Patient-reported outcomes in chronic hepatitis delta: An exploratory analysis of the Phase III MYR301 trial of bulevirtide.

BACKGROUND & AIMS: Once-daily treatment of chronic hepatitis delta (CHD) with bulevirtide is well tolerated and associated with significant reductions in HDV RNA in the blood and in biochemical liver disease activity. This study explored the effects of 48-week bulevirtide treatment on health-related quality of life (HRQoL) in patients with CHD. METHODS: In an open-label, randomised, Phase 3 trial, 150 patients with CHD and compensated liver disease were stratified by liver cirrhosis status and randomised 1:1:1 to no treatment (control), bulevirtide 2 mg/day, or bulevirtide 10 mg/day for 48 weeks. HRQoL was evaluated by the following patient-reported outcome (PRO) instruments at baseline, 24 weeks, and 48 weeks: EQ-5D-3L, Hepatitis Quality of Life Questionnaire (HQLQ), and Fatigue Severity Scale (FSS). RESULTS: Patient characteristics and HRQoL scores were balanced at baseline between the treatment (2 mg, n = 49; 10 mg, n = 50) and control (n = 51) groups. Patients receiving 2-mg bulevirtide reported significant improvements compared with controls on the HQLQ domains of role physical, hepatitis-specific limitations, and hepatitis-specific health distress. Numerically higher scores for general health, hepatitis-specific limitations, and hepatitis-specific health distress domains were reported by patients with cirrhosis who received bulevirtide vs control. FSS scores remained stable across treatment groups throughout. At week 48, patients in the 2-mg group showed greater mean improvement from baseline in health status compared with controls on the EQ-5D-3L visual analogue scale. CONCLUSION: PROs indicate that 48-week treatment with bulevirtide monotherapy may improve aspects of HRQoL in patients with CHD. IMPACT AND IMPLICATIONS: Bulevirtide 2 mg is the only approved treatment for patients with chronic hepatitis delta (CHD) in the EU. Patients with CHD have worse quality of life scores than those with chronic hepatitis B. Bulevirtide treatment for 48 weeks reduced HDV RNA and alanine aminotransferase levels and was well tolerated among patients with CHD. For the first time, this study shows that patients who received bulevirtide therapy for 48 weeks reported improvements in physical and hepatitis-related quality of life domains compared to those who did not receive therapy (control group). CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier, NCT03852719.

Influence of Flexible and Textile Substrates on Frequency-Selective Surfaces (FSS).

Frequency-selective surfaces (FSS) are two-dimensional geometric structures made of conductive materials that selectively transmit or reflect electromagnetic waves. In this paper, flexible FSS made on textile and film substrates is presented and compared to show the effect of the texture associated with the type of substrate on the shielding properties. Three geometries of patterns of squares in the border, inversion of squares in the border, and circles with a border were used, and the patterns were made by the silver paste screen printing technique. Microscopic analysis (SEM and optical) was performed to determine the degree of substrate coverage and the actual geometry of the pattern. The resistance per square of the obtained patterns was about 50 mΩ/□. The shielding properties of FSS were simulated in Comsol Multiphysics 6.2 software and then measured by the antenna method. Selective textile filters were obtained, depending on the pattern used, with one or two modals with a transmission attenuation of about 15 dB. The paper analyzes the effect of the substrate and the screen printing technique used on the shielding properties of the flexible FSS.

Band-Stop Frequency-Selective Surface (FSS) with Elliptic Response Designed by the Extracted Pole Technique.

This paper describes and validates an advanced synthesis design process of Frequency-Selective Surfaces (FSSs) with elliptic band-stop responses. A systematic procedure based on the Generalized Chebyshev Function and the extracted pole technique enables control of the position of the transmission zeros and the attenuation level to obtain an equiripple rejection response. A systematic process is followed to obtain the lumped LC values of the resonator circuits extracted as poles and the impedance inverters. Then, equivalent dipoles and transmission lines are obtained to carry out the electromagnetic design at normal incidence for a linearly polarized field. The impact of the higher-order modes of the periodic structure on the electrical response of the FSS, which can be relevant due to the stringent selected specifications, has been also analyzed. A fourth-order band-stop filter with a 3 GHz bandwidth centered at 30 GHz and its attenuation at 50 dB has been designed considering three different implementations: two filters using a vacuum as a transmission line with different connection lengths and a third one using a dielectric substrate to enable its manufacturing. In order to verify the design procedure using experimental results, the third filter with printed dipoles in the dielectric substrate has been manufactured and measured, thus validating the developed process.

Compensation of Heat Effect in Dielectric Barrier Discharge (DBD) Plasma System for Radar Cross-Section (RCS) Reduction.

In this study, the problems encountered in radar cross-section (RCS) measurement experiments utilizing a dielectric barrier discharge (DBD) plasma system are examined and an effective solution is proposed. A DBD plasma system generates heat due to the high bias voltage required for plasma generation. The thermal-induced structural deformation of the DBD structure caused by this high voltage and its impact on RCS measurements are analyzed. In addition, techniques for minimizing the thermal-induced deformation and compensation methods for addressing the minimized deformation are proposed. Furthermore, RCS measurements are conducted on two kinds of DBD structures using the proposed method to experimentally demonstrate the improved agreement between the simulation and measurement results. For both structures, the RCS experimental results are in very good agreement with the simulation results, which enables accurate plasma characterization. In conclusion, it can be expected that the proposed method can be used to provide more accurate RCS measurements on various DBD structures that generate high heat.

Four-Port 38 GHz MIMO Antenna with High Gain and Isolation for 5G Wireless Networks.

In this paper, a 38 GHz 4-port multiple-input multiple-output (MIMO) antenna with considerable isolation and gain enhancement for 5G applications is introduced. The suggested antenna element is a monopole antenna composed of a circular patch with a rectangular slot etched from it and a partial ground plane is used to extend the desired frequency to operate from 36.6 GHz to 39.5 GHz with a center frequency of 38 GHz. The high isolation is achieved by arranging the four elements orthogonally and adding four stubs to reduce mutual coupling between elements at the desired frequency bands. The gain improvement is also introduced by placing a frequency selective structure (FSS) which is designed at the same frequency bands of the antenna under the suggested MIMO antenna to act as a reflector. The proposed four-element MIMO with the FSS prototype is built and tested in order to confirm the simulated results. The suggested antenna operated from 37.2 GHz to 39.2 GHz with an isolation of less than 25 dB across the obtained frequency range. The peak gain of the antenna is enhanced from 5.5 dBi to around 10 dBi by utilizing the FSS structure; furthermore, the back radiation is enhanced. The MIMO performance is validated by extracting its parameters and comparing with the simulated results. The results extracted from the simulation and the measurement show satisfactory matching along with the target band, indicating that the proposed structure could be used for 5G communications.

Evaluation of 5G and Fixed-Satellite Service Earth Station (FSS-ES) Downlink Interference Based on Artificial Neural Network Learning Models (ANN-LMS).

Fifth-generation (5G) networks have been deployed alongside fourth-generation networks in high-traffic areas. The most recent 5G mobile communication access technology includes mmWave and sub-6 GHz C-bands. However, 5G signals possibly interfere with existing radio systems because they are using adjacent and co-channel frequencies. Therefore, the minimisation of the interference of 5G with other signals already deployed for other services, such as fixed-satellite service Earth stations (FSS-Ess), is urgently needed. The novelty of this paper is that it addresses issues using measurements from 5G base stations (5G-BS) and FSS-ES, simulation analysis, and prediction modelling based on artificial neural network learning models (ANN-LMs). The ANN-LMs models are used to classify interference events into two classes, namely, adjacent and co-channel interference. In particular, ANN-LMs incorporating the radial basis function neural network (RBFNN) and general regression neural network (GRNN) are implemented. Numerical results considering real measurements carried out in Malaysia show that RBFNN evidences better accuracy with respect to its GRNN counterpart. The outcomes of this work can be exploited in the future as a baseline for coexistence and/or mitigation techniques.

Transcriptome analysis reveals fluid shear stress (FSS) and atherosclerosis pathway as a candidate molecular mechanism of short-term low salinity stress tolerance in abalone.

BACKGROUND: Transcriptome sequencing is an effective tool to reveal the essential genes and pathways underlying countless biotic and abiotic stress adaptation mechanisms. Although severely challenged by diverse environmental conditions, the Pacific abalone Haliotis discus hannai remains a high-value aquaculture mollusk and a Chinese predominantly cultured abalone species. Salinity is one of such environmental factors whose fluctuation could significantly affect the abalone's cellular and molecular immune responses and result in high mortality and reduced growth rate during prolonged exposure. Meanwhile, hybrids have shown superiority in tolerating diverse environmental stresses over their purebred counterparts and have gained admiration in the Chinese abalone aquaculture industry. The objective of this study was to investigate the molecular and cellular mechanisms of low salinity adaptation in abalone. Therefore, this study used transcriptome analysis of the gill tissues and flow cytometric analysis of hemolymph of H. discus hannai (DD) and interspecific hybrid H. discus hannai ♀ x H. fulgens ♂ (DF) during low salinity exposure. Also, the survival and growth rate of the species under various salinities were assessed. RESULTS: The transcriptome data revealed that the differentially expressed genes (DEGs) were significantly enriched on the fluid shear stress and atherosclerosis (FSS) pathway. Meanwhile, the expression profiles of some essential genes involved in this pathway suggest that abalone significantly up-regulated calmodulin-4 (CaM-4) and heat-shock protein90 (HSP90), and significantly down-regulated tumor necrosis factor (TNF), bone morphogenetic protein-4 (BMP-4), and nuclear factor kappa B (NF-kB). Also, the hybrid DF showed significantly higher and sustained expression of CaM and HSP90, significantly higher phagocytosis, significantly lower hemocyte mortality, and significantly higher survival at low salinity, suggesting a more active molecular and hemocyte-mediated immune response and a more efficient capacity to tolerate low salinity than DD. CONCLUSIONS: Our study argues that the abalone CaM gene might be necessary to maintain ion equilibrium while HSP90 can offset the adverse changes caused by low salinity, thereby preventing damage to gill epithelial cells (ECs). The data reveal a potential molecular mechanism by which abalone responds to low salinity and confirms that hybridization could be a method for breeding more stress-resilient aquatic species.

Calcium response of spatially arranged cell networks to shear stress by confined single cell patterned microfluidic chips.

Osteoblasts in multicellular organisms are sensitive to fluid shear stress (Fss) and respond smartly with versatile patterns of intracellular calcium signal ([Ca2+]i). In this study, a spatial-single cell patterning method was developed by combining micro-contact printing (µCP) and reversible microfluidic chip mounted with vacuum together. Based on this well-defined patterning platform, it's possible to investigate calcium response to Fss modulated by spatial factors, and to characterize multiple calcium patterns quantitatively in terms of cell spacing and cell orientation. The result showed that the Fss-induced [Ca2+]i profiles revealed oscillational signal patterns in non-connected cells such as those in physical-contacted cells. Close-arrayed osteoblasts showed remarkably more [Ca2+]i oscillations than sparse-arrayed cells. The circular shape of the cells was sensitive to oscillational [Ca2+]i as a potential major cause. The consistency of cell orientation and shear stress promoted temporal homogeneity of calcium oscillations.

Female sexual dysfunction in newly diagnosed egyptian patients with neuromyelitis optica spectrum disorder.

BACKGROUND: Few research works have explored female sexual dysfunction (FSD) in patients with Neuromyelitis optica spectrum disorder (NMOSD) which remains an ignored disease symptom. This work aimed to describe the frequency, patterns, and predictors of FSD in a sample of newly diagnosed AQP4-ab seropositive NMOSD patients. METHODS: This case-control study was conducted on 28 seropositive NMOSD patients and 31 age matched healthy controls. All included patients were asked to privately fill and hand back the following questionnaires: female sexual function index questionnaire (FSFI), Beck depression inventory II (BDI) and fatigue severity scale (FSS). Also, Modified Modified Ashworth scale (MMAS) and Expanded disability status scale (EDSS) were applied to all included patients. RESULTS: NMOSD patients had significantly lower total FSFI scores and significantly higher BDI and FSS scores than controls (P < 0.001). FSS scores were negatively correlated with total scores of FSFI as well as desire, lubrication, orgasm, and satisfaction scores. BDI scores was negatively correlated with desire and orgasm scores. The uncorrected visual FS score was negatively correlated with lower total scores of FSFI as well as arousal, orgasm, and satisfaction scores. The pain score was negatively correlated with the scores of the MMAS. The only predictors of FSFI total score were fatigue and visual disability. Visual disability was also a predictor of dysfunction in arousal and satisfaction domains, whereas spasticity in the lower limbs predicted sexual related pain. CONCLUSIONS: Sexual dysfunction in patients with NMOSD is strongly related to fatigue, depression, visual disability, and lower limbs spasticity.

Italian translation and validation of fatigue symptoms and impacts questionnaire in relapsing multiple sclerosis (FSIQ-RMS).

BACKGROUND: Fatigue is a disabling symptom of multiple sclerosis (MS) and impacts on daily life. The Fatigue Symptoms and Impacts Questionnaire-Relapsing Multiple Sclerosis (FSIQ-RMS) is a new 20-item tool that investigates the aspects of fatigue in MS. It concerns motor, cognitive, social, and emotional aspects of fatigue. We aim at validating the Italian version of FSIQ-RMS in an Italian population of MS patients and demonstrate its reliability and construct validity. METHODS: We included patients with diagnosis of MS, age between 18 and 70 years with ability to participate in a 90-min interview. Each patient completed the Italian version of FSIQ-RMS and Fatigue Severity Scale (FSS) at the same time. Construct validity was explored by the exploratory factor analysis; reliability was assessed with Cronbach's alpha; and test-retest stability was examined through intraclass correlation coefficient (ICC). Concurrent validity was calculated using Pearson's correlation. RESULTS: We enrolled 171 patients (126 female and 45 male), 83% with relapsing MS (RMS), and 17% with secondary progressive MS (SPMS). Italian FSIQ-RMS showed a Cronbach's alpha of 0.92; ICC was 0.96. Pearson's correlation coefficient between FSIQ-RMS and FSS total score was statistically significant (p < 0.01); FSIQ-RMS inversely correlated also with BMI and positively with EDSS. CONCLUSION: The Italian version of FSIQ-RMS has excellent psychometric properties and can be used in research and clinical setting to evaluate physical, cognitive, and social fatigue in both RMS and SPMS.

A prospective cohort study: platelet-rich plasma combined with carpal tunnel release treating carpal tunnel syndrome.

BACKGROUND: PRP injection was proved to promote the health condition of individuals with mild to moderate Carpal Tunnel Syndrome (CTS). However, carpal tunnel release (CTR) was still a necessary treatment for individuals with moderate and severe CTS. METHODS: To explore whether adjuvant PRP treatment would improve the prognosis while using CTR, we included 82 patients in this study. Preoperative and postoperative visual analog scale (VAS), Boston carpal tunnel syndrome questionnaire-symptom severity scale (BCTQ-SSS), Boston carpal tunnel syndrome questionnaire-functional status scale (BCTQ-FSS), and grip strength were used to examine the patient's symptoms and function. RESULTS: CTR combined with PRP treatment improved the VAS (1.9 ± 0.5 versus 1.4 ± 0.4, P < .05), BCTQ-SSS (1.8 ± 0.4versus 1.5 ± 0.3, P < .05) and BCTQ-FSS (1.8 ± 0.5 versus 1.4 ± 0.6, P < .05) in patients with moderate symptoms within one month after surgery. At the same time, it does not show any advantages in treating individuals with severe carpal tunnel syndrome. CONCLUSIONS: PRP does not affect long-term prognosis while increasing the surgery cost. To conclude, PRP as an adjuvant treatment of CTR has limited effect. Considering the additional financial burden on patients, CTR combined with PRP should be cautious in CTS treatment.

Monopole Antenna with Enhanced Bandwidth and Stable Radiation Patterns Using Metasurface and Cross-Ground Structure.

In this paper, a printed monopole antenna with stable omnidirectional radiation patterns is presented for applications in ocean buoy and the marine Internet of Things (IoT). The antenna is composed of a rectangular patch, a cross-ground structure, and two frequency-selective surface (FSS) unit cells. The cross-ground structure is incorporated into the antenna design to maintain consistent monopole-like radiation patterns over the antenna's operating band, and the FSS unit cells are placed at the backside of the antenna to improve the antenna gain aiming at the L-band. In addition, the FSS unit cells exhibit resonance characteristics that, when incorporated with the cross-ground structure, result in a broader impedance bandwidth compared to the conventional monopole antenna. To validate the structure, a prototype is fabricated and measured. Good agreement between the simulated and measured results show that the proposed antenna exhibits an impedance bandwidth of 83.2% from 1.65 to 4 GHz, compared to the conventional printed monopole antenna. The proposed antenna realizes a peak gain of 4.57 dBi and a total efficiency of 97% at 1.8 GHz.

Coexistence of Satellite Ground Stations in Teleport Facilities: Interference Assessment, Real Application Scenario and Measurements.

This article introduces a unified and detailed methodology for interference assessment between coexisting fixed satellite service (FSS) and broadcast satellite service (BSS) with spectrum sharing at the Ka-band. The interference analysis is presented along with a step-by-step algorithm for the calculation of the carrier-to-interference ratio (CIR). The proposed procedure takes into consideration the near-field effect of ground-satellite-terminal antennas since these may reside at very close distances. Furthermore, numerical results are delivered so as to assess the CIR in relation to the relative geometry and the technical characteristics of the satellite terminals. A real application scenario is also provided along with measurements so as to validate the recommended methodology. Finally, mitigation techniques are proposed for the protection of the victim stations and operation under harmful interference conditions.

Progression of fatigue in Parkinson's disease - a 9-year follow-up.

BACKGROUND AND PURPOSE: Although highly disabling, the pathogenesis and evolution of fatigue in Parkinson's disease (PD) is largely unknown, and no sufficiently documented treatment currently exists. The aim of the present study was to investigate the evolution of fatigue during the first 9 years after diagnosis. METHODS: This study is part of the Norwegian ParkWest collaboration, a prospective population-based longitudinal cohort study. The present study comprised 191 newly diagnosed patients and 170 control participants. Fatigue was assessed by the Fatigue Severity Scale, with examinations at baseline and then every other year up to 9 years of follow-up. Linear mixed models were applied to investigate possible variables associated with fatigue. RESULTS: It was found that there was a statistically significant increase in the proportion of PD patients with fatigue during the first 9 years after diagnosis. A large proportion of patients had a significant increase or decrease in fatigue score between consecutive visits. In addition, the relative risk of persistent fatigue and ever having fatigue was higher than for controls. There were statistically significant longitudinal associations between higher levels of fatigue and female gender, comorbidity at baseline, depressive symptoms, dependency in activities of daily living and better cognitive functioning. Lower levels of fatigue were associated with the use of dopamine agonists. CONCLUSION: Fatigue is a common, severely limiting symptom in PD. This study demonstrates associations with other factors that could yield a better understanding of the symptom and thus possible treatment strategies, although further investigations are necessary to establish causal relationships.

Plasma Generator with Dielectric Rim and FSS Electrode for Enhanced RCS Reduction Effect.

In this study, a method was experimentally verified for further reducing the radar cross-section (RCS) of a two-dimensional planar target by using a dielectric rim in a dielectric barrier discharge (DBD) plasma generator using a frequency selective surface (FSS) as an electrode. By designing the frequency selective surface such that the passbands of the radar signal match, it is possible to minimize the effect of the conductor electrode, in order to maximize the RCS reduction effect due to the plasma. By designing the FSS to be independent of the polarization, the effect of RCS reduction can be insensitive to the polarization of the incoming wave. Furthermore, by introducing a dielectric rim between the FSS electrode and the target, an additional RCS reduction effect is achieved. By fabricating the proposed plasma generator, an RCS reduction effect of up to 6.4 dB in X-band was experimentally verified.

The effect of electroacupuncture merged with rehabilitation for frozen shoulder syndrome: A single-blind randomized sham-acupuncture controlled study.

PURPOSE: Frozen shoulder syndrome (FSS) causes pain and reduces the range of motion in the shoulder joint. To investigate the short and medium-term effects of electroacupuncture in people with FSS, we evaluated the therapeutic effects of true and sham electroacupuncture on pain relief and improvement of shoulder function. METHODS: In this randomized, single-blind controlled clinical trial, 21 subjects with FSS were randomly assigned to two groups: a true electroacupuncture group (TEAG) and a sham electroacupuncture group (SEAG). The two groups underwent 18 sessions of treatment over approximately 6-9 weeks and were then followed up at 1, 3, and 6 months. Their effectiveness for alleviating the intensity of shoulder pain was evaluated with a visual analog scale (VAS), while improved shoulder mobility was evaluated by the active range of motion (AROM) and passive range of motion (PROM), and shoulder functional ability was evaluated using the Shoulder Pain and Disability Index (SPADI). RESULTS: It demonstrated that the TEAG or SEAG showed lasting effects at 1, 3, and 6 months, although with no significant difference between these two groups in the shoulder functional ability outcomes. However, the decline in the VAS occurred earlier in the TEAG than the SEAG. Also, there was much more improvement in AROM for flexion and abduction in the TEAG than the SEAG. An increase in the abduction angle after electroacupuncture and manual rehabilitation was also apparent. CONCLUSION: These results suggest that electroacupuncture plus rehabilitation may provide earlier pain relief for patients with FSS and could be applied clinically.

A New, High-Efficacy, Noninvasive Transcranial Electric Stimulation Tuned to Local Neurodynamics.

In this paper, we pose the following working hypothesis: in humans, transcranial electric stimulation (tES) with a time course that mimics the endogenous activity of its target is capable of altering the target's excitability. In our case, the target was the primary motor cortex (M1). We identified the endogenous neurodynamics of hand M1's subgroups of pyramidal neuronal pools in each of our subjects by applying Functional Source Separation (FSS) to their EEG recordings. We then tested whether the corticospinal excitability of the hand representation under the above described stimulation, which we named transcranial individual neurodynamics stimulation (tIDS), was higher than in the absence of stimulation (baseline). As a check, we compared tIDS with the most efficient noninvasive facilitatory corticospinal tES known so far, which is 20 Hz transcranial alternating current stimulation (tACS). The control conditions were as follows: (1) sham, (2) transcranial random noise stimulation (tRNS) in the same frequency range as tIDS (1-250 Hz), and (3) a low current tIDS (tIDSlow). Corticospinal excitability was measured with motor-evoked potentials under transcranial magnetic stimulation. The mean motor-evoked potential amplitude increase was 31% of the baseline during tIDS (p < 0.001), and it was 15% during tACS (p = 0.096). tRNS, tIDSlow, and sham induced no effects. Whereas tACS did not produce an enhancement in any subject at the individual level, tIDS was successful in producing an enhancement in 8 of the 16 subjects. The results of the present proof-of-principle study showed that proper exploitation of local neurodynamics can enhance the efficacy of personalized tES.SIGNIFICANCE STATEMENT This study demonstrated that, in humans, transcranial individual neurodynamics stimulation (tIDS), which mimics the endogenous dynamics of the target neuronal pools, effectively changes the excitability of these pools. tIDS holds promise for high-efficacy personalized neuromodulations based on individual local neurodynamics.

P3b amplitude as a signature of cognitive decline in the older population: An EEG study enhanced by Functional Source Separation.

With the greying population, it is increasingly necessary to establish robust and individualized markers of cognitive decline. This requires the combination of well-established neural mechanisms, and the development of increasingly sensitive methodologies. The P300 event-related potential (ERP) has been one of the most heavily investigated neural markers of attention and cognition, and studies have reliably shown that changes in the amplitude and latency of the P300 ERP index the process of aging. However, it is still not clear whether either the P3a or P3b sub-components additionally index levels of cognitive impairment. Here, we used a traditional visual three-stimulus oddball paradigm to investigate both the P3a and P3b ERP components in sixteen young and thirty-four healthy elderly individuals with varying degrees of cognitive ability. EEG data extraction was enhanced through the use of a novel signal processing method called Functional Source Separation (FSS) that increases signal-to-noise ratio by using a weighted sum of all electrodes rather than relying on a single, or a small sub-set, of EEG channels. Whilst clear differences in both the P3a and P3b ERPs were seen between young and elderly groups, only P3b amplitude differentiated older people with low memory performance relative to IQ from those with consistent memory and IQ. A machine learning analysis showed that P3b amplitude (derived from FSS analysis) could accurately categorise high and low performing elderly individuals (78% accuracy). A comparison of Bayes Factors found that differences in cognitive decline within the elderly group were 87 times more likely to be detected using FSS compared to the best performing single electrode (Cz). In conclusion, we propose that P3b amplitude could be a sensitive marker of early, age-independent, episodic memory dysfunction within a healthy older population. In addition, we advocate for the use of more advanced signal processing methods, such as FSS, for detecting subtle neural changes in clinical populations.

Psychological and sleep-related functioning among women with unsettled infants in Victoria, Australia: a cross-sectional study.

Objective: To identify (a) clinical symptom profiles based on psychological and sleep-related functioning among women admitted to a residential early parenting service (REPS) and (b) factors associated with membership of profile groups. Background: Depression and anxiety are common among women with unsettled infants; less is known about other indicators of psychological distress and about maternal sleep. Methods: Women admitted to a REPS during a 5-month period completed validated measures of depression, anxiety, stress, irritability, alcohol use, fatigue, sleepiness and sleep quality. Latent class analysis was used to identify symptom profiles. Factors significantly associated with class membership were identified. Results: Surveys were completed by 167/380 women. Scores on all measures were statistically significantly poorer than community norms. Two classes were identified, characterised by high versus low psychological distress. Mean scores on measures of fatigue, sleepiness and sleep quality were high in both classes. High psychological distress was associated with having previous mental health problems and an unmet need for emotional support. Conclusion: Fatigue and poor sleep quality are universal among women admitted to REPS. Health services providing assistance with unsettled infant behaviour should include strategies to improve maternal sleep, and encourage social interaction among women to protect against social isolation.

Fluid shear stress improves morphology, cytoskeleton architecture, viability, and regulates cytokine expression in a time-dependent manner in MLO-Y4 cells.

The effects of load-induced interstitial fluid shear stress (FSS) on instantaneous signaling response of osteocytes (e.g., calcium signaling) have been well documented. FSS can also initiate the release of many important messenger molecules of osteocytes (e.g., ATP and PGE2 ). However, the effects of FSS on cellular function and bone metabolism-modulating cytokine expression of osteocytes have not been fully identified (some inconsistent/conflicting results have been documented). Herein, osteocyte-like MLO-Y4 cells were stimulated with 1 Pa, 2-h FSS, and the effects of FSS on cellular morphology, cytoskeletal microstructure, biological activity, and gene and protein expression of important cytokines were investigated. SEM and cytoskeleton staining revealed that FSS induced well-organized cytoskeleton and increased filopodia processes. The osteocytic viability was sustained and apoptosis was inhibited via flow cytometry. FSS promoted Wnt3a and ß-catenin gene and protein expression in 0-, 3-, and 6-h (sample collection time post FSS) groups. The FSS-stimulated cells in the 3-h group exhibited more significant effects on the promotion of OCN and Cx43 and inhibition of DKK1 and SOST expression than the 0- and 6-h groups. The 3-h group with FSS stimulation also showed the most prominent effects on suppressing RANKL and RANKL/OPG gene and protein expression. This study revealed a direct regulatory effect of FSS on osteocytic morphology and apoptotic characteristics, and showed that osteocyte-secreted bone metabolism-modulating molecule expression was regulated by FSS in a time-dependent manner. This study not only enriches our basic knowledge for understanding osteocytic mechanotransduction, but also provides important evidence for more scientific experimental design.