Impairment of entorhinal cortex network activity in Alzheimer’s disease

The entorhinal cortex (EC) stands out as a critical brain region affected in the early phases of Alzheimer’s disease (AD), with some of the disease’s pathological processes originating from this area, making it one of the most crucial brain regions in AD. Recent research highlights disruptions in the brain’s network activity, characterized by heightened excitability and irregular oscillations, may contribute to cognitive impairment. These disruptions are proposed not only as potential therapeutic targets but also as early biomarkers for AD. In this paper, we will begin with a review of the anatomy and function of EC, highlighting its selective vulnerability in AD. Subsequently, we will discuss the disruption of EC network activity, exploring changes in excitability and neuronal oscillations in this region during AD and hypothesize that, considering the advancements in neuromodulation techniques, addressing the disturbances in the network activity of the EC could offer fresh insights for both the diagnosis and treatment of AD

The beneficial effects of chick embryo extract preconditioning on hair follicle stem cells: A promising strategy to generate Schwann cells

The beneficial effects of hair follicle stem cells in different animal models of nervous system conditions have been extensively studied. While chick embryo extract (CEE) has been used as a growth medium supplement for these stem cells, this is the first study to show the effect of CEE on them. The rat hair follicle stem cells were isolated and supplemented with 10% fetal bovine serum plus 10% CEE. The migration rate, proliferative capacity and multipotency were evaluated along with morphometric alteration and differentiation direction. The proteome analysis of CEE content identified effective factors of CEE that probably regulate fate and function of stem cells. The CEE enhances the migration rate of stem cells from explanted bulges as well as their proliferation, likely due to activation of AP-1 and translationally controlled tumour protein (TCTP) by thioredoxin found in CEE. The increased length of outgrowth may be the result of cyclic AMP response element binding protein (CREB) phosphorylation triggered by active CamKII contained in CEE. Further, CEE supplementation upregulates the expression of vascular endothelial growth factor (VEGF), brain-derived neurotrophic factor and glial cell line-derived neurotrophic factor. The elevated expression of target genes and proteins may be due to CREB, AP-1 and c-Myc activation in these stem cells. Given the increased transcript levels of neurotrophins, VEGF, and the expression of PDGFR-α, S100B, MBP and SOX-10 protein, it is possible that CEE promotes the fate of these stem cells towards Schwann cells

Developing Framework and Strategies for Capacity Building to Apply Evidence-Informed Health Policy-Making in Iran: Mixed Methods Study of SAHSHA Project

BACKGROUND: SASHA, which stands for "evidence-informed health policy-making (EIHP)" in Persian, is a national project to draw a roadmap for strengthening EIHP in Iran. As a part of SASHA, this research aimed to develop evidence-based and context-aware policy options for increasing the capacity of decision-makers to apply EIHP in Iran. METHODS: This was a qualitative study, which was informed by a literature review of pull efforts' capacity building programs. Based on the review, we developed policy options and validated them through an expert panel that involved twelve experts. Data were analyzed using a content analysis method. RESULTS: We extracted data from 11 articles. The objectives of capacity building programs were: single-skill development, personal/professional development, and organizational development. According to these objectives, the contents and training methods of the programs vary. Capacity building programs have shown positive impacts on individual knowledge/attitudes to use EIHP. However, the impacts of programs at the organizational or the health system level remain under-researched. We followed several threads from the literature review through to the expert panel that included training the management team, instead of training managers, training for problem-solving skills, and designing tailored programs. Barriers of capacity building for EIHP regard the context of the health system (weak accountability and the widespread conflict of interest) and healthcare organizational structures (decision support systems, knowledge management infrastructures, and lack of management team). Experts suggested interventions on the barriers, particularly on resolving the conflict of interests before launching new programs. A proposed framework to increase the capacity of health policy-makers incorporates strategies at three levels: capacity building program, organizational structure, and health system context. CONCLUSION: To prepare the context of Iranian healthcare organizations for capacity building programs, the conflict of interests needs to be resolved, decision-makers should be made more accountable, and healthcare organizations need to provide more knowledge management infrastructures and decision support systems

Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026

Background The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well as a robust global system for pandemic preparedness. We aimed to provide a comparative assessment of global health spending at the onset of the pandemic; characterise the amount of development assistance for pandemic preparedness and response disbursed in the first 2 years of the COVID-19 pandemic; and examine expectations for future health spending and put into context the expected need for investment in pandemic preparedness. Methods In this analysis of global health spending between 1990 and 2021, and prediction from 2021 to 2026, we estimated four sources of health spending: development assistance for health (DAH), government spending, out-of-pocket spending, and prepaid private spending across 204 countries and territories. We used the Organisation for Economic Co-operation and Development (OECD)'s Creditor Reporting System (CRS) and the WHO Global Health Expenditure Database (GHED) to estimate spending. We estimated development assistance for general health, COVID-19 response, and pandemic preparedness and response using a keyword search. Health spending estimates were combined with estimates of resources needed for pandemic prevention and preparedness to analyse future health spending patterns, relative to need. Findings In 2019, at the onset of the COVID-19 pandemic, US$9·2 trillion (95$7·3 trillion (95% UI 7·2–7·4) in 2019; 293·7 times the $24·8 billion (95$43·1 billion in development assistance was provided to maintain or improve health. The pandemic led to an unprecedented increase in development assistance targeted towards health; in 2020 and 2021, $1·8 billion in DAH contributions was provided towards pandemic preparedness in LMICs, and$37·8 billion was provided for the health-related COVID-19 response. Although the support for pandemic preparedness is 12·2% of the recommended target by the High-Level Independent Panel (HLIP), the support provided for the health-related COVID-19 response is 252·2% of the recommended target. Additionally, projected spending estimates suggest that between 2022 and 2026, governments in 17 (95% UI 11–21) of the 137 LMICs will observe an increase in national government health spending equivalent to an addition of 1% of GDP, as recommended by the HLIP. Interpretation There was an unprecedented scale-up in DAH in 2020 and 2021. We have a unique opportunity at this time to sustain funding for crucial global health functions, including pandemic preparedness. However, historical patterns of underfunding of pandemic preparedness suggest that deliberate effort must be made to ensure funding is maintained

Geology, petrography, geochemistry and petrogenesis of Alishahi rhyodacitic-dacitic columnar joints (Southeast of Rayen, Kerman)

The Alishahi rhyodacitic-dacitic columnar joints are outcropped in the Middle-Upper Eocene Razak complex in the southeastern of Urumieh-Dokhtar volcanic belt in the Dehaj-Sarduieh volcano-sedimentary belt. The complex consists of intermittent of pyroclastic rocks, andesite, rhyolite, and rhyodacite-dacitic lava flows. The latter partially shows 5 to 6 unequal sided columnar structure in which entablature and colonnade sections along with stria are clearly visible. The predominant textures are phyritic, hyaloporphiritic, glomeroporphyritic, flow and sieve textures along with perlitic cracks. Mineralogically, the Alishahi rhyodacitic-dacitic rocks consist of plagioclase phenocrysts together with rare microphenocrysts of sanidine, orthoclase, hornblende, pyroxene, biotite and accessory minerals including apatite, titanite and opaques are setting in a cryptocrystalline glassy matrix. The matrix is partly in the verge of devitrification process and conversion to mixture of quartz and alkali feldspars. Geochemically, the Alishahi columnar joints are rhyodacitic-dacitic in composition with calc-alkaline nature. Negative Eu anomaly and decrease in Sr content along with increase in Si amount reveal the significance of plagioclase as a differentiated phase. Enrichment in large lithophile elements and depletion in high field strength elements normalized to primitive mantle such as Ti, Ta, Nb along with their chondrite normalized rare earth elements patterns are pointing to their magma formation in a volcanic arc setting in an active continental margin. The depletion in Nb and Ta could be related to their low solubility in aqueous fluids and melts formed under relatively low pressures in the shallow part of the subduction zone

Comparison of Rat Primary Midbrain Neurons Cultured in DMEM/F12 and Neurobasal Mediums

Introduction: Midbrain dopaminergic neurons are involved in various brain functions, including motor behavior, reinforcement, motivation, learning, and cognition. Primary dopaminergic neurons and also several lines of these cells are extensively used in cell culture studies. Primary dopaminergic neurons prepared from rodents have been cultured in both DMEM/F12 and neurobasal mediums in several studies. However, there is no document reporting the comparison of these two mediums. So in this study, we evaluated the neurons and astroglial cells in primary midbrain neurons from rat embryos cultured in DMEM/F12 and neurobasal mediums. Methods: Primary mesencephalon cells were prepared from the E14.5 rat embryo. Then they were seeded in two different mediums ( Dulbeccochr('39')s Modified Eagle Medium/Nutrient Mixture F-12 [DMEM/F12] and neurobasal). On day 3 and day 5, half of the medium was replaced with a fresh medium. On day 7, β3-tubulin-, GFAP (Glial fibrillary acidic protein)- and Tyrosine Hydroxylase TH-positive cells were characterized as neurons, astrocytes, and dopaminergic neurons, respectively, using immunohistochemistry. Furthermore, the morphology of the cells in both mediums was observed under light microscopy on days 1, 3, and 5. Results: The cells cultured in both mediums were similar under light microscopy regarding the cell number, but in a neurobasal medium, the cells have aggregated and formed clustering structures. Although GFAP-immunoreactive cells were lower in neurobasal compared to DMEM/F12, the number of β3-tubulin- and TH-positive cells in both cultures was the same. Conclusion: This study’s findings demonstrated that primary midbrain cells from the E14.5 rat embryo could grow in both DMEM/F12 and neurobasal mediums. Therefore, considering the high price of a neurobasal medium, it can be replaced with DMEM/F12 for culturing primary dopaminergic neurons

The effect of a theory of planned behavior-based educational intervention on vaginal birth after cesarean intention and behavior in pregnant women: A randomized controlled trial study

Background & Aim: The high prevalence of cesarean section in most developed countries, exceeding 50%, has led to detrimental effects on maternal and child health. Vaginal birth after cesarean (VBAC) is a beneficial way to reduce cesarean rates. This study aimed to determine the effect of theory of planned behavior-based training on the intention and behavior of VBAC in pregnant women with previous cesarean section. Methods & Materials: In this randomized controlled trial study, a convenience sample of 70 pregnant women with a history of cesarean section, referred to comprehensive health centers in Ardabil in 2020, were randomly assigned to either the intervention or control group. The intervention group received four weekly education sessions based on the theory of planned behavior structures, while the control group received standard care. Data were collected using a researcher-developed questionnaire at three time points: before, immediately after, and four weeks after the intervention. Data analysis was conducted using SPSS software version 16, employing independent t-test, Fisher’s exact test, chi-square test, and repeated measures ANOVA at a 95% confidence level. Results: Repeated measures ANOVA revealed significant differences in mean scores of attitude, subjective norm, perceived behavior control, intention, and awareness over time between the intervention and control groups (P<0.001). However, the educational intervention did not lead to a behavior change. Conclusion: Based on the findings, it is imperative for health planners to focus on providing organizational support and fostering a positive attitude among obstetricians and midwives to prioritize the implementation of VBAC. Clinical trial registry: IRCT20200519047509N

The Status of Clinical Supervision in Midwifery Education: Perspective of Midwifery Clinical Teachers and Students in Tehran University of Medical Sciences

Introduction: Implementation of clinical supervision of student training could bring about high standards in patient care. The purpose of this study was to determine the status of clinical supervision in midwifery education from the perspective of midwifery clinical teachers and students in Tehran University of Medical Sciences. Methods: This descriptive cross-sectional study was performed on 90 midwifery students in different field internship training units and 25 midwifery clinical teachers who were selected through census method. Data collection tool was the 15-item, 5-point Likert scale CCTEI standardized questionnaire. The data were analyzed using independent t-test, chi-square and ANOVA. Results: A total of 80 student questionnaires and 20 clinical teacher questionnaires were analyzed. The status of clinical supervision in midwifery education was evaluated as average with the mean score 52.5 out of 75. There was a significant difference between the views of clinical teachers and students about the status of clinical supervision such that the clinical teachers evaluated it at a high level with the mean score 60.3 (SD=5.07) while the students evaluated it at an average level with the mean score 46.2 (SD=9.94). The statuses of clinical supervision were significantly different in different clinical arrangements. Conclusion: This difference between the views of clinical teachers and students about the status of clinical education could be due to students’ needs such that the students needed more training in diagnostic skills which is not fully provided by clinical teachers. Since clinical supervision is a teacher-student interaction, further research is recommended to account for these different views