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Introduction: Approved in 2020, the Algoma Ontario Health Team (OHT) has been working towards integrating care for specific target populations. Given the prevalence of older adults in Algoma, foundational work on integrating care is focused on frail older adults.The COVID-19 pandemic disproportionately impacted older adults through the negative clinical outcomes and protective precautions to prevent virus contraction. Community consultations with clinicians, older adults and their caregivers elicited the impact of the pandemic on this population.Aims, Objectives, Theory or Methods: The impacts of the pandemic, combined with historical funding and services inequities within Algoma, precipitated the development of a post-COVID recovery plan. The Algoma OHT Healthy Aging advisory team (the team) developed a comprehensive plan to identify and reduce service gaps caused by the pandemic. The purpose of the plan is to create an integrated care strategy for older adults and their caregivers that incorporates best practice standards within the context of local capacity and system development.The ‘Algoma Post-COVID 19 Recovery Plan for Older Adults and their Caregivers’ is informed by evidence and standards from the North East Specialized Geriatric Centre (NESGC) and Provincial Geriatrics Leadership Ontario (PGLO), including the ‘Design Elements for Integrated Care for Older Adults with Complex Health Concerns’. Using these design elements, the team created recommendations to address identified service gaps and help to advance integrated care within Algoma.Highlights, Results, or Key Findings: Recovery Plan recommendations were developed using best practice guidelines, opportunities to spread successful programs, and innovative approaches to care. The team engaged local health leaders, regional and provincial geriatric specialists, and older adults and caregivers to inform and refine the recommendations. Consulted stakeholders confirmed the focus on high impact design elements for integrated care, and older adults and caregivers validated that the recommendations were reflective of both the current impacts of the pandemic and anticipated future health service needs.The recovery plan has served as a foundational element in developing programs and projects including patient experience qualitative research, funding applications, and program development. It created a tangible means by which various organizations, leaders and providers came together to formulate a shared strategy. Conclusion: The case study will review the recovery plan development, how both provincial and regional specialized geriatric resources informed the recommendations and development of projects, methods to engage the community, and how the plan has informed an intentional streamlining of work to improve care for older adults in Algoma.Implications: The process of developing the recommendations and building the plan alongside the health leaders and patients are foundational elements of engaging the community. The limitations of the report is the short timelines and COIVD restrictions limited the ways in which we could interact with older adults and their caregivers. Overall, the approach taken with the post-COVID recovery plan in Algoma is a straightforward process that can be easily replicated.

Increasing evidence suggests that during the COVID-19 pandemic, anxiety and depression during the perinatal period increased. The aim of the study is to estimate the prevalence of risk for both maternal depression and anxiety among women attending 18 healthcare centres in Italy during the SARS-COV-2 pandemic and to investigate the psychosocial risks and protective factors associated. It was divided into a retrospective phase (2019, 2020, and the first nine months of 2021) and a prospective phase (which began in November 2021 and it is still ongoing), which screened 12,479 and 2349 women, respectively, for a total of 14,828 women in the perinatal period. To evaluate the risk of anxiety and depression, the General Anxiety Disorder-7 (GAD-7), the Edinburgh Postnatal Depression Scale (EPDS), and an ad hoc form were used to collect sociodemographic variables. In the prospective study, the average age of the women is 31 (range 18–52) years. Results showed that the percentage of women who had EPDS score ≥9 increased from 11.6% in 2019 to 25.5% in the period ranging from November 2021 to April 2022. In logistic regression models, the variables associated with the risk of depression at a level ≤0.01 include having economic problems (OR 2.16) and not being able to rely on support from relatives or friends (OR 2.36). Having the professional status of the housewife is a lower risk (OR 0.52). Those associated with the risk of anxiety include being Italian (OR 2.97), having an education below secondary school level (OR 0.47), having some or many economic problems (OR 2.87), being unable to rely on support from relatives or friends (OR 2.48), and not having attended an antenatal course (OR 1.41). The data from this survey could be useful to determine the impact of the SARS-COV-2 pandemic on women and to establish a screening program with common and uniformly applied criteria which are consistent with national and international women’s mental health programs.

Background Cytomegalovirus (CMV)-specific CD8 + T-cell responses can be detected early in fetal life, but their role in the manifestations of congenital CMV (cCMV) infection remains largely unknown. Methods CMV-specific CD8 + T-cell responses were assessed in neonates with cCMV using QuantiFERON®-CMV assay, within day 14 of life (T0) and during the second month of life (T1). Detection and quantification of CMV DNA in whole blood and urine samples were performed at both time points. QuantiFERON®-CMV results were evaluated in relation to timing of maternal infection, clinical manifestations of cCMV and CMV DNA levels. Results Thirty neonates were enrolled (10/30 [33%] symptomatic; 20/30 [67%] asymptomatic). At T0 16/30 (53%) subjects had a reactive QuantiFERON®-CMV result and 16/16 (100%) were asymptomatic, whereas 14/30 (47%) had a nonreactive or indeterminate QuantiFERON®-CMV result and 4/14 (29%) were asymptomatic. At T1, 17/29 (59%) subjects had a reactive QuantiFERON®-CMV result, and 17/17 (100%) were asymptomatic, whereas 12/29 (41%) had a nonreactive or indeterminate result and 3/12 (25%) were asymptomatic. At both T0 and T1 reactive QuantiFERON®-CMV results correlated with lack of symptoms (P = .0001). At T1 median CMV DNAemia was lower in subjects with reactive QuantiFERON®-CMV results as compared with subjects with nonreactive or indeterminate results (1.82 log IU/mL [1.82–2.89] vs 2.55 log IU/mL [1.82–4.42], P = .009). No correlation was found between QuantiFERON®-CMV results and gestational age at maternal infection nor with urine CMV DNA levels. Conclusions A detectable CMV-specific CD8 + T-cell response, evaluated using the QuantiFERON®-CMV assay, correlates with the lack of CMV-related symptoms and the control of CMV DNAemia.

BACKGROUND Preterm infants often require red blood cell (RBC) transfusions, which may impair splanchnic hemodynamics, thus predisposing to necrotizing enterocolitis (NEC). The aim of this study was to evaluate whether RBC transfusions alter splanchnic oxygenation patterns in response to enteral feeding in this population. MATERIALS AND METHODS Preterm neonates (gestational age

Despite the well-recognized importance of proper gut microbiota assembly for the child's future health, the connections between the early-life gut microbiota and neurocognitive development in humans have not been thoroughly explored so far. In this pilot observational study, we aimed to unveil the relation between dynamic succession of the gut microbiota in very low birth weight infants during the first month of life and their neurodevelopment, assessed at 24-month corrected age. According to our data, the early-life gut microbiota of preterm infants with normal vs. impaired neurodevelopment followed distinct temporal trajectories with peculiar compositional rearrangements. In this context, early Bifidobacterium deficiency appears to be a negative biomarker of adverse neurological outcomes.Conclusion: Our data might pave the way for future in-depth studies focusing on the potential impact of bifidobacteria or specific microbiota patterns on neonatal neurodevelopment and lay the foundation for microbiome-based clinical practices to modulate altered profiles and improve long-term health. What is Known: • Preterm infants are at increased risk for adverse neurological outcomes and gut microbiota dysbiosis. • The gut microbiota and the nervous system share critical developmental windows in early life. What is New: • The absence of Bifidobacterium at 30 days of life in preterm infants is associated with neurodevelopmental impairment in early childhood. • The administration of Bifidobacterium strains could promote optimal neurocognitive development in fragile infants.

Breastfeeding is considered the gold standard for infants' nutrition and provides unique benefits for infants' health.Great research interest has been raised about the use of bioactive components in neonatal medicine, both as standalone products and as addition to infant formula, in the attempt to reproduce human milk beneficial effects. Thus, the aim of this narrative review is to summarize most recent evidence on biotics' use in the neonatal period, with a focus on infant formula (IF) supplemented with probiotics, prebiotics, synbiotics and postbiotics.Growing data indicate overall positive effects of biotic supplemented formula on microbiome composition and metabolic activity. Furthermore, some benefits are also emerging from randomized controlled trials (RCTs) evaluating the clinical impact these enriched formulas may have on the health of formula fed infants. However, clear evidence still lacks and none of this supplemented IF has demonstrated conclusive superiority.To date, whereas no routine recommendations can be done, biotics supplemented IF have generally proven to be well-tolerated and safe in ensuring infants' normal growth, paving the way for future IF alternatives for those infants who are not able to be (fully) breastfed. More RCTs, with adequate design and statistical power, are still needed to better clarify, if present, which benefits the supplementation of IF may confer to infants' short and long-term outcomes.

Parent-implemented language interventions have been used for children with expressive language delays, but no study has yet been carried out using this intervention for low-risk preterm children. The current study examined the effect of a parent-implemented dialogic book reading intervention, determining also whether the intervention differently impacted low-risk preterm and full-term children. Fifty 31-month-old late talkers with their parents participated, 27 late talkers constituted the intervention group, and 23 constituted the control group. The overall results indicated that more children in the intervention group showed partial or full recovery of their lexical expressive delay and acquired the ability to produce complete sentences relative to the control group. Concerning full-term late talkers, those in the intervention group showed a higher daily growth rate of total words, nouns, function words, and complete sentences, and more children began to produce complete sentences relative to those in the control group. Concerning low-risk preterm late talkers, children in the intervention group increased their ability to produce complete sentences more than those in the control group. We conclude that a parent-focused intervention may be an effective, ecological, and cost-effective program for improving expressive lexical and syntactic skills of full-term and low-risk preterm late talkers, calling for further studies in late talkers with biological vulnerabilities.

Tissue engineering is emerging as a preferred choice for regeneration of irreversible bone tissue defects. It’s main “weapons” are the artificially created biocompatible three-dimensional cellular matrices that mimic the extracellular matrix’s structure and provide a mechanically stable inert substrate for the natural growth of cells. These porous scaffolds provide sufficient inner surface for cell adhesion, migration, proliferation and protrusion “inside” the temporal implant, facilitating in that way the natural bone ingrowth and vascularization. This leads, eventually, to overgrowing the outer and inner surface of the biomimetic implant with recipient self-formed bone tissue, thus avoiding a possible immune response. In the current study 3D Polystyrene (PS) non-resorbable synthetic cellular bone scaffolds, produced by 3D microfabrication technology, were additionally structured by applying femtosecond (fs) laser radiation with variable parameters thus achieving optimal laser processing conditions, for creation of 3D matrix with enhanced fiber surface properties. The main aim is the establishment of surface structured microporous biomimetic scaffolds, providing improved cell adhesion, infiltration and formation of extracellular matrix. The 3D laser functionalized PS samples were investigated by Scanning Electron Microscopy (SEM), Energy Dispersive X-Ray analysis (EDX), confocal (optical profilometer) and roughness analyses for evaluation of their morphological and chemical properties before and after fs structuring was performed. Water contact angle (WCA) evaluation was also conducted. Future experimental work will include in vitro cellular studies for determining the optimal structuring laser parameters, providing osteoconductive and osteoinductive qualities of the 3D fs-microstructured PS scaffolds.

Tricalcium phosphate (Ca3(PO4)2, TCP), is one of the most studied and used as material for bioresorbable implants. The β phase has a slower dissolution dynamic and ensures mechanical support for a longer time in biological environment, while a faster release of ions characterize the α phase that trigger a stronger biological response. In this work a femtosecond laser system was used to process β-TCP pellets surface. The femtosecond laser processing results in surface morphology modification, by turning the flat mirror polished surface into a rough and opaque one. The morphological and phisycochemical characteristics of material surface were studied by means of SEM, AFM, Raman, XRD and contact angle measurement. The processed surface showed the formation of micro and nano roughness alongside, furthermore a partial phase transformation from β-TCP to α-TCP was detected. A significant improvement in surface wettability for three different liquids (i.e.water, ethylene glycol and diiodo-methane) is reported. This implies an increase in surface free energy as well. The combination of α and β phase, together with the increased roughness obtained by laser processing, could positively affect the cell adhesion and metabolic activity.

Cette étude exploratoire illustre les défis et les opportunités de l’enquête qualitative à distance sur des sujets sensibles. L’analyse s’appuie sur l’expérience de quatorze chercheur·euse·s ayant vécu la bascule digitale liée à la pandémie du Covid-19 tantôt comme une contrainte, tantôt comme une ressource. À partir d’échanges en quatre focus groups, les participant·e·s relèvent des tensions au cœur de la recherche qualitative à distance : les données récoltées manquent d’informations proxémiques et contextuelles, tout en bénéficiant de plus de profondeur discursive ; l’interaction permet une certaine redistribution du pouvoir, mais s’accompagne d’une perte de contrôle de la part des chercheur·euse·s ; la distance virtuelle favorise l’intégrité et l’autonomie de l’enquêté·e, tout en faisant obstacle à l’empathie et à l’éthique du care ; l’accès facilité et le rapport coût-efficacité rendent la pratique online attractive, au risque de générer de nouvelles inégalités et des analyses superficielles. Ces résultats montrent que l’enquête à distance sur des sujets sensibles est une pratique scientifique paradoxale, capable d’innover comme de dénaturer le processus de recherche. This exploratory study illustrates the challenges and opportunities of remote qualitative research on sensitive issues. The analysis is based on the experience of fourteen researchers who have lived the digital switchover linked to the covid-19 pandemic as both a constraint and a resource. Based on exchanges in four focus groups, the participants identified tensions at the heart of remote qualitative research: the data collected lacks proxemic and contextual information, while benefiting from more discursive depth; interaction allows for a certain redistribution of power, but is accompanied by a loss of control on the part of the researcher; virtual distance favors the integrity and autonomy of the respondent, while hindering empathy and the ethic of care. Easy access and cost-effectiveness make remote research attractive, at the risk of generating new inequalities and superficial analyses. These results show that remote investigation on sensitive subjects is a paradoxical scientific practice, capable of both innovating and distorting the research process.

To investigate the cause of lymphopenia in patients with newly diagnosed COVID-19, we measured [We studied, by [Patients had moderate severity COVID-19 syndrome. Basal [These findings indicate that lymphopenia in COVID-19 patients is associated with large bowel inflammation supporting the hypothesis that CD4 + lymphocytes migrate to peripheral lymphoid tissues in the bowel.