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BACKGROUND: Research on age-progression facial morphing interventions for smoking cessation has not investigated the effect of different instructions for intervention delivery. The objective of this pilot study was to investigate the influence of two instruction types used to deliver the intervention on efficacy of the intervention. METHOD: Women were recruited and randomly allocated to an age-progression intervention session with (i) neutral instructions; (ii) instructions designed to reassure; or (iii) a condition that controlled for participant engagement ("control"). The conditions were delivered in a one-time procedure, after which primary (quitting intentions) and secondary (cigarettes/week, quit attempts) outcomes were measured immediately post-intervention, and at 1 and 3 months. RESULTS: Seventy-two women (M = 25.7; SD = 0.9) were recruited and randomly allocated to condition (Neutral n = 27, Reassuring n = 22, Control n = 23). Quitting intentions were higher in the Reassuring versus Control arm (3 months post-intervention, F = 4.37, p = 0.016, 95% CI [0.231, 2.539], eta2 = 0.11); quit attempts were greater in the two intervention arms (58%) versus Control (1-month post-intervention, 15%) (χ2 = 9.83, p < 0.05, OR 1.00 [0.28, 3.63]). CONCLUSIONS: Findings highlight the importance of optimising instructions to enhance intervention efficacy. TRIAL REGISTRATION: clinicaltrials.gov Record: NCT03749382.
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In the context of the alarming rise of infant obesity and its health implications, the present research aims to uncover disruptions in postprandial lipid metabolism and the composition of triglyceride-rich lipoproteins in obese adolescents. A double-blind, controlled clinical trial in the postprandial phase on 23 adolescents aged 12 to 16 years was carried out. Twelve participants were categorized as obese (BMI > 30 kg/m2 and percentile > 95) and 11 as normal-weight (BMI = 20-25 kg/m2, percentile 5-85). Blood samples were collected after a 12-h overnight fast and postprandially after consumption of a standardized breakfast containing olive oil, tomato, bread, orange juice, and skimmed milk. Obese adolescents exhibited elevated triglyceride concentrations in both fasting and postprandial states and higher TG/apo-B48 ratios, indicating larger postprandial triglyceride-rich lipoprotein (TRL) particle size, which suggests impaired clearance. Obese subjects also exhibited higher n-6 PUFA concentrations, potentially linked to increased TRL hydrolysis and the release of pro-inflammatory adipokines. In contrast, TRL from normal-weight individuals showed higher concentrations of oleic acid and DHA (n-3 PUFA), with possible anti-inflammatory effects. The results indicate an interplay involving postprandial TRL metabolism and adipokines within the context of adolescent obesity, pointing to potential cardiovascular implications in the future.
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Ácidos Graxos Ômega-3 , Obesidade Infantil , Lactente , Humanos , Adolescente , Adipocinas , Pão , LipoproteínasRESUMO
Breast cancer continues to be the leading cause of death in women worldwide. Mammography, which is the current gold standard technique used to diagnose it, presents strong limitations in early ages where breast cancer is much more aggressive and fatal. MiRNAs present in numerous body fluids might represent a new line of research in breast cancer biomarkers, especially oncomiRNAs, known to play an important role in the suppression and development of neoplasms. The aim of this systematic review and meta-analysis was to evaluate dysregulated miRNA biomarkers and their diagnostic accuracy in breast cancer. Two independent researchers reviewed the included studies according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A protocol for this review was registered in PROSPERO with the registration number "CRD42021256338". Observational case-control-based studies analyzing concentrations of microRNAs which have been published within the last 10 years were selected, and the concentrations of miRNAs in women with breast cancer and healthy controls were analyzed. Random-effects meta-analyses of miR-155 were performed on the studies which provided enough data to calculate diagnostic odds ratios. We determined that 34 microRNAs were substantially dysregulated and could be considered biomarkers of breast cancer. Individually, miR-155 provided better diagnostic results than mammography on average. However, when several miRNAs are used to screen, forming a panel, sensitivity and specificity rates improve, and they can be associated with classic biomarkers such us CA-125 or CEA. Based on the results of our meta-analysis, miR-155 might be a promising diagnostic biomarker for this patient population.
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Neoplasias da Mama , MicroRNAs , Humanos , Feminino , MicroRNAs/genética , Biomarcadores Tumorais/genética , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/genética , Mama , Sensibilidade e EspecificidadeRESUMO
OBJECTIVE: To describe the magnitude and spatial distribution of household food and nutrition security (FNS) during the COVID-19 pandemic in Tucumán (Argentina) and identify factors associated with food insecurity. METHODS: During April and May 2020 a cross-sectional quantitative study was performed. Data from 3915 households were analyzed. The study of FNS was performed with the Latin American and Caribbean Scale for Food Security. To identify associated factors, bivariate and multivariate logistic regression models were applied. RESULTS: Household food insecurity affected 55.9% of the sample (mild: 39.3%, moderate: 10.8%, severe: 5.8%). Analyzing the spatial distribution, the eastern area showed the highest food insecurity prevalence, followed by the south and west areas. Logistic regression analysis showed that household food insecurity varied according to household size, presence of children, socioeconomic status, and health area of residence. CONCLUSIONS: Household size, presence of children, socioeconomic status and public health area of residence were associated to household food insecurity. The perception of hunger was higher in larger households, in those with low and medium socioeconomic status and in households located in the southern area of the province.
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COVID-19 , Argentina , COVID-19/epidemiologia , Criança , Estudos Transversais , Abastecimento de Alimentos , Humanos , Pandemias , SARS-CoV-2 , Fatores SocioeconômicosRESUMO
BACKGROUND: Low back pain (LBP) causes 2.6 million visits to U.S. emergency departments (EDs) annually. These patients are often treated with skeletal muscle relaxants (SMRs). OBJECTIVES: The goal of this study was to determine whether efficacy of SMRs is associated with age, sex, or baseline LBP severity. METHODS: This was a planned analysis of data from 4 randomized studies of patients with acute nonradicular LBP. Patients were enrolled during an ED visit and followed-up 1 week later. The primary outcome was improvement in the Roland-Morris Disability Questionnaire (RMDQ) between ED discharge and the 1-week follow-up. We compared the change in RMDQ among 8 groups: placebo, baclofen, metaxalone, tizanidine, diazepam, orphenadrine, methocarbamol, and cyclobenzaprine. All patients also received a nonsteroidal anti-inflammatory drug. We performed analysis of variance to determine statistically significant differences between medications and linear regression to determine the association of age, sex, and baseline severity with the primary outcome. RESULTS: The mean improvement in RMDQ per group was placebo 10.5 (95% confidence interval [CI] 9.5-11.5), baclofen 10.6 (95% CI 8.6-12.7), metaxalone 10.3 (95% CI 8.1-12.4), tizanidine 11.5 (95% CI 9.5-13.4), diazepam 11.1 (95% CI 9-13.2), orphenadrine 9.5 (95% CI 7.4-11.5), methocarbamol 8.1 (95% CI 6.1-10.1), and cyclobenzaprine 10.1 (95% CI 8.3-12). The between-group differences were not statistically significantly different. Results were similar regardless of age, sex, and baseline severity. Higher baseline RMDQ was associated with greater clinical improvement (B coefficient 5.7, p < 0.01). Adverse medication effects were more common with cyclobenzaprine than with placebo (p < 0.01). CONCLUSIONS: Among patients in the ED with acute LBP treated with a nonsteroidal anti-inflammatory drug, SMRs do not improve outcomes more than placebo. Neither age, sex, nor baseline impairment impacts these results.
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Dor Aguda , Dor Lombar , Metocarbamol , Fármacos Neuromusculares , Dor Aguda/tratamento farmacológico , Anti-Inflamatórios não Esteroides/farmacologia , Anti-Inflamatórios não Esteroides/uso terapêutico , Baclofeno/uso terapêutico , Diazepam/uso terapêutico , Humanos , Dor Lombar/tratamento farmacológico , Metocarbamol/uso terapêutico , Fármacos Neuromusculares/farmacologia , Fármacos Neuromusculares/uso terapêutico , Orfenadrina/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do TratamentoRESUMO
We confine a dense suspension of motile Escherichia coli inside a spherical droplet in a water-in-oil emulsion, creating a "bacterially" propelled droplet. We show that droplets move in a persistent random walk, with a persistence time τâ¼ 0.3 s, a long-time diffusion coefficient Dâ¼ 0.5 µm2 s-1, and an average instantaneous speed Vâ¼ 1.5 µm s-1 when the bacterial suspension is at the maximum studied concentration. Several droplets are analyzed, varying the drop radius and bacterial concentration. We show that the persistence time, diffusion coefficient and average speed increase with the bacterial concentration inside the drop, but are largely independent of the droplet size. By measuring the turbulent-like motion of the bacteria inside the drop, we demonstrate that the mean velocity of the bacteria near the bottom of the drop, which is separated from a glass substrate by a thin lubrication oil film, is antiparallel to the instantaneous velocity of the drop. This suggests that the driving mechanism is a slippery rolling of the drop over the substrate, caused by the collective motion of the bacteria. Our results show that microscopic organisms can transfer useful mechanical energy to their confining environment, opening the way to the assembly of mesoscopic motors composed of microswimmers.
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Escherichia coli/química , Óleos/química , Fenômenos Biomecânicos , Emulsões/química , Escherichia coli/citologia , Propriedades de Superfície , Tensoativos/química , Água/químicaRESUMO
Dapsone intoxication can be a life-threatening condition due its enterohepatic recirculation pharmacokinetics, and therefore, persistent methemoglobinemia development. We describe a case of a 17-year-old girl who was admitted 4 h after ingesting 5 g of dapsone. She presented methemoglobinemia (39%) and showed clinical signs of toxicity (cyanosis and altered mental status) despite mechanical ventilation. Multiple activated charcoal dosis and methylene blue infusions were performed. Notwithstanding initial improvement, a pattern of peaks and valleys was observed in serial methemoglobinemia measurements, with cyclic states of hypoxemia. On account of enterohepatic recirculation pharmacokinetics, clearance was enhanced by whole bowel irrigation. After 7 days of hospitalization, she was discharged in good general condition.
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Dapsona/intoxicação , Trato Gastrointestinal/metabolismo , Metemoglobinemia/terapia , Azul de Metileno/uso terapêutico , Irrigação Terapêutica/métodos , Adolescente , Dapsona/efeitos adversos , Feminino , Trato Gastrointestinal/efeitos dos fármacos , Trato Gastrointestinal/fisiopatologia , Humanos , Metemoglobinemia/etiologia , Metemoglobinemia/fisiopatologia , Azul de Metileno/farmacologia , Irrigação Terapêutica/instrumentaçãoRESUMO
OBJECTIVE: The aim of this article was to describe the nutritional status and body composition of schoolchildren from Tucumán (Argentina) and analyze variations according to sex, area of residence, and socioeconomic status (SES). METHODS: A cross-sectional study was performed in 1948 schoolchildren aged 8.0 to 11.9 years. Body weight, height, triceps skinfold, waist, and upper arm circumferences were measured. Nutritional status and body composition were estimated using the NHANES III reference. SES was surveyed with the Family Affluence Scale. Area of residence was classified as urban or rural based on the criteria of the National Institute of Statistics and Censuses of Argentina. Logistic regression analysis was applied to evaluate nutritional status and body composition according to sex, area of residence, and SES. RESULTS: The prevalence of overweight and obesity was 12.3% and 18.2%, respectively, as compared with that of underweight (2.3%), stunting (3%), and wasting (2.1%). The prevalence of stunting and wasting was higher in girls, while that of obesity was higher in boys. Low SES schoolchildren registered a higher prevalence of stunting. Analysis of body composition indicated modifications in adipose and muscular tissues, especially in undernourished (underweight, stunting, or wasting) children and children with excess weight (overweight or obesity). CONCLUSION: The child population from Tucumán is undergoing an accelerated process of nutritional transition, manifested by the double burden of malnutrition. The distribution of stunting, wasting, and obesity, and changes in fat and muscular tissues were not homogeneous, revealing differences according to sex, area of residence, and SES.
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Composição Corporal , Estado Nutricional , Características de Residência/estatística & dados numéricos , Fatores Sexuais , Classe Social , Argentina , Peso Corporal , Criança , Estudos Transversais , Feminino , Humanos , MasculinoRESUMO
Importance: Pediatric guidelines for the management of nonalcoholic fatty liver disease (NAFLD) recommend a healthy diet as treatment. Reduction of sugary foods and beverages is a plausible but unproven treatment. Objective: To determine the effects of a diet low in free sugars (those sugars added to foods and beverages and occurring naturally in fruit juices) in adolescent boys with NAFLD. Design, Setting, and Participants: An open-label, 8-week randomized clinical trial of adolescent boys aged 11 to 16 years with histologically diagnosed NAFLD and evidence of active disease (hepatic steatosis >10% and alanine aminotransferase level ≥45 U/L) randomized 1:1 to an intervention diet group or usual diet group at 2 US academic clinical research centers from August 2015 to July 2017; final date of follow-up was September 2017. Interventions: The intervention diet consisted of individualized menu planning and provision of study meals for the entire household to restrict free sugar intake to less than 3% of daily calories for 8 weeks. Twice-weekly telephone calls assessed diet adherence. Usual diet participants consumed their regular diet. Main Outcomes and Measures: The primary outcome was change in hepatic steatosis estimated by magnetic resonance imaging proton density fat fraction measurement between baseline and 8 weeks. The minimal clinically important difference was assumed to be 4%. There were 12 secondary outcomes, including change in alanine aminotransferase level and diet adherence. Results: Forty adolescent boys were randomly assigned to either the intervention diet group or the usual diet group (20 per group; mean [SD] age, 13.0 [1.9] years; most were Hispanic [95%]) and all completed the trial. The mean decrease in hepatic steatosis from baseline to week 8 was significantly greater for the intervention diet group (25% to 17%) vs the usual diet group (21% to 20%) and the adjusted week 8 mean difference was -6.23% (95% CI, -9.45% to -3.02%; P < .001). Of the 12 prespecified secondary outcomes, 7 were null and 5 were statistically significant including alanine aminotransferase level and diet adherence. The geometric mean decrease in alanine aminotransferase level from baseline to 8 weeks was significantly greater for the intervention diet group (103 U/L to 61 U/L) vs the usual diet group (82 U/L to 75 U/L) and the adjusted ratio of the geometric means at week 8 was 0.65 U/L (95% CI, 0.53 to 0.81 U/L; P < .001). Adherence to the diet was high in the intervention diet group (18 of 20 reported intake of <3% of calories from free sugar during the intervention). There were no adverse events related to participation in the study. Conclusions and Relevance: In this study of adolescent boys with NAFLD, 8 weeks of provision of a diet low in free sugar content compared with usual diet resulted in significant improvement in hepatic steatosis. However, these findings should be considered preliminary and further research is required to assess long-term and clinical outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT02513121.
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Dieta com Restrição de Carboidratos , Açúcares da Dieta , Hepatopatia Gordurosa não Alcoólica/dietoterapia , Adolescente , Glicemia/análise , Índice de Massa Corporal , Criança , Hispânico ou Latino , Humanos , Lipídeos/sangue , Testes de Função Hepática , Masculino , Hepatopatia Gordurosa não Alcoólica/sangue , Hepatopatia Gordurosa não Alcoólica/etnologia , Resultado do Tratamento , Redução de PesoRESUMO
INTRODUCTION: Postpartum depression (PPD) can begin within 6 weeks postpartum (International Classification of Diseases, 10th Revision) and represents a significant health problem for mothers. AIM: To determine whether physical activity during pregnancy alleviates PPD. METHOD: Randomized controlled trial in which the exercise group practiced moderate physical exercise in an aquatic environment (1-hour sessions, 3 days a week), following the recommendations of the SWEP method. RESULTS: The results observed in the Edinburgh Postnatal Depression Scale were significant between the exercise group and the control group ( p < .001). In addition, significant differences were observed according in body mass index between the exercise group and control group in the overweight and obesity categories ( p < .05). CONCLUSION: Women who perform moderate physical exercise in an aquatic environment are at lower risk of PPD than sedentary women. Overweight and obesity among sedentary women during pregnancy are closely associated with positive screening for PPD.
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Depressão Pós-Parto/prevenção & controle , Exercício Físico/psicologia , Natação/psicologia , Natação/estatística & dados numéricos , Adulto , Feminino , Humanos , Gravidez , Espanha , Adulto JovemRESUMO
Limbal stem cells are responsible for the continuous renewal of the corneal epithelium. The destruction or dysfunction of these stem cells or their niche induces limbal stem cell deficiency (LSCD) leading to visual loss, chronic pain, and inflammation of the ocular surface. To restore the ocular surface in cases of bilateral LSCD, an extraocular source of stem cells is needed to avoid dependence on allogeneic limbal stem cells that are difficult to obtain, isolate, and culture. The aim of this work was to test the tolerance and the efficacy of human adipose tissue-derived mesenchymal stem cells (hAT-MSCs) to regenerate the ocular surface in two experimental models of LSCD that closely resemble different severity grades of the human pathology. hAT-MSCs transplanted to the ocular surface of the partial and total LSCD models developed in rabbits were well tolerated, migrated to inflamed tissues, reduced inflammation, and restrained the evolution of corneal neovascularization and corneal opacity. The expression profile of the corneal epithelial cell markers CK3 and E-cadherin, and the limbal epithelial cell markers CK15 and p63 was lost in the LSCD models, but was partially recovered after hAT-MSC transplantation. For the first time, we demonstrated that hAT-MSCs improve corneal and limbal epithelial phenotypes in animal LSCD models. These results support the potential use of hAT-MSCs as a novel treatment of ocular surface failure due to LSCD. hAT-MSCs represent an available, non-immunogenic source of stem cells that may provide therapeutic benefits in addition to reduce health care expenses. Stem Cells 2017;35:2160-2174.
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Córnea/fisiopatologia , Células-Tronco Mesenquimais/metabolismo , Nicho de Células-Tronco/fisiologia , Animais , Células Cultivadas , Humanos , CoelhosRESUMO
Women who have experienced interpersonal violence (IPV) are at a higher risk to develop posttraumatic stress disorder (PTSD), with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis and impaired social behavior. Previously, we had reported impaired maternal sensitivity and increased difficulty in identifying emotions (i.e. alexithymia) among IPV-PTSD mothers. One of the aims of the present study was to examine maternal IPV-PTSD salivary cortisol levels diurnally and reactive to their child's distress in relation to maternal alexithymia. Given that mother-child interaction during infancy and early childhood has important long-term consequences on the stress response system, toddlers' cortisol levels were assessed during the day and in response to a laboratory stressor. Mothers collected their own and their 12-48month-old toddlers' salivary samples at home three times: 30min after waking up, between 2-3pm and at bedtime. Moreover, mother-child dyads participated in a 120-min laboratory session, consisting of 3 phases: baseline, stress situation (involving mother-child separation and exposure to novelty) and a 60-min regulation phase. Compared to non-PTSD controls, IPV-PTSD mothers - but not their toddlers, had lower morning cortisol and higher bedtime cortisol levels. As expected, IPV-PTSD mothers and their children showed blunted cortisol reactivity to the laboratory stressor. Maternal cortisol levels were negatively correlated to difficulty in identifying emotions. Our data highlights PTSD-IPV-related alterations in the HPA system and its relevance to maternal behavior. Toddlers of IPV-PTSD mothers also showed an altered pattern of cortisol reactivity to stress that potentially may predispose them to later psychological disorders.
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Ritmo Circadiano/fisiologia , Hidrocortisona/metabolismo , Relações Mãe-Filho , Mães/psicologia , Transtornos de Estresse Pós-Traumáticos/metabolismo , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico , Violência/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Sistema Hipotálamo-Hipofisário/metabolismo , Lactente , Relações Interpessoais , Estudos Longitudinais , Masculino , Comportamento Materno , Privação Materna , Sistema Hipófise-Suprarrenal/metabolismo , Estresse Psicológico/metabolismo , Estresse Psicológico/psicologia , Adulto JovemRESUMO
Newborns are often subjected to invasive and painful medical procedures. This happens even more frequently when they require hospitalization. The aim of this paper was to evaluate pain in healthy newborns and in newborns with Down syndrome (DS). We performed a prospective cohort study in the neonatal service of the San Cecilio University Hospital in Granada (Spain) from January 2008 to September 2013. The universe of our study comprised a study group of 20 newborns with DS and a control group of 20 newborns without DS. All of the infants were hospitalized, and thus had to undergo painful medical procedures. The variables studied were basal recovery time (as reflected in crying and the normalization of biological constants), number of punctures, oxygen saturation, heartbeat, blood pressure, response to skin-to-skin contact, and gestational age. The evaluation was performed during blood extraction, vein canalization, and heel puncture. The significant differences in the basal recovery time between the two groups of newborns indicated that those with DS were slower to express pain, and when they did, their response was not as clearly defined as that of babies without DS. The oxygen saturation in babies with DS after the puncture was found to be significantly lower than that of the control group (p < .001). The results of this study revealed that babies with DS were not as quick to perceive pain after a puncture. However, when pain was finally perceived, it persisted for a longer time. This situation should be taken into account in the design of pharmacologic and nonpharmacologic therapies.
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Síndrome de Down/fisiopatologia , Dor/fisiopatologia , Pressão Sanguínea , Estudos de Casos e Controles , Cateterismo/efeitos adversos , Choro/fisiologia , Idade Gestacional , Frequência Cardíaca/fisiologia , Humanos , Recém-Nascido , Oxigênio/sangue , Medição da Dor/métodos , Limiar da Dor/fisiologia , Estudos Prospectivos , Punções/efeitos adversos , TatoRESUMO
Maternal interpersonal violence-related post-traumatic stress disorder (IPV-PTSD) is known to be associated with impairment of a mother's capacity to participate in mutual emotion regulation during her child's first years of life. This study tested the hypothesis that maternal difficulty in identifying feelings in self and other, as an important dimension of the construct of alexithymia, together with maternal IPV-PTSD, would be negatively associated with maternal sensitivity. Maternal sensitivity to child emotional communication is a marker of maternal capacity to engage in mutual regulation of emotion and arousal. Following diagnostic interviews and administration of the Toronto Alexithymia Scale, 56 mothers and their toddlers (ages 12-42 months) were filmed during free-play and separation/novelty-exposure. Observed maternal sensitivity was coded via the CARE-Index. Maternal IPV-PTSD severity, difficulty in identifying emotions, and lower socio-economic status were all associated with less maternal sensitivity, and also with more maternal controlling and unresponsive behavior on the CARE-Index.
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Sintomas Afetivos/psicologia , Exposição à Violência/psicologia , Comportamento Materno/psicologia , Relações Mãe-Filho/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
BACKGROUND: It is well established that extra virgin olive oil (EVOO), applied to the skin, has healing and anti-inflammatory properties. AIM: To evaluate the effectiveness of EVOO in the prevention of nipple cracking in lactating women. METHODS: Experimental, prospective, randomized study of 300 lactating women, admitted to the postpartum unit of the city's general hospital (Cienfuegos, Cuba). The study was carried out in 2012. Eligible patients were randomized into two groups of 150 women. In Group 1, EVOO was applied on the nipple after feeding, and in Group 2, drops of breast milk were applied to the nipple after feeding. Clinical evaluations were made during the first week of treatment and after the first month. All women who initiated breastfeeding were considered eligible to be included in this study; breastfeeding was characterized as the moment of mother-child interaction with suction on the nipple. Efficacy was evaluated quantitatively, as the absence of cracks in the nipple during the first 2 weeks of lactation using as the proportion of women with or without nipple cracks, and if present, whether they were moderate or slight. RESULTS: The quantitative efficacy was 97.3% and no adverse effects occurred in mothers and newborns during the administration of EVOO. DISCUSSION AND CONCLUSIONS: EVOO helps prevent nipple cracking in lactating women. It has been shown to have protective effects when breastfeeding presents technical difficulties. This conclusion is borne out by the frequency distribution results obtained, which reflect a significantly higher proportion of nipple cracking in the population that was not treated with EVOO. LINKING EVIDENCE TO ACTION: Use EVOO to prevent nipple cracking during breastfeeding by administering 3 drops on each nipple after each feeding. Decreased nipple cracking will reduce pain and enhance breastfeedinging by administering 3 drops on each nipple after each feeding, improving the health of mothers and infants.
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Administração Cutânea , Lactação/efeitos dos fármacos , Mamilos/lesões , Azeite de Oliva/uso terapêutico , Adulto , Cuba , Feminino , Humanos , Gravidez , Estudos ProspectivosRESUMO
OBJECTIVE: The objective was to investigate the effectiveness of a person-centred active rehabilitation programme on symptoms associated with suspected Chronic Traumatic Encephalopathy (CTE). This was accomplished by (1) assessing the effect that a person-centred active rehabilitation programme had on participant symptoms, and (2) exploring how temporal contextual factors affected the participants' experience with, and perceived effectiveness of, the active rehabilitation programme. METHODS: A twelve-month mixed-methods single case experimental research design was used with six cases (participants). Individual cases were involved in a 51-week study period including an initial interview and three-week baseline phase. Cases were then randomly allocated to one of two n-of-1 study designs (i.e., A-B, B-A, B-A, A-B or B-A, A-B, A-B, B-A) where A and B represent a non-intervention and intervention phase, respectively. Interviews were conducted regularly throughout the study whilst outcome measures were assessed at each follow-up. Analysis of the data included visual, statistical, and qualitative analysis. RESULTS: Visual and statistical analysis of cognitive and executive function, and mindful attention, demonstrated trivial-to-large effects with the summary reflecting positive or unclear results. A mixed picture was observed for mood and behaviour with effects considered trivial-to-large, and the summary demonstrating positive, unclear and negative effects. Qualitative analysis indicated a perceived improvement in outcome measures such as memory, attention, anxiety, and emotional control despite mixed quantitative findings whilst a clear impact of contextual factors, such as COVID-19, the political atmosphere, exercise tolerance, programme progression, and motivation were evident during the intervention. CONCLUSIONS: This study has provided primary-level evidence to suggest active rehabilitation as a potential intervention for the management of suspected CTE symptoms. This study has also demonstrated the benefit of a person-centred approach to both clinical research and practice, particularly by considering contextual factors for a better understanding of an intervention effect.
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Encefalopatia Traumática Crônica , Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Encefalopatia Traumática Crônica/reabilitação , Assistência Centrada no Paciente , Cognição , Função Executiva , COVID-19/complicações , COVID-19/psicologia , Estudos de Caso Único como AssuntoRESUMO
The properties of an active fluid, for example, a bacterial bath or a collection of microtubules and molecular motors, can be accessed through the dynamics of passive particle probes. Here, in the perspective of analyzing experimental situations of confinement in droplets, we consider the kinematics of a negatively buoyant probe particle in an active fluid, both confined within a spherical domain. The active bath generates a fluctuating flow that pushes the particle with a velocity that is modeled as a colored stochastic noise, characterized by two parameters, the intensity and memory time of the active flow. When the particle departs a little from the bottom of the spherical domain, the configuration is well approximated by a particle in a two-dimensional harmonic trap subjected to the colored noise, in which case an analytical solution exists, which is the base for quantitative analysis. We numerically simulate the dynamics of the particle and use the planar, two-dimensional mean square displacement to recover the activity parameters of the bath. This approach yields satisfactory results as long as the particle remains relatively confined; that is, as long as the intensity of the colored noise remains low.
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Can topography be used to control bacteria accumulation? We address this question in the model system of smooth-swimming and run-and-tumble Escherichia coli swimming near a sinusoidal surface, and show that the accumulation of bacteria is determined by the characteristic curvature of the surface. For low curvatures, cells swim along the surface due to steric alignment and are ejected from the surface when they reach the peak of the sinusoid. Increasing curvature enhances this effect and reduces the density of bacteria in the curved surface. However, for curvatures larger than κ^{*}≈0.25µm^{-1}, bacteria become trapped in the valleys, where they can remain for long periods of time. Minimal simulations considering only steric interactions with the surface reproduce these results and give insights into the physical mechanisms defining the critical curvature, which is found to scale with the inverse of the bacterial length. We show that for curvatures larger than κ^{*}, the otherwise stable alignment with the wall becomes unstable while the stable orientation is now perpendicular to the wall, thus predicting accurately the onset of trapping at the valleys.
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Escherichia coli , Modelos Biológicos , Propriedades de Superfície , Escherichia coli/citologia , MovimentoRESUMO
Structural and systemic barriers entrenched in academia have sustained for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for women and underrepresented racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. Increasing opposition to diversity, equity, and inclusion (DEI) efforts in higher education via legislation, policies, and general anti-DEI sentiment contextualizes the importance of prioritizing DEI. The goal of this commentary is to open discussion among academic institutions regarding changes in DEI culture that will facilitate the growth of diverse early-career faculty (ECF). We use an adapted framework which incorporates DEI into a faculty competency model to (i) guide our discussion of the rationale for restructuring academic systems to promote DEI and (ii) recommend strategies for institutional progress for ECF that can translate across academic institutions. Implementing policies and practices that seek to recruit, retain, and support historically underrepresented ECF are needed, and may involve faculty mentorship programs, establishing equitable funding mechanisms, reforming faculty evaluation practices, and examining and correcting inequities in faculty workloads. The onus is on institutions to recognize and replace the exclusionary practices and biases that have existed within their walls, and continuously promote and monitor their DEI efforts and initiatives to ensure their efficacy. Inclusive academic cultures that demonstrate their value of diversity and commitment to equity promotion at all levels of the organization, including among ECF, are necessary for ensuring excellence in scholarship in academia.
Existing structural and systemic barriers in academia have continued for decades, and resulted in a lack of diversity in leadership positions, inequitable workloads for underrepresented gender and racial/ethnic groups, and increasing issues with retention of faculty, particularly following the COVID-19 pandemic. We outline the need for promoting diversity, equity, and inclusion (DEI) practices in academia, and that it will involve changes to the existing structures within universities. This is especially important as we want our higher education workforce to reflect our increasingly diverse society in its own diversity, but current policies and structures do not promote diversity in our institutions and in our research. Our rationale for restructuring academic systems to promote DEI also stems from a need for behavioral medicine and research more broadly to recognize and challenge the biases and practices that sustain inequity in our researchfrom the questions we ask, the participants we include (and exclude), and the ways in which the system creates unnecessary barriers for researchers who try to mitigate or address these biases in our work. We recommend implementing strategies for institutional progress that benefit diverse early-career faculty including mentoring programs, developing funding opportunities, changing faculty evaluation practices, and creating equitable workloads.