against the caprine apicomplexan Eimeria ninakohlyakimovae.

Continuous use of anticoccidial treatments against Eimeria infections has resulted in the development of drug resistance. This study aimed to evaluate the anticoccidial efficacy of a methanolic extract derived from the endemic Canary rue (Ruta pinnata) plant of the Canary Islands, Spain, against Eimeria ninakohlyakimovae using in vitro assays. Freshly unsporulated oocysts were exposed to different concentrations of R. pinnata extract and thereafter evaluated for sporulation inhibition. Additionally, anticoccidial activity was examined by testing the viability of the E. ninakohlyakimovae sporozoites and their ability to infect bovine colonic epithelial cells after incubation with different concentrations of R. pinnata plant extract. The inhibition of oocyst sporulation by the extract was both time and concentration dependent, with certain combinations affording the same levels of sporulation inhibition as formaldehyde used as positive control (P < 0.001). Moreover, concentrations >0.1 mg/mL also affected not only the viability of the sporozoites but also their cell invasion capacity (P < 0.001). Altogether, these results show that methanolic fruit extracts from R. pinnata have important anticoccidial activity against oocysts and sporozoites of Eimeria. The potential efficacy of the extracts against other animal/human parasites remains to be elucidated, and further studies are needed to better understand its mode of action against coccidian parasites.

Individual patient data meta-analysis shows no association between the SNP rs1800469 in TGFB and late radiotherapy toxicity.

BACKGROUND AND PURPOSE: Reported associations between risk of radiation-induced normal tissue injury and single nucleotide polymorphisms (SNPs) in TGFB1, encoding the pro-fibrotic cytokine transforming growth factor-beta 1 (TGF-ß1), remain controversial. To overcome publication bias, the international Radiogenomics Consortium collected and analysed individual patient level data from both published and unpublished studies. MATERIALS AND METHODS: TGFB1 SNP rs1800469 c.-1347T>C (previously known as C-509T) genotype, treatment-related data, and clinically-assessed fibrosis (measured at least 2years after therapy) were available in 2782 participants from 11 cohorts. All received adjuvant breast radiotherapy. Associations between late fibrosis or overall toxicity, reported by STAT (Standardised Total Average Toxicity) score, and rs1800469 genotype were assessed. RESULTS: No statistically significant associations between either fibrosis or overall toxicity and rs1800469 genotype were observed with univariate or multivariate regression analysis. The multivariate odds ratio (OR), obtained from meta-analysis, for an increase in late fibrosis grade with each additional rare allele of rs1800469 was 0.98 (95% Confidence Interval (CI) 0.85-1.11). This CI is sufficiently narrow to rule out any clinically relevant effect on toxicity risk in carriers vs. non-carriers with a high probability. CONCLUSION: This meta-analysis has not confirmed previous reports of association between fibrosis or overall toxicity and rs1800469 genotype in breast cancer patients. It has demonstrated successful collaboration within the Radiogenomics Consortium.

Control strategies using diclazuril against coccidiosis in goat kids.

Coccidiosis is probably the main parasitic disease affecting goat kids around the weaning period, leading to high economic losses in goat production due to deaths and delayed growth rates of infected animals. A total of 101 kids of 2-4 weeks of age, naturally infected with Eimeria spp., were divided into five groups and studies were conducted to analyse the effects of metaphylactic administration of diclazuril (Vecoxan®) on parasitological and productive parameters. Two different doses of diclazuril (1 and 2 mg/kg BW, p.o.) were given either at 3 weeks (single treatment) or at 3 and 5 weeks of life (double treatment). The faecal oocyst shedding and the body weights of the animals were monitored at 2-weeks intervals for 6 consecutive weeks. Treatments of goat kids with diclazuril were effective against the three most predominant Eimeria species recorded in this study (E. arloingi, E. ninakohlyakimovae and E. christenseni) and also against other minor species found in faecal examinations, including E. alijevi, E. caprina, E. jolchijevi, E. caprovina, E. hirci and E. aspheronica). In consequence, OPG values lower than 1 × 10(3) were detected in 90 to 100% of the animals up to 15-20 days post-treatment depending on the treatment regimen. Even a single dose of 1 mg/kg BW p.o. resulted in an increase of growth rates in treated animals and therefore should be considered as a control strategy in farms precluding coccidian infections, whilst double and multiple dose treatments could be the recommendation for environments heavily contaminated with Eimeria oocysts. In relation to the OPG reduction and increased growth rates, the severity of the clinical signs (i.e., diarrhoea) was ameliorated in treated animals during the course of infection compared to that of non-treated or control kids. The precise timing of treatment appears crucial in order to prevent severe clinical coccidiosis and thereby enabling the adequate development of protective immune response against Eimeria challenge infections.

Role of serotonin in cerebral oxidative stress in rats.

Serotonin or 5-hydroxytryptamine (5-HT) is a monoamine neurotransmitter synthesized by the aromatic amino acid decarboxylase using 5-hydroxytryptophan (5-HTP) as a substrate. It was recently shown that serotonin and its precursor have powerful antioxidant properties. The aim of this study was to evaluate the effect of reduction in 5-HT levels by parachlorophenylalanine (pCPA) and their restoration by 5-HTP administration on lipid peroxidation and antioxidant status in rat brain. Serotonin levels were decreased by p-chlorophenylalanine administration. The effect of p-chlorophenylalanine was counteracted by the intraperitoneal administration of 5-hydroxytryptophan. We evaluated the concentration of serotonin, malonyl dialdehyde and the status of antioxidants (GSH, catalase and superoxide dismutase) in brain. The results showed that p-chlorophenylalanine (300 mg/kg) induced a depletion of serotonin concentration and antioxidant status, as well as enhancing malonyl dialdehyde concentration in brain. The exogenous administration of 5-hydroxytryptophan prevented all effects induced by p-chlorophenylalanine in brain tissue. The recovery of the neurotransmitter concentration in brain was related to the reduction of lipid peroxide generation and improved antioxidant status. In conclusion, our study supports the view that the antioxidant properties of serotonin protect against basal oxidative stress in brain.

Ovariectomy exacerbates oxidative stress and cardiopathy induced by adriamycin.

Ovarian hormone depletion in ovariectomized experimental animals is a useful model with which to study the physiopathological consequences of menopause in women. It has been suggested that menopause is a risk factor for the induction of several cardiovascular disorders. In the present study we analyzed the effects of ovarian hormone depletion by ovariectomy (OVX) in a model of oxidative stress and cardiopathy induced by adriamycin (AD). To evaluate these effects, we measured parameters related to cardiac damage (creatinine kinase, lactate dehydrogenase, aspartate aminotransferase and alanine aminotransferase) and oxidative stress (malondialdehyde, catalase, superoxide dismutase, glutathione peroxidase, reduced glutathione, nitric oxide and carbonyl proteins) in cardiac tissue and erythrocytes. OVX was found to alter all markers of oxidative stress and cell damage in cardiac tissue. Similarly, the OVX-derived loss of ovarian hormones enhanced cardiac damage and oxidative stress induced by AD. Our results suggest that antioxidant status in cardiac tissue and erythrocytes is seriously compromised by OVX during the cardiomyopathy induced by AD in experimental animals. In conclusion, the absence of hormones caused by OVX or menopause may induce or accelerate pre-existing cardiovascular dysfunctions.

Estradiol and catecholestrogens protect against adriamycin-induced oxidative stress in erythrocytes of ovariectomized rats.

The beneficial effect of estrogens and catecholestrogens against oxidative stress associated tissue injury has been observed in different experimental model. The administration of adriamycin (AD) has been shown to enhance oxidative stress in different tissues. The lack of estrogens during ovariectomy (OVX) also induces oxidative damage in several tissues. However, the antioxidant properties of estrogens and catecholestrogens administration have not been evaluated in erythrocytes and plasma from ovariectomized animals in presence or not of AD toxicity. We have assessed the antioxidant capacity of 17beta-estradiol (17beta) and catecholestrogens against oxidative stress in erythrocytes and plasma induced by OVX in control animals or AD-treated animals. We analyzed the level of lipid peroxides, carbonyl proteins and reduced glutathione (GSH) as well as glutathione peroxidase (GPx) and superoxide dismutase (SOD) activities in plasma and erythrocytes. The results showed that AD, OVX and its combination increased lipid peroxides and carbonyl proteins, as well as reduced glutathione, superoxide dismutase and glutathione peroxidase activities in plasma and erythrocytes. The administration of 17beta and its metabolites (2- and 4-hydroxyestradiol) prevented all markers of oxidative stress induced by OVX in control and AD-treated animals. In conclusion, the administration of estrogens and cathecolestrogens counteract the oxidative stress in erythrocytes and plasma induced by OVX in presence or not toxic injury.

Protective effect of red wine on oxidative stress and antioxidant enzyme activities in the brain and kidney induced by feeding high cholesterol in rats.

The effect of red wine (400 ml/70 kg) on brain and kidney oxidative stress and antioxidative enzymes activities induced by cholesterol-enriched diet (supplemented with 1.65% of cholesterol (w/w) for 4 weeks) was studied in rats. When red wine (Montilla-Moriles, Cordoba, Spain) was simultaneously supplemented to high-cholesterol diet for 4 weeks, total cholesterol and lipid peroxidation products in the brain, kidney and erythrocytes significantly decreased compared with the high-cholesterol, while GSH content and antioxidative enzymes activities enhanced. On the other hand, the urinary excretion of urea, creatinine and albumin decreased significantly. These results suggest that red wine may have a neuro-nephroprotective effect against oxidative stress and hypercholesterolemia.

Effect of 17-beta-estradiol administration during adriamycin-induced cardiomyopathy in ovariectomized rat.

The incidence of cardiovascular diseases in humans differs in relation to the age of the patient. Although women suffer less than men from cardiovascular disorders during 15-55 years, after this period the incidence is equivalent in both sexes. This data suggests a cytoprotective effect of estrogens against cardiovascular disease. The estrogens, especially 17-beta-estradiol, are important antioxidant molecules with potential cytoprotective properties during oxidant/antioxidant disbalance induced by oxidative stress. Oxidative stress is often the underlying mechanism during vascular alterations and cardiac damage. The present study evaluated the role of ovariectomy and/or 17-beta-estradiol administration on antioxidant status and lipid peroxidation during cardiac injury induced by adriamycin. Different parameters were measured, including hemodynamic response (arterial pressure and cardiac frequency), lipid peroxidation products (malondialdehyde), protein carbonylation, antioxidant status (reduced glutathione, glutathione peroxidase, superoxide dismutase and catalase), and cardiac injury (creatinine kinase, lactate dehydrogenase, aspartate and alanine aminotransferase). Our study showed that 17-beta-estradiol reduced all of the parameters related to oxidative stress and cardiac injury in ovariectomized rats treated with adriamycin.

Red wine prevents brain oxidative stress and nephropathy in streptozotocin-induced diabetic rats.

We have studied the effects of red wine on brain oxidative stress and nephropathy in streptozotocin (STZ)-induced diabetic rats. Diabetes was induced in Wistar rats with a single intraperitonally injection of STZ (50 mg/kg). Two weeks before and four weeks after injection, red wine was given orally in both normal and diabetic rats. Blood samples were taken from the neck vascular trunk in order to determine the glucose, triglycerides, total cholesterol, HDL-cholesterol (HDL-c), atherogenic index (AI), total protein, blood urea nitrogen (BUN), creatinine, insulin, lipid peroxidation products, reduced glutathione (GSH) and superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities. As well, we estimated the lipid peroxidtion, GSH and SOD, GSH-Px and catalase activities in brain and renal homogenates, and the excretion of albumin, proteins and glucose in urine over 24 h period. The administration of STZ caused significant increases in levels of glycosuria, proteinuria, albuminuria, glycemia, total cholesterol and AI, as well as in lipid peroxidation products in the brain, plasma and kidney, whereas it decreased the GSH content and SOD, GSH-Px and catalase activities. Treatment with red wine significantly prevented the changes induced by STZ. These data suggested that red wine has a protective effect against brain oxidative stress, diabetic nephropathy and diabetes induced by STZ, as well as it protects against hypercholesterolemia and atherogenic risk.

Parachlorophenylalanine exacerbates oxidative stress induced by gentamicin in rats.

The present work studies the effect of parachlorophenylalanine (PCPA, 200 mg/kg intraperitoneally/48 hr for 7 days) on the oxidative stress and nephropathy induced by gentamicin (80 mg/kg intraperitoneally/daily for 7 days) in Wistar rats. The effect of PCPA on lipid peroxidation products and reduced glutathione content in renal and brain tissue, as well as on 5HT content in brain was assessed. Catalase and superoxide dismutase activities were determined in brain tissue. Blood urea nitrogen and creatinine in plasma and total protein content in urine were also measured. Gentamicin caused significant increases in proteinuria, non-protein nitrogen compounds and lipid peroxidation markers, together with decreases in both reduced glutathione content in renal and brain tissue and enzymatic activities in brain homogenates. PCPA harnessed the effect of gentamicin in the brain and the kidney, while PCPA alone induced brain oxidative stress. These results support the prooxidant action of PCPA in brain tissue and its capacity to exacerbate the oxidative stress and renal dysfunction induced by gentamicin, as well as the possible antioxidant property of serotonin.