Phthalate Exposure and Neurotoxicity in Children: A Systematic Review and Meta-analysis

Objectives: This systematic review aims to assess the relationship between prenatal and childhood exposure to phthalates and neurodevelopmental outcomes, identifying periods of heightened susceptibility. Data sources considered studies examining repeated phthalate exposure during pregnancy and childhood on neurodevelopment.Methods: Evaluation included bias risk and study quality criteria. Evidence was synthesized by groups of low and high phthalate molecular weight and exposure measured prenatally and postnatally and outcome measured in childhood. Beta coefficients and their standard errors were extracted, leading to meta-analyses of various neurodevelopmental outcomes: cognition, motor skills, language, behavior, and temperament.Results: Eleven pregnancy and birth cohort studies were identified as relevant. For each phthalate group and outcome combination, there was low or very low evidence of an association, except for prenatal and postnatal phthalate exposure and behavioral development and postnatal exposure and cognition.Conclusion: The estimated effects sizes were relatively small and strong evidence for periods of heightened susceptibility could not be elucidated. No distinction between phthalates of low molecular weight and those of high molecular weight with regards to the outcomes was found

Food cue reactivity, obesity, and impulsivity:are they associated?

Heightened reactivity to food-associated cues and impulsive responding to these cues may be important contributors to the obesity epidemic. This article reviews the evidence for a role of food cue reactivity and impulsivity in food intake, body mass index, and weight-loss success. Inconsistencies in defining and measuring these constructs create difficulties in interpreting findings; however, evidence does support their role in obesity. The relationship between food cue reactivity and impulsivity may depend on the measurement used, but some studies have demonstrated that interactions between these constructs rather than direct effects are important in accounting for food intake pattern. Thus, multimodal assessment of both constructs is recommended. Future research would benefit from standardized definitions, measures, procedures, and reporting to enhance comparisons across studies. Implications for therapy are discussed and suggestions for further research are provided

Effects of maternal depression in the Still-Face Paradigm: A meta-analysis

The Still-Face Paradigm (SFP) enables researchers to examine the quality of mother-infant interactions. In typical infants, a classic still-face effect (SFE) has been confirmed whereby infants demonstrate reduced positive affect (PA), reduced gaze (GA), and increased negative affect (NA). Recently, the SFP has been used to examine the effect of maternal depression upon infant behaviour. However, the nature and consistency of the behavioural responses of infants of depressed mothers during the SFP remains unclear. In the current meta-analysis, we examined whether or not infants of depressed mothers demonstrate the classic SFE, as well as whether or not these infants display the same levels of PA, NA, and GA as their counterparts with non-depressed mothers. Results revealed that infants of depressed mothers display the classic SFE like infants of their non-depressed counterparts. However, infants of depressed mothers also demonstrated significantly higher levels of PA during the still-face episode. One potential interpretation of this finding is that infants prior experience of similar, depressed interactions with their mothers, encourages them to amplify their positive attachment signals in order to engage maternal attention and response. Alternatively, or additionally, infants of depressed mothers could be using PA in order to regulate their own NA

Ventricular Pace Suppression Function: Prophylaxing from Iatrogenic Dyssynchrony

A patient with an implanted dual-chamber pacemaker (DDDR) for sick sinus syndrome had a pulse generator exchange due to battery depletion. Apropos with the procedure, it was noted that the patient had continuous ventricular pacing via a pacing lead located at the right ventricular apex. In order to avoid possible deleterious effects of the iatrogenic dyssynchrony conferred by this kind of pacing, the algorithm of ventricular pace suppression function was activated in the new device that practically led to functional AAI pacing, deemed a more physiologic mode of pacing that could prevent the potential harmful effects of right ventricular apical pacing. Rhythmos 2018;13(3):59-61

Cesarean Delivery and Mental Health

A delivery by cesarean can be a cause of development of mental illness, especially posttraumatic stress disorder or the profile of the disorder for a percentage of women. Despite the global increase in cesarean deliveries, there is a paucity of adequate research into posttraumatic stress disorder after cesarean delivery and at many times is associated with other mental disorders of the postpartum period. The purpose of this research is to identify if there is a link between the type of cesarean delivery and posttraumatic stress disorder among postpartum women. Our sample consisted of 162 women who underwent a cesarean section in a public University Hospital in Greece and consented to participate in the study. The results show a high prevalence of postpartum posttraumatic stress disorder (31.7%) and profile postpartum posttraumatic stress disorder (14.3%) in women after emergency cesarean delivery with additional risk factors of preterm delivery, inclusion in Neonatal Intensive Care Unit, lack of support from the partner, and lack of breastfeeding

First treatment of mycosis fungoides by total skin electron beam (TSEB) therapy in Greece

BackgroundMycosis fungoides (MF), the most common subtype of cutaneous T-Cell Lymphoma (CTCL), is a rare chronic skin neoplasia. Total skin electron irradiation has been employed along with a variety of other topical or systemic treatments for MF management.AimTo report the first case treated by TSEB irradiation protocol in Greece.Materials and methodsA fractionated 36[[ce:hsp sp="0.25"/]]Gy total skin electron beam (TSEB) therapy was prescribed to a 65-years-old male patient with mycosis fungoides (MF), stage IIB, refractory to several treatments during a 20-year period. Dose uniform delivery was monitored by thermo-luminescence dosimetry.Results and discussionThe homogeneous skin dose distribution resulted in a complete clinical response. Limited, irradiation-oriented, side effects appeared.ConclusionsThe first TSEB irradiation prescription in Greek medical chronicles was proved effective in this case of tumor stage MF (T3-IIB), which had been refractory to several single or combination treatments

Comprehensive single-cell genome analysis at nucleotide resolution using the PTA Analysis Toolbox

Detection of somatic mutations in single cells has been severely hampered by technical limitations of whole-genome amplification. Novel technologies including primary template-directed amplification (PTA) significantly improved the accuracy of single-cell whole-genome sequencing (WGS) but still generate hundreds of artifacts per amplification reaction. We developed a comprehensive bioinformatic workflow, called the PTA Analysis Toolbox (PTATO), to accurately detect single base substitutions, insertions-deletions (indels), and structural variants in PTA-based WGS data. PTATO includes a machine learning approach and filtering based on recurrence to distinguish PTA artifacts from true mutations with high sensitivity (up to 90%), outperforming existing bioinformatic approaches. Using PTATO, we demonstrate that hematopoietic stem cells of patients with Fanconi anemia, which cannot be analyzed using regular WGS, have normal somatic single base substitution burdens but increased numbers of deletions. Our results show that PTATO enables studying somatic mutagenesis in the genomes of single cells with unprecedented sensitivity and accuracy.</p

Virtual reality reusable e-resources for clinical skills training: a mixed-methods evaluation

Virtual reality has long existed, but its wider adoption in education is recent. Studies informed by theoretical underpinned co-creation frameworks and utilization of theoretical informed evaluations are scarce in literature. Thus, this study internationally evaluated the efficacy of three virtual reality reusable e-resources (VRReRs), co-created based on the ASPIRE framework, for teaching clinical skills to university students. The study followed a mixed-methods approach, combining SUS, SUS Presence Questionnaire, TAM, and UTAUT2 with a focus group discussion. Additionally, for one VRReR, a quantitative pre/post evaluation of knowledge and comparison with lecture notes followed. Results demonstrated moderately to highly usability, effectively facilitated a strong sense of presence, confidence while using them, and willingness to continue using VRReRs in the future, while increased knowledge of the learners, highlighted their effectiveness. Although some usability issues were identified, these were considered easy to address. This work evidence, in an international context, that co-created VR resources are highly acceptable and effective, similar to other types of digital or traditional resources developed through participatory inquiry paradigm. By leveraging the benefits of VR technology, VRReRs have the potential to transform and enhance the learning experience in the field of clinical skills, ultimately advancing the digitalization of higher education