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Mind-body medicine (MBM) is based on the assumption that interactions between the brain, mind, body, and behavior can be used to activate health-promoting pathways towards better health. It includes behavioral medical approaches and techniques in conjunction with exercise, relaxation, stress regulation, and nutrition. MBM and MBM interventions are well-established in the US healthcare system. This also includes an exploration of their underlying mechanisms. In Germany, too, a growing body of interventions are now summarized under this generic term.In this narrative review, the emergence of MBM is illuminated in the context of historical developments as well as against the background of the meditation research that has been emerging since the 1970s and the investigation of the stress phenomenon. References to basic research including neurobiological reward/placebo physiology are presented. Distinctions to psychotherapy are made and an implementation framework is described.MBM is related to health promotion and the therapy of chronic, especially lifestyle-related diseases. It is based on the salutogenesis approach, i.e., a paradigm that seeks to explore and reinforce health determinants and resistance resources (individual resilience and coherence factors) and strives to reduce stress. This approach corresponds to self-healing or self-care principles. Neurobiologically, it is associated with the placebo effect. MBM interventions typically follow the BERN model (behavior-exercise-relaxation-nutrition).As a facilitator of self-healing and self-care, MBM can be professionally trained and empowered. For doing so, "health promotion experts" are used.BACKGROUND Since long travel times to reach health facilities are associated with worse outcomes, geographic accessibility is one of the six core global surgery indicators; this corresponds to the second of the "Three Delays Framework," namely "delay in reaching a health facility." Most attempts to estimate this indicator have been based on geographical information systems (GIS) algorithms. The aim of our study was to compare GIS derived estimates to self-reported travel times for patients traveling to a district hospital in rural Rwanda for emergency obstetric care. METHODS Our study includes 664 women who traveled to undergo a Cesarean delivery in Kirehe, Rwanda. We compared self-reported travel time from home to the hospital (excluding waiting time) with GIS estimated travel times, which were computed using the World Health Organization tool AccessMod, using linear regression. RESULTS The majority of patients used multiple modes of transportation (walking = 48.5%, public transport = 74.2%, private transport = 2.9%, and ambulance 70.6%). Self-reported times were longer than GIS estimates by a factor of 1.49 (95% CI 1.40-1.57). Concordance was higher when the GIS model took into account that all patients in Rwanda are referred via their health center (β = 1.12; 95% CI 1.05-1.18). CONCLUSIONS To our knowledge, in this largest to date GIS validation study for geographical access to healthcare in low- and middle-income countries, a standard GIS model was found to significantly underestimate real travel time, which likely is in part because it does not model the actual route patients are travelling. Therefore, previous studies of 2-h access to surgery will need to be interpreted with caution, and future studies should take local travelling conditions into account.BACKGROUND This study aimed to investigate the transcatheter arterial embolization (TAE) in treatment of abdominal bleeding in patients being treated with open abdomen due to duodenal fistula. METHODS This was a retrospective study performed at our center. From January 2005 to November 2010, all patients with abdominal bleeding were treated with surgical hemostasis (SH) and included in SH group. From January 2012 to December 2018, all patients with a bleeding were treated with TAE and included in the TAE group. Clinical data were reviewed and compared between the two groups. The effect of TAE in the management of abdominal bleeding was evaluated. RESULTS A total of 131 patients were enrolled, and there were 64 in the SH group and 67 in the TAE group. The success rate of hemostasis was higher in the TAE group (89.55% vs. 73.44%, adjusted OR = 4.065, 95% CI 1.336-12.336, P = 0.013). Moreover, the recognition rate of hemorrhagic vessels in the TAE group was higher (91.04 vs. 51.56; P  less then  0.001). The re-bleeding occurred in 20 patients, 7(11.67%) in the TAE group and 13(27.66%) in the SH group. The re-bleeding rate in SH group was higher (adjusted HR = 2.564, 95% CI 1.023-6.428, P = 0.045) CONCLUSIONS TAE is an effective method in treatment of abdominal bleeding in patients being treated with open abdomen due to duodenal fistula.The Xizang plateau frog, Nanorana parkeri, has the highest altitudinal distribution of all frogs in the world and survives the cold of winter without feeding by entering into a hibernating state. However, little attention has been paid to its physiological and biochemical characteristics that support overwintering underwater in small ponds. Here, we measured metabolic rate and heart rate, and collected liver and muscle samples from N. parkeri in summer and winter for analysis of mitochondrial respiration rate, and activities and relative mRNA transcript expression of metabolic enzymes. Compared with summer-collected frogs, both resting metabolic rate and heart rate were significantly reduced in winter-collected frogs. Both state 3 and state 4 respiration of liver mitochondria were also significantly reduced in winter but muscle mitochondria showed a decline only in state 3 respiration in winter. The activities and corresponding mRNA expression of cytochrome c oxidase showed a marked decline in winter, whereas the activities and corresponding mRNA expression of lactate dehydrogenase increased in winter-collected frogs, compared to summer. The thermal sensitivity (Q10 values) for state 3 respiration rate by liver mitochondria, and activities of lactate dehydrogenase, and cytochrome c oxidase all increased in winter-collected frogs, compared with summer frogs, suggesting that overwintering frogs were more sensitive to changes in external temperature. Enzyme changes mainly result from lower overall quantities of these enzymes as well as post-translational modifications. We conclude that overwintering N. parkeri exhibit a seasonal, temperature-independent suppression of metabolism that is mediated at multiple levels physiological, mitochondrial, gene expression and enzyme activity levels.Autophagy is an evolutionarily conserved dynamic process and present in variety of cells at basal levels to maintain homeostasis and to promote cell survival in response to stresses. The early bone loss with excessive glucocorticoids (GCs) was reported to be related with the extension of the life span of osteoclasts. However, the connection between GCs induced bone loss and osteoclast autophagy remains to be elucidated. Autophagy was detected in a Dexamethasone (Dex) induced osteoporotic mice model and primary osteoclast cultures by autophagosome detection kit, and autophagy-related proteins were assayed by Western blotting and Immunostaining. The bone morphology was examined by micro-CT and TRAP staining. The trabecular bone micro-architecture was deteriorated, and the osteoclast number and spread area were increased in the Dex-treated mice compared with the control group (P  less then  0.01). Meanwhile, autophagy in pre-osteoclasts was increased in mice under Dex administration evidenced by the increased number of autophagosome and up-regulation of autophagy-related protein levels. Further, the enhanced autophagy under Dex treatment was verified in primary cultured osteoclasts, as shown by the increased levels of Beclin 1 and LC3-II/LC3-I and the autophagy complex formation members including Atg1, Atg13, and Atg7. However, the expressions of PI3K, p-Akt and p-mTOR in primary cultured osteoclasts were inhibited under Dex induced autophagy. Using the selective PTEN inhibitor SF1670 to activate the PI3K/Akt/mTOR pathway reversed this osteoclast autophagy under Dex treatment. Our study suggests that osteoclast autophagy was enhanced in glucocorticoids induced bone loss, and the PI3K/Akt/mTOR signaling pathway mediated the increased autophagy in primary cultured osteoclasts under glucocorticoids treatment.After an uneventful intravitreal injection (IVI) of Ocriplasmin in a patient with reduced visual acuity due to vitreomacular traction (VMT) and a small macular hole, retinal detachment occurred within a few days after the operation. Although retinal detachment is known as a risk factor of IVI this case is noteworthy an excessive reaction occurred in the region of the vitreous body, which resulted in the development of severe traction on the retina leading to a posterior vitreous body detachment, retinal holes and complete retinal detachment. This possible complication should be discussed in the preoperative patient informed consent and the reason for this excessive reaction should be the subject of further investigations.ISP-SW5 is an intracellular alkaline serine protease gene from Bacillus velezensis SW5 that was heterologously expressed in Escherichia coli BL21 (DE3). Sequence analysis indicated that the ISP-SW5 gene has 960 bp open reading frame and encodes a protein of 319 amino acid residues. Three-dimensional structure of ISP-SW5 with the fibrinolytic activity from Bacillus velezensis was predicted by in silico analysis. https://www.selleckchem.com/products/cobimetinib-gdc-0973-rg7420.html Gly219 was the most likely active site for the fibrinolytic activity of ISP-SW5. The recombinant enzyme ISP-SW5 was purified by Ni-NTA Superflow Column. SDS-PAGE showed that this enzyme had a molecular mass of 34 kDa. The result of native-PAGE and N-terminal sequencing showed that the N-terminal propeptide of ISP-SW5 was cleaved during the maturation of protease. The optimum pH and temperature were 8.0 and 40 °C, respectively. Enzyme activity was markedly inhibited by PMSF and EDTA but enhanced by 5 mM Ca2+ and 2 mM Zn2+ by up to 143% and 115%, respectively. Additionally, ISP-SW5 retained 93%, 78%, and 49% relative enzyme activity after incubation with 0.5 M, 1 M and 2 M NaCl, respectively, at 4 °C for 12 h. The enzyme activity determined by casein as substrate was 1261 U/mg. ISP-SW5 could degrade fibrin at an activity of 3428 U/mg, and its properties reflect its potential application in developing a novel biological catalyst for efficient fibrin hydrolysis in medical treatment.OBJECTIVE To investigate the association between HLA‑G polymorphisms and systemic lupus erythematosus (SLE) susceptibility as well as the relationship between circulating soluble HLA‑G (sHLA‑G) levels and SLE. METHODS A meta-analysis was performed to investigate the relationships between HLA‑G 14-bp insertion (I)/deletion (D), +3142 G/C, +3035 T/C, and +3003 C/T polymorphisms and SLE as well as the relationship between sHLA‑G serum/plasma levels in SLE patients and controls. RESULTS Eleven publications fulfilled our inclusion criteria. Meta-analysis under the dominant model showed an association in the overall group between the II+ID genotype of HLA‑G 14-bp I/D polymorphism and SLE (OR = 1.213, 95%CI = 1.077-1.365, P = 0.001). Ethnicity-specific meta-analysis showed an association between II+ID and SLE in Asians but not in South American and European populations. No correlation was observed using the allele contrast between HLA‑G +3142 G/C polymorphisms and SLE. Contrastingly, +3035 T/C and +3003 C/T meta-analysis showed a significant allelic association between SLE and HLA‑G polymorphisms (OR = 1.
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