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Abstract Background Bronchial thermoplasty (BT) is a non-pharmacological intervention for severe asthma whose mechanism of action is not completely explained by a reduction of airway smooth muscle (ASM). In this study we analyzed the effect of BT on nerve fibers and inflammatory components in the bronchial mucosa at 1 year. Methods Endobronchial biopsies were obtained from 12 subjects (mean age 47 ± 11.3 years, 50% male) with severe asthma. Biopsies were performed at baseline (T0) and after 1 (T1), 2 (T2) and 12 (T12) months post-BT, and studied with immunocytochemistry and microscopy methods. Clinical data including Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ) scores, exacerbations, hospitalizations, oral corticosteroids use were also collected at the same time points. Results A statistically significant reduction at T1, T2 and T12 of nerve fibers was observed in the submucosa and in ASM compared to T0. Among inflammatory cells, only CD68 showed significant changes at all time points. Improvement of all clinical outcomes was documented and persisted at the end of follow up. Conclusions A reduction of nerve fibers in epithelium and in ASM occurs earlier and persists at one year after BT. We propose that nerve ablation may contribute to mediate the beneficial effects of BT in severe asthma. Trial registration Registered on April 2, 2013 at ClinicalTrials.gov Identifier: NCT01839591.

Importance: Occupational therapists often address financial occupations of clients with acquired functional impairments who experience challenges with financial capability (FC). Objective: To explore the intervention literature aimed at improving FC in five diagnostic adult populations. Data Sources: MEDLINE, CINAHL, PsycInfo, EconLit, and EMBASE; researchers also completed backward and forward citation searching and contacted expert authors. Study Selection and Data Collection: Two independent reviewers completed article screening, selection, and extraction using a scoping review approach; a priori inclusion criteria were peer-reviewed articles, written in English, involving adults with one of five diagnostic conditions, describing any intervention to improve FC. Findings: Twenty-four articles met the inclusion criteria. Most articles were aimed at substance use or mental health populations (n = 20); fewer focused on brain injury (n = 2), multiple sclerosis (n = 1), or mixed-diagnosis (n = 1) populations. Only 4 were randomized controlled trials (RCTs). Interventions were heterogeneous and complex, including components of skills training (n = 21), individualized budgeting (n = 18), representative payeeship (n = 11), education (n = 10), structured goal setting (n = 7), savings building (n = 5), metacognitive strategies (n = 2), and assistive technology (n = 1). Conclusions and Relevance: Despite growth in the area, the literature regarding FC intervention is limited, with few RCTs and many populations unrepresented. The literature for a systematic review of FC intervention efficacy for these populations is insufficient, particularly because included studies used varied components, limiting comparison. Further research is imperative to guide evidence-based practice. Plain-Language Summary: This study is an overview of literature about interventions to address the financial occupations of clients with acquired functional impairments. The findings give occupational therapy researchers and clinicians the information they need to begin analyzing, using, and building the evidence to support the use of interventions to improve clients' financial capability and well-being. This study provides an overview of literature regarding interventions to improve the financial capability of clients with acquired functional impairments. [ABSTRACT FROM AUTHOR]

The aim of the paper is to compare the pre-operative and postoperative urodynamic parameters of women with stress incontinence undergoing a TVT (Tension-free Vaginal Tape) operation in order to evaluate the functional dynamics of the operation. Twenty-two patients (mean age 56.3 years, range 30-69 years) underwent the TVT operation for the correction of stress urinary incontinence. Cervical urethral hypermobility was present in all the patients and only the TVT operation and no other surgical procedure was performed. The main urodynamic modification was the improved transmission pressure to the urethra (CTU%) at the post-operative check up, although the maximum urethral closure pressure (MUCP), the functional length (FL) and the maximum flow (Qmax) remained unchanged.

Objective: This study aimed to assess the efficacy of sonographic assessment of fetal occiput position before operative vaginal delivery to decrease the number of failed operative vaginal deliveries.Data Sources: The search was conducted in MEDLINE, Embase, Web of Science, Scopus, ClinicalTrial.gov, Ovid, and Cochrane Library as electronic databases from the inception of each database to April 2021. No restrictions for language or geographic location were applied.Study Eligibility Criteria: Selection criteria included randomized controlled trails of pregnant women randomized to either sonographic or clinical digital diagnosis of fetal occiput position during the second stage of labor before operative vaginal delivery.Methods: The primary outcome was failed operative vaginal delivery, defined as a failed fetal operative vaginal delivery (vacuum or forceps) extraction requiring a cesarean delivery or forceps after failed vacuum. The summary measures were reported as relative risks or as mean differences with 95% confidence intervals using the random effects model of DerSimonian and Laird. An I2 (Higgins I2) >0% was used to identify heterogeneity.Results: A total of 4 randomized controlled trials including 1007 women with singleton, term, cephalic fetuses randomized to either the sonographic (n=484) or clinical digital (n=523) diagnosis of occiput position during the second stage of labor before operative vaginal delivery were included. Before operative vaginal delivery, fetal occiput position was diagnosed as anterior in 63.5% of the sonographic diagnosis group vs 69.5% in the clinical digital diagnosis group (P=.04). There was no significant difference in the rate of failed operative vaginal deliveries between the sonographic and clinical diagnosis of occiput position groups (9.9% vs 8.2%; relative risk, 1.14; 95% confidence interval, 0.77-1.68). Women randomized to sonographic diagnosis of occiput position had a significantly lower rate of occiput position discordance between the evaluation before operative vaginal delivery and the at birth evaluation when compared with those randomized to the clinical diagnosis group (2.3% vs 17.7%; relative risk, 0.16; 95% confidence interval, 0.04-0.74; P=.02). There were no significant differences in any of the other secondary obstetrical and perinatal outcomes assessed.Conclusion: Sonographic knowledge of occiput position before operative vaginal delivery does not seem to have an effect on the incidence of failed operative vaginal deliveries despite better sonographic accuracy in the occiput position diagnosis when compared with clinical assessment. Future studies should evaluate how a more accurate sonographic diagnosis of occiput position or other parameters can lead to a safer and more effective operative vaginal delivery technique. [ABSTRACT FROM AUTHOR]

This research summary will explore the ways psychological aspects of employees can be incorporated into the change management consulting technique, the mirror effect. The health of an organization reflects the health of the individual employees. By including some of the psychological literature that can create triggers of emotional trauma, depression, anxiety or grief, our paper shows how to incorporate an impressionable impact on the employees during the mirror effect. By revealing a deeper story, the amount of human potential for an organization can be enhanced. The detailed story can provide a secure environment and resource for the improvement of an employee over time. [ABSTRACT FROM AUTHOR]

Introduction: Elder abuse in recent times has reached a remarkable international importance. This complex phenomenon is still little understood and studied in Italy. The aim of this study was to explore Italian healthcare professionals' attitude and barriers toward elder abuse, with a glimpse on the current scenario and evidences to develop an action plan.Materials and Methods: 42 healthcare professionals filled a questionnaire with 13 open-ended questions, analyzed with a qualitative content analysis. Data were grouped under the following 4 core-themes: description of elder abuse, abuse detection and perception, barriers to reporting, and professional orientation and approach; then they were analyzed to find their central component and discussed jointly.Results: The respondents described physical (64%) and psychological (50%) abuse and neglect (50%) as the three main characteristics of elder abuse; the 59% of them reported at least one experience in detecting or suspecting elder abuse. The 76% of participants believed the report has to be submitted to the Judicial Authority only in presence of compelling evidences. Furthermore, the 73% of the sample perceived that healthcare professionals are the main figures who have to cope with elder abuse, however they did not feel as their exclusive role the assessment of the patients' potential abuse.Conclusion: Knowledge about elder abuse was limited to physical/psychological issues and, moreover, the legal obligation to report was only poorly known. Imperative is the creation of specific education and training courses, in addition to the need for a multidisciplinary and empathetic approach. [ABSTRACT FROM AUTHOR]

The heterotrimeric NF-Y complex is a pioneer factor that binds to CCAAT-genes and regulates their transcription. NF-Y cooperates with multiple transcription factors and co-regulators in order to positively or negatively influence gene transcription. The recruitment of NF-Y to CCAAT box is significantly enriched in cancer-associated gene promoters loci and positively correlates with malignancy. NF-Y subunits, in particular the DNA-binding subunit NF-YA and the histone-fold subunit NF-YC, appear overexpressed in specific types of cancer. Here we demonstrate that NF-Y subunits expression is finely regulated through transcriptional and post-translational mechanisms thus allowing control over basal expression levels. NF-Y negatively regulates the transcription of the genes encoding for its subunits. DNA pull-down/affinity purification assay coupled with Mass Spectrometry identified putative co-regulators, such as Lamin A, involved in NF-YA gene transcription level. We also evidentiate how the stability of the complex is severely affected by the absence of one subunit. Our results identified for the first time one of the mechanisms responsible for NF-Y expression, which may be involved in the aberrant expression and activity observed in tumor cells and other pathological conditions. [ABSTRACT FROM AUTHOR]