Perfil de mulheres climatéricas em Estratégia de Saúde da Família no interior paulista / Health profile of climacteric women from the Family Health Strategy in the countryside of the state of São Paulo

Introdução: o climatério pode ser influenciado por mudanças psicossociais simultâneas, que associadas às alterações hormonais, como o hipoestrogenismo e a diminuição dos níveis de progesterona, podem intensificar os sintomas e agravos na mulher. Objetivo: identificar os perfis sociodemográficos, obstétricos, ginecológicos, de saúde e hábitos de vida das mulheres climatéricas atendidas na rede básica de saúde, por meio da aplicação de questionário, escalas de Hamilton de Ansiedade e Depressão, e Índice Menopausal de Kupperman e Blatt. Material e Método: estudo transversal descritivo exploratório de relato de experiência, desenvolvido por graduandas em Medicina e Enfermagem. As participantes apresentam idade entre 45 e 60 anos, atendidas em quatro unidades de Estratégia de Saúde da Família. Resultados: participaram 41 mulheres, com idade média de 52,3 anos. Prevaleceram brancas, casadas, com filhos, ensino médio completo, sem plano de saúde, escore de depressão leve, índice menopausal leve, ansiedade normal e uso regular de medicamentos. Conclusão: as mulheres climatéricas necessitam de um espaço para verbalizar seus sentimentos e dúvidas em relação ao climatério e ter acesso à escuta atenta por profissionais capacitados, visando o atendimento integral de saúde com resolutividade.

Introduction: climacteric can be influenced by simultaneous psychosocial changes, which associated with hormonal changes, such as hypoestrogenism and decreased progesterone levels, can intensify symptoms and health problems in women. Objective: to identify the health profile of climacteric women in primary care regarding their obstetrics, gynecological, social, and demographic aspects, and their lifestyle as well, through a questionnaire and the application of the Hamilton Anxiety Scale, Depression Scale, and the Blatt-Kupperman Menopausal Index. Materials and Methods: it is an exploratory-descriptive cross-sectional study presented as an experience report, developed by medical and nursing students. The participants had 45 to 60 years-old and visited four units of the Family Health Strategy. Results: 41 women participated in the research, with an average age of 52.3-year-old. The majority were white, married, high school graduates, with no health insurance; had children, normal anxiety levels, mild depression, mild menopausal index, and reported regular use of medication. Conclusion: the climacteric women need some time to verbalize their feelings and doubts about the climacteric to trained professionals, aiming for a resolutive and comprehensive health care.

PyJAMAS: open-source, multimodal segmentation and analysis of microscopy images.

SUMMARY: Our increasing ability to resolve fine details using light microscopy is matched by an increasing need to quantify images in order to detect and measure phenotypes. Despite their central role in cell biology, many image analysis tools require a financial investment, are released as proprietary software, or are implemented in languages not friendly for beginners, and thus are used as black boxes. To overcome these limitations, we have developed PyJAMAS, an open-source tool for image processing and analysis written in Python. PyJAMAS provides a variety of segmentation tools, including watershed and machine learning-based methods; takes advantage of Jupyter notebooks for the display and reproducibility of data analyses; and can be used through a cross-platform graphical user interface or as part of Python scripts via a comprehensive application programming interface. AVAILABILITY AND IMPLEMENTATION: PyJAMAS is open-source and available at https://bitbucket.org/rfg_lab/pyjamas. SUPPLEMENTARY INFORMATION: Supplementary data are available at Bioinformatics online.

Cytoskeletal tension regulates mesodermal spatial organization and subsequent vascular fate.

Morphogenesis during human development relies on the interplay between physiochemical cues that are mediated in part by cellular density and cytoskeletal tension. Here, we interrogated these factors on vascular lineage specification during human-induced pluripotent stem-cell (hiPSC) fate decision. We found that independent of chemical cues, spatially presented physical cues induce the self-organization of Brachyury-positive mesodermal cells, in a RhoA/Rho-associated kinase (ROCK)-dependent manner. Using unbiased support vector machine (SVM) learning, we found that density alone is sufficient to predict mesodermal fate. Furthermore, the long-withstanding presentation of spatial confinement during hiPSC differentiation led to an organized vascular tissue, reminiscent of native blood vessels, a process dependent on cell density as found by SVM analysis. Collectively, these results show how tension and density relate to vascular identity mirroring early morphogenesis. We propose that such a system can be applied to study other aspects of the stem-cell niche and its role in embryonic patterning.

Compliant substratum guides endothelial commitment from human pluripotent stem cells.

The role of mechanical regulation in driving human induced pluripotent stem cell (hiPSC) differentiation has been minimally explored. Although endothelial cell (EC) fate from hiPSCs has been demonstrated using small molecules to drive mesoderm induction, the effects of substrate stiffness with regard to EC differentiation efficiency have yet to be elucidated. We hypothesized that substrate compliance can modulate mesoderm differentiation kinetics from hiPSCs and affect downstream EC commitment. To this end, we used polydimethylsiloxane (PDMS)-a transparent, biocompatible elastomeric material-as a substrate to study EC commitment of hiPSCs using a stepwise differentiation scheme. Using physiologically stiff (1.7 MPa) and soft (3 kPa) PDMS substrates, compared to polystyrene plates (3 GPa), we demonstrate that mechanical priming during mesoderm induction activates the Yes-associated protein and drives Wnt/ß-catenin signaling. When mesoderm differentiation was induced on compliant PDMS substrates in both serum and serum-free E6 medium, mesodermal genetic signatures (T, KDR, MESP-1, GATA-2, and SNAIL-1) were enhanced. Furthermore, examination of EC fate following stiffness priming revealed that compliant substrates robustly improve EC commitment through VECad, CD31, vWF, and eNOS marker expression. Overall, we show that substrate compliance guides EC fate by enhancing mesoderm induction through Wnt activation without the addition of small molecules. These findings are the first to show that the mechanical context of the differentiation niche can be as potent as chemical cues in driving EC identity from hiPSCs.