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Athletes are exposed to various psychological and physiological stressors, such as losing matches and high training loads. Understanding and improving the resilience of athletes is therefore crucial to prevent performance decrements and psychological or physical problems. In this review, resilience is conceptualized as a dynamic process of bouncing back to normal functioning following stressors. This process has been of wide interest in psychology, but also in the physiology and sports science literature (e.g. load and recovery). To improve our understanding of the process of resilience, we argue for a collaborative synthesis of knowledge from the domains of psychology, physiology, sports science, and data science. Accordingly, we propose a multidisciplinary, dynamic, and personalized research agenda on resilience. We explain how new technologies and data science applications are important future trends (1) to detect warning signals for resilience losses in (combinations of) psychological and physiological changes, and (2) to provide athletes and their coaches with personalized feedback about athletes' resilience. [ABSTRACT FROM AUTHOR]

Feeding difficulties and subsequent malnutrition are common in children with cerebral palsy (CP). A study was undertaken to determine the current practices and challenges of South African registered dietitians (SA RD) regarding the nutritional management of children with CP, to compare these practices with international guidelines and to compare the practices of private- and public-sector dietitians. This was a cross-sectional descriptive study with an analytical component. The SA RDs completed an online questionnaire, which was developed according to the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) guidelines. Participant answers were scored to assess their management of children with CP. Of the 87 SA RDs who participated, 78 had work experience in CP (40 public and 38 private sector). Over two-thirds (n = 62/87, 71.2%) received training on the management of CP at university, albeit inadequate (n = 42/62, 67.7%). Common challenges that affect RDs' management are poor caregiver compliance (n = 72; 92.2%) and poor networking between healthcare professionals (HCPs) (n = 60; 77.0%). The SA RD (n = 78) management of children with CP was significantly different from the ESPGHAN guidelines (p < 0.001). When comparing the total practice score, no significant difference was found between private- and public-sector RDs. The SA RDs did not achieve many of the recommended practices, particularly those pertaining to anthropometry. Improved training of SA RDs in the assessment and management of children with CP, and addressing barriers such as poor caregiver compliance, would enhance SA RDs' competence to improve the nutritional management of children with CP. [ABSTRACT FROM AUTHOR]

Inflammatory bowel disease (IBD) is a long-life disease with periods of recurrence and relief. Oxidative stress plays an important role in the pathogenesis of this disease. Recent years' studies in the field of IBD treatment mostly have focused on targeting cytokines and immune cell trafficking using antibodies and inhibitors, altering the composition of intestinal bacteria in the line of attenuation of inflammation using probiotics and prebiotics, and attenuating oxidative stress through antioxidant supplementation. Studies in animal models of IBD have shown that some polyphenolic compounds including curcumin, quercetin, resveratrol, naringenin, and epigallocatechin-3-gallate can affect almost all of the above aspects and are useful compounds in the treatment of IBD. Clinical studies performed on IBD patients have also confirmed the findings of animal model studies and have shown that supplementation with some of the above-mentioned polyphenolic compounds has positive effects in reducing disease clinical and endoscopic activity, inducing and maintaining remission, and improving quality of life. In this review article, in addition to a detailed reviewing the effects of the above-mentioned polyphenolic compounds on the events involved in the pathogenesis of IBD, the results of these clinical studies will also be reviewed. [ABSTRACT FROM AUTHOR]

Accumulating evidence has demonstrated that diet-derived gut microbiota participates in the regulation of host metabolism and becomes the foundation for precision-based nutritional interventions and the biomarker for potential individual dietary recommendations. However, the specific mechanism of the gut microbiota-host crosstalk remains unclear. Recent studies have identified that noncoding RNAs, as important elements in the regulation of the initiation and termination of gene expression, mediate microbiota-host communication. Besides, the cross-kingdom regulation of non-host derived microRNAs also influence microbiota-host crosstalk via diet motivation. Hence, understanding the relationship between gut microbiota, miRNAs, and host metabolism is indispensable to revealing individual differences in dietary motivation and providing targeted recommendations and strategies. In this review, we first present an overview of the interaction between diet, host genetics, and gut microbiota and collected some latest research associated with microRNAs modulated gut microbiota and intestinal homeostasis. Then, specifically described the possible molecular mechanisms of microRNAs in sensing and regulating gut microbiota-host crosstalk. Lastly, summarized the prospect of microRNAs as biomarkers in disease diagnosis, and the disadvantages of microRNAs in regulating gut microbiota-host crosstalk. We speculated that microRNAs could become potential novel circulating biomarkers for personalized dietary strategies to achieve precise nutrition in future clinical research implications. [ABSTRACT FROM AUTHOR]

This study explored the experiences of parents of young children with cerebral palsy who used Ankle-Foot Orthoses (AFOs). Parents of children with cerebral palsy (n = 11; age range 2–6 years) who used solid or hinged AFOs participated. Interpretive Description, a qualitative methodological approach focused on the application of findings to clinical practice, was used. Semi-structured interviews were conducted, and themes were developed using thematic analysis. Four themes described parent experience with their children's AFOs: 1) "Hear what I am saying": Collaborative decision-making with families, 2) "Is my child going to be excluded because of AFOs?": Parent and child adjustment was a journey, 3) AFOs created financial and practical challenges, 4) The perceived benefits of AFO use. Adjusting to AFOs was a challenging and time-consuming process for parents and children, which may have resulted in lower frequency and duration of use than anticipated by clinicians. Clinicians must be aware of the physical and psychosocial adjustment process as children and families adapt over time and work with families to ensure AFO use is optimized and individualized. Clinical practice will be enhanced by understanding parent experience with their children's receipt and use of Ankle-Foot Orthoses (AFOs). Clinicians should work with families to establish and monitor individualized wear-time schedules that align with family routines. Information about AFOs, including appearance and alternative clothing requirements, should be provided to families in advance of receiving AFOs. [ABSTRACT FROM AUTHOR]

Adolescents with CP classified as Gross Motor Functional Classification System Level V attend school up to 8 h daily with limited ability to self-reposition. Despite pain reported within this population, perceived pain and self-pressure relief during prolonged classroom sitting is unknown. A case series design was used with a convenience sample of six students (13–18 years) with CP. Pain assessments were taken every 30 min for 5 h. Self-relief assessments using the SensiMATTM were recorded while students were in their wheelchairs. One student self-reported pain and three students proxy reported pain movements. All students had unrelieved pressure or did not self-relieve pressure for at least 1.5 consecutive hours. Four students increased their self-pressure relief movements after 3.5 h. This study provided preliminary data regarding perceived pain and self-pressure relief during prolonged sitting and demonstrated that the SensiMATTM can capture pressure relief movements in sitting of students with severe CP. Although there was no trend of reported pain, students may either be moving enough, as demonstrated by recorded pressure relief movements, to independently relieve pressure and pain, or current pain assessments may not be sensitive enough for those with the most severe disabilities. [ABSTRACT FROM AUTHOR]

The IndieTrainer system, comprised of both a mobility device and gamified training modules, was developed to aid powered wheelchair (PWC) skills acquisition in children with cerebral palsy (CP). The aims of this small-scale study are to: explore use of the IndieTrainer system to improve PWC skills in children who have CP and document parental/caregiver perceptions of, and satisfaction with, the IndieTrainer system. This small-scale study is an open-label single-arm clinical trial involving a three-week PWC training intervention consisting of two 60-minute training sessions per week. A single session retention trial will be held four weeks after the completion of the intervention period. All research activities will take place in-person in a laboratory-based setting located within a university. Twenty-five child-parent/caregiver dyads will participate in the study. Each child participant will be 3 to 21 years of age and have a diagnosis of CP or other similar condition. The Assessment of Learning Powered mobility use will be the primary outcome measure. Secondary outcome measures will include the Wheelchair Skills Checklist, the Canadian Occupational Performance Measure, the Customer Satisfaction Questionnaire-8, and a qualitative interview. Data analyses will involve one-way repeated measures ANOVAs followed by paired samples t-tests with Bonferroni adjustments. The IndieTrainer system allows children to explore and use power mobility in their own manual wheelchair and was designed to meet the needs of power mobility learners across the continuum of learning. It is the first PWC training system to optimize learning for early learners who do not yet understand cause and effect concepts. The IndieTrainer system is designed to meet the needs of power mobility learners across the continuum of learning. This protocol outlines a novel means of providing progressive power mobility training. The IndieTrainer was designed to expand power mobility access to children with cerebral palsy, a previously underserved population. [ABSTRACT FROM AUTHOR]

Assistive technology intervention has become an important strategy in enhancing function in young children with cerebral palsy. This study aimed to provide an in-depth knowledge of the use of assistive devices by describing their purposes, the environments in which they are used, frequency of use and perceived benefits from the caregiver's perspective. This is a cross-sectional population-based study using data from national cerebral palsy registers in Norway. Of a total of 202 children, 130 participated (mean age 49.9 months, SD 14.0 months). The 130 children and their families used a median of 2.5 assistive devices (range 0–12) to support positioning, mobility, self-care and training, stimulation and play. Devices most commonly had one or two main purposes and were used both at home and in kindergarten/school. The usage rate varied from less than twice a week to several times a day. The majority of parents reported significant benefits for caregiving and/or the child's functioning. Total use increased in accordance with the level of the child's gross motor limitations and was associated with restrictions imposed by housing concerns. The frequent use of a wide range of devices, and the intended and perceived benefits, demonstrates that early provision of assistive devices can be an effective function-enhancing strategy in young children with cerebral palsy. However, the findings also indicate that factors others than the child's motor abilities must be considered when integrating the use of devices into the child's daily routines and activities. Early provision of assistive devices can be a powerful strategy to support everyday functioning and facilitate care in young children with cerebral palsy. Assistive devices seems to be most effective when they are well integrated into the child's daily routines and activities across environments. The clinical classifications of motor abilities (Gross Motor Function Classification System and Manual Ability Classification System) can be used to estimate the need for assistive devices, however, factors others than the child's motor function seem to be critical for optimum effectiveness, such as type of equipment, its physical and social environment and the intended benefits of use. [ABSTRACT FROM AUTHOR]

This study proposes a concept for emotion recognition systems for children with profound intellectual and multiple disabilities (PIMD) based on artificial intelligence (AI) using physiological and motion signals. First, the heartbeat interval (R–R interval, RRI) of a child with PIMD was measured, and the correlation between the RRI and emotion was briefly tested in a preliminary experiment. Then, a concept based on AI for emotion recognition systems for children with PIMD was created using physiological and motion signals, and an emotion recognition system based on the proposed concept was developed using a random forest classifier taking as inputs the RRI, eye gaze, and other data acquired using low physical burden sensors. Subsequently, the developed emotion recognition system was evaluated, validating the proposed concept. Finally, we proposed a validated concept for emotion recognition systems. A correlation was found between the RRI and emotion. The emotion recognition system was created based on the proposed concept and tested. According to the results, the recognition rate of "negative" and "not negative" of 70.4% ± 6.1% (Mean ± S.D.) of the developed emotion recognition system was higher than 48.5% ± 5.0% of an unfamiliar person used as a control. The results indicate that the proposed concept for emotion recognition systems is useful for communicating with children with PIMD. A new concept based on artificial intelligence for emotion recognition systems for children with profound intellectual and multiple disabilities (PIMD) using physiological and motion signals is proposed. An emotion recognition system based on the proposed concept developed using a random forest classifier taking as inputs the heartbeat interval, eye gaze, and other data acquired using low physical burden sensors were tested in terms of the emotion recognition rate. The recognition rate of "negative" and "not negative" of the developed system (i.e., 70.4% ± 6.1%) is higher than that of an unfamiliar person (i.e., 48.5% ± 5.0%). The proposed concept for emotion recognition systems may be useful for communicating with children with PIMD. [ABSTRACT FROM AUTHOR]

To investigate the effects of postural control and upper extremity functional capacity on functional independence and identify whether quality of upper extremity skills mediates the effects of postural control on functional independence in preschool-age children with spastic cerebral palsy (CP). 106 children with CP -mean age 43.4 ± 11.3 (24–71 months)- were included in this cross-sectional study. Postural control, upper extremity functional capacity, and functional independence in activities of daily living were evaluated using the Early Clinical Assessment of Balance (ECAB), Quality of Upper Extremity Skills Test (QUEST), and the Functional Independence Measure of Children (WeeFIM), respectively. A path model was used to evaluate the total, direct, and indirect effects. According to the path model, ECAB (direct effect; r = 0.391, p < 0.01, indirect effect; r = 0.398) and QUEST (direct effect; r = 0.493, p < 0.01) had an impact on WeeFIM. In addition, QUEST had mediating effects on the relationship between ECAB and WeeFIM. The path model explained 71% of the variation in functional independence of the participants. In the management of CP in preschool-age children, the focus should be on improving not only upper extremity capacity but also postural control to help improve functional independence in activities of daily living. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was thus to evaluate the effect of Cr supplementation on morphological changes and expression of pro-inflammatory cytokines in the hippocampus and on developmental parameters. Methods: Male Wistar rat pups were submitted to an experimental model of CP. Cr was administered via gavage from the 21st to the 28th postnatal day, and in water after the 28th, until the end of the experiment. Body weight (BW), food consumption (FC), muscle strength, and locomotion were evaluated. Expression of interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor α (TNF-α) were assessed in the hippocampus by quantitative real-time polymerase chain reaction. Iba1 immunoreactivity was assessed by immunocytochemistry in the hippocampal hilus. Results: Experimental CP caused increased density and activation of microglial cells, and overexpression of IL-6. The rats with CP also presented abnormal BW development and impairment of strength and locomotion. Cr supplementation was able to reverse the overexpression of IL-6 in the hippocampus and mitigate the impairments observed in BW, strength, and locomotion. Discussion: Future studies should evaluate other neurobiological characteristics, including changes in neural precursor cells and other cytokines, both pro- and anti-inflammatory. [ABSTRACT FROM AUTHOR]

To identify participation-focused measures used for young people with cerebral palsy (CP), evaluate their psychometric evidence, and map item content to the International Classification of Functioning, Disability, and Health (ICF), and family of Participation-Related Constructs (fPRC) frameworks. Four databases (PubMed, Embase, Web of Science, CINAHL) were searched for papers that involved young people with CP aged 15 to 25 years and reported original data from a participation measure. Each measure was examined for validity, reliability, responsiveness (using the COSMIN checklist), clinical utility, the inclusion of accessible design features, self- and/or proxy-report from people with communication support needs, and item content according to ICF and fPRC. Of 895 papers, 80 were included for review. From these, 26 measures were identified. Seven measures (27 papers/resources) were participation-focused, capable of producing a score for participation Attendance and/or Involvement. Of these, all measured Attendance (n = 7) but fewer than half measured Involvement (n = 3). Few included studies (37%) reported including some self-report of people with communication support needs. Participation measures for young people with CP are evolving but require more: (i) emphasis on measurement of involvement; (ii) investigation of psychometric properties; and (iii) adaptation to enable self-report by young people with communication support needs. Identifies seven participation-focused measures which are available for young people with cerebral palsy, all seven measure Attendance and three measure Involvement. Provides a decision-making tool to assist clinicians and researchers with the selection of participation-focused measures for young people with cerebral palsy. Recommends that more accessible self-report measures are needed which capture age-appropriate participation of young people with cerebral palsy. [ABSTRACT FROM AUTHOR]

Understanding cytochrome P450 (CYP) enzymes in the canine intestine is vital for predicting drug metabolism and developing safer oral medications. This study evaluates canine colonoids as a model to assess the expression and induction of essential intestinal CYP enzymes. Canine colonoids were cultured in expansion medium (EM) with Wnt-3A and in differentiation medium (DM) without Wnt-3A. We assessed the mRNA expression of CYP2B11, CYP2C21, CYP3A12, and CYP3A98 using qPCR and examined the effects of rifampicin and phenobarbital as inducers. Our findings show that DM significantly increased the mRNA expression of CYP3A98 and CYP2B11, but not CYP3A12, compared to EM. CYP2C21, not typically expressed in the intestine, remained unexpressed in colonoids. Rifampicin induced CYP3A98, aligning with pregnane x receptor (PXR) regulation, while phenobarbital did not, suggesting no constitutive androstane receptor (CAR) involvement. CYP2B11 did not respond to either inducer, suggesting alternative regulatory pathways in canine colonoids. This study is a pioneering effort to establish conditions for studying P450 expression in canine colonoids, confirming significant CYP3A98 expression in the canine intestine. It demonstrated colonoids can induce CYP activity post drug treatments. Further research is needed to enhance species-specific drug metabolism understanding and validate this model for broader applications. [ABSTRACT FROM AUTHOR]

Psoriasis is a chronic inflammatory disease characterized by squamous and erythematous plaques on the skin and the involvement of the immune system. Global prevalence for psoriasis has been reported around 1–3% with a higher incidence in adults and similar proportions between men and women. The risk factors associated with psoriasis are both extrinsic and intrinsic, out of which a polygenic predisposition is a highlight out of the latter. Psoriasis etiology is not yet fully described, but several hypothesis have been proposed: 1) the autoimmunity hypothesis is based on the over-expression of antimicrobial peptides such as LL-37, the proteins ADAMTSL5, K17, and hsp27, or lipids synthesized by the PLA2G4D enzyme, all of which may serve as autoantigens to promote the differentiation of autoreactive lymphocytes T and unleash a chronic inflammatory response; 2) dysbiosis of skin microbiota hypothesis in psoriasis has gained relevance due to the observations of a loss of diversity and the participation of pathogenic bacteria such as Streptococcus spp. or Staphylococcus spp. the fungi Malassezia spp. or Candida spp. and the virus HPV, HCV, or HIV in psoriatic plaques; 3) the oxidative stress hypothesis, the most recent one, describes that the cell injury and the release of proinflammatory mediators and antimicrobial peptides that leads to activate of the Th1/Th17 axis observed in psoriasis is caused by a higher release of reactive oxygen species and the imbalance between oxidant and antioxidant mechanisms. This review aims to describe the mechanisms involved in the three hypotheses on the etiopathogeneses of psoriasis. [ABSTRACT FROM AUTHOR]

Endoplasmic reticulum stress (ERS) and Toll-like receptor 2 (TLR2) signaling play an important role in inflammatory bowel disease (IBD); however, the link between TLR2 and ERS in IBD is unclear. This study investigated whether Thapsigargin (TG) -induced ER protein expression levels contributed to TLR2-mediated inflammatory response. The THP-1 cells were treated with TLR2 agonist (Pam3CSK4), ERS inducer Thapsigargin (TG) or inhibitor (TUDCA). The mRNA expressions of TLR1-TLR10 were detected by qPCR. The production and secretion of inflammatory factors were detected by PCR and ELISA. Immunohistochemistry was used to detect the expressions of GRP78 and TLR2 in the intestinal mucosa of patients with Crohn's disease (CD). The IBD mouse model was established by TNBS in the modeling group. ERS inhibitor (TUDCA) was used in the treatment group. The expression of TLRs was detected via polymerase chain reaction (PCR) in THP-1 cells treated by ERS agonist Thapsigargin (TG). According to the findings, TG could promote TLR2 and TLR5 expression. Subsequently, in TLR2 agonist Pam3CSK4 induced THP-1 cells, TG could lead to increased expression of the inflammatory factors such as TNF-α, IL-1β and IL-8, and ERS inhibitor (TUDCA) could block this effect. However, Pam3CSK4 did not significantly impact the GRP78 and CHOP expression. Based upon the immunohistochemical results, TLR2 and GRP78 expression were significantly increased in the intestinal mucosa of patients with Crohn's disease (CD). For in vivo experiments, TUDCA displayed the ability to inhibit intestinal mucosal inflammation and reduce GRP78 and TLR2 proteins. ERS and TLR2 is upregulated in inflammatory bowel disease, ERS may promote TLR2 pathway-mediated inflammatory response. Moreover, ERS and TLR2 signaling could be novel therapeutic targets for IBD. [ABSTRACT FROM AUTHOR]

Adipose tissue is a complex organ that is increasingly being recognised as the largest endocrine organ in the body. Adipocytes among multiple cell types of adipose tissue can secrete a variety of adipokines, which are involved in signalling pathways and these can be changed by obesity and cancer. There are proposed mechanisms to link obesity/adiposity to cancer development including adipocytokine dysregulation. Among these adipokines, leptin acts through multiple pathways including the STAT3, MAPK, and PI3K pathways involved in cell growth. Adiponectin has the opposite action from leptin in tumour growth partly because of increased apoptotic responses of p53 and Bax. Visfatin increases cancer cell proliferation through ERK1/2, PI3K/AKT, and p38 which are stimulated by proinflammatory cytokines. Omentin through the PI3K/Akt-Nos pathway is involved in cancer-tumour development. Apelin might be involved through angiogenesis in tumour progressions. PAI-1 via its anti-fibrinolytic activity on cell adhesion and uPA/uPAR activity influence cancer cell growth. [ABSTRACT FROM AUTHOR]

This paper authentically represents the voices of non-verbal children with cerebral palsy using a case study design. Policy suggests that children should have the right to play and leisure opportunities, however non-verbal children with cerebral palsy have fewer choices. Additionally, children with communication, learning and mobility limitations are usually excluded from research. The aim of this research was to capture the voices of non-verbal children by exploring their well-being impact in terms of their experiences and choices about their level of participation in recreational activities. A qualitative case series study included interviews, observations, photographs and diaries. Where possible, the diaries were completed by both caregivers and children. Data were analysed thematically, and the lens of positioning theory applied. Seven children aged nine to sixteen years participated. The findings showed how equipment, people and environments enabled or hindered the children's participation. The children also advocated as champions for their own well-being. Positioning theory was applied across the data and was adapted offering a way to better understand the children's well-being responses. The findings demonstrate how these children were able to self-advocate, demonstrating their well-being by their intentional behaviours from their level of participation in a recreational activity. The voices of non-ambulant and non-verbal children are underrepresented in the literature. This study offers an innovative approach to highlight their voices using visual data. The images project the narrative about their choices for participation in recreational activities. The proposed kaleidoscope of well-being offers a way to demonstrate the fluctuations in their emotional responses from their participation. Choices for participation in recreational activities remains limited for non-ambulant and non-verbal children with cerebral palsy. Designers and policy makers should consider how equipment and environments can be adapted or created to increase the choices for non-ambulant and non-verbal children with cerebral palsy. Practitioners in health and social care should consider how to listen to the voices of non-verbal and non-ambulant children with cerebral palsy and their parents/guardians and work towards jointly setting participation goals to affirm their strengths. [ABSTRACT FROM AUTHOR]

To identify specific factors influencing the participation experiences of young people with cerebral palsy (CP) aged 15 to 26 years. A three-round Delphi survey study design was used. Consumers (young people with CP and caregivers) and health professionals were asked to generate and then rate items influencing positive and negative participation experiences. Qualitative content analysis and descriptive statistics were used to classify items across the family of Participation-Related Constructs (fPRC) framework. Sixty-eight participants completed Round I (25 consumers, 43 health professionals). Round II resulted in a consensus for all but two items, with Round III not required. The fPRC construct with the most items rated as extremely important for positive participation experiences was Environment–Availability, and for negative participation, experiences were Environment-Acceptability for both adolescents and young adults. A consensus was reached on the most important items influencing the positive and negative participation experiences of young people with CP. These items should be prioritised when developing support services and allocating funding to improve the participation experiences of young people with CP. This study is reporting consumer and professional consensus on the factors promoting positive and negative participation for young people with cerebral palsy. Ensuring availability of appropriate activities and services is extremely important for enabling positive participation experiences. Promoting acceptable attitudes of others is extremely important for alleviating negative participation experiences. [ABSTRACT FROM AUTHOR]

Blood barriers serve as key points of transport for essential molecules as well as lines of defense to protect against toxins. In vitro modeling of these barriers is common practice in the study of their physiology and related diseases. This review describes a common method of using an adaptable, low cost, semipermeable, suspended membrane to experimentally model three blood barriers in the human body: the blood-brain barrier (BBB), the gut-blood barrier (GBB), and the air-blood barrier (ABB). The GBB and ABB both protect from the outside environment, while the BBB protects the central nervous system from potential neurotoxic agents in the blood. These barriers share several commonalities, including the formation of tight junctions, polarized cellular monolayers, and circulatory system contact. Cell architectures used to mimic barrier anatomy as well as applications to study function, dysfunction, and response provide an overview of the versatility enabled by these cultural systems. [ABSTRACT FROM AUTHOR]

Intestinal organoid technology has revolutionized our approach to in vitro cell culture due in part to their three-dimensional structures being more like the native tissue from which they were derived with respect to cellular composition and architecture. For this reason, organoids are becoming the new gold standard for undertaking intestinal epithelial cell research. Unfortunately, their otherwise advantageous three-dimensional geometry prevents easy access to the apical epithelium, which is a major limitation when studying interactions between dietary or microbial components and host tissues. To overcome this problem, we developed porcine colonoid-derived monolayers cultured on both permeable Transwell inserts and tissue culture treated polystyrene plates. We found that seeding density and culture format altered the expression of genes encoding markers of specific cell types (stem cells, colonocytes, goblets, and enteroendocrine cells), and barrier maturation (tight junctions). Additionally, we found that changes to the formulation of the culture medium altered the cellular composition of colonoids and of monolayers derived from them, resulting in cultures with an increasingly differentiated phenotype that was similar to that of their tissue of origin. [ABSTRACT FROM AUTHOR]

The intestinal mucosal immune system is challenged with bacteria, viruses, and parasites, in addition to food and environmental antigens, that require dynamic immune responsiveness for homeostasis. One central signaling pathway is JAK-STAT, which regulates the adaptive and innate immune arms of mucosal immunity as well as epithelial repair and regeneration. Adaptive immunity includes lymphocyte mediated secretion of specific antibodies, while innate immune respones include secreiton of non-antigen specifc compounds. This review examines effects of specialized nutrition support on JAK-STAT in innate immune function and in lymphocyte modulation and epithelial antibody transport in gut-associated lymphoid tissue. [ABSTRACT FROM AUTHOR]

Graphene quantum dots (GQDs) have gained significant attention in various biomedical applications. The physicochemical properties of these nanoparticles, including toxic effects, are largely determined by their surface modifications. Previous studies have demonstrated high in vitro cytotoxicity of the hydroxylated GQDs (OH-GQDs). The focus of this study was on the intestinal toxicity of OH-GQDs. Briefly, C57BL/6J mice were given daily oral gavage of 0.05, 0.5 or 5 mg/kg OH-GQD for 7 days, and the indices of intestinal damage were evaluated. Higher doses of the OH-GQDs caused significant intestinal injuries, such as enhanced intestinal permeability, shortened villi and crypt loss. The number of Lgr5+ intestinal stem cells also decreased dramatically upon OH-GQDs exposure, which also inhibited the Ki67+ proliferative progenitor cells. In addition, an increased number of crypt cells harboring the oxidized DNA base 8-OHdG and γH2AX foci were also detected in the intestines of OH-GQD-treated mice. Mechanistically, the OH-GQDs up-regulated both total and phosphorylated p53. Consistent with this, the average number of TUNEL+ and cleaved caspase-3+ apoptotic intestinal epithelial cells were significantly increased after OH-GQDs treatment. Finally, a 3-dimensional organoid culture was established using isolated crypts, and OH-GQDs treatment significantly reduced the size of the surviving intestinal organoids. Taken together, the intestinal toxicity of the OH-GQDs should be taken into account during biomedical applications. [ABSTRACT FROM AUTHOR]

Aims. To do a genome-wide gene expression study of active and inactive ulcerative colitis and Crohn's disease (inflammatory bowel disease - IBD) and examine the most differentially expressed genes. As the study showed an extreme upregulation of all regenerating islet-derived genes (REG proteins) in active IBD, we further studied the expression of REGs on protein level in active and inactive IBD, as well as in non-IBD (pseudomembranous) colitis. Methods. Microarray analysis was done on a total of 100 pinch biopsy samples from healthy controls and patients with Crohn's disease or ulcerative colitis. Tissue samples from IBD and pseudomembranous colitis were examined with routine histology and immunohistochemical analysis for REGIα, REGIV, DEFA6, and serotonin. Results. REG mRNAs were up to 83 times overexpressed in diseased mucosa compared with mucosa from healthy individuals. REGIα and REGIV were overexpressed at immunohistochemistry and located to different mucosal cell types. REGIα was expressed in basal half of crypts, REGIV in mid and outer parts of crypts and in surface epithelium and seems to be stored in, and secreted from, goblets. Pseudomembranous colitis samples showed similar staining patterns, and some IBD samples stained REG positive without inflammation on routine histology. Conclusions. All REG family mRNAs are upregulated in IBD. REGIα and REGIV have different cellular localization, possibly reflecting different biological functions. REG protein expression also in pseudomembranous colitis shows that REG family proteins are regulated in inflammatory injury and repair, not specifically for IBD as previously thought. [ABSTRACT FROM AUTHOR]

Adult stem cell niches are characterized by a dichotomy of cycling and quiescent stem cells: while the former are responsible for tissue turnover, their quiescent counterparts are thought to become active upon tissue injury thus underlying the regenerative response. Moreover, quiescence prevents adult stem cells from accumulating mutations thus ensuring a reservoir of unaltered stem cells. In the intestine, while cycling stem cells were shown to give rise to the main differentiated lineages, the identity of their quiescent equivalents remains to date elusive. This is of relevance for conditions such as Crohn's disease and ulcerative colitis where quiescent stem cells may underlie metaplasia and the increased cancer risk associated with chronic inflammation. Tumours are thought to share a comparable hierarchical structure of adult tissues with pluripotent and self-renewing cancer stem cells (CSCs) giving rise to more differentiated cellular types. As such, neoplastic lesions may encompass both cycling and quiescent CSCs. Because of their infrequent cycling, quiescent CSCs are refractory to chemo- and radiotherapy and are likely to play a role in tumour dissemination, dormancy and recurrence. [ABSTRACT FROM AUTHOR]

Gastric juice contains both pancreatic group I phospholipase A2 (PLA2-I) and synovial-type group II phospholipase A2 (PLA2-II), which may play a crucial role in Helicobacter pylori infection and gastric mucosal injury. PLA2-I present in gastric juice is derived from pancreatic acinar cells. The cellular source of PLA2-II found in gastric juice is unknown. A specific cell type of the intestinal mucosa, the Paneth cell, is known to secrete PLA2-II. The purpose of the present study was to define the source of PLA2-II present in gastric juice. For this purpose, gastric juice was collected from 29 individuals during gastroscopy, and mucosal biopsies were taken from the antrum and body of the stomach and from the duodenum as well as from the jejunum of individuals with resected stomach, for immunohistochemical detection of PLA2-II. The concentration of bilirubin in the gastric juice samples was determined to identify duodenogastric regurgitation. The PLA2-II content was significantly higher in bilirubin-positive than in bilirubin-negative gastric juice samples. PLA2-II was localized by immunohistochemistry in Paneth cells in three patients with areas of intestinal metaplasia of the gastric mucosa and in Paneth cells of duodenal and jejunal mucosa in all patients, but not in any other epithelial cell type of the mucosa of the stomach or the small intestine. Inflammatory cells did not contain PLA2-II. The current results suggest that PLA2-II found in gastric juice is derived from the Paneth cells of the small intestinal mucosa. [ABSTRACT FROM AUTHOR]

To explore pain experiences of children with cerebral palsy, and how it influences their everyday life. Fourteen children with CP between eight and seventeen years old were included, using a purposeful sampling strategy. They had different experiences of pain, and different degrees of physical and cognitive impairments. Sixteen individual semi-structured interviews were carried out, and analyzed using inductive thematic analysis. Data analysis resulted in the main theme "I have to obey my pain" and four themes were identified. Experiences regarding pain varied ("My pain is mine alone"). Both pain itself and the use of cognitive strategies to cope with pain involved a mental struggle ("Pain brings me down"). The children had to make adjustments to manage their pain ("I want to participate, but I have to rest"). The most important help was to be understood, but adults also provided valuable help with interventions like stretching, medication and adjustment of activity levels ("Others can help me"). Pain was a determining feature in the lives of these children with CP. The wide variety of experiences and challenges emphasized the need for tailored management strategies developed together with each child and their parents. Children with cerebral palsy had varied experiences of pain, and health professionals need to tailor their pain management approaches to the individual child. Health services should offer pain education to expand children's repertoire of pain management strategies. When a child's pain influences their daily activities, health services must ensure that the school is informed of the child's situation, and able to make necessary adjustments. Health professionals should strive to include children's own descriptions whenever possible to make sure children feel heard and believed. Even children with communicative and cognitive impairments were able to self-report when necessary adjustments in the communication situation were made. [ABSTRACT FROM AUTHOR]

The labour market consequences of early-onset or congenital disabilities have received little attention in the literature. In this paper, we study the consequences of cerebral palsy (CP), a lifelong early onset disability, and pathways through which it affects labour outcomes. We use data from multiple linked Swedish National Population Registers between 1990 and 2015 and apply both regression and mediation analysis. Our results show, as expected, strong negative consequences of CP on labour outcomes, and that the consequences have increased over time. The social insurance system, we find, compensates for some of the losses through non-work-related benefits. The results also suggest that the direct effects of CP per se have prominent impact on labour market outcomes. Thus, given the same level of mediators, persons with CP will have lower labour outcomes compared to persons without CP. Our results draw attention to the widening labour market consequences of CP in Sweden. [ABSTRACT FROM AUTHOR]

Children with cerebral palsy frequently experience challenges and barriers to inclusion in early childhood education and care. However, there is limited research exploring the experiences of children with cerebral palsy and their families. Understanding family perspectives on their experience is likely to provide insights for professionals to improve inclusive practices. Using Bronfenbrenner's bioecological theory, this study evaluates online survey responses of factors that parents believed facilitated – or created barriers towards – inclusive early childhood education. Ninety-eight parents shared their levels of satisfaction and perspectives regarding the importance of inclusion practices involving their child in Australian settings. Parents reported overall high levels of satisfaction, highlighting the importance of positive educator attitudes, communication between home and settings and partnerships between home, allied health practitioners and early childhood education and care settings. Concerns related to children's psychological wellbeing were raised, particularly regarding children's experiences and challenges with anxiety including separation anxiety. [ABSTRACT FROM AUTHOR]

In this paper, we investigate whether fertility and newborn health changed during the Covid-19 pandemic in Mexico. We use national administrative data and an event-study design to examine the impact of the Covid-19 pandemic on fertility and newborn health characteristics. Our findings suggest that Mexico's fertility declined temporarily as measured by conceptions that likely occurred during the stay-at-home order. Initially, the general fertility rate fell by 11–12 per cent but quickly rebounded and returned close to its original levels by the end of 2021. Newborn health also deteriorated during the pandemic. Instances of low birthweight and prematurity substantially increased, with both remaining elevated over the entire pandemic period. [ABSTRACT FROM AUTHOR]

The study aimed to describe the implementation of a collaborative ride-on car (ROC) intervention by applying a practice model of family-professional collaboration. The model involves specific strategies for collaboration, "visualizing a preferred future" and "scaling questions." The participants were two young children with mobility limitations and their mothers. The 12-week of ROC intervention involved training sessions with a therapist and home sessions. The outcomes included the Canadian Occupational Performance Measure (COPM) and Goal Attainment Scaling (GAS). The collaborative strategies facilitated parent engagement in goal setting, planning, and evaluation. After the intervention, the mothers' ratings of their children's performance and parent satisfaction on the COPM increased by 6 and 3 points, respectively, and the level of goal attainment exceeded expectations (+1 on GAS) in both families. Prior to the ROC intervention, both families were hesitant to use powered mobility. However, the experience of participating in the ROC intervention process broadened parents' perspectives on self-directed mobility and led them to explore options for their children to move independently. The collaborative ROC intervention can be used as an intervention for early mobility and a bridging step for families reluctant to use a powered wheelchair. [ABSTRACT FROM AUTHOR]

The prevalence of generalised anxiety disorder (GAD) is high. However, the underlying mechanisms remain elusive. Proteomics techniques can be employed to assess the pathological mechanisms involved in GAD. Twenty-two drug-naive GAD patients were recruited, their serum samples were used for protein quantification and identified using Tandem Mass Tag and Multiple Reaction Monitoring (MRM). Machine learning models were employed to construct predictive models for disease occurrence by using clinical scores and target proteins as input variables. A total of 991 proteins were differentially expressed between GAD and healthy participants. Gene Ontology analysis revealed that these proteins were significantly associated with stress response and biological regulation, suggesting a significant implication in anxiety disorders. MRM validation revealed evident disparities in 12 specific proteins. The machine learning model found a set of five proteins accurately predicting the occurrence of the disease at a rate of 87.5%, such as alpha 1B-glycoprotein, complement component 4 A, transferrin, V3-3, and defensin alpha 1. These proteins had a functional association with immune inflammation. The development of generalised anxiety disorder might be closely linked to the immune inflammatory stress response. [ABSTRACT FROM AUTHOR]

The growing concern over potential unintended nuclear accidents or malicious activities involving nuclear/radiological devices cannot be overstated. Exposure to whole-body doses of radiation can result in acute radiation syndrome (ARS), colloquially known as "radiation sickness," which can severely damage various organ systems. Long-term health consequences, such as cancer and cardiovascular disease, can develop many years post-exposure. Identifying effective medical countermeasures and devising a strategic medical plan represents an urgent, unmet need. Various clinical studies have investigated the therapeutic use of umbilical cord blood (UCB) for a range of illnesses, including ARS. The objective of this review is to thoroughly discuss ARS and its sub-syndromes, and to highlight recent findings regarding the use of UCB for radiation injury. UCB, a rich source of stem cells, boasts numerous advantages over other stem cell sources, like bone marrow, owing to its ease of collection and relatively low risk of severe graft-versus-host disease. Preclinical studies suggest that treatment with UCB, and often UCB-derived mesenchymal stromal cells (MSCs), results in improved survival, accelerated hematopoietic recovery, reduced gastrointestinal tract damage, and mitigation of radiation-induced pneumonitis and pulmonary fibrosis. Interestingly, recent evidence suggests that UCB-derived exosomes and their microRNAs (miRNAs) might assist in treating radiation-induced damage, largely by inhibiting fibrotic pathways. UCB holds substantial potential as a radiation countermeasure, and future research should focus on establishing treatment parameters for ARS victims. [ABSTRACT FROM AUTHOR]

Micro(nano)plastics (MNPs) in human food system have been broadly recognized by researchers and have drawn an increasing public attention to their potential health risks, particularly the risk to the intestinal system regarding the long-term exposure to MNPs through food consumption. This study aims to review the environmental properties (formation and composition) of MNPs and MNPs pollution in human food system following the order of food production, food processing and food consumption. The current analytic and identical technologies utilized by researchers are also summarized in this review. In fact, parts of commonly consumed food raw materials, processed food and the way to take in food all become the possible sources for human MNPs ingestion. In addition, the available literatures investigating MNPs-induced intestinal adverse effect are discussed from in vitro models and in vivo mammalian experiments, respectively. Particle translocation, cytotoxicity, damaged gut barrier, intestinal inflammation as well as microbial alteration are mostly reported. Moreover, the practical remediation strategies for MNPs pollution are also illustrated in the last section. This review is expected to provide a research insight for foodborne MNPs and arouse more public awareness of MNPs pollution in food and potential risk for human intestinal health. [ABSTRACT FROM AUTHOR]

Objective: To evaluate gender differences in physical activity (PA), stress and resiliency during the COVID-19 pandemic. Participants: Students (n = 300) at a southeastern US university. Methods: Perceived Stress (PSS), Resiliency (BRS), Life Events (LEI), and PA were recorded via online survey in Summer 2020. PSS, BRS, LEI, and PA were compared between males and females. Two-way ANOVAs examined gender and frequency effects on PSS and BRS. Results: Females had lower BRS and higher PSS and LEI scores than males (all p <.001). PSS/BRS scores were more strongly correlated with PA in males. Significant gender × frequency interactions were found for PSS (vigorous, p =.03) and for BRS (moderate, p =.049). There was a significant main effect of frequency for PSS with strength training (p <.001). Conclusions: Results suggest that interventions may be particularly needed for females and those with low PA levels. [ABSTRACT FROM AUTHOR]

Gastric dysplasia in the absence of an endoscopically defined lesion is rare, usually either a false positive diagnosis or a previously unidentified precancerous lesion during esophagogastroduodenoscopy (EGD). Evaluate factors associated with the presence of an endoscopically visible lesion during follow-up in patients with histologic diagnosis of gastric dysplasia in random biopsies. Retrospective cohort study including patients referred to our institution for gastric dysplasia in random biopsies during Index EGD. Endoscopic evaluation was performed with a high-definition endoscope using narrow band imaging (HD EGD-0). If no lesion was detected, endoscopic surveillance (HD EGD-FU) was conducted within 6 months for high grade dysplasia (HGD) or 12 months for low grade (LGD) or indefinite for dysplasia (IFD). From a total sample of 96 patients, 5 (5.2%) presented with an endoscopically visible lesion during HD EGD-0, while 10 lesions (10.4%) were identified during HD EGD-FU. Patients with Helicobacter pylori infection at Index EDG and with regular alcohol consumption (≥25 g/day) were 8 and 4 times more likely to have an endoscopically visible lesion on HD EGD-FU (p = 0.012 and p = 0.047). In binary logistic regression, both factors were independent predictors of the presence of gastric lesion on HD EGD-FU (OR 9.284, p = 0.009 and OR 5.025, p = 0.033). The presence of an endoscopically visible lesion after the histologic diagnosis of gastric dysplasia in random biopsies was more frequent during HD EGD-FU. H. pylori infection at Index EGD and regular alcohol consumption were significant predictors of the presence of gastric lesion on HD EGD-FU. [ABSTRACT FROM AUTHOR]

Four organoruthenium(II) arene dithiocarbamate complexes: RuCl(piperidine dithiocarbamate)(p-cymene), C1; RuCl(1-phenylpiperazine dithiocarbamate)(p-cymene), C2, RuCl(ethylphenyl dithiocarbamate)(p-cymene), C3; RuCl(4-benzylpiperidine dithiocarbamate)(p-cymene), C4 were synthesized and characterized by elemental analysis, UV-Vis, FTIR, NMR and mass spectroscopic techniques. Spectroscopic data indicate that the complexes are four coordinate tetrahedral geometry consisting of one dithiocarbamato anion, p-cymene and a chlorido ligand around the ruthenium(II) ion. The dithiocarbamato anions coordinate the ruthenium(II) ions isobidentately. The cytotoxic effects of the compounds were assessed against human cervical cancer (HeLa) and human lung fibroblast (MRC5-SV2) cell lines using the 3-(4,5-dimethylthiazol-2-yl)−2,5-diphenyl tetrazolium bromide (MTT) assay. Only two compounds, C1 and C3 showed potent cytotoxicity after 48 h treatment. C1 was the most potent, with IC50 values of 6.7 ± 2.3 µM and 8.1 ± 0.8 µM against the HeLa and MRC5-SV2 cells, respectively, while C3 had IC50 values of 11.5 ± 3.1 µM and 10.3 ± 1.3 µM, respectively. Remarkably, compared to cisplatin (used as the reference anticancer drug), C1 was twice more potent against HeLa cells and more than five times more potent against MRC5-SV2 cells, while C3 was nearly equipotent with cisplatin against HeLa cells but five times more potent against MRC5-SV2 cells. These two compounds exhibited good potential as anticancer agents, thus warranting further studies. [ABSTRACT FROM AUTHOR]

Both pyrazole and coumarin moiety are important scaffolds for their natural occurrences as well as a broad spectrum of pharmaceutical properties. When coumarin fuses with pyrazole containing a diverse functionality, synergic effect may be observed in the field of medicinal and material chemistry. Owing to their various functionality on the pyrazole as well as coumarin moiety of the title compounds, they possess fantastic biological properties including antimicrobial, antiproliferative, CpIMPDH inhibition, α-glucosidase inhibition, selective hCA IX inhibition as well as anticancer activities. Some architectural pyrazolo[c]coumarin derivatives were reported to be used in bipolar host materials and blue TADF-OLEDs. For these reasons, a special attention has been paid to researchers for the searching of new, greener and efficient protocols for the design and synthesis of pyrazolo[c]coumarins to evaluate their biological activities. This paper reviews the research data in the literature on the synthetic strategies for structurally designed pyrazolo[c]coumarin derivatives. Furthermore, the biological properties of these synthesized compounds are described by highlighting their mode of interactions with different cells and enzymes. [ABSTRACT FROM AUTHOR]

High myopia is demonstrated as a pathogenic factor for nuclear cataract. The main mechanism of high-myopia cataracts (HMC) is oxidative damage, which causes mitochondrial homeostasis imbalance. This study aimed to explore the mitochondrial homeostasis alterations in lens epithelial cells (LECs) of HMC. The lens epithelium tissues of 20 patients with HMC and 20 control subjects with age-related cataracts (ARC) were collected. The real-time quantitative PCR and western blot assays were performed for gene expressions. Immunofluorescence (IF) assays were performed for mitochondrial marker TOM20, DNA damage marker 15A3, and autophagosome marker LC3. Transmission electron microscopy (TEM) was used to observe the changes in mitochondria morphology. Mitochondrial ROS, and mitochondrial membrane potential were detected by MitoSOX fluorescence, and JC-1 MitoMP staining, respectively. Rat lenses cultured in vitro were pretreated with CCCP and H2O2 (10 and 400 µM) for 24 h. The copy number of mtDNA was decreased in HMC patients compared to the ARC patients. Increased mitochondrial-oriented oxidative stress response was detected in LECs of HMC compared to that of ARC. Altered expressions of mitochondrial homeostasis and mitophagy markers, including TFAM, PGC1α, MFN1, MFN2, Drp1, PINK1, Parkin and LC3, were found in HMC patients. Reciprocally, no significant differences in the expression of BNIP3 and FUNDC1 were found between HMC and ARC patients. Importantly, TEM revealed that the obvious mitochondrial fission and mitophagy phenomena occur in the LECs of HMC patients compared to the ARC patients. Moreover, CCCP aggreated the mitoROS production and depolarized mitochondrial membrane potential in the H2O2-treated human lens epithelial cells line (SRA01/04); Most important, rat lens organ culture experiments indicated a significant increase in H2O2-induced lens opacity following mitochondrial uncoupling CCCP treatment. This study has identified for the first time the abnormal mitochondrial homeostasis in HMC, and provide a new perspective on the potential mechanisms of HMC, which occurs earlier and at a higher incidence rate than ARC. [ABSTRACT FROM AUTHOR]

To develop a tool to assess the progression of powered mobility skills for children and determine its psychometric properties. A three-phase, the mixed-method design included: I) conceptualisation based on international specialists' input through a focus group or interview to generate initial items; II) tool development using a two-round Delphi survey and III) evaluation of psychometric properties from eight video recordings of children. The Progression of Paediatric Powered Mobility (3PM) was validated via Intraclass correlation coefficients (ICC) calculated from conventionally powered mobility assessments: the Powered Mobility Program, the Assessment of Learning Powered Mobility tool, and the Powered Mobility Proficiency test. Content derived from 20 clinical experts led to the development of the first version consisting of 19 demographic and 61 driving skill items. Following two Delphi rounds, the final tool included 14 demographic and 41 driving skill items. Internal consistency was excellent (Cronbach alpha = 0.96) as was the inter-rater reliability (ICC = 0.96, 95% confidence interval = 0.95–0.96). Pearson correlation coefficients between the 3PM and other PM assessments demonstrated good convergent validity. The 3PM, created through international collaboration with experts in PM, has excellent psychometric values as a valid measure that can be used reliably to assess children's powered mobility skills. The 3PM reflects the three stages of powered mobility development: exploratory, operational, and functional stages. Input from clinical experts in PM mobility contributed to the identification of the key driving skills important to include in the 3PM. A reliable and valid tool can facilitate assessment and tailored intervention in paediatric powered mobility. [ABSTRACT FROM AUTHOR]

Eye-gaze assistive technology offers children with severe motor and communication difficulties the opportunity to access and control a computer through eye movements. The aim of this study was to examine the impact of eye-gaze assistive technology intervention on participation in computer activities and technology usability among children with complex needs in Taiwan. This study involved a multiple baseline design across individuals. The participants were four children aged three to six years with severe motor and communication difficulties and low eye-control skills. The six-month intervention consisted of two collaborative team meetings and 12 individual supports to facilitate the use of eye-gaze assistive technology at home or in educational environments. Participation in computer activities (diversity, frequency, and duration) was repeatedly measured through a computer use diary. Other outcomes included assessments of goal achievements and parents/teachers' ratings on children's performance in computer activities. The young children increased the diversity of their computer activities and their frequency and duration of computer use from baseline to the intervention phase. The children attained six of eight predefined goals related to play, communication, and school learning. Parents and teachers perceived the children's changes in performance as meaningful. This study strengthens the evidence that eye-gaze assistive technology is useful in everyday contexts for children with complex needs in Taiwan. The findings add knowledge that children with weak eye-control skills increased participation in computer activities as a result of the eye-gaze assistive technology. Eye-gaze assistive technology (EGAT) as an access method to control a computer can provide opportunities for children with severe motor and communication difficulties to participate in computer activities. Children with severe motor and communication difficulties and low eye-control skills with sufficient practice can learn to use EGAT for communication and learning, with support from stakeholders and collaborative service. EGAT could be introduced for children with complex needs at early ages as a means of using computers for play, communication, and school learning, which could be helpful for later education and learning. Stakeholders in educational environments could include EGAT in educational computer systems so that pupils with severe motor and communication difficulties could interact with a computer, thereby enhancing their engagement and learning. [ABSTRACT FROM AUTHOR]

Despite the importance of having knowledge about a child's cognitive functioning, less than one-third of children with cerebral palsy (CP) are formally assessed. Consequently, the cognitive strengths of many children with severe CP may be underestimated or go overlooked. This case study aimed to test accommodations to cognitive assessment administration procedures to enable switch access. A 9-year-old boy with dyskinetic CP tested a suite of cognitive assessments with accommodations for single switch access and measures of user experience. The cognitive assessment included: receptive vocabulary; non-verbal reasoning; sustained attention; executive functions of problem solving and shifting; and visual perception skills. The participant's ability to independently undertake assessment on the receptive vocabulary, non-verbal reasoning and the sustained attention measures indicates that accommodations made for single switch access were appropriate. Assessment took 1–2 h longer than expected for a typically developing child via standardised administration procedures, but was considerably faster than expected if undertaken via low-tech partner assisted scanning. Accessibility barriers continued to be present for the executive function and visual perception measures. Overall, the user experience was positive, both in regards to usability and cognitive load. This case study provides emerging data for usability and accessibility of accommodations to a battery of cognitive assessment tasks. Further research is needed to devise appropriate accommodations for executive function and visual perception measures and to determine whether the accommodations are accessible more generally for children with motor and/or speech impairments. Accommodations can be successfully made to receptive vocabulary, non-verbal reasoning and sustained attention assessment administration procedures for switch technologies. Cognitive assessment with switch accommodations takes considerably longer to complete than standardised administration estimates for a typically developing child. Assessment may need to be scheduled over more than one session. User experience, including usability and cognitive load, of accommodations was positive. [ABSTRACT FROM AUTHOR]

This study explored the experience of adolescents with brain injuries and their caregivers who participated in the Program for the Education and Enrichment of Relational Skills (PEERS®) in Australia. Twenty-seven adolescents and 31 caregivers, who completed the PEERS® intervention as part of an RCT, contributed to focus groups following the 14-week program. Semi-structed interviews guided focus groups. An interpretive description methodology was used to understand participants' experiences in the program and suggestions for improvements. Thematic analysis led to the development of five themes. "Challenging families and meeting expectations" explored the challenge and worth of participating. "Learnt new skills" highlighted skills and strategies gained and methods used to achieve these. "Connecting, belonging and understanding that's our normal" represented the value placed on the group experience. "Confidence in knowing and doing" reflected the changes in everyday social experiences and "Where to from here?" provided many suggestions for adaptation to improve practice. After taking part in the PEERS® social skills group intervention, most adolescents with brain injury and their caregivers perceived improvement in their social participation and had suggestions for improving the group experience. Some adolescents didn't enjoy the program. Offering adolescents with brain injury and their caregivers the opportunity to participate in a group social skills intervention is an important part of paediatric rehabilitation. Participants of group social skills interventions are likely to perceive improvements in their everyday social functioning following completion. Considering strategies to enhance engagement in the group is expected to be important for outcomes. Participants of group social skills programs may need additional support and adjustments to balance the demands of the intervention with other everyday family and school tasks and requirements. [ABSTRACT FROM AUTHOR]

To measure body composition by using bioelectrical impedance analysis (BIA) and body mass index (BMI) and to investigate the correlation and agreement between BMI and fat mass percentage in children with spastic Cerebral Palsy. BIA was used to assess fat mass percentage and BMI was determined from body weight and height. BMI and fat mass percentage were both categorized into five categories. The association between fat mass percentage and BMI was assessed using Pearson's correlation coefficient. Agreement between BMI and fat mass percentage was investigated with weighted Cohen's kappa coefficient. One hundred and three children with CP across all Gross Motor Function Classification Levels (61% boys, mean age 9 years) were included. Mean BMI was 18.3 kg/m2 and mean fat mass was 24.9%. A large inter-subject variability was found with a weak correlation between BMI and fat mass percentage in children with a BMI < 20 kg/m2. Little agreement (k = 0.299, CI 0.16–0.44) between the categorization of children based on BMI and based on fat mass percentage was found. The large inter-subject variability in fat mass percentage combined with little agreement between the BMI and BIA categories suggests that BMI is not a suitable measure of fat mass in children with CP. Using body mass index (BMI) and instead of fat mass percentage increases the risk of misclassifying body composition in children with spastic Cerebral Palsy. Children with a BMI < 20 kg/m2 are more at risk to be misclassified for body composition. [ABSTRACT FROM AUTHOR]

The application of most chemical fixatives, such as formalin, in the anatomic pathology laboratory requires safety training and hazardous chemical monitoring due to the toxicity and health risks associated with their use. Consequently, the use of formalin has been banned in most applications in Europe; the primary exception is its use in the histology laboratory in lieu of a suitable and safer alternative. Glyoxal based solutions, several of which are available commercially, are the most promising alternative fixatives, because they are based on a mechanism of fixation similar to that of formalin. Unlike formalin, however, glyoxal based solutions do not dissociate from water and therefore do not require ventilation measures such as a fume hood. A primary barrier to the adoption of commercially available glyoxal based solutions is their low pH, which can produce undesirable morphological and antigenic tissue alterations; however, a recently available neutral pH glyoxal product (glyoxal acid free) (GAF) has been developed to mitigate the challenges of low pH. We compared the morphology and histochemistry among tissues fixed in 10% neutral buffered formalin, a commercially available acidic glyoxal product (Prefer), and GAF. Tissues fixed in formalin and Prefer exhibited similar morphology and staining properties; tissues fixed with 2% GAF exhibited deleterious effects. [ABSTRACT FROM AUTHOR]

Hypertension is a major global health concern, with deaths attributed to the condition expected to increase to 1.57 million by 2034, particularly affecting low-and-middle-income countries such as those within sub-Saharan Africa. Non-communicable diseases, with hypertension as a core contributor, account for 74.36% of global deaths. The burden of hypertension in sub-Saharan Africa is significant, with an estimated 10–20 million people currently affected. Systemic barriers, such as fragmented health services and socioeconomic inequalities, coupled with shifts in greater salt-intake, ultra-processed foods, more sedentary lifestyles, and overburdened healthcare services, have exacerbated elevated blood pressure and poorer management of people living with hypertension in sub-Saharan Africa. Most public health strategies focus on detecting, treating, and controlling hypertension through lifestyle modifications and medication. However, evidence suggests only 10% of population hypertension is well managed. This indicates a growing need to shift towards preventative efforts. Precision prevention, a tailored health intervention approach utilising individual and population-specific factors – genetic, environmental, and social determinants – offers a potential alternative. Precision prevention aims to deliver the right preventative measures to the right population at the right time, promising to enhance intervention efficiency and health outcomes. This paper highlights various intervention levers, including environmental, biological, and behavioural modifications, examines case studies from high-income countries, and discusses the potential for implementing precision prevention in South Africa. While precision prevention shows promise, we also discuss the significant barriers to its implementation in LMICs such as those within sub-Saharan Africa. Paper context: Main findings: Hypertension affects 1 billion people globally and is a significant health burden in sub-Saharan Africa, where socioeconomic and lifestyle changes have increased its prevalence. Added knowledge: Precision prevention, a tailored health intervention approach, offers potential advantages over traditional methods by targeting individual and population-specific factors. Global health impact for policy and action: Implementing precision prevention strategies can improve health outcomes and reduce the burden of hypertension in sub-Saharan Africa, necessitating policy shifts and collaborative efforts to address infrastructural and resource challenges. [ABSTRACT FROM AUTHOR]