Maternal Sleeping Problems Before and After Childbirth - A Systematic Review.

The perinatal and postpartum period is of great significance for women due to physiological changes, shifts in circadian rhythms, social setting, and psychological well-being, all of which affect the quality and quantity of their sleep. A mixed-studies systematic review was undertaken to enhance our understanding of sleep disturbances and mood disorders in women in late pregnancy and the postpartum period, their connection with breastfeeding, and the assessment of interventions for sleep disturbance. Three electronic databases (PUBMED, EMBASE and Google Scholar) were searched for qualitative, observational, and mixed-method studies from the year 2016 to June 2023. Twenty-nine articles were included in the analysis. The results were synthesized into four overarching themes: (і) the sleep quality of women in the perinatal period; (ii) the relationship between sleep and breastfeeding; (iii) the relationship between sleep quality and emotional disturbance in the perinatal period; (iv) sleep interventions in the researched group. The subjective nature of the perception of sleep disturbances, along with the absence of an objective measurement tool is clearly an inconvenience. It is advisable to include the assessment of maternal sleep hygiene and family sleep patterns during postpartum healthcare provider appointments to develop strategies not only for women's sleep quality but also for their mental well-being.

Telemedicine in Emergency Medicine in the COVID-19 Pandemic-Experiences and Prospects-A Narrative Review.

Even before the year 2020, telemedicine has been proven to contribute to the efficacy of healthcare systems, for example in remote locations or in primary care. However, with the outbreak of the COVID-19 pandemic, telehealth solutions have emerged as a key component in patient healthcare delivery and they have been widely used in emergency medicine ever since. The pandemic has led to a growth in the number of telehealth applications and improved quality of already available telemedicine solutions. The implementation of telemedicine, especially in emergency departments (EDs), has helped to prevent the spread of COVID-19 and protect healthcare workers. This narrative review focuses on the most important innovative solutions in emergency care delivery during the COVID-19 pandemic. It outlines main categories of active telehealth use in daily practice of dealing with COVID-19 patients currently, and in the future. Furthermore, it discusses benefits as well as limitations of telemedicine.

Musculoskeletal diseases as the basis for disability certificates in Lublin (Poland) in 2006-2021.

Introduction: Musculoskeletal diseases are not a leading cause of death but one of the common causes of disability and therefore play an important role in the global burden of diseases producing financial costs, need for hospitalization, treatment, rehabilitation, and hiring numerous medical personnel and caregivers. Patients who obtain a moderate or severe disability certificate may more easily find a job, have shorter working hours, apply for reduced tax, parking cards, co-financing of rehabilitation or renovation of the bathroom in order to adapt it to their disability. The aim of the study was to investigate the characteristics of people obtaining a disability certificate due to diseases of the locomotor system in Lublin within the last 16 years. Material and methods: The authors asked the Municipal Disability Adjudication Council in Lublin to provide data on the number of disability certificates issued in the years 2006-2021. Results: In the years 2006-2021 the Municipal Disability Adjudication Council in Lublin issued 76,581 disability certificates. The most common was the moderate degree of disability (36,458 certificates). The most common reason for being diagnosed with disability was diseases of the locomotor system. In the years 2006-2013, 41% of people obtaining disability certificates because of bone and joint diseases were in the 41-50 age group. From 2014, people over 60 years predominated. Of these, 57% were women. The majority of them had a secondary education. As many as 74% were unemployed, while only 36% were employed. Conclusions: Musculoskeletal diseases are a leading reason for issuing disability certificates in Lublin within the last 16 years. The certificates most often let patients obtain parking cards, facilitate the search for employment and enable them to apply for tax reductions.

How Knowledge about Stem Cells Influences Attitudes towards Breastfeeding: Case Study of Polish Women.

Maternal breastfeeding is associated with multiple health benefits, both for the child and the mother. Since breastfeeding rates are declining, finding new, future-oriented strategies to strengthen and support mothers' positive attitudes towards breastfeeding need to be developed. In this paper, we describe how information about the presence of stem cells in breast milk can influence the willingness to breastfeed in the population of Polish pregnant women. A cross-sectional study involving a group of 150 pregnant women was conducted to assess the correlation between their knowledge about stem cells and their attitude towards breastfeeding. Among the respondents, only 6% claimed that they did not know anything about stem cells, but general knowledge about stem cells in the research group was poor. The survey results indicated that city residence, university degree, maternal experience and advanced pregnancy correlated with higher general knowledge regarding stem cells. Most respondents (77.3%) had no knowledge regarding the presence of stem cells in breast milk. Approximately two-thirds of mothers with earlier negative breastfeeding experience declared that information about the presence of stem cells in breast milk could have influenced the decision to continue and extend the time of breastfeeding. Hence highlighting the presence of stem cells in breast milk can be used to encourage breastfeeding as a unique activity.

Milk Therapy: Unexpected Uses for Human Breast Milk.

BACKGROUND: Human breast milk provides a child with complete nutrition but is also a popular therapeutic remedy that has been used in traditional, natural pharmacopeia, and ethnomedicine for many years. The aim of this current review is to summarize studies of non-nutritional uses of mothers' milk. METHODS: Two databases (PubMed and Google Scholar) were searched with a combination of twelve search terms. We selected articles that were published between 1 January 2010, and 1 January 2019. The language of publication was limited to English. RESULTS: Fifteen studies were included in the systematic review. Ten of these were randomized controlled trials, one was a quasi-experimental study, two were in vitro studies, and four employed an animal research model. CONCLUSIONS: Many human milk components have shown promise in preclinical studies and are undergoing active clinical evaluation. The protective and treatment role of fresh breast milk is particularly important in areas where mothers and infants do not have ready access to medicine.

Non-nutritional use of breast milk.

Mammals milk, in addition to nutrients, contains many biologically active substances including immunoglobulins, growth factors, cytokines, acute phase proteins, and antimicrobial and antiviral proteins. Thanks to its unique composition, for hundreds of years it is used in post-natal care, treatment of wounds, as well as to fight bacterial and viral infections. The discovery of stem cells and HAMLET complex in breast milk resulted in increased interest in human breast milk as a natural medicine. Milk therapy is devoid of side effects, and breast milk banks may serve as a potential source of milk as a drug substance. In this study we collected information about the possible non-nutritional use of breast milk.

Cells of human breast milk.

Human milk is a complex fluid that has developed to satisfy the nutritional requirements of infants. In addition to proteins, lipids, carbohydrates and other biologically active components, breast milk contains a diverse microbiome that is presumed to colonize the infant gastrointestinal tract and a heterogeneous population of cells with unclear physiological roles and health implications. Noteworthy cellular components of breast milk include progenitor/stem cells. This review summarizes the current state of knowledge of breast milk cells, including leukocytes, epithelial cells, stem cells and potentially probiotic bacteria.

[Perinatal sources of stem cells]. / Okoloporodowe zródla komórek macierzystych.

Recently, stem cell biology has become an interesting topic. Several varieties of human stem cells have been isolated and identified in vivo and in vitro. Successful application of hematopoietic stem cells in hematology has led to the search for other sources of stem cells and expanding the scale of their application. Perinatal stem cells are a versatile cell population, and they are interesting for both scientific and practical objectives. Stem cells from perinatal tissue may be particularly useful in the clinic for autologous transplantation for fetuses and newborns, and after banking in later stages of life, as well as for in utero transplantation in the case of genetic disorders. In this review paper we focus on the extraction and therapeutic potential of stem cells derived from perinatal tissues such as the placenta, the amnion, amniotic fluid, umbilical cord blood and Wharton's jelly.

α2ß1 integrin-mediated mechanical signals during osteodifferentiation of stem cells from the Wharton's jelly of the umbilical cord.

INTRODUCTION: The formation and maintenance of tissues is regulated by various signals triggered by biological, chemical, and physical factors. Data increasingly confirm that matrix or tissue elasticity plays an influential role in regulating numerous cell functions. The aim of the present study was to better understand the regulation of cellular differentiation by mechanical cues. We studied the influence of matrix stiffness on the osteodifferentiation of two cell lineages characterized by different responses: mesenchymal stromal/stem cells isolated from the Wharton's jelly of the umbilical cord (UC-MSCs) with strong stiffness-dependent responses; and bone-derived cells (BDCs), which are insensitive to changes in matrix rigidity. The study also aimed to delineate how matrix stiffness affects intracellular signaling through focal adhesion kinase (FAK) activity­one of the key components in integrin-mediated signaling pathways. MATERIAL AND METHODS: The effect of substrate stiffness on the expression of α2, α5, and ß1 integrin was studied using real time PCR and Western blot using cells cultured in an osteogenic medium on tunable polyacrylamide gels coated with type I collagen, with elasticities corresponding to Young's moduli of 1.46 kPa and 26.12 kPa. FAK activity was monitored using ELISA assays. RESULTS: We demonstrate for the first time the changes in the expression of α2, α5, and ß1 integrin subunits in perinatal stem cells and in adult osteoblast precursor cells during in vitro osteogenic differentiation on surfaces characterized by different stiffness. We found that matrix rigidity significantly affects the osteogenic differentiation of UC-MSCs through α2 integrin-mediated mechanotransduction events, though not through the α5 integrin subunit. In BDCs, there were no significant changes in the expression levels of the tested protein associated with varying stiffness. CONCLUSIONS: Our results provide evidence that matrix rigidity affects the osteogenic differentiation of UC-MSCs via mechanotransduction events mediated by α2 integrin subunits.

Effect of substrate stiffness on the osteogenic differentiation of bone marrow stem cells and bone-derived cells.

There is a profound dependence of cell behaviour on the stiffness of its microenvironment. To gain a better understanding of the regulation of cellular differentiation by mechanical cues, we investigated the influence of matrix stiffness (E = 1.46 kPa and E = 26.12 kPa) on differentiated osteogenic cell lineage of bone marrow stem cells (BM-MSCs) and bone-derived cells (BDCs) using flexible collagen-coated polyacrylamide substrates. Differentiation potential was determined by measuring alkaline phosphatase activity, expression of osteoblast-specific markers including alkaline phosphatase, osteocalcin, Runx2 and collagen type I, as well as assessment of mineralisation (Alizarin Red S staining). We found that osteogenic differentiation can be regulated by the rigidity of the substrate, which may depend on the commitment in multi- or uni-potent targeting cells. Osteogenic differentiation of BM-MSCs was enhanced on a stiff substrate compared to a soft one, whereas BDCs osteogenic differentiation did not vary depending on the substrate stiffness. The data help in understanding the role of the external mechanical determinants in stem cell differentiation, and can also be useful in translational approach in functional tissue engineering.

[Verification of the effectiveness of the dietary supplementation in infertility treatment]. / Ocena skutecznosci suplementacji zywieniowej w terapii nieplodnosci.

UNLABELLED: Fertility problems are observed in a growing number of couples in many countries, including Poland. The treatment of infertile couple should be comprehensive and apart from medical procedures also other factors affecting fertility potential should be taken into account. There is increasing evidence that a properly balanced diet and/or administration of specifically composed supplements may increase the chances of conceiving both naturally as well as in result of assisted reproductive techniques. THE AIM OF STUDY: Preliminary verification of the effectiveness of vitamin preparation to improve the quality of semen and the number of pregnancies achieved. MATERIAL AND METHODS: In total 28 infertile couples were included to the study. Within 6 months from the start of diet supplementation seminological studies and the assessment of getting pregnant have been conducted. RESULTS: The consumption of vitamin and mineral ingredients improves sperm quality and increases pregnancy rate. CONCLUSIONS: Dietary supplement may help to conceive by increasing the number and improving sperm motility.

Effect of substrate stiffness on differentiation of umbilical cord stem cells.

Tissue formation and maintenance is regulated by various factors, including biological, physiological and physical signals transmitted between cells as well as originating from cell-substrate interactions. In our study, the osteogenic potential of mesenchymal stromal/stem cells isolated from umbilical cord Wharton's jelly (UC-MSCs) was investigated in relation to the substrate rigidity on polyacrylamide hydrogel (PAAM). Osteogenic differentiation of UC-MSCs was enhanced on stiff substrate compared to soft substrates, illustrating that the mechanical environment can play a role in differentiation of this type of cells. These results show that substrate stiffness can regulate UC-MSCs differentiation, and hence may have significant implications for design of biomaterials with appropriate mechanical properties for regenerative medicine.

Perinatal sources of mesenchymal stem cells: Wharton's jelly, amnion and chorion.

Recently, stem cell biology has become an interesting topic, especially in the context of treating diseases and injuries using transplantation therapy. Several varieties of human stem cells have been isolated and identified in vivo and in vitro. Ideally, stem cells for regenerative medical application should be found in abundant quantities, harvestable in a minimally invasive procedure, then safely and effectively transplanted to either an autologous or allogenic host. The two main groups of stem cells, embryonic stem cells and adult stem cells, have been expanded to include perinatal stem cells. Mesenchymal stem cells from perinatal tissue may be particularly useful in the clinic for autologous transplantation for fetuses and newborns, and after banking in later stages of life, as well as for in utero transplantation in case of genetic disorders.This review highlights the characteristics and therapeutic potential of three human mesenchymal stem cell types obtained from perinatal sources: Wharton's jelly, the amnion, and the chorion.

Stem cells from adipose tissue.

This is a review of the growing scientific interest in the developmental plasticity and therapeutic potential of stromal cells isolated from adipose tissue. Adipose-derived stem/stromal cells (ASCs) are multipotent somatic stem cells that are abundant in fat tissue. It has been shown that ASCs can differentiate into several lineages, including adipose cells, chondrocytes, osteoblasts, neuronal cells, endothelial cells, and cardiomyocytes. At the same time, adipose tissue can be harvested by a minimally invasive procedure, which makes it a promising source of adult stem cells. Therefore, it is believed that ASCs may become an alternative to the currently available adult stem cells (e.g. bone marrow stromal cells) for potential use in regenerative medicine. In this review, we present the basic information about the field of adipose-derived stem cells and their potential use in various applications.

Biological mechanisms of implant osseointegration.

Osseointegration is the development of a stable connection between the recipient bone and the implant surface. This process is a function of the time it takes for the implant to become fixed in bone tissue. The essence of osseointegration is the achievement of permanent stability of the implant, which ensures the proper course of the healing process, and "acceptance" of the implant by the living bone tissue, which leads to the initiation of osteogenesis and formation of young bone on the surface of the bone graft. Bone reconstruction within the implant depends on the specific factors related both to the implant material properties and to the status of the patient's skeletal system. High biocompatibility of the implant material ensures the maintenance of permanent and stable bone-implant contact and successful normal osseointegration. This work presents the cellular and extracellular mechanisms and factors influencing the process of osseointegration.

Structural basis of the sulphate starvation response in E. coli: crystal structure and mutational analysis of the cofactor-binding domain of the Cbl transcriptional regulator.

Cbl is a member of the large family of LysR-type transcriptional regulators (LTTRs) common in bacteria and found also in Archaea and algal chloroplasts. The function of Cbl is required in Escherichia coli for expression of sulphate starvation-inducible (ssi) genes, associated with the biosynthesis of cysteine from organic sulphur sources (sulphonates). Here, we report the crystal structure of the cofactor-binding domain of Cbl (c-Cbl) from E. coli. The overall fold of c-Cbl is very similar to the regulatory domain (RD) of another LysR family member, CysB. The RD is composed of two subdomains enclosing a cavity, which is expected to bind effector molecules. We have constructed and analysed several full-length Cbl variants bearing single residue substitutions in the RD that affect cofactor responses. Using in vivo and in vitro transcription assays, we demonstrate that pssuE, a Cbl responsive promoter, is down-regulated not only by the cofactor, adenosine phosphosulphate (APS), but also by thiosulphate, and, that the same RD determinants are important for the response to both cofactors. We also demonstrate the effects of selected site-directed mutations on Cbl oligomerization and discuss these in the context of the structure. Based on the crystal structure and molecular modelling, we propose a model for the interaction of Cbl with adenosine phosphosulphate.

Identification of activating region (AR) of Escherichia coli LysR-type transcription factor CysB and CysB contact site on RNA polymerase alpha subunit at the cysP promoter.

CysB is a LysR-type transcriptional regulator (LTTR) controlling the expression of numerous genes involved in bacterial sulphur assimilation via cysteine biosynthesis. Our previous mutational analysis of CysB identified several residues within the N-terminal domain crucial for DNA-binding function. Here, we focus on the functional significance of CysB residues localized in the turn between the alpha2 and alpha3 helices forming an N-terminal helix-turn-helix motif. On the basis of the characteristics of alanine-substituted mutants, we propose that CysB residues Y27, T28 and S29, lying in this turn region, comprise an 'activating region' (AR) that is crucial for positive control of the cysP promoter, but not for DNA binding and inducer response activities of CysB. Using a library of alanine substitutions in the C-terminal domain of the RNAP alpha subunit (alpha-CTD), we identify several residues in alpha-CTD that are important for CysB-dependent transcription from the cysP promoter. After probing potential protein-protein contacts in vivo with a LexA-based two-hybrid system, we propose that the '273 determinant' on alpha-CTD, including residues K271 and E273, represents a target for interaction with CysB at the cysP promoter.