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1.
Cell ; 184(15): 3884-3898.e11, 2021 07 22.
Artículo en Inglés | MEDLINE | ID: mdl-34143954

RESUMEN

Immune-microbe interactions early in life influence the risk of allergies, asthma, and other inflammatory diseases. Breastfeeding guides healthier immune-microbe relationships by providing nutrients to specialized microbes that in turn benefit the host's immune system. Such bacteria have co-evolved with humans but are now increasingly rare in modern societies. Here we show that a lack of bifidobacteria, and in particular depletion of genes required for human milk oligosaccharide (HMO) utilization from the metagenome, is associated with systemic inflammation and immune dysregulation early in life. In breastfed infants given Bifidobacterium infantis EVC001, which expresses all HMO-utilization genes, intestinal T helper 2 (Th2) and Th17 cytokines were silenced and interferon ß (IFNß) was induced. Fecal water from EVC001-supplemented infants contains abundant indolelactate and B. infantis-derived indole-3-lactic acid (ILA) upregulated immunoregulatory galectin-1 in Th2 and Th17 cells during polarization, providing a functional link between beneficial microbes and immunoregulation during the first months of life.


Asunto(s)
Bifidobacterium/fisiología , Sistema Inmunológico/crecimiento & desarrollo , Sistema Inmunológico/microbiología , Antibacterianos/farmacología , Biomarcadores/metabolismo , Lactancia Materna , Linfocitos T CD4-Positivos/inmunología , Polaridad Celular , Proliferación Celular , Citocinas/metabolismo , Heces/química , Heces/microbiología , Galectina 1/metabolismo , Microbioma Gastrointestinal , Humanos , Indoles/metabolismo , Recién Nacido , Inflamación/sangre , Inflamación/genética , Mucosa Intestinal/inmunología , Metaboloma , Leche Humana/química , Oligosacáridos/metabolismo , Células Th17/inmunología , Células Th2/inmunología , Agua
2.
Cell ; 174(5): 1277-1292.e14, 2018 08 23.
Artículo en Inglés | MEDLINE | ID: mdl-30142345

RESUMEN

Epidemiological data suggest that early life exposures are key determinants of immune-mediated disease later in life. Young children are also particularly susceptible to infections, warranting more analyses of immune system development early in life. Such analyses mostly have been performed in mouse models or human cord blood samples, but these cannot account for the complex environmental exposures influencing human newborns after birth. Here, we performed longitudinal analyses in 100 newborn children, sampled up to 4 times during their first 3 months of life. From 100 µL of blood, we analyze the development of 58 immune cell populations by mass cytometry and 267 plasma proteins by immunoassays, uncovering drastic changes not predictable from cord blood measurements but following a stereotypic pattern. Preterm and term children differ at birth but converge onto a shared trajectory, seemingly driven by microbial interactions and hampered by early gut bacterial dysbiosis.


Asunto(s)
Sangre Fetal/inmunología , Sistema Inmunológico/fisiología , Recien Nacido Prematuro/inmunología , Inflamación , Linaje de la Célula , Disbiosis , Femenino , Microbioma Gastrointestinal , Humanos , Inmunoensayo , Recién Nacido , Leucocitos Mononucleares/metabolismo , Estudios Longitudinales , Masculino , Padres , Fenotipo , Nacimiento Prematuro/inmunología , Transcriptoma
3.
Immunity ; 53(4): 775-792.e9, 2020 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-33002412

RESUMEN

Innate lymphoid cells (ILCs) are generated early during ontogeny and persist predominantly as tissue-resident cells. Here, we examined how ILCs are maintained and renewed within tissues. We generated a single cell atlas of lung ILC2s and found that Il18r1+ ILCs comprise circulating and tissue-resident ILC progenitors (ILCP) and effector-cells with heterogeneous expression of the transcription factors Tcf7 and Zbtb16, and CD103. Our analyses revealed a continuous differentiation trajectory from Il18r1+ ST2- ILCPs to Il18r- ST2+ ILC2s, which was experimentally validated. Upon helminth infection, recruited and BM-derived cells generated the entire spectrum of ILC2s in parabiotic and shield chimeric mice, consistent with their potential role in the renewal of tissue ILC2s. Our findings identify local ILCPs and reveal ILCP in situ differentiation and tissue adaptation as a mechanism of ILC maintenance and phenotypic diversification. Local niches, rather than progenitor origin, or the developmental window during ontogeny, may dominantly imprint ILC phenotypes in adult tissues.


Asunto(s)
Inmunidad Innata/inmunología , Linfocitos/inmunología , Células Progenitoras Linfoides/inmunología , Animales , Diferenciación Celular/inmunología , Células Cultivadas , Femenino , Humanos , Subunidad alfa del Receptor de Interleucina-18/inmunología , Pulmón/inmunología , Ratones , Ratones Endogámicos C57BL , Proteína de la Leucemia Promielocítica con Dedos de Zinc/inmunología , Transducción de Señal/inmunología , Análisis de la Célula Individual/métodos , Factor 1 de Transcripción de Linfocitos T/inmunología , Factores de Transcripción/inmunología
4.
Semin Immunol ; 73: 101885, 2024 May 23.
Artículo en Inglés | MEDLINE | ID: mdl-38788491

RESUMEN

The gut microbiota is well known to possess immunomodulatory capacities, influencing a multitude of cellular signalling pathways to maintain host homeostasis. Although the formation of the immune system initiates before birth in a sterile environment, an emerging body of literature indicates that the neonatal immune system is influenced by a first wave of external stimuli that includes signals from the maternal microbiota. A second wave of stimulus begins after birth and must be tightly regulated during the neonatal period when colonization of the host occurs concomitantly with the maturation of the immune system, requiring a fine adjustment between establishing tolerance towards the commensal microbiota and preserving inflammatory responses against pathogenic invaders. Besides integrating cues from commensal microbes, the neonatal immune system must also regulate responses triggered by other environmental signals, such as dietary antigens, which become more complex with the introduction of solid food during the weaning period. This "window of opportunity" in early life is thought to be crucial for the proper development of the immune system, setting the tone of subsequent immune responses in adulthood and modulating the risk of developing chronic and metabolic inflammatory diseases. Here we review the importance of host-microbiota interactions for the development and maturation of the immune system, particularly in the early-life period, highlighting the known mechanisms involved in such communication. This discussion is focused on recent data demonstrating microbiota-mediated education of innate immune cells and its role in the development of lymphoid tissues.

5.
Development ; 150(9)2023 05 01.
Artículo en Inglés | MEDLINE | ID: mdl-37170957

RESUMEN

The peripheral nervous system (PNS) represents a highly heterogeneous entity with a broad range of functions, ranging from providing communication between the brain and the body to controlling development, stem cell niches and regenerative processes. According to the structure and function, the PNS can be subdivided into sensory, motor (i.e. the nerve fibers of motor neurons), autonomic and enteric domains. Different types of neurons correspond to these domains and recent progress in single-cell transcriptomics has enabled the discovery of new neuronal subtypes and improved the previous cell-type classifications. The developmental mechanisms generating the domains of the PNS reveal a range of embryonic strategies, including a variety of cell sources, such as migratory neural crest cells, placodal neurogenic cells and even recruited nerve-associated Schwann cell precursors. In this article, we discuss the diversity of roles played by the PNS in our body, as well as the origin, wiring and heterogeneity of every domain. We place a special focus on the most recent discoveries and concepts in PNS research, and provide an outlook of future perspectives and controversies in the field.


Asunto(s)
Neurogénesis , Sistema Nervioso Periférico , Cresta Neural , Células de Schwann , Neuronas Motoras
6.
Dev Biol ; 517: 117-125, 2024 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-39341445

RESUMEN

While the nervous system of bilaterian animals is mainly left-right (L-R) symmetric at the anatomical level, some molecular and functional L-R asymmetries exist. However, the extent of these molecular asymmetries and their functional consequences remain poorly characterized. C. elegans allows to study L-R asymmetries in the nervous system with single-neuron resolution. We have previously shown that a neural bHLH transcription factor, HLH-16/Olig, is L-R asymmetrically expressed in the AIY neuron lineage and regulates AIY axon projections in a L-R asymmetric manner. Here, by combining a candidate approach and single-cell RNA sequencing data analysis, we identify the ephrin protein EFN-2 and the Flamingo protein FMI-1 as downstream targets of HLH-16 that are L-R asymmetrically expressed in the AIY lineage. We show that EFN-2 and FMI-1 collaborate in the L-R asymmetric regulation of axonal growth. EFN-2 may act via a non-canonical receptor of the L1CAM family, SAX-7. Our study reveals novel molecular L-R asymmetries in the C. elegans nervous system and their functional consequences.

7.
EMBO Rep ; 24(2): e55313, 2023 02 06.
Artículo en Inglés | MEDLINE | ID: mdl-36413000

RESUMEN

Growing evidence suggests that the corticotropin-releasing hormone (CRH) signaling pathway, mainly known as a critical initiator of humoral stress responses, has a role in normal neuronal physiology. However, despite the evidence of CRH receptor (CRHR) expression in the embryonic ventricular zone, the exact functions of CRH signaling in embryonic brain development have not yet been fully determined. In this study, we show that CRHR1 is required for the maintenance of neural stem cell properties, as assessed by in vitro neurosphere assays and cell distribution in the embryonic cortical layers following in utero electroporation. Identifying the underlying molecular mechanisms of CRHR1 action, we find that CRHR1 functions are accomplished through the increasing expression of the master transcription factor REST. Furthermore, luciferase reporter and chromatin immunoprecipitation assays reveal that CRHR1-induced CREB activity is responsible for increased REST expression at the transcriptional level. Taken together, these findings indicate that the CRHR1/CREB/REST signaling cascade plays an important role downstream of CRH in the regulation of neural stem cells during embryonic brain development.


Asunto(s)
Hormona Liberadora de Corticotropina , Células-Madre Neurales , Animales , Hormona Liberadora de Corticotropina/genética , Hormona Liberadora de Corticotropina/metabolismo , Receptores de Hormona Liberadora de Corticotropina/genética , Receptores de Hormona Liberadora de Corticotropina/metabolismo , Neuronas/metabolismo , Transducción de Señal , Células-Madre Neurales/metabolismo , Mamíferos/metabolismo
8.
Dev Dyn ; 2024 Sep 19.
Artículo en Inglés | MEDLINE | ID: mdl-39297504

RESUMEN

BACKGROUND: The vertebrate enteric nervous system (ENS) consists of a series of interconnected ganglia within the gastrointestinal (GI) tract, formed during development following migration of enteric neural crest cells (ENCCs) into the primitive gut tube. Much work has been done to unravel the complex nature of extrinsic and intrinsic factors that regulate processes that direct migration, proliferation, and differentiation of ENCCs. However, ENS development is a complex process, and we still have much to learn regarding the signaling factors that regulate ENCC development. RESULTS: Here in zebrafish, through transcriptomic, in situ transcript expression, immunohistochemical analysis, and chemical attenuation, we identified a time-dependent role for bone morphogenetic protein (BMP) in the maintenance of Phox2bb+ enteric progenitor numbers and/or time of differentiation of the progenitor pool. In support of our in silico transcriptomic analysis, we identified expression of a novel ENS ligand-encoding transcript, bmp5, within developmental regions of ENCCs. Through generation of a novel mutant bmp5wmr2 and bmp5 crispants, we identified a functional role for BMP5 in proper GI tract colonization, whereby phox2bb+ enteric progenitor numbers were reduced. CONCLUSION: Altogether, this work identified time-dependent roles for BMP signaling and a novel extrinsic factor, BMP5, that is necessary for vertebrate ENS formation.

9.
Biochem Soc Trans ; 52(1): 177-190, 2024 02 28.
Artículo en Inglés | MEDLINE | ID: mdl-38174765

RESUMEN

The enteric nervous system (ENS) is a complex series of interconnected neurons and glia that reside within and along the entire length of the gastrointestinal tract. ENS functions are vital to gut homeostasis and digestion, including local control of peristalsis, water balance, and intestinal cell barrier function. How the ENS develops during embryological development is a topic of great concern, as defects in ENS development can result in various diseases, the most common being Hirschsprung disease, in which variable regions of the infant gut lack ENS, with the distal colon most affected. Deciphering how the ENS forms from its progenitor cells, enteric neural crest cells, is an active area of research across various animal models. The vertebrate animal model, zebrafish, has been increasingly leveraged to understand early ENS formation, and over the past 20 years has contributed to our knowledge of the genetic regulation that underlies enteric development. In this review, I summarize our knowledge regarding the genetic regulation of zebrafish enteric neuronal development, and based on the most current literature, present a gene regulatory network inferred to underlie its construction. I also provide perspectives on areas for future zebrafish ENS research.


Asunto(s)
Sistema Nervioso Entérico , Pez Cebra , Animales , Humanos , Pez Cebra/genética , Sistema Nervioso Entérico/fisiología , Neuronas , Neurogénesis/genética , Regulación del Desarrollo de la Expresión Génica
10.
Crit Care ; 28(1): 47, 2024 02 16.
Artículo en Inglés | MEDLINE | ID: mdl-38365782

RESUMEN

INTRODUCTION: Trauma burden is one of the leading causes of young human life and economic loss in low- and middle-income countries. Improved emergency and trauma care systems may save up to 2 million lives in these countries. METHOD: This is a comprehensive expert opinion participated by 4 experts analyzing 6 Asian countries compiling the most pressing trauma care issues in Asia as well as goal directed solutions for uplifting of trauma care in these countries. RESULT: Lack of legislation, stable funding under a dedicated lead agency is a major deterrent to development and sustainment of trauma systems in most Asian countries. While advocating trauma, critical care as a specialty is a key event in the system establishment, Trauma specialized training is challenging in low resource settings and can be circumvented by regional cooperation in creating trauma specialized academic centers of excellence. Trauma quality improvement process is integral to the system maturity but acquisition and analysis of quality data through trauma specific registries is the least developed in the Asian setting.


Asunto(s)
Países en Desarrollo , Heridas y Lesiones , Humanos , Asia , Sistema de Registros , Mejoramiento de la Calidad , Heridas y Lesiones/terapia
11.
BMC Pediatr ; 24(1): 189, 2024 Mar 16.
Artículo en Inglés | MEDLINE | ID: mdl-38493096

RESUMEN

BACKGROUND: HSCR is a complex genetic disorder characterized by the absence of ganglion cells in the intestine, leading to a functional obstruction. It is due to a disruption of complex signaling pathways within the gene regulatory network (GRN) during the development of the enteric nervous system (ENS), including SRY-Box Transcription Factor 10 (SOX10) and REarranged during Transfection (RET). This study evaluated the expressions of SOX10 and RET in HSCR patients in Indonesia. METHODS: Total RNA of 19 HSCR ganglionic and aganglionic colons and 16 control colons were analyzed using quantitative real-time polymerase chain reaction for SOX10 and RET with GAPDH as the reference gene. Livak's method (2-ΔΔCT) was used to determine the expression levels of SOX10 and RET. RESULTS: Most patients were males (68.4%), in the short aganglionosis segment (78.9%), and had undergone transanal endorectal pull-through (36.6%). There were significant upregulated SOX10 expressions in both ganglionic (2.84-fold) and aganglionic (3.72-fold) colon of HSCR patients compared to controls' colon (ΔCT 5.21 ± 2.04 vs. 6.71 ± 1.90; p = 0.032; and ΔCT 4.82 ± 1.59 vs. 6.71 ± 1.90; p = 0.003; respectively). Interestingly, the RET expressions were significantly downregulated in both ganglionic (11.71-fold) and aganglionic (29.96-fold) colon of HSCR patients compared to controls' colon (ΔCT 12.54 ± 2.21 vs. 8.99 ± 3.13; p = 0.0004; and ΔCT 13.90 ± 2.64 vs. 8.99 ± 3.13; p = 0.0001; respectively). CONCLUSIONS: Our study shows aberrant SOX10 and RET expressions in HSCR patients, implying the critical role of SOX10 and RET in the pathogenesis of HSCR, particularly in the Indonesian population. Our study further confirms the involvement of SOX10-RET within the GNR during the ENS development.


Asunto(s)
Enfermedad de Hirschsprung , Masculino , Humanos , Femenino , Enfermedad de Hirschsprung/metabolismo , Transducción de Señal , Indonesia , Proteínas Proto-Oncogénicas c-ret/genética , Proteínas Proto-Oncogénicas c-ret/metabolismo , Factores de Transcripción SOXE/genética
12.
Dev Dyn ; 252(1): 172-185, 2023 01.
Artículo en Inglés | MEDLINE | ID: mdl-35112412

RESUMEN

BACKGROUND: Development of the nervous system and the correct connection of nerve cells require coordinated axonal pathfinding through an extracellular matrix. Outgrowing axons exhibit directional growth toward or away from external guidance cues such as Netrin. Guidance cues can be detected by growth cones that are located at the end of growing axons through membrane-bound receptors such as Uncoordianted-5 and Frazzled. Binding of Netrin causes reformation of the cytoskeleton and growth of the axon toward (or away from) the source of Netrin production. RESULTS: Here, we investigate the embryonic mRNA expression patterns of netrin genes and their potential receptors, uncoordinated-5 and frazzled in arthropod species that cover all main branches of Arthropoda, that is, Pancrustacea, Myriapoda, and Chelicerata. We also studied the expression patterns in a closely related outgroup species, the onychophoran Euperipatoides kanangrensis, and provide data on expression profiles of these genes in larval tissues of the fly Drosophila melanogaster including the brain and the imaginal disks. CONCLUSION: Our data reveal conserved and diverged aspects of neuronal guidance in Drosophila with respect to the other investigated species and suggest a conserved function in nervous system patterning of the developing appendages.


Asunto(s)
Artrópodos , Proteínas de Drosophila , Animales , Netrinas/genética , Netrinas/metabolismo , Drosophila melanogaster/genética , Artrópodos/genética , Artrópodos/metabolismo , Orientación del Axón , Proteínas de Drosophila/genética , Proteínas de Drosophila/metabolismo , Drosophila/genética , Axones/metabolismo , Receptores de Netrina/metabolismo
13.
J Neurochem ; 2023 Sep 11.
Artículo en Inglés | MEDLINE | ID: mdl-37697696

RESUMEN

This is a tribute to John Edmond, professor emeritus of biological chemistry in the David Geffen School of Medicine at UCLA, a renowned neurochemist who had a leadership role in founding the ICBEM meeting series in 1993. John was known for his very warm and engaging personality and his innovative approaches to studying the developing brain and auditory system. He was a brilliant scientist and a fun and delightful person. Without John Edmond's enthusiasm and contributions, we would not have the biennial ICBEM meetings which as noted by Dienel et al. "have had a high impact on conceptual and experimental advances" … "in the energetics and metabolism underlying neural functions"… and "on promoting collaborative interactions among neuroscientists." Sadly, John Edmond passed away on February 18, 2022, following a cerebral hemorrhage. He will be greatly missed by his colleagues and friends.

14.
J Nutr ; 153(8): 2482-2496, 2023 08.
Artículo en Inglés | MEDLINE | ID: mdl-37276938

RESUMEN

BACKGROUND: Docosahexaenoic acid (DHA) and arachidonic acid (AA) on oral tolerance (OT) development in allergy-prone infants is less known. OBJECTIVES: We aim to determine the effects of early life DHA supplementation (1% of total fat, from novel canola oil), along with AA, on OT toward ovalbumin (ova, egg protein) in allergy-prone BALB/c pups at 6-wk. METHODS: Breastfeeding dams (n ≥ 10/diet) were fed DHA+AA (1% DHA, 1% AA wt/wt of total fat) or control (0% DHA, 0% AA) suckling period diet (SPD) during which pups consumed dam's milk. At 3-wk, pups from each SPD group were assigned to either the control or DHA+AA weaning diet. For OT, pups from each diet group were either orally fed ova or placebo daily from 21-25 d. Systemic immunization to ova was induced through intraperitoneal injections before euthanizing 6-wk pups. Ova-specific immunoglobulin (ova-Ig) and splenocytes ex-vivo cytokine response to different stimuli were analyzed using a 3-factor analysis of variance. RESULTS: OT-induced suppression was seen in ova-stimulated splenocyte ex-vivo response, where ova-tolerized pups showed significantly lower total immunoglobulin (Ig)G, IgG1, interleukin (IL)-2 and IL-6 production than sucrose (placebo) pups. DHA+AA SPD was associated with 3 times lower plasma concentrations of ova-IgE (P = 0.03) than controls. DHA+AA weaning diet resulted in lower T helper type-2 cytokines (IL-4 and IL-6) with ova stimulation than controls, which may benefit OT. DHA+AA SPD resulted in significantly higher T cell cytokine response [IL-2, interferon-gamma, (IFNγ) and IL-1ß] to anti-CD3/CD28 stimulation than controls. The splenocytes stimulated with lipopolysaccharide produced lower inflammatory cytokines (IFNγ, tumor necrosis factor-alpha, IL-6, and C-X-C motif ligand 1), which may be because of lower CD11b+CD68+ splenocytes proportion in pups from DHA+AA SPD than control (all P < 0.05). CONCLUSIONS: DHA and AA in early life may influence OT in allergy-prone BALB/c mouse offspring, as they effectively promote T helper type-1 immune responses.


Asunto(s)
Ácidos Docosahexaenoicos , Hipersensibilidad , Animales , Ratones , Ácidos Docosahexaenoicos/farmacología , Ácido Araquidónico , Interleucina-6 , Citocinas/metabolismo , Ovalbúmina/farmacología , Inmunoglobulina G , Linfocitos T/metabolismo , Ratones Endogámicos BALB C , Tolerancia Inmunológica
15.
J Biomed Inform ; 143: 104414, 2023 07.
Artículo en Inglés | MEDLINE | ID: mdl-37276948

RESUMEN

OBJECTIVE: Trust determines the success of Health-Behavior-Change Artificial Intelligence Apps (HBC-AIApp). Developers of such apps need theory-based practical methods that can guide them in achieving such trust. Our study aimed to develop a comprehensive conceptual model and development process that can guide developers how to build HBC-AIApp in order to support trust creation among the app's users. METHODS: We apply a multi-disciplinary approach where medical informatics, human-centered design, and holistic health methods are integrated to address the trust challenge in HBC-AIApps. The integration extends a conceptual model of trust in AI developed by Jermutus et al., whose properties guide the extension of the IDEAS (integrate, design, assess, and share) HBC-App development process. RESULTS: The HBC-AIApp framework consists of three main blocks: (1) system development methods that study the users' complex reality, hence, their perceptions, needs, goals and environment; (2) mediators and other stakeholders who are important for developing and operating the HBC-AIApp, boundary objects that examine users' activities via the HBC-AIApp; and (3) the HBC-AIApp's structural components, AI logic, and physical implementation. These blocks come together to provide the extended conceptual model of trust in HBC-AIApps and the extended IDEAS process. DISCUSSION: The developed HBC-AIApp framework drew from our own experience in developing trust in HBC-AIApp. Further research will focus on studying the application of the proposed comprehensive HBC-AIApp development framework and whether applying it supports trust creation in such apps.


Asunto(s)
Inteligencia Artificial , Aplicaciones Móviles , Humanos , Confianza , Conductas Relacionadas con la Salud , Registros
16.
BMC Med Educ ; 23(1): 498, 2023 Jul 06.
Artículo en Inglés | MEDLINE | ID: mdl-37415150

RESUMEN

BACKGROUND: Policymakers and program developers in low-and lower-middle-income countries (LLMICs) are increasingly seeking evidence-based information and guidance on how to successfully develop and implement continuing professional development (CPD) systems. We conducted a rapid scoping review to map and synthesize what is known regarding the development, implementation, evaluation and sustainability of CPD systems for healthcare professionals in LLMICs. METHODS: We searched MEDLINE, CINAHL and Web of Science. Reference lists were screened and a cited reference search of included articles was conducted. Supplementary information on the CPD systems identified in the articles was also identified via an online targeted grey literature search. English, French and Spanish literature published from 2011 to 2021 were considered. Data were extracted and combined and summarized according to country/region and healthcare profession via tables and narrative text. RESULTS: We included 15 articles and 23 grey literature sources. Africa was the region most represented followed by South and Southeast Asia and the Middle East. The literature most often referred to CPD systems for nurses and midwives; CPD systems for physicians were frequently referred to as well. Findings show that leadership and buy-in from key stakeholders, including government bodies and healthcare professional organizations, and a framework are essential for the development, implementation and sustainability of a CPD system in a LLMIC. The guiding framework should incorporate a regulatory perspective, as well as a conceptual lens (that informs CPD objectives and methods), and should consider contextual factors (support for CPD, healthcare context and population health needs). In terms of important steps to undertake, these include: a needs assessment; drafting of a policy, which details the regulations (laws/norms), the CPD requirements and an approach for monitoring, including an accreditation mechanism; a financing plan; identification and production of appropriate CPD materials and activities; a communication strategy; and an evaluation process. CONCLUSION: Leadership, a framework and a clearly delineated plan that is responsive to the needs and context of the setting, are essential for the development, implementation and sustainability of a CPD system for healthcare professionals in a LLMIC.


Asunto(s)
Países en Desarrollo , Médicos , Humanos , Personal de Salud/educación , Atención a la Salud , Evaluación de Necesidades
17.
Sensors (Basel) ; 23(22)2023 Nov 20.
Artículo en Inglés | MEDLINE | ID: mdl-38005670

RESUMEN

Neurogenic bladder is a dysfunction in the lower urinary tract due to damage to the nervous system. One of the treatments that has shown important results is transcutaneous neuromodulation. The neuromodulation equipment available on the market does not allow remote activation or offer many resources for adjusting the parameters of the generated stimulus, as most devices operate with pre-established parameters in closed packages. For this reason, customizing therapy for each individual can be difficult. Therefore, the objective was to develop and validate a neuromodulation device capable of being remotely programmed and properly monitored. Materials and methods for validating devices were used according to the Brazilian Regulatory Standard (NBR), which deals with general requirements for the basic safety and essential performance of electromedical devices. After verifying the reliability of the device, which was capable of generating a biphasic and symmetrical wave, measured by an oscilloscope, considered safe by the technical requirements, it was tested in a real application. Users reported feeling a comfortable stimulus, similar to other previously used devices, and considered the device easy to use. In this way, it was possible to demonstrate the reliability and validity of the developed device.


Asunto(s)
Terapia por Estimulación Eléctrica , Vejiga Urinaria Neurogénica , Humanos , Vejiga Urinaria Neurogénica/terapia , Reproducibilidad de los Resultados , Vejiga Urinaria , Terapia por Estimulación Eléctrica/métodos , Brasil
18.
Sensors (Basel) ; 23(24)2023 Dec 11.
Artículo en Inglés | MEDLINE | ID: mdl-38139605

RESUMEN

In badminton, accurate service height detection is critical for ensuring fairness. We developed an automated service fault detection system that employed computer vision and machine learning, specifically utilizing the YOLOv5 object detection model. Comprising two cameras and a workstation, our system identifies elements, such as shuttlecocks, rackets, players, and players' shoes. We developed an algorithm that can pinpoint the shuttlecock hitting event to capture its height information. To assess the accuracy of the new system, we benchmarked the results against a high sample-rate motion capture system and conducted a comparative analysis with eight human judges that used a fixed height service tool in a backhand low service situation. Our findings revealed a substantial enhancement in accuracy compared with human judgement; the system outperformed human judges by 3.5 times, achieving a 58% accuracy rate for detecting service heights between 1.150 and 1.155 m, as opposed to a 16% accuracy rate for humans. The system we have developed offers a highly reliable solution, substantially enhancing the consistency and accuracy of service judgement calls in badminton matches and ensuring fairness in the sport. The system's development signifies a meaningful step towards leveraging technology for precision and integrity in sports officiation.

19.
Sensors (Basel) ; 23(17)2023 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-37687973

RESUMEN

Abnormal formation of girth weld is a major threat to the safe operation of pipelines, which may lead to serious accidents. Therefore, regular inspection and maintenance of girth weld are essential for accident prevention and energy security. This paper presents a novel method for inspecting abnormal girth weld formation in oil and gas pipelines using alternating excitation detection technology. The method is based on the analysis of the microscopic magnetic variations in the welded area under alternating magnetic fields. An internal inspection probe and electronic system for detecting abnormal girth weld formation were designed and developed. The system's capability to identify misalignment, undercutting, root concavity, and abnormal formation height of girth weld was tested by numerical simulation and experimental study. The results show that the detection system can effectively identify a minimum misalignment of 0.5 mm at a lift-off height of 15 mm. The proposed method offers several advantages, such as rapid response, low cost, non-contact operation, and high sensitivity to surface flaws in ferromagnetic pipelines.

20.
Genes Dev ; 29(7): 746-59, 2015 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-25838543

RESUMEN

Alternative splicing (AS) generates vast transcriptomic complexity in the vertebrate nervous system. However, the extent to which trans-acting splicing regulators and their target AS regulatory networks contribute to nervous system development is not well understood. To address these questions, we generated mice lacking the vertebrate- and neural-specific Ser/Arg repeat-related protein of 100 kDa (nSR100/SRRM4). Loss of nSR100 impairs development of the central and peripheral nervous systems in part by disrupting neurite outgrowth, cortical layering in the forebrain, and axon guidance in the corpus callosum. Accompanying these developmental defects are widespread changes in AS that primarily result in shifts to nonneural patterns for different classes of splicing events. The main component of the altered AS program comprises 3- to 27-nucleotide (nt) neural microexons, an emerging class of highly conserved AS events associated with the regulation of protein interaction networks in developing neurons and neurological disorders. Remarkably, inclusion of a 6-nt, nSR100-activated microexon in Unc13b transcripts is sufficient to rescue a neuritogenesis defect in nSR100 mutant primary neurons. These results thus reveal critical in vivo neurodevelopmental functions of nSR100 and further link these functions to a conserved program of neuronal microexon splicing.


Asunto(s)
Proteínas del Tejido Nervioso/genética , Proteínas del Tejido Nervioso/metabolismo , Sistema Nervioso/embriología , Neurogénesis/genética , Empalme del ARN/genética , Animales , Embrión de Mamíferos , Exones/genética , Ratones , Ratones Endogámicos C57BL , Ratones Endogámicos ICR , Mutación , Análisis de Secuencia de ARN
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