Deciphering the antidepressant effects of Rosa damascena essential oil mediated through the serotonergic synapse signaling pathway.

ETHNOPHARMACOLOGICAL RELEVANCE: Rosa damascena is an ancient plant with significance in both medicine and perfumery that have a variety of therapeutic properties, including antidepressant, anti-anxiety, and anti-stress effects. Rose damascena essential oil (REO) has been used to treat depression, anxiety and other neurological related disorders in Iranian traditional medicine. However, its precise mechanism of action remains elusive. AIM OF THE STUDY: The aim of this study was to investigate the impact and mechanism underlying the influence of REO on chronic unpredictable mild stress (CUMS) rats. MATERIALS AND METHODS: Gas chromatography-mass spectrometry (GC-MS) technique coupling was used to analyze of the components of REO. A CUMS rat model was replicated to assess the antidepressant effects of varying doses of REO. This assessment encompassed behavioral evaluations, biochemical index measurements, and hematoxylin-eosin staining. For a comprehensive analysis of hippocampal tissues, we employed transcriptomics and incorporated weighting coefficients by means of network pharmacology. These measures allowed us to explore differentially expressed genes and biofunctional pathways affected by REO in the context of depression treatment. Furthermore, GC-MS metabolomics was employed to assess metabolic profiles, while a joint analysis in Metscape facilitated the construction of a network elucidating the links between differentially expressed genes and metabolites, thereby elucidating potential relationships and clarifying key pathways regulated by REO. Finally, the expression of relevant proteins in the key pathways was determined through immunohistochemistry and Western blot analysis. Molecular docking was utilized to investigate the interactions between active components and key targets, thereby validating the experimental results. RESULTS: REO alleviated depressive-like behavior, significantly elevated levels of the neurotransmitter 5-hydroxytryptamine (5-HT), and reduced hippocampal neuronal damage in CUMS rats. This therapeutic effect may be associated with the modulation of the serotonergic synapse signaling pathway. Furthermore, REO rectified metabolic disturbances, primarily through the regulation of amino acid metabolic pathways. Joint analysis revealed five differentially expressed genes (EEF1A1, LOC729197, ATP8A2, NDST4, and GAD2), suggesting their potential in alleviating depressive symptoms by modulating the serotonergic synapse signaling pathway and tryptophan metabolism. REO also modulated the 5-HT2A-mediated extracellular regulated protein kinases-cAMP-response element binding protein-brain-derived neurotrophic factor (ERK-CREB-BDNF) pathway. In addition, molecular docking results indicated that citronellol, geraniol and (E,E)-farnesol in REO may serve as key active ingredients responsible for its antidepressant effects. CONCLUSIONS: This study is the first to report that REO can effectively alleviate CUMS-induced depression-like effects in rats. Additionally, the study offers a comprehensive understanding of its intricate antidepressant mechanism from a multi-omics and multi-level perspective. Our findings hold promise for the clinical application and further development of this essential oil.

Patient Preferences in Metastatic Breast Cancer Care: A Scoping Review.

People with metastatic breast cancer (MBC) have diverse medical, physical, and psychosocial needs that require multidimensional care. Understanding patient preferences is crucial to tailor treatments, services, and foster patient-centered care. A scoping review was performed to summarize the current evidence on the preferences of people with MBC regarding their care to identify knowledge gaps and key areas for future research. The Embase, MEDLINE, CINAHL and PsycInfo databases were searched. Twenty studies enrolling 3354 patients met the study eligibility criteria. Thirteen quantitative studies, four mixed methods studies, and three qualitative studies were included. Seven studies captured healthcare provider perspectives; thirteen studies evaluated patient preferences relating specifically to cancer treatments; three studies evaluated preferences relating to supportive care; and four studies evaluated communication and decision-making preferences. The current literature evaluating MBC patient preferences is heterogeneous with a focus on cancer treatments. Future research should explore patient preferences relating to multidisciplinary, multi-modal care that aims to improve quality of life. Understanding MBC patient preferences regarding their comprehensive care can help tailor healthcare delivery, enhance the patient experience, and improve outcomes.

Determining patient preferences in the treatment of medication-refractory overactive bladder.

INTRODUCTION: Overactive bladder (OAB) is often suboptimally addressed by behavioral or pharmacological treatments. Less than 15% of patients choose to pursue advanced OAB therapy (sacral nerve stimulation [SNS], percutaneous tibial nerve stimulation [PTNS], and bladder onabotulinum toxin type-A [BTX-A]). We seek to better understand which factors are most important to patients when choosing a third-line therapy. METHODS/MATERIALS: We developed a conjoint analysis survey that included five attributes of the third-line options for OAB (SNS, PTNS, and BTX-A). We administered the survey to new patients with urinary incontinence at two institutions. A hierarchical Bayes random effects regression analysis was used to determine the relative importance of the attributes. A choice simulator was used to model which third-line treatment options patients preferred. We followed patients to see if they pursued their predicted treatment. RESULTS: A total of 108 patients completed the study of whom 89% were women. There was representation from all age groups. The most important attributes of decision-making were the frequency of future procedures, the risk of catheterization, and the need for a device. On market simulation, SNS was the preferred treatment option (47%), followed by PTNS (29%) and BTX-A (14%). Only 10% of patients did not find any treatment option acceptable. CONCLUSIONS: Frequent follow-up, risk of catheterization, and the need for a device were the most important attributes when making a decision on third-line OAB therapy. On market simulation, SNS is the preferred treatment for all age groups though the ultimate choice in third-line therapy may be affected by external factors.

Examining the role of depression in the Filipino elderly's food preferences in prison setting: data from conjoint analysis and SEM.

PURPOSE: Previous studies suggest that the care for elderly prisoners is a growing problem. The emerging phenomenon such as the correctional ageing crisis is an urgent concern that needs to be collectively and holistically addressed from a multi-sectoral perspective. In a developing country, like the Philippines, where prison congestion is alarming, the need for more empirical investigations that probe into the prison life and services is warranted to better inform penal policy and practice that would improve health outcomes among incarcerated individuals. The purpose of this study is to examine the extent to which depression among Filipino elderly prisoners shape their food choices. DESIGN/METHODOLOGY/APPROACH: A survey of 160 Filipino elderly prisoners of age 60 and above from October to November 2018 was conducted using a three-part research instrument, which consists of a personal and nutrition-related checklist, 15-point geriatric depression scale and a set of cards that were ranked and sorted through the balanced incomplete block design. FINDINGS: Results of the survey were subjected to conjoint analysis and structural equation modeling using the Statistical Package for the Social Sciences 24. Interestingly, taste was the most considered attribute (30.765%) while portion size (9.759%) is the least considered by the Filipino elderly prisoners. Notably, depression has a significant positive effect on their food preferences in all attributes except portion size. RESEARCH LIMITATIONS/IMPLICATIONS: This study was limited to two prison settings in the Philippines. Considering the results from the conjoint analysis, strategies can be developed in designing an individualized meal plan suitable for the needs of each elderly prisoner. Also, sizeable government appropriations should be in place to ensure the nutritional quality of food served to aging Filipino prisoners. PRACTICAL IMPLICATIONS: Provisions for a pool of nutritionists working hand in hand with other health members would guarantee a prison system that promotes the overall well-being of each prisoner. Further, this study can contribute valuable inputs in the menu cycle practice of prisons in the country. There may be a need to prioritize the nutritional aspect of these vulnerable and deprived groups so as to promote a better quality of life among elderly prisoners. Also, other forms of psychosocial, physical and spiritual health activities extended to elderly prisoners may prevent depressive symptoms. ORIGINALITY/VALUE: Conjoint analysis is remarkably gaining prominence in not only the health-care setting (Phillips et al., 2002; Ryan and Farrar, 2000) but also the field of nutrition. It holds a number of unique and practical promises to prison settings.

Effect of Environmental Enrichment and Herbal Compounds-Supplemented Diet on Pig Carcass, Meat Quality Traits, and Consumers' Acceptability and Preference.

Animal welfare can be considered an ethical attribute of product quality, but consumers should appreciate its added value. The aim of this study was to evaluate consumer's acceptability, preference, and the meat and carcass quality of pigs reared with two stress-reducing strategies: supplementation of an herbal compound (HC) containing Valeriana officinalis and Passiflora incarnata, and environmental enrichment (EE) by the provision of hemp ropes, sawdust, and rubber balls. A total of 56 pigs were divided in four treatments in two pens of seven pigs per treatment (2 × 2 factorial design). Meat and carcass quality were evaluated. Consumer's acceptability and preference were analysed with a sensory test and a conjoint analysis in 110 consumers. Before slaughter, control pigs (no EE and no HC) presented lower live weight compared with other treatments (p = 0.0009). Although acceptance was the same for all of the treatments, consumers preferred systems aiming to increase pig welfare. The most important factor was production system, with a preference for those improving welfare, followed by feeding system, with a preference for those with natural herbs supplementation. Although price was the least important factor, a segment of consumers showed a clear preference for lower prices. These results suggest that welfare improvements could be appreciated by particular consumer segments.

Quantifying population preferences around vaccination against severe but rare diseases: A conjoint analysis among French university students, 2016.

BACKGROUND: Several concepts are available to explain vaccine decision making by individual and inter-individual factors, including risk perception, social conformism and altruism. However, only a few studies have quantified the weight of these determinants in vaccine acceptance. Using a conjoint analysis tool, we aimed at eliciting preferences in a student population regarding vaccination against a rare, severe and rapidly evolving hypothetical disease, similar to meningococcal serogroup C meningitis or measles. METHODS: During March-May 2016, we conducted an emailing survey among university students aged 18-24years (N=775) in Rennes, France. Participants were asked to decide for or against immediate vaccination in 24 hypothetical scenarios, containing various levels of four attributes: epidemic situation, adverse events, information on vaccination coverage, and potential for indirect protection. Data were analysed using random effect estimator logit models. RESULTS: Participants accepted on average 52% of scenarios and all attributes significantly impacted vaccination acceptance. The highest positive effects were seen with an epidemic situation (OR 3.81, 95%-CI 3.46-4.19), 90% coverage in the community (3.64, 3.15-4.20) and potential for disease elimination from the community (2.87, 2.53-3.26). Information on "insufficient coverage" was dissuasive (vs. none of friends vaccinated: 0.65, 0.56-0.75). Controversy had a significantly greater negative effect than a confirmed risk of severe adverse events (OR 0.05 vs. 0.22). In models including participant characteristics, preference weights were unchanged, while trust in health authorities and vaccination perceptions strongly influenced acceptance themselves. The greatest significant variation of preference weights between subgroups was observed with controversy among students using alternative medicine daily (OR 0.28) and among students relying on scientific vaccine information (OR 0.02). CONCLUSIONS: Among young adults, potential for indirect protection and factual information on coverage in the community and potential side effects positively impact theoretical vaccine acceptance. Conjoint analyses should be conducted to understand vaccine hesitancy in specific vaccination programs.

Prioritising wheelchair services for children: a pilot discrete choice experiment to understand how child wheelchair users and their parents prioritise different attributes of wheelchair services.

BACKGROUND: Approximately 95 million children worldwide are disabled; 10 % use a wheelchair. In the UK, an estimated 770,000 children are disabled. National Health Service Wheelchair Services are the largest provider of wheelchairs in the UK; however, recent reports have highlighted issues with these services. This study explores the use of discrete choice experiment methods to inform wheelchair service provision for disabled children based on service user preferences. The aim was to explore how disabled children and their parents prioritise different attributes of wheelchair services. The secondary aims were to compare priorities between parents and disabled children and to explore marginal rate of substitution for incremental changes in attributes. METHODS: Discrete choice experiments are a method of attribute-based stated preference valuation used by health economists to understand how individuals prioritise different attributes of healthcare services and treatments. We conducted the first pilot discrete choice experiment to explore how disabled children (aged 11 to 18) and their parents prioritise different attributes of hypothetical wheelchair services. Eleven disabled children (aged 11 to 18) and 30 parents of disabled children completed eight pairwise choice tasks based on five service attributes: wheelchair assessment, cost contribution, training, delivery time and frequency of review. Data were analysed using conditional logistic regression. For each pairwise choice, the participants were asked to choose which service scenario (A or B) they preferred. RESULTS: Comprehensiveness of wheelchair assessment and wheelchair delivery time significantly (P < 0.05) affected service preferences of children (ß-coefficients = 1.43 [95 % bootstrapped CI = 1.42 to 2.08] and -0.92 [95 % bootstrapped CI = -1.41 to -0.84], respectively) and parents (ß-coefficients = 1.53 [95 % bootstrapped CI = 1.45 to 2.16] and -1.37 [95 % bootstrapped CI = -1.99 to -1.31], respectively). Parents were willing to contribute more financially to receive preferred services, although this was non-significant. CONCLUSIONS: Both samples placed the greatest importance on holistic wheelchair assessments encompassing more than health. The National Health Service should consider using discrete choice experiment methods to examine wheelchair service preferences of disabled children (aged 11 and over) and their parents on a wider scale; however, care must be taken to ensure that this method is used appropriately.

Understanding Pediatric Dentists' Dental Caries Management Treatment Decisions: A Conjoint Experiment.

When traditional ranking and rating surveys are used to assess dentists' treatment decisions, the patient's source of payment appears to be of little importance. Therefore, this study used the marketing research tool conjoint analysis to investigate the relative impact of source of payment along with the child's age and cooperativeness on pediatric dentists' willingness to use Atraumatic Restorative Treatment (ART) to restore posterior primary teeth. A conjoint survey was completed by 707 pediatric dentists. Three factors (age of the child, cooperativeness, type of insurance) were varied across 3 levels to create 9 patient scenarios. The relative weights that dentists placed on these factors in the restorative treatment decision process were determined by conjoint analysis. "Cooperativeness" (52%) was the most important factor, "age of the child" (26%) the second-most important factor, followed by "insurance status of the child" (22%). For the third factor, insurance, pediatric dentists were least willing to use ART with publicly insured children (-0.082), and this was significantly different from their willingness to use ART with uninsured children (0.010) but not significantly different than their willingness to use ART for children with private insurance (0.073). Unlike traditional ranking and rating tools, conjoint analysis found that the insurance status of the patient appeared to be an important factor in dentists' decisions about different restorative treatment options. When pediatric dentists were forced to make tradeoffs among different patients' factors, they were most willing to use ART technique with young, uncooperative patients when they had no insurance. Knowledge Transfer Statement: The present study suggests the feasibility of using techniques borrowed from marketing research, such as conjoint analysis, to understand dentists' restorative treatment decisions. Results of this study demonstrate pediatric dentists' willingness to use a particular restorative treatment option (Atraumatic Restorative Treatment in this application) when forced to make tradeoffs in a "conjoined," or holistic, context among different factors presented in real-life patient scenarios. A deeper understanding of dentists' treatment decisions is vital to develop valid practice guidelines and interventions that encourage the use of appropriate restorative treatment modalities.