Tecnologias em saúde da hanseníase no âmbito da Atenção Primária à Saúde: revisão de escopo / Leprosy health technologies in Primary Health Care: a scoping review / Tecnologías en salud de la lepra en el ámbito de la Atención Primaria a la Salud: revisión del alcance

Objetivo: mapear as tecnologias em saúde para manejo no cuidado à pessoa com hanseníase na Atenção Primária à Saúde. Método: revisão de escopo baseada na metodologia do JBI, em seis bases de dados, seguindo a checklist Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Foram incluídos estudos publicados em qualquer idioma, com diferentes abordagens metodológicas. Resultados: os 14 estudos incluídos na revisão mostram que a aplicabilidade de tecnologias para o manejo do cuidado a pessoa com hanseníase na Atenção Primária à Saúde, possibilitam a confirmação de diagnóstico, acompanhamento, monitoramento e prevenção de incapacidades. Conclusão: nota-se que tecnologia em saúde se apresentam como ferramentas que auxiliam no processo de cuidado na assistência a pessoas com hanseníase, a fim de permitir aos profissionais de saúde conhecimento sobre a doença, proporcionando qualidade na sua prática de saúde.

Objective: to map health technologies for managing the care of people with leprosy in Primary Health Care. Method: scoping review based on the JBI methodology in six databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Studies published in any language were included, with different methodological approaches. Results: the 14 studies included in the review show that the applicability of technologies for the management of care for people with leprosy in Primary Health Care makes it possible to confirm diagnosis, follow-up, monitoring, and prevention of disabilities. Conclusion: it has been noted that health technologies are tools that help in the process of caring for people with leprosy, to provide health professionals with knowledge about the disease, improving quality of health practice.

Objetivo: mapear las tecnologías en salud para el manejo en el cuidado a la persona con lepra en la Atención Primaria a la Salud. Método: revisión del alcance basada en la metodología del JBI, en seis bases de datos, siguiendo la checklist Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews. Se han incluido estudios publicados en cualquier idioma, con diferentes enfoques metodológicos. Resultados: los 14 estudios incluidos en la revisión muestran que la aplicabilidad de tecnologías para el manejo del cuidado a la persona con lepra en la Atención Primaria a la Salud posibilita la confirmación de diagnóstico, seguimiento, monitoreo y prevención de incapacidades. Conclusión: se percibe que las tecnologías en salud se presentan como herramientas que ayudan en el proceso de cuidado en la asistencia a personas con lepra, con fines de permitir a los profesionales de salud el acceso al conocimiento sobre la enfermedad, proporcionando calidad en su práctica de salud.

A smart device application for acute pain service in surgical patients at a tertiary hospital in South Korea: a prospective observational feasibility study.

Background: Pain assessment and patient education are essential for successful postoperative pain management. However, the provision of personnel for performing these tasks is often insufficient. Recently, attempts have been made to implement smartphone applications for educating and monitoring surgical patients. We developed a smartphone application (app) for postoperative pain management, and conducted a feasibility study. Methods: This single-center prospective observational study included 60 patients aged < 70 years who underwent elective surgery. This study evaluated the SmartAPS application, which offers tools for postoperative pain assessment and educational materials for pain management. The primary outcome was the active usage rate, defined as responding at least twice daily on postoperative days (PODs) 1 and 2. Additionally, we investigated patient satisfaction with the app and educational videos as well as any challenges encountered during use. Results: Sixty patients were enrolled in the study and active app use was achieved in 56.7% of them. Response rates peaked at 85.0% for pain intensity and 83.3% for opioid-related side effects at 14:00 on POD 1 but dropped to 56.7% and 58.3%, respectively, at 18:00 on POD 2. Among the patients who responded to the survey regarding the app usage, 84.0% reported satisfaction with the app and 80% found it beneficial for managing postoperative pain. Furthermore, 92.0% did not encounter difficulties using the app, indicating a generally positive user experience. Conclusions: Our findings support the utility of the SmartAPS application in acute pain services, highlighting its potential for improving postoperative pain management.

Immunologic Mechanisms of BCc1 Nanomedicine Synthesized by Nanochelating Technology in Breast Tumor-Bearing Mice: Immunomodulation and Tumor Suppression.

INTRODUCTION: The side effects of anti-cancer chemotherapy remain a concern for patients. So, designing alternative medications seems inevitable. In this research, the immunological mechanisms of BCc1 nanomedicine on tumor-bearing mice were investigated. METHODS: BALB/c mice underwent tumor transplantation and were assigned into four groups. Group 1 was orally administered with PBS buffer, Group 2 was orally administered BCc1 10 mg/kg, and Group 3 was orally administered BCc1 40 mg/kg daily, respectively. In addition, a group of mice was administered Cyclophosphamide, 20 mg/kg daily. The weight and tumor volume of mice were evaluated bi-weekly. After 24 days of treatment, cytokines and CTL assay in the spleen cell and the tumor were assessed. Furthermore, the spleen, liver, kidney, lung, gut, and uterine tissue were stained with hematoxylin and eosin. Finally, the tumor samples were stained and analyzed for FOXP3. The survival rate of mice was recorded. RESULTS: The results confirmed the histological safety of BCc1. This nanomedicine, especially BCc1 10 mg/kg, led to a strong IFN-γ response and suppressed TGF-ß cytokine. The frequency of Treg in the tumor tissue of BCc1 nanomedicine groups was decreased. In addition, nanomedicine repressed tumor volume and tumor weight significantly, which was comparable to Cyclophosphamide. These immunologic events increased the survival rate of BCc1-treated groups. The results indicate that BCc1 nanomedicine can suppress tumor growth and thereby increase the survival rate of experimental mice. CONCLUSION: It seems a modulation in the tumor microenvironment and polarization toward a Th1 response may be involved. So, BCc1 nanomedicine is efficient for human cancer therapy.

Robot-Assisted Total Hip Arthroplasty Demonstrates Improved 90-Day Clinical and Patient-Reported Outcomes.

Background: The utilization of technology, including robotics and computer navigation, in total hip arthroplasty (THA) has been steadily increasing; however, conflicting data exists regarding its effect on short-term clinical and patient-reported outcomes. Therefore, this study sought to explore the association between different surgical technologies and postoperative outcomes following THA. Methods: We retrospectively reviewed 9892 primary THA cases performed by 62 surgeons from a single institution from September 2017 to November 2022. Three cohorts were created based on the utilization of technology: conventional (no technology), navigation, or robotics. Patient demographics, clinical outcomes, and patient-reported outcome measures were collected over the first 90 days following surgery. This data was compared using analysis of variance and multivariate logistic regressions. In total, 4275 conventional, 4510 navigation, and 1107 robotic cases were included in our analyses. Results: The robotic cohort achieved a perfect Activity Measure for Post-Acute Care (AM-PAC) score earliest (0.1 days, P < .001). After adjusting for potential confounding variables, use of robotic assistance was associated with greater odds of achieving a perfect AM-PAC score on postoperative day 0 (odds ratio 1.6, P < .001) and greater odds of having length of stay shorter than 24 hours (odds ratio 2.3, P < .001) compared to no technology use in THA. Hip dysfunction and Osteoarthritis Outcome Score, Joint Replacement and Patient-Reported Outcomes Measurement Information System Pain Interference scores showed the greatest improvement in the robotic cohort at both 6 weeks and 3 months following surgery. Conclusions: The present study demonstrates favorable clinical and patient-reported outcomes in the first 90 days following surgery for patients undergoing robot-assisted THA compared to conventional and navigation-assisted THA.

The Role of Medical Societies and the Relevance of Clinical Perspective in the Evolving EU HTA Process: Insights Generated at the 2023 Fall Convention and Survey of the European Access Academy.

BACKGROUND: This work aimed to determine the role and action points for the involvement of medical societies in the European Health Technology Assessment (EU HTA) Methods: An online pre-convention survey was developed addressing four areas related to the EU HTA: (i) medical societies' role; (ii) role of clinical guidelines; (iii) interface with the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS); and (iv) approaching 'best-available evidence' (BAE). A descriptive analysis of questionnaire outcomes was conducted to inform the European Access Academy (EAA) Fall Convention 2023. Within the working groups (WGs), action points were identified and prioritised. RESULTS: A total of 57 experts from 15 countries responded to the survey. The WGs were attended by (i) 11, (ii) 10, (iii) 12, and (iv) 12 experts, respectively, representing a variety of national backgrounds and stakeholder profiles. The most relevant action points identified were as follows: (i) incorporation of clinical context into population, intervention, comparator, outcomes (PICO) schemes, (ii) timely provision of up-to-date therapeutic guidelines, (iii) ensuring the inclusion of MCBS insights into the EU HTA process, and (iv) considering randomized controlled trials (RCTs) as the gold standard and leveraging regulatory insights if development programs only include single-arm trials. CONCLUSIONS: The involvement of medical societies is a critical success factor for the EU HTA. The identified key action points foster the involvement of patient associations and medical societies.

Using the Probability Density Function-Based Channel-Combination Bloch-Siegert Method Realizes Permittivity Imaging at 3T.

Magnetic resonance electrical properties tomography (MR EPT) can retrieve permittivity from the B1+ magnitude. However, the accuracy of the permittivity measurement using MR EPT is still not ideal due to the low signal-to-noise ratio (SNR) of B1+ magnitude. In this study, the probability density function (PDF)-based channel-combination Bloch-Siegert (BSS) method was firstly introduced to MR EPT for improving the accuracy of the permittivity measurement. MRI experiments were performed using a 3T scanner with an eight-channel receiver coil. The homogeneous water phantom was scanned for assessing the spatial distribution of B1+ magnitude obtained from the PDF-based channel-combination BSS method. Gadolinium (Gd) phantom and rats were scanned for assessing the feasibility of the PDF-based channel-combination BSS method in MR EPT. The Helmholtz-based EPT reconstruction algorithm was selected. For quantitative comparison, the permittivity measured by the open-ended coaxial probe method was considered as the ground-truth value. The accuracy of the permittivity measurement was estimated by the relative error between the reconstructed value and the ground-truth value. The reconstructed relative permittivity of Gd phantom was 52.413, while that of rat leg muscle was 54.053. The ground-truth values of relative permittivity of Gd phantom and rat leg muscle were 78.86 and 49.04, respectively. The relative error of average permittivity was 33.53% for Gd and 10.22% for rat leg muscle. The results indicated the high accuracy of the permittivity measurement using the PDF-based channel-combination BSS method in MR EPT. This improvement may promote the clinical application of MR EPT technology, such as in the early diagnosis of cancers.

Recent Advances in Astaxanthin as an Antioxidant in Food Applications.

In recent years, astaxanthin as a natural substance has received widespread attention for its potential to replace traditional synthetic antioxidants and because its antioxidant activity exceeds that of similar substances. Based on this, this review introduces the specific forms of astaxanthin currently used as an antioxidant in foods, both in its naturally occurring forms and in artificially added forms involving technologies such as emulsion, microcapsule, film, nano liposome and nano particle, aiming to improve its stability, dispersion and bioavailability in complex food systems. In addition, research progress on the application of astaxanthin in various food products, such as whole grains, seafood and poultry products, is summarized. In view of the characteristics of astaxanthin, such as insolubility in water and sensitivity to light, heat, oxygen and humidity, the main research trends of astaxanthin-loaded systems with high encapsulation efficiency, good stability, good taste masking effect and cost-effectiveness are also pointed out. Finally, the possible sensory effects of adding astaxanthin to food aresummarized, providing theoretical support for the development of astaxanthin-related food.

Targeted Delivery of Nanoparticles to Blood Vessels for the Treatment of Atherosclerosis.

Atherosclerosis is a common form of cardiovascular disease, which is one of the most prevalent causes of death worldwide, particularly among older individuals. Surgery is the mainstay of treatment for severe stenotic lesions, though the rate of restenosis remains relatively high. Current medication therapy for atherosclerosis has limited efficacy in reversing the formation of atherosclerotic plaques. The search for new drug treatment options is imminent. Some potent medications have shown surprising therapeutic benefits in inhibiting inflammation and endothelial proliferation in plaques. Unfortunately, their use is restricted due to notable dose-dependent systemic side effects or degradation. Nevertheless, with advances in nanotechnology, an increasing number of nano-related medical applications are emerging, such as nano-drug delivery, nano-imaging, nanorobots, and so forth, which allow for restrictions on the use of novel atherosclerotic drugs to be lifted. This paper reviews new perspectives on the targeted delivery of nanoparticles to blood vessels for the treatment of atherosclerosis in both systemic and local drug delivery. In systemic drug delivery, nanoparticles inhibit drug degradation and reduce systemic toxicity through passive and active pathways. To further enhance the precise release of drugs, the localized delivery of nanoparticles can also be accomplished through blood vessel wall injection or using endovascular interventional devices coated with nanoparticles. Overall, nanotechnology holds boundless potential for the diagnosis and treatment of atherosclerotic diseases in the future.

The Advancement of Waterjet-Guided Laser Cutting System for Enhanced Surface Quality in AISI 1020 Steel Sheets.

This study investigates the effects of a water-guided laser on the cutting performance of AISI 1020 steel sheets of various thicknesses by comparing the results with respect to a conventional laser. For this purpose, a novel nozzle design has been devised enabling the delivery of laser beams to the workpiece conventionally as well as through water guidance. Diverging from prior literature, a fiber laser is used with a high wavelength and a laser power output of 1 kW. Experiments are conducted on steel sheets with thicknesses ranging from 1.5 mm to 3 mm using three different cutting speeds and laser power levels. Analysis focuses on assessing surface roughness, burr formation and heat effects on the cut surfaces for both conventional and waterjet-guided cutting. Surface roughness is evaluated by using a 3D profilometer and cut surfaces are examined through SEM imaging. The results showed that the waterjet-guided laser system greatly reduced surface roughness and minimized problems associated with traditional laser cutting such as kerf, dross adherence and thermal damage. The study revealed that cutting speed had a greater effect on surface roughness reduction than laser power, with the most noticeable differences occurring in thinner sheets. Furthermore, the investigation suggests that the waterjet-guided laser cutting system demonstrates superior performance relative to conventional methods, particularly in surface quality.

The Main Failure Modes of Hot-Work Die Steel and the Development Status of Traditional Strengthening Methods and Nano-Strengthening Technology.

As an important part of die steels, hot-work die steels are mainly used to manufacture molds made of solid metal or high-temperature liquid metal from heating to recrystallization temperature. In view of the requirements for mechanical properties and service life for hot-work die steel, it is conducive to improve the thermal fatigue resistance, wear resistance, and oxidation resistance of hot work die steel. In this review, the main failure modes of hot-work die steel were analyzed. Four traditional methods of strengthening and toughening die steel were summarized, including optimizing alloying elements, electroslag remelting, increasing the forging ratio, and heat treatment process enhancement. A new nano-strengthening method was introduced that aimed to refine the microstructure of hot-work abrasive steel and improve its service performance by adding nanoparticles into molten steel to achieve uniform dispersion. This review provides an overview to improve the service performance and service life of hot work die steel.

Research on the Influence of HMFI and PWHT Treatments on the Properties and Stress States of MAG-Welded S690QL Steel Joints.

The aim of this study was to analyze the effect of the HFMI (high-frequency mechanical impact) treatment of each weld bead on the properties of a butt joint with a ceramic backing welded by robotic method 135 (MAG-metal active gas welding method) and to determine the effect of HMFI on the stress level. This analysis was based on a comparison of three butt joints made of a S690QL plate, in the as-welded condition, with the HFMI of each bead and with the heat treatment carried out with PWHT stress relief annealing. The high-frequency (90 Hz) peening of each weld bead was linked with a stress reduction in the weld via the implementation of compressive stresses into the joint. The HFMI pneumatic hammer was used for this. The correctness of treatment was achieved when 100% of the surface of each bead including the face was treated. As part of the post-welding tests, basic tests were carried out based on the standards for the qualification of welding technology, and as a supplementary test, a stress state analysis using the Barkhausen effect was carried out. The tests carried out showed that the use of high-frequency peening after each pass did not affect the negative results of all the required tests when qualifying the welding technology of S690QL sheet metal compared to the test plates in the as-welded condition and after heat treatment-stress relief annealing. Inter-pass peening of the welded face and HAZ (heat-affected zone) resulted in a reduction in post-weld residual stresses at a distance of 12 mm from the joint axis compared to the stress measurement result for the sample in the as-welded condition. This allowed for a positive assessment of peening in the context of reducing the notch, which is the concentration of tensile stresses in the area of the fusion line and HAZ. The tests carried out showed that the peening process does not reduce the strength properties of welded joints, and the results obtained allow the technology to be qualified based on applicable standards.

Advanced Sperm Selection Techniques for Assisted Reproduction.

Male infertility accounts for approximately 40% of infertility cases. There are many causes of male infertility, including environmental factors, age, lifestyle, infections, varicocele, and cancerous pathologies. Severe oligozoospermia, cryptozoospermia, and azoospermia (obstructive and non-obstructive) are identified as severe male factor infertility, once considered conditions of sterility. Today, in vitro fertilization (IVF) techniques are the only treatment strategy in cases of male factor infertility for which new methodologies have been developed in the manipulation of spermatozoa to achieve fertilization and increase success rates. This review is an update of in vitro manipulation techniques, in particular sperm selection, emphasizing clinical case-specific methodology. The success of an IVF process is related to infertility diagnosis, appropriate choice of treatment, and effective sperm preparation and selection. In fact, selecting the best spermatozoa to guarantee an optimal paternal heritage means increasing the blastulation, implantation, ongoing pregnancy and live birth rates, resulting in the greater success of IVF techniques.

Heart Rate Variability Biofeedback Efficacy on Fatigue and Energy Levels in Fibromyalgia: A Secondary Analysis of RCT NCT0412183.

Background: Fibromyalgia syndrome (FMs) is a chronic condition characterized by widespread musculoskeletal pain and a range of complex symptoms, with chronic fatigue being a central feature significantly impacting daily life. The aim of this study was to analyze the secondary outcomes, specifically those related to perceived energy and fatigue symptoms in a randomized controlled trial (RCT) assessing the efficacy of heart rate variability biofeedback (HRV-BF) as an adjunctive treatment for FMs. Methods: Sixty-four FMs patients were randomly assigned to either receive 10 HRV-BF training sessions alongside standard pharmacological therapy (experimental group) or standard therapy alone for 10 weeks (control group). For this secondary analysis, potential improvements in specific items were evaluated regarding perceived energy (Item 10 of the Short-Form Health Survey), the ability to walk and climb stairs (Item 7 and Item 11 of the Fibromyalgia Impact Questionnaire, respectively), and the impact of pain on movement ability (Item 17 of the Bodily and Emotional Perception of Pain). Results: The experimental group demonstrated an improvement in the perception of energy, the ability to walk, and the impact of pain on movement ability. However, the same improvement was not observed in the ability to climb stairs. Conclusions: Fatigue assessment has emerged as a crucial factor for evaluating treatment efficacy in FMs and related conditions linked to altered energy levels, such as bipolar depression, and can offer valuable insights for precisely guiding HRV-BF treatments. ClinicalTrials.gov with code: NCT04121832.

Innovative Mitral Valve Repair Using a Novel Automated Suturing System: Preliminary Data.

(1) Background and Objectives: Mitral regurgitation is a common valve disease requiring surgical repair. Even with satisfactory results, repair techniques may underlie subjectivity and variability and require long learning curves. A novel approach, the "Roman Arch" technique, may ease the technical burden. This study assessed an automated suturing device's feasibility and time efficiency for a proposed simplified technique. (2) Materials and Methods: Using the MiStitch™ and MiKnot™ devices (LSI Solutions, Inc., Victor, NY, USA), the suture pattern was performed in a cadaver model. Three surgeons with different expertise levels conducted the procedures. Repair and suture placement times were recorded and analyzed. (3) Results: The modified "Roman Arch" repair was completed on all ten human heart specimens with an average total repair time of 3:01 ± 00:59 min and a trend toward reduced times as experience increased. The study confirmed the technical feasibility with 90% of the attempts rated as rather satisfactory or very satisfactory. (4) Conclusions: The MiStitch™ system effectively facilitated the modified "Roman Arch" repair in an ex vivo setting, suggesting its potential to reduce the technical complexity of mitral valve repairs. Further studies are needed to confirm its efficacy and safety in clinical practice.

Advances of 3D Cell Co-Culture Technology Based on Microfluidic Chips.

Cell co-culture technology aims to study the communication mechanism between cells and to better reveal the interactions and regulatory mechanisms involved in processes such as cell growth, differentiation, apoptosis, and other cellular activities. This is achieved by simulating the complex organismic environment. Such studies are of great significance for understanding the physiological and pathological processes of multicellular organisms. As an emerging cell cultivation technology, 3D cell co-culture technology, based on microfluidic chips, can efficiently, rapidly, and accurately achieve cell co-culture. This is accomplished by leveraging the unique microchannel structures and flow characteristics of microfluidic chips. The technology can simulate the native microenvironment of cell growth, providing a new technical platform for studying intercellular communication. It has been widely used in the research of oncology, immunology, neuroscience, and other fields. In this review, we summarize and provide insights into the design of cell co-culture systems on microfluidic chips, the detection methods employed in co-culture systems, and the applications of these models.

Supportive eHealth Technologies and Their Effects on Physical Functioning and Quality of Life for People With Lung Cancer: Systematic Review.

BACKGROUND: Despite advancements in treatment and early diagnosis, people with lung cancer are not living as long as those with other cancers. The more common symptoms of lung cancer, such as breathlessness, fatigue, and depression, can be alleviated by improving patients' physical functioning. Therefore, good symptom management and improved health-related quality of life (HRQoL) are priorities in this patient group. However, current health care services have limited capacity to provide this support. One way to address this issue of health care resources is to empower patients to self-manage their condition using eHealth technologies. OBJECTIVE: The purpose of this review was to identify and assess available research on technologies that support persons with lung cancer to improve or maintain their physical functioning, HRQoL, or both. METHODS: Six databases-PubMed, Web of Science, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO-were searched from January 1, 1990, to April 30, 2023. Studies were suitable for inclusion if the participants included people with lung cancer aged >18 years who had been exposed to a physical activity, exercise, or training intervention that was delivered via an electronic or web-based application with or without a comparator. Furthermore, the study had to report on the impact of the intervention on physical functioning and HRQoL. Studies that focused on telemedicine without a digital intervention were excluded. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assess the quality of the included papers. Due to the heterogeneity of the studies, a narrative synthesis was undertaken. RESULTS: This review is reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. A total of 794 papers were initially identified through our search, of which, after screening, 8 (1%) were confirmed suitable for inclusion in the review. As 2 (25%) of the 8 papers reported on different stages of the same study, we included only 7 studies in our analysis. The studies were undertaken between 2010 and 2018 across multiple countries and aimed to develop a technology and test its feasibility or acceptance. The 7 technologies identified included web-based applications, mobile apps, and gaming consoles. The studies demonstrated impact on walking distance, muscle strength, balance, dyspnea symptoms, and cancer-related fatigue. HRQoL scores also showed improvement. CONCLUSIONS: The findings indicate that eHealth technologies can positively impact physical functioning and well-being for people with lung cancer, but there are limited studies that demonstrate the impact of these digital interventions over longer periods. None of the studies reported on the implementation or adoption of a mobile health or eHealth intervention in routine clinical practice, highlighting the need for further research in this area. TRIAL REGISTRATION: PROSPERO CRD42023414094; https://tinyurl.com/39hhbwyx.

Untangling the independent effect of endometriosis, adenomyosis, and ART-related factors on maternal, placental, fetal, and neonatal adverse outcomes: results from a systematic review and meta-analysis.

BACKGROUND: Women with endometriosis may constitute a group at a particularly increased risk of pregnancy-related complications. Furthermore, women selected for assisted reproductive technology (ART) are exposed to additional endocrinological and embryological factors that have been associated with adverse pregnancy outcomes. OBJECTIVE AND RATIONALE: This study aimed to investigate the independent effect of endometriosis, adenomyosis, and various ART-related factors on adverse maternal, placental, fetal, and neonatal outcomes. SEARCH METHODS: Published randomized controlled trials, cohort studies, and case-control studies were considered eligible. PubMed, MEDLINE, ClinicalTrials.gov, Embase, and Scopus were systematically searched up to 1 March 2024. This systematic review and meta-analysis was performed in line with the PRISMA and the MOOSE reporting guidelines. To thoroughly investigate the association between endometriosis/adenomyosis and adverse pregnancy outcomes, sub-analyses were conducted, whenever possible, according to: the method of conception (i.e. ART and non-ART conception), the endometriosis stage/phenotype, the coexistence of endometriosis and adenomyosis, any pre-pregnancy surgical treatment of endometriosis, and the form of adenomyosis. The odds ratio (OR) with 95% CI was used as effect measure. The quality of evidence was assessed using the GRADE approach. OUTCOMES: We showed a higher risk of placenta previa in women with endometriosis compared to controls (34 studies, OR 2.84; 95% CI: 2.47, 3.26; I2 = 83%, moderate quality). The association was observed regardless of the method of conception and was particularly strong in the most severe forms of endometriosis (i.e. rASRM stage III-IV endometriosis and deep endometriosis (DE)) (OR 6.61; 95% CI: 2.08, 20.98; I2 = 66% and OR 14.54; 95% CI: 3.67, 57.67; I2 = 54%, respectively). We also showed an association, regardless of the method of conception, between endometriosis and: (i) preterm birth (PTB) (43 studies, OR 1.43; 95% CI: 1.32, 1.56; I2 = 89%, low quality) and (ii) cesarean section (29 studies, OR 1.52; 95% CI: 1.41, 1.63; I2 = 93%, low quality). The most severe forms of endometriosis were strongly associated with PTB. Two outcomes were associated with adenomyosis both in the main analysis and in the sub-analysis that included only ART pregnancies: (i) miscarriage (14 studies, OR 1.83; 95% CI: 1.53, 2.18; I2 = 72%, low quality) and (ii) pre-eclampsia (7 studies, OR 1.70; 95% CI: 1.16, 2.48; I2 = 77%, low quality). Regarding ART-related factors, the following associations were observed in the main analysis and confirmed in all sub-analyses conducted by pooling only risk estimates adjusted for covariates: (i) blastocyst stage embryo transfer (ET) and monozygotic twinning (28 studies, OR 2.05; 95% CI, 1.72, 2.45; I2 = 72%, low quality), (ii) frozen embryo transfer (FET) and (reduced risk of) small for gestational age (21 studies, OR 0.59; 95% CI, 0.57, 0.61; P < 0.00001; I2 = 17%, very low quality) and (increased risk of) large for gestational age (16 studies, OR 1.70; 95% CI, 1.60, 1.80; P < 0.00001; I2 = 55%, very low quality), (iii) artificial cycle (AC)-FET and pre-eclampsia (12 studies, OR 2.14; 95% CI: 1.91-2.39; I2 = 9%, low quality), PTB (21 studies, OR 1.24; 95% CI 1.15, 1.34; P < 0.0001; I2 = 50%, low quality), cesarean section (15 studies, OR 1.59; 95% CI 1.49, 1.70; P < 0.00001; I2 = 67%, very low quality) and post-partum hemorrhage (6 studies, OR 2.43; 95% CI 2.11, 2.81; P < 0.00001; I2 = 15%, very low quality). WIDER IMPLICATIONS: Severe endometriosis (i.e. rASRM stage III-IV endometriosis, DE) constitutes a considerable risk factor for placenta previa and PTB. Herein, we recommend against superimposing on this condition other exposure factors that have a strong association with the same obstetric adverse outcome or with different outcomes which, if coexisting, could determine the onset of an ominous obstetric syndrome. Specifically, we strongly discourage the use of AC regimens for FET in ovulatory women with rASRM stage III-IV endometriosis or DE. We also recommend single ET at the blastocyst stage in this high-risk population. REGISTRATION NUMBER: CRD42023401428.

Natural fermentation of fresh Jasmine flowers inspired the development of a biotechnological ingredient with global anti-ageing properties.

OBJECTIVE: This study focused on the development of a new-to-world ingredient harnessing the natural potential of fresh Jasminum grandiflorum flowers to self-ferment by its phytobiome revealing flower content. Analytical investigations were conducted to highlight specific phytocompounds generated during the natural fermentation of flowers in comparison to a conventional extraction. The synergy with another extraction technology maximized the generation of biocompounds for an interesting efficacy. METHODS: Jasmine extract was elaborated by combining two patented technologies: the phytofermentology™, inspired by plant-microorganisms interaction and designed to develop ingredients obtained by natural fermentation of the vegetal using its own phytobiota; and the PSR™ technology allowing the extraction of bioactive phytocompounds such as small RNAs from plants. RESULTS: Analytical investigations of Jasmine extract highlighted uniqueness and richness of the phytocompound profiles, such as organics acids and phenolic compounds, markers of fermentation only obtained after phytofermentology in comparison to conventional extraction. Jasmine extract has the particularity to contain jasmintides, flower small peptides belonging to the family of cysteine-rich peptides (CRPs). Antioxidant and global anti-ageing properties were investigated in cell-free assays demonstrating interesting results: about 20% scavenging of free radicals from 0.5% of Jasmine extract and protection from DNA damage of 26% in comparison to a stressed control. CONCLUSION: Phytofermentology™ technology combined with PSR™ technology, meant to be respectful of the environment, allowed to development of biofunctionals very close to nature with a unique analytical signature as Jasmine extract, using the potential of fresh flowers phytobiota to self-ferment. The efficacy of the ingredient on global antioxidation and anti-ageing via hyaluronidase/tyrosinase inhibitions was highlighted by cell-free evaluation assays. Further and complementary studies should be conducted to confirm the bioefficacy of this ingredient with in vitro / ex vivo assays.

Cette étude a pour objectif de développer un nouvel ingrédient unique en exploitant le potentiel des fleurs fraîches de Jasminum grandiflorum à fermenter naturellement en utilisant leur phytobiome, révélant ainsi le contenu de ces fleurs. Des investigations analytiques ont été menées pour mettre en évidence des phytocomposés spécifiques générés lors de la fermentation naturelle des fleurs par rapport à une extraction conventionnelle. La synergie avec une autre technologie d'extraction maximise la génération de biocomposés pour une plus grande efficacité de l'extrait. L'extrait de jasmin a été élaboré en combinant deux technologies brevetées: la phytofermentologie™, inspirée de l'interaction plante/micro­organismes et conçue pour développer des ingrédients obtenus par fermentation naturelle d'un végétal en utilisant son propre phytobiote; et la technologie PSR™ permettant l'extraction de phytocomposés bioactifs tels que les petits ARN des plantes. Les recherches analytiques de l'extrait de jasmin ont mis en évidence le caractère unique et la richesse des profils des différents phytocomposés composant l'extrait, tels que les acides organiques et les composés phénoliques, marqueurs de fermentation obtenus uniquement grâce à la phytofermentologie par rapport à l'extraction conventionnelle. L'extrait de jasmin a la particularité de contenir des jasmintides, petits peptides de fleurs appartenant à la famille des peptides riches en cystéine (CRP). Les propriétés antioxydantes et anti­âge ont été étudiées par des tests acellulaires démontrant des résultats intéressants: environ 20 % d'élimination des radicaux libres à partir de 0,5 % d'extrait de jasmin et une protection contre les dommages à l'ADN de 26 % par rapport à un contrôle stressé. La technologie phytofermentologie™ combinée à la technologie PSR™, se voulant respectueuse de l'environnement, a permis de développer des ingrédients très proches de la nature avec une signature analytique unique comme l'extrait de Jasmin, utilisant le potentiel d'auto­fermentation du phytobiote des fleurs fraîches. L'efficacité de l'ingrédient sur l'antioxydation globale et l'anti­âge via les inhibitions enzymatiques de la hyaluronidase et de la tyrosinase a été mise en évidence par des tests d'évaluation acellulaires. Des études supplémentaires et complémentaires devraient être menées pour confirmer la bioefficacité de cet ingrédient avec des tests in vitro/ex vivo.

Mechanism Analysis of Selenium-Containing Compounds in Alleviating Spinal Cord Injury Based on Network Pharmacology and Molecular Docking Technology.

Spinal cord injury (SCI) is a severe traumatic condition in spinal surgery characterized by nerve damage in and below the injured area. Despite advancements in understanding the pathophysiology of SCI, effective clinical treatments remain elusive. Selenium compounds have become a research hotspot due to their diverse medicinal activities. Previously, our group synthesized a selenium-containing Compound 34# with significant anti-inflammatory activity. This study aimed to explore the anti-SCI effects of selenium-containing compounds using network pharmacology, molecular docking (MD), and ADMET methods. To identify SCI-related targets and those associated with 34#, GeneCards, NCBI, and SEA databases were employed. Eight overlapping targets were considered candidate targets, and molecular docking was performed using the PDB database and AutoDock software. The STRING database was used to obtain protein-protein interactions (PPI). Molecular dynamics simulation, MM/GBSA binding free energy score, and ADMET prediction were used to evaluate the potential targets and drug properties of 34#. Finally, experiments on NSC34 cells and mice were to verify the effects of 34# on SCI. Our results revealed eight candidate targets for 34# in the treatment of SCI. PPI and MD identified ADRB2 and HTR1F as the highest connectivity with 34#. ADMET analysis confirmed the low toxicity and safety of 34#. In vitro and in vivo models validated the anti-SCI effects. Our study elucidated candidate targets for alleviating SCI with 34#, explored PPI and target-related signaling pathways, and validated its anti-SCI effects. These findings enhance our understanding of 34#'s mechanism in treating SCI, positioning it as a potential candidate for SCI prevention.

Applying artificial intelligence on EDA sensor data to predict stress on minimally invasive robotic-assisted surgery.

PURPOSE: This study aims predicting the stress level based on the ergonomic (kinematic) and physiological (electrodermal activity-EDA, blood pressure and body temperature) parameters of the surgeon from their records collected in the previously immediate situation of a minimally invasive robotic surgery activity. METHODS: For this purpose, data related to the surgeon's ergonomic and physiological parameters were collected during twenty-six robotic-assisted surgical sessions completed by eleven surgeons with different experience levels. Once the dataset was generated, two preprocessing techniques were applied (scaled and normalized), these two datasets were divided into two subsets: with 80% of data for training and cross-validation, and 20% of data for test. Three predictive techniques (multiple linear regression-MLR, support vector machine-SVM and multilayer perceptron-MLP) were applied on training dataset to generate predictive models. Finally, these models were validated on cross-validation and test datasets. After each session, surgeons were asked to complete a survey of their feeling of stress. These data were compared with those obtained using predictive models. RESULTS: The results showed that MLR combined with the scaled preprocessing achieved the highest R2 coefficient and the lowest error for each parameter analyzed. Additionally, the results for the surgeons' surveys were highly correlated to the results obtained by the predictive models (R2 = 0.8253). CONCLUSIONS: The linear models proposed in this study were successfully validated on cross-validation and test datasets. This fact demonstrates the possibility of predicting factors that help us to improve the surgeon's health during robotic surgery.