Introduction: The professional exhaustion syndrome, also referred to as burnout, combines deep fatigue, disinvestment in professional activity, a feeling of failure and incompetence at work resulting from the chronic ...Introduction: The professional exhaustion syndrome, also referred to as burnout, combines deep fatigue, disinvestment in professional activity, a feeling of failure and incompetence at work resulting from the chronic constraints suffered by the worker. The purpose of this work is to assess its prevalence among caregivers of the maternity wards in the district hospitals of Brazzaville. Methodology: This is a descriptive cross-sectional study carried out in four maternities of respectively Bacongo, Makélékélé, Mfilou and Talangai hospitals in Brazzaville between February 1st and February 28th, 2021. Socio-demographic and professional characteristics were collected from a sample of midwives and nurses. The level of exhaustion was evaluated using the “Maslach Burnout Inventory” scale defined as “high” when the 3 dimensions are reached, “moderate” when only 2 are reached, and low for any other result. Results: Among the 143 caregivers investigated (62.9%) of respondents declared being in burnout. According to the dimensions of the Maslach Burnout Inventory scale, 53.1% are caregivers are in high emotional exhaustion;53.1% have a high level of depersonalization and 75.5% have a low level of personal accomplishment. Workload (OR = 13.69;[4.28 - 61.27];p Conclusion: In our study, all dimensions of burnout were high. It is therefore a real phenomenon among caregivers in the four maternities of the district hospitals of Brazzaville. The associated factors can be avoided through prevention.展开更多
Objectives:Loneliness among left-behind adolescents is the most frequently reported emotional problem because of parental neglect.The present study explored the relationship between maternal absence and adolescent lon...Objectives:Loneliness among left-behind adolescents is the most frequently reported emotional problem because of parental neglect.The present study explored the relationship between maternal absence and adolescent loneliness as well as its mechanisms.Methods:The study included 305 participants(Meanage=15.99±0.81,48.9%females)in southeast China,and constructed a chain mediation model to test the roles of rejection sensitivity and friendship quality.Parent absence types,rejection sensitivity,friendship quality,and adolescent loneliness were all assessed with questionnaires.Results:The results showed that adolescents with a mother absent(both-parent absent,mother-only absent)experienced higher levels of loneliness than those with a mother not absent(father-only absent,non-parent absent)(β=0.3137,95%CI[0.0849,0.5425],p<0.01).Besides,the mediating roles of rejection sensitivity(β=0.0344,95%CI[0.0020,0.0808])and friendship quality(β=0.1198,95%CI[0.0049,0.2428])and their chain mediating role were found significant between maternal absence and loneliness(β=0.0245,95%CI[0.0015,0.0575]).Conclusions:These findings have revealed the significant impact of maternal absence on adolescent loneliness and provide important practical implications for educators to reduce adolescent loneliness.展开更多
Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recogn...BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.展开更多
Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess...Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.展开更多
广义Matern硬核点过程(Generalized Matern Hard-Core Point Process,GMHCPP)是在硬核点过程的基础上通过引入竞争函数和删减函数来限制保留概率的一种排斥点过程。针对两层异构蜂窝网络模型中宏基站与微基站的性能进行了深入研究,获得...广义Matern硬核点过程(Generalized Matern Hard-Core Point Process,GMHCPP)是在硬核点过程的基础上通过引入竞争函数和删减函数来限制保留概率的一种排斥点过程。针对两层异构蜂窝网络模型中宏基站与微基站的性能进行了深入研究,获得了该模型的覆盖概率和平均可达速率的近似表达式。首先,基于宏基站的性能差异及其排斥性生成保留概率函数,进而,将宏基站的部署以GMHCPP建模。然后,采用蒙特卡罗模拟方法对基站分布进行仿真,并绘制出了平均干扰信号比与路径损耗因子的关系图,根据该函数图,拟合得到了用泊松点过程近似时GMHCPP的增益因子表达式。最后,将增益因子代入覆盖概率和平均可达速率公式,对两层异构蜂窝网络模型的性能指标进行了仿真与分析。展开更多
OBJECTIVES:To investigate the effect of Bushen Tongluo recipe(BSTLR, 补肾通络方) on rats with diabetic kidney disease(DKD) and to explore the underlying mechanism of action. METHODS:The rat model of DKD was establishe...OBJECTIVES:To investigate the effect of Bushen Tongluo recipe(BSTLR, 补肾通络方) on rats with diabetic kidney disease(DKD) and to explore the underlying mechanism of action. METHODS:The rat model of DKD was established, and rats were treated with different doses of BSTLR. Body weight and the levels of urinary protein, α1-microglobulin, glucose, blood urea nitrogen, creatinine, Cystatin C, superoxide dismutase, malondialdehyde, and catalase were analyzed biochemically or by enzyme-linked immunosorbent assay. The pathological damage to renal tissues was assessed by hematoxylin-eosin staining. Immunohistochemical staining was carried out to detect the expression levels of fibronectin, E-cadherin, α-smooth muscle actin, laminin, vimentin, collagen type Ⅳ in kidney tissues. Western blot analysis was conducted to analyze the expression levels of Nephrin, Desmin, Podocin, transforming growth factor-β1, mothers against decapentaplegic homolog 3(Smad3), Notch1, jagged, hairy and enhancer of split 1(Hes1) in kidney tissues, and the expression levels of maternally expressed gene 3(MEG3) and mi R-145 were measured by quantitative reverse transcription-polymerase chain reaction. Moreover, dual-luciferase reporter assay was employed to verify the binding of mi R-145 to MEG3. RESULTS:BSTLR increased the body weight of DKD rats, effectively ameliorated the renal function and pathological injury in DKD, regulated the balance of renal oxidative stress, inhibited the TGF/Notch signaling pathway, and affected the variations in the lnc RNA MEG3/mi R-145 axis. CONCLUSION:BSTLR improved oxidative stress homeostasis, inhibited the TGF/Notch signaling pathway, and regulated the lnc RNA MEG3/mi R-145 axis, effectively delaying the progression of DKD.展开更多
Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically...Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.展开更多
Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descript...Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descriptive cross-sectional study with retrospective data collection from archived records and reviewed maternal death reports. Our study lasted 8 months, from October 1, 2023 to May 31, 2024. The study covered maternal death files at the HGOPY over an 8-year period, from 1st of January 2016 to the 31st of December 2023. Data were processed and analyzed using Statitical Paquage for Social Science (SPSS) version 26.0. Results: We counted a total of 160 maternal deaths, of which 97 had been reviewed. We excluded 61 deceased women reviewed and retained 33. We recorded a cumulative total of 160 maternal deaths and 19,651 live births. The peak in the proportion of maternal deaths at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital was in 2021, with a proportion of 0.013. No maternal deaths had been reviewed between 2016 to 2017. Most deaths (64%) occurred between 37 and 40 weeks. The majority (30.5%) were aged between 30 and 35. The data show that 80.6% of maternal deaths were due to direct obstetric causes, while 19.4% were due to indirect causes. Most deaths (69.4%) were preventable. Only 8.3% were not preventable. Conclusion: Concerted efforts must be made to adapt maternal death prevention and management strategies to local contexts in order to significantly reduce these alarming figures.展开更多
Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal ant...Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.展开更多
Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of a...Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.展开更多
Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth reco...Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.展开更多
Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,po...Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,poses a significant risk of mortality in infants,children,and adolescents.However,the impact of maternal EC exposure on PH development in offspring remains unclear.To address this,we established a PH rat model with maternal EC exposure.Methods Maternal EC exposure was initiated on gestation day 12 via electronic nicotine delivery systems.Offspring were administered monocrotaline(MCT)at 6 weeks of age(6-wo)to induce PH.Mechanistic experiments were conducted at 10-week-old(10-wo).Protein expression of NADPH oxidases,DNA methyltransferases,and autophagy-related markers was analyzed by Western blot.Morphological changes and the severity of PH were evaluated via hematoxylin and eosin(HE)staining and echocardiography,respectively.Furthermore,the involvement of the oxidative stress/DNA methylation/autophagy axis in response to maternal EC exposure was confirmed through a combination of ELISA,Western blot,HE staining,and echocardiography.Additionally,ATG5 mRNA expression was measured by qRT-PCR.Results Compared with control conditions,maternal EC exposure significantly worsened MCT-induced PH in male offspring.This was associated with increased oxidative stress,DNA hypomethylation,and anomalous autophagy in the offspring.In vivo treatment with chloroquine inhibited autophagy and ameliorated PH development in offspring exposed to maternal EC.Furthermore,N-acetylcysteine(NAC),an antioxidant,attenuated maternal EC exposure-induced oxidative stress,DNA hypomethylation,and excessive autophagy,thereby improving PH.DNA hypermethylation also reversed PH development,accompanied by reduced oxidative stress and suppressed autophagy.ATG5,a key regulator of autophagy,was identified as a potential therapeutic target,as its repression mitigated PH in maternal EC-exposed offspring.Conclusion Maternal EC exposure induces oxidative stress and DNA hypomethylation in offspring,leading to anomalous autophagy and exacerbation of PH development.Targeting ATG5-mediated autophagy may represent a novel therapeutic approach for improving PH outcomes in offspring exposed to maternal EC.Graphical Abstract Pregnant rats were exposed to either EC vapor or standard air from gestation day 12 until 2 days before delivery,with all offspring undergoing PH induction at 6-wo.Offspring exposed to maternal EC presented increased oxidative stress,which in turn affected DNA methylation patterns.The decreased DNA methylation in male offspring led to the activation of autophagy,exacerbating the development of PH.Treatment with ATG5 siRNA inhibited autophagy and alleviated heightened PH in male offspring with maternal EC exposure.展开更多
Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women ...Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.展开更多
Paternal predation risk can program offspring phenotypes via maternal responses and epigenetic marks of spermatozoa.However,the processes and consequences of this experience in biparental species are unknown.Here,we e...Paternal predation risk can program offspring phenotypes via maternal responses and epigenetic marks of spermatozoa.However,the processes and consequences of this experience in biparental species are unknown.Here,we examined how preconception and postconception paternal cat odor(CO)exposure affects anxiety-like behavior and antipredator response in Brandt’s voles(Lasiopodomys brandtii).We found that preconception paternal CO exposure inhibited maternal investment when offspring were raised by mothers alone,while postconception exposure increased paternal investment towards the offspring raised by both parents.The increased paternal behavior may be associated with an increasing grooming behavior received from their mates,which alleviated the anxiety-like behavior in CO-exposed males.Both paternal experiences increased the levels of anxiety-like behavior in adolescent offspring but differentially altered adult phenotypes.Specifcally,adult females from preconception CO-exposed fathers spent less time in defensive concealing,whereas the offspring of postconception CO-exposed fathers showed more in response to acute cat urine exposure.Correspondingly,baseline corticosterone levels were decreased and increased in these offspring,respectively.Our results indicate that in biparental species,paternal predation risk exposure affects offspring phenotypes in pathway-dependent and age-specifc manners and that only the presence of both parents can elicit adaptive responses to a high predation-risk environment.展开更多
Breast cancer’s heterogeneous progression demands innovative tools for accurate prediction.We present a hybrid framework that integrates machine learning(ML)and fractional-order dynamics to predict tumor growth acros...Breast cancer’s heterogeneous progression demands innovative tools for accurate prediction.We present a hybrid framework that integrates machine learning(ML)and fractional-order dynamics to predict tumor growth across diagnostic and temporal scales.On the Wisconsin Diagnostic Breast Cancer dataset,seven ML algorithms were evaluated,with deep neural networks(DNNs)achieving the highest accuracy(97.72%).Key morphological features(area,radius,texture,and concavity)were identified as top malignancy predictors,aligning with clinical intuition.Beyond static classification,we developed a fractional-order dynamical model using Caputo derivatives to capture memory-driven tumor progression.The model revealed clinically interpretable patterns:lower fractional orders correlated with prolonged aggressive growth,while higher orders indicated rapid stabilization,mimicking indolent subtypes.Theoretical analyses were rigorously proven,and numerical simulations closely fit clinical data.The framework’s clinical utility is demonstrated through an interactive graphics user interface(GUI)that integrates real-time risk assessment with growth trajectory simulations.展开更多
Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with ...Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.展开更多
Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widel...Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widely employed in the management of neurologic conditions.Nevertheless,the efficacy of AMA in treating MIA is currently not established.Methods:MIA was induced by polyinosinic acid-polycytidylic acid(poly(I:C));AMA was administered from embryonic(E)day 11.5 for 3 days.BV-2 cells were stimulated using poly(I:C)and treated with AMA.Behavior was assessed via open field test,elevated plus maze test,three-chamber sociability test,and marble burying test.Neuronal morphology was vizualized using Nissl stain;apoptosis via TUNEL(terminal deoxynucleotidyl transferase dUTP nick-end labeling)stain;protein expression(Iba1,NeuN,CD68,TNF-α[tumor necrosis factor-alpha],IL-1β[interleukin-1β])using immunofluorescence(IF);interleukin-6(IL-6)levels using enzyme-linked immunosorbent assay;reactive oxygen species using staining;Iba1,NeuN,Bcl-2,Bax,and cleaved caspase 3 using Western blot;and gene expression changes using RNA-seq.Results:AMA treatment reduced the levels of IL-6 in maternal blood,improved autism-like behaviors in MIA offspring,and effectively prevented neuronal damage and neuroinflammation.In vitro cellular studies have demonstrated that AMA effectively downregulates the expression levels of pro-inflammatory cytokines,including IL-6,TNF-α,and IL-1β.RNA-seq analysis indicated that AMA mitigates abnormal activation of microglia by modulating inflammatory pathways associated with IL-6.Conclusion:AMA can prevent the development of neuropsychiatric disorders in MIA offspring.This effect may be related to its ability to attenuate neuronal damage,reduce neuronal apoptosis,and inhibit neuroinflammation,indicating that the antiviral drug AMA may be a potential treatment for MIA.展开更多
Objective:To evaluate the impact of a group embryo culture approach for women of advanced age.Methods:In this prospective study,two embryo culturing strategies—group and individual—were compared in women who were ol...Objective:To evaluate the impact of a group embryo culture approach for women of advanced age.Methods:In this prospective study,two embryo culturing strategies—group and individual—were compared in women who were older(≥35 years)and younger(<35 years).Data was collected from 450 embryos over 291 intracytoplasmic sperm injection(ICSI)cycles performed on 291 patients.A grouped embryo culture group and an individual embryo culture group were generated by selecting the zygotes into two groups based on the type of culture that was used.The main outcomes compared between the groups were the pregnancy and the live birth rates.Results:The pregnancy,and live births rates were significantly higher when group culture was carried out in an advanced-aged women group(41.5%vs.25.0%,P=0.04;14.3%vs.6.6%,P=0.04;respectively).Similarly,the cleavage rate was better in the same group(98.6%vs.91.2%,P=0.001).However,in the group of young women,there were not significant differences in these rates.Conclusions:Group embryo culturing seems to be a promising strategy to improve embryo development and live births for patients over 35 years of age.展开更多
文摘Introduction: The professional exhaustion syndrome, also referred to as burnout, combines deep fatigue, disinvestment in professional activity, a feeling of failure and incompetence at work resulting from the chronic constraints suffered by the worker. The purpose of this work is to assess its prevalence among caregivers of the maternity wards in the district hospitals of Brazzaville. Methodology: This is a descriptive cross-sectional study carried out in four maternities of respectively Bacongo, Makélékélé, Mfilou and Talangai hospitals in Brazzaville between February 1st and February 28th, 2021. Socio-demographic and professional characteristics were collected from a sample of midwives and nurses. The level of exhaustion was evaluated using the “Maslach Burnout Inventory” scale defined as “high” when the 3 dimensions are reached, “moderate” when only 2 are reached, and low for any other result. Results: Among the 143 caregivers investigated (62.9%) of respondents declared being in burnout. According to the dimensions of the Maslach Burnout Inventory scale, 53.1% are caregivers are in high emotional exhaustion;53.1% have a high level of depersonalization and 75.5% have a low level of personal accomplishment. Workload (OR = 13.69;[4.28 - 61.27];p Conclusion: In our study, all dimensions of burnout were high. It is therefore a real phenomenon among caregivers in the four maternities of the district hospitals of Brazzaville. The associated factors can be avoided through prevention.
基金supported by the National Natural Science Foundation of China(32171069).
文摘Objectives:Loneliness among left-behind adolescents is the most frequently reported emotional problem because of parental neglect.The present study explored the relationship between maternal absence and adolescent loneliness as well as its mechanisms.Methods:The study included 305 participants(Meanage=15.99±0.81,48.9%females)in southeast China,and constructed a chain mediation model to test the roles of rejection sensitivity and friendship quality.Parent absence types,rejection sensitivity,friendship quality,and adolescent loneliness were all assessed with questionnaires.Results:The results showed that adolescents with a mother absent(both-parent absent,mother-only absent)experienced higher levels of loneliness than those with a mother not absent(father-only absent,non-parent absent)(β=0.3137,95%CI[0.0849,0.5425],p<0.01).Besides,the mediating roles of rejection sensitivity(β=0.0344,95%CI[0.0020,0.0808])and friendship quality(β=0.1198,95%CI[0.0049,0.2428])and their chain mediating role were found significant between maternal absence and loneliness(β=0.0245,95%CI[0.0015,0.0575]).Conclusions:These findings have revealed the significant impact of maternal absence on adolescent loneliness and provide important practical implications for educators to reduce adolescent loneliness.
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
基金Supported by High-level Professional Groups in Gangdong Province,No.GSPZYQ2020101Guangdong Province Educational Research Planning Project,No.2024GXJK742。
文摘BACKGROUND Paternal perinatal depression(PPD)is closely associated with maternal mental health challenges,marital strain,and adverse child developmental outcomes.Despite its significant impact,PPD remains under-recognized in family-centered clinical practice.Concurrently,against the backdrop of rising rates of delayed marriage and China’s Maternity Incentive Policy,the proportion of women giving birth at an advanced maternal age is increasing.Nevertheless,research specifically examining PPD among spouses of older mothers remains critically scarce,both in China and globally.AIM To investigate PPD and its influencing factors in Chinese advanced maternal age families.METHODS This cross-sectional study included 358 participants;it was conducted among fathers of pregnant women of advanced maternal age at five hospitals in the Pearl River Delta region of China from September 2023 to June 2024.Data were collected via a general information questionnaire,the Social Support Rating Scale,and the Edinburgh Postnatal Depression Scale.Latent profile analysis and regression mixture models(RMMs)were adopted to analyze the latent PPD types and factors that influenced PPD.RESULTS The incidence of PPD was 16.48%,and three profiles were identified:Low-symptomatic(175 cases,48.89%),monophasic(140 cases,39.10%),and high-symptomatic(43 cases,12.01%).The RMM analysis revealed that first pregnancy,low income(<¥3000/month),part-time work,and a history of abnormal pregnancy were positively associated with the high-symptomatic type(P<0.05).Conversely,high subjective support and support utilization were negatively associated with the high-symptomatic type compared with the low-symptomatic type(P<0.05).Good couple relationships,high objective and subjective support,and high support utilization were negatively associated with monophasic disorder(P<0.05).CONCLUSION PPD incidence is high among Chinese fathers with advanced maternal age partners,and the characteristics of depression are varied.Healthcare practitioners should prioritize individuals with low levels of social support.
基金supported by an Innovation Fund for Medical Sciences of the Chinese Academy of Medical Sciences (Grant No.2019-I2M-2-007).
文摘Objective:Postpartum nutrition plays a critical role in maternal recovery and long-term health.However,the nutritional status of working mothers in the postpartum period remains understudied.This study aimed to assess the dietary quality of postpartum women in urban Beijing,identify occupational-related factors influencing their diet,and explore potential interventions to improve maternal nutrition during the postpartum period.Methods:In this cross-sectional analysis,554 women one year after delivery were recruited from ten community health centers.Sociodemographic,occupational and postpartum care variables were collected via questionnaire.Dietary intake over the preceding year was assessed using a food frequency questionnaire.The modified dietary balance index for postpartum women were used for dietary quality assessment.Results:The study revealed severe dietary imbalances among postpartum women,characterized by excessive consumption of cereals,eggs,and meats,while their intake of vegetables,fruits,and dairy products was inadequate.According to dietary balance index for postpartum women,66.25%of mothers showed varying degrees of excessive intake.45.31%of mothers experienced varying levels of insufficient intake,with only 19.86%of participants having a relatively balanced diet.Occupational differences were observed,with women in the commercial employment group showing higher levels of excessive food intake.The analysis of influencing factors showed that family monthly income,maternity leave,and postpartum care significantly affected the dietary quality.Conclusions:Postpartum women in Beijing experience widespread dietary imbalances,with both excesses and deficiencies.Occupational context and related factors significantly shape diet quality.These findings highlight the need for targeted nutritional interventions tailored to the specific challenges of different occupational groups.
文摘广义Matern硬核点过程(Generalized Matern Hard-Core Point Process,GMHCPP)是在硬核点过程的基础上通过引入竞争函数和删减函数来限制保留概率的一种排斥点过程。针对两层异构蜂窝网络模型中宏基站与微基站的性能进行了深入研究,获得了该模型的覆盖概率和平均可达速率的近似表达式。首先,基于宏基站的性能差异及其排斥性生成保留概率函数,进而,将宏基站的部署以GMHCPP建模。然后,采用蒙特卡罗模拟方法对基站分布进行仿真,并绘制出了平均干扰信号比与路径损耗因子的关系图,根据该函数图,拟合得到了用泊松点过程近似时GMHCPP的增益因子表达式。最后,将增益因子代入覆盖概率和平均可达速率公式,对两层异构蜂窝网络模型的性能指标进行了仿真与分析。
文摘OBJECTIVES:To investigate the effect of Bushen Tongluo recipe(BSTLR, 补肾通络方) on rats with diabetic kidney disease(DKD) and to explore the underlying mechanism of action. METHODS:The rat model of DKD was established, and rats were treated with different doses of BSTLR. Body weight and the levels of urinary protein, α1-microglobulin, glucose, blood urea nitrogen, creatinine, Cystatin C, superoxide dismutase, malondialdehyde, and catalase were analyzed biochemically or by enzyme-linked immunosorbent assay. The pathological damage to renal tissues was assessed by hematoxylin-eosin staining. Immunohistochemical staining was carried out to detect the expression levels of fibronectin, E-cadherin, α-smooth muscle actin, laminin, vimentin, collagen type Ⅳ in kidney tissues. Western blot analysis was conducted to analyze the expression levels of Nephrin, Desmin, Podocin, transforming growth factor-β1, mothers against decapentaplegic homolog 3(Smad3), Notch1, jagged, hairy and enhancer of split 1(Hes1) in kidney tissues, and the expression levels of maternally expressed gene 3(MEG3) and mi R-145 were measured by quantitative reverse transcription-polymerase chain reaction. Moreover, dual-luciferase reporter assay was employed to verify the binding of mi R-145 to MEG3. RESULTS:BSTLR increased the body weight of DKD rats, effectively ameliorated the renal function and pathological injury in DKD, regulated the balance of renal oxidative stress, inhibited the TGF/Notch signaling pathway, and affected the variations in the lnc RNA MEG3/mi R-145 axis. CONCLUSION:BSTLR improved oxidative stress homeostasis, inhibited the TGF/Notch signaling pathway, and regulated the lnc RNA MEG3/mi R-145 axis, effectively delaying the progression of DKD.
文摘Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
文摘Background: Maternal mortality remains a major public health problem worldwide. Objectives: Our study aims to present the results of an analysis of reviews of maternal deaths at HGOPY. Methodology: This was a descriptive cross-sectional study with retrospective data collection from archived records and reviewed maternal death reports. Our study lasted 8 months, from October 1, 2023 to May 31, 2024. The study covered maternal death files at the HGOPY over an 8-year period, from 1st of January 2016 to the 31st of December 2023. Data were processed and analyzed using Statitical Paquage for Social Science (SPSS) version 26.0. Results: We counted a total of 160 maternal deaths, of which 97 had been reviewed. We excluded 61 deceased women reviewed and retained 33. We recorded a cumulative total of 160 maternal deaths and 19,651 live births. The peak in the proportion of maternal deaths at the Yaoundé Gynaeco-Obstetric and Paediatric Hospital was in 2021, with a proportion of 0.013. No maternal deaths had been reviewed between 2016 to 2017. Most deaths (64%) occurred between 37 and 40 weeks. The majority (30.5%) were aged between 30 and 35. The data show that 80.6% of maternal deaths were due to direct obstetric causes, while 19.4% were due to indirect causes. Most deaths (69.4%) were preventable. Only 8.3% were not preventable. Conclusion: Concerted efforts must be made to adapt maternal death prevention and management strategies to local contexts in order to significantly reduce these alarming figures.
文摘Background: Birth weight has been identified as one of the most significant predictors of a child’s physical growth, development, and survival in later life. A quest to provide an answer on the impact of maternal anthropometry on neonatal birth weight necessitated this study. Materials and methods: It is a cross-sectional descriptive hospital based study that involved 130 participants selected using a systematic sampling method, utilizing a semi-structured, pre-tested interviewer administered questionnaire. Data were collected using a standard procedure and were summarized using proportions, and the Chi square test was used to explore the association between categorical variables. Predictors of birth weight were determined using logistic regression. The level of statistical significance was set at p Results: Participants had a mean age of 28.6 ± 5.1 years, mean weight of 72.2 ± 11.2 kg and mean height of 1.63 ± 0.07m while the mean fetal birth weight was 3.10 ± 0.56 kg. There was a significant association between maternal delivery body mass index and neonatal birth weight (p Conclusion: The prevalence of low birth weight and macrosomia in this study population was high. The focus should be geared towards balanced nutrition support for all mothers at booking so as to mitigate the risks associated with these extremes of birth weight.
基金supported in part by the Higher Education Sprout Project,Ministry of Education,to the Headquarters of University Advancement at National Cheng Kung University(NCKU).
文摘Background:While various factors contributing to delinquency have been explored,the role of selfesteem in this specific context has received little attention.Hence,this study aims to investigate the complex issue of adolescent delinquency in Iran by focusing on the mediating role of self-esteem in the relationship between parental attachment and delinquent behavior.Methods:Using the multistage cluster random sampling method,the research involved 528 high school students in Tehran.Each student completed validated scales assessing their parental attachment,self-esteem,and delinquency at school.Multiple regression analyses with the Sobel test and bootstrappingmethod were used to examine mediated effects.Results:Thefindings reveal that self-esteem significantly mediates the relationship betweenmaternal attachment and delinquency(standardized coefficient=−0.0292;p=0.04).Adolescents with secure maternal attachments tend to exhibit higher self-esteem,which reduces the likelihood of delinquent behavior.In contrast,paternal attachment did not show a significant mediating effect in this study.These results underscore the importance of cultivating secure maternal relationships and fostering positive self-esteem to address adolescent delinquency.Conclusion:The study suggests that targeted interventions that strengthen maternal attachment and boost self-esteem could effectively mitigate delinquent behaviors among Iranian adolescents.These interventions should prioritize the emotional support and value of secure maternal bonds as key factors in promoting healthy adolescent development.
文摘Background:Preterm birth and neonatal mortality continue to pose significant public health challenges in Ghana.This study explores their temporal trends and associated determinants from 2008 to 2022.Methods:Birth record data from the Ghana Demographic and Health Surveys(2008,2014,and 2022)were used to analyse trends and determinants in neonatal mortality and preterm birth aligned with World Health Organization antenatal care(ANC)guidelines using Pearson’s Chi-square test and multivariate logistic regression with statistical significance at P<0.05 and 95%confidence intervals(CI).Results:Preterm birth rate and neonatal mortality rate decreased from 13.0%to 9.1%and 27.6 to 23.7 per 1000 live births from 2008 to 2022 respectively.Lack of iron supplementation(odds ratio[OR]1.127,95%CI:1.047 to 1.967)a nutritional intervention maternal assessments(moderate/severe anaemia(OR 1.423,95%CI:1.178 to 2.051),preventive measures(Untreated malaria(OR 1.449,95%CI:1.104 to 2.411)or deworming(OR 1.267,95%CI:0.970 to 1.645)were associated with increased preterm birth risk.Attending<8 ANC visits raised the odds of preterm birth(OR 1.24,95%CI:1.03 to 1.257)and neonatal mortality(OR 1.583,95%CI:1.120 to 2.480).Conclusion:Despite reductions in preterm birth and neonatal mortality rates,substantial gaps in antenatal care remain.Strengthening the implementation of World Health Organization ANC guidelines is critical to reducing preterm birth and neonatal mortality in Ghana.
基金supported by National Natural Science Foundation of China(No.82300268)Guangzhou Municipal Science and Technology Project(No.2023B03J1255).
文摘Objective Electronic cigarettes(ECs)differ from traditional tobacco smoke but may contribute to cardiopulmonary remodeling.Pulmonary hypertension(PH),characterized by pulmonary artery and right ventricle remodeling,poses a significant risk of mortality in infants,children,and adolescents.However,the impact of maternal EC exposure on PH development in offspring remains unclear.To address this,we established a PH rat model with maternal EC exposure.Methods Maternal EC exposure was initiated on gestation day 12 via electronic nicotine delivery systems.Offspring were administered monocrotaline(MCT)at 6 weeks of age(6-wo)to induce PH.Mechanistic experiments were conducted at 10-week-old(10-wo).Protein expression of NADPH oxidases,DNA methyltransferases,and autophagy-related markers was analyzed by Western blot.Morphological changes and the severity of PH were evaluated via hematoxylin and eosin(HE)staining and echocardiography,respectively.Furthermore,the involvement of the oxidative stress/DNA methylation/autophagy axis in response to maternal EC exposure was confirmed through a combination of ELISA,Western blot,HE staining,and echocardiography.Additionally,ATG5 mRNA expression was measured by qRT-PCR.Results Compared with control conditions,maternal EC exposure significantly worsened MCT-induced PH in male offspring.This was associated with increased oxidative stress,DNA hypomethylation,and anomalous autophagy in the offspring.In vivo treatment with chloroquine inhibited autophagy and ameliorated PH development in offspring exposed to maternal EC.Furthermore,N-acetylcysteine(NAC),an antioxidant,attenuated maternal EC exposure-induced oxidative stress,DNA hypomethylation,and excessive autophagy,thereby improving PH.DNA hypermethylation also reversed PH development,accompanied by reduced oxidative stress and suppressed autophagy.ATG5,a key regulator of autophagy,was identified as a potential therapeutic target,as its repression mitigated PH in maternal EC-exposed offspring.Conclusion Maternal EC exposure induces oxidative stress and DNA hypomethylation in offspring,leading to anomalous autophagy and exacerbation of PH development.Targeting ATG5-mediated autophagy may represent a novel therapeutic approach for improving PH outcomes in offspring exposed to maternal EC.Graphical Abstract Pregnant rats were exposed to either EC vapor or standard air from gestation day 12 until 2 days before delivery,with all offspring undergoing PH induction at 6-wo.Offspring exposed to maternal EC presented increased oxidative stress,which in turn affected DNA methylation patterns.The decreased DNA methylation in male offspring led to the activation of autophagy,exacerbating the development of PH.Treatment with ATG5 siRNA inhibited autophagy and alleviated heightened PH in male offspring with maternal EC exposure.
文摘Introduction: The Coronavirus pandemic was responsible for an unprecedented health crisis that shook the world with its high contagiousness and lethality. Its impact on maternal and fetal health places pregnant women at high risk. The aim of our study was to determine the factors associated with the occurrence of COVID-19 in pregnant women, and the maternal and perinatal outcomes of infected patients. Methodology: This was a case-control study involving 42 cases matched to 42 controls recruited from two public and tertiary hospitals in the cities of Yaoundé and Douala over a period from November 31 to May 31, 2024. Cases were defined as deliveries or records of COVID-19 deliveries confirmed positive by reverse transcription polymerase chain reaction (RT-PCR) or by a COVID-19 rapid diagnostic test (Covid-RDT). Controls were defined as deliveries or records of deliveries negative to the same test. They were matched by the hospital. Non-consenting births and unusable records were excluded. The data collected were recorded on a pre-established, pretexted data sheet examining sociodemographic, clinical characteristics and maternal and perinatal outcomes which were then analyzed using SPSS version 23.0 software. Results: After multivariate analysis, the independent sociodemographic factors were: belonging to the [30 - 40] age group (OR: 4.4;P = 0.010), being married (OR: 8.1;P = 0.030);being unemployed (OR: 3;P = 0.040). Independent clinical factors were: being in the third trimester of pregnancy (OR: 1.1;P = 0.017), being diabetic (OR: 5;P = 0.033) and being obese (OR: 11.5;P = 0.043). Independent factors associated with maternal outcome were: caesarean section (OR: 10;P = 0.001);admission to intensive care (OR: 30.7;P = 0.013);SO2 ≤ 94% (OR: 11.7;P = 0.033);HR > 100 (OR: 15.5;P = 0.001). Independent factors associated with perinatal outcome were: weight Conclusion: The factors associated with the occurrence of COVID-19 in pregnant women are multiple, and maternal outcome depends on its condition on admission, and has a significant impact on perinatal health, including mode of delivery. Emphasis must be placed on prevention and optimal management of these associated factors.
基金supported by grants from the National Natural Science Foundation of China(31770422 and 31900334)Natural Science Foundation of Jiangsu Province(BK20190910)+2 种基金Postdoctoral Science Foundation of China(2018M630610 and 2019T120468)Students’Project for Innovation and Entrepreneurship Training Program of Yangzhou University(XCX20230796)Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘Paternal predation risk can program offspring phenotypes via maternal responses and epigenetic marks of spermatozoa.However,the processes and consequences of this experience in biparental species are unknown.Here,we examined how preconception and postconception paternal cat odor(CO)exposure affects anxiety-like behavior and antipredator response in Brandt’s voles(Lasiopodomys brandtii).We found that preconception paternal CO exposure inhibited maternal investment when offspring were raised by mothers alone,while postconception exposure increased paternal investment towards the offspring raised by both parents.The increased paternal behavior may be associated with an increasing grooming behavior received from their mates,which alleviated the anxiety-like behavior in CO-exposed males.Both paternal experiences increased the levels of anxiety-like behavior in adolescent offspring but differentially altered adult phenotypes.Specifcally,adult females from preconception CO-exposed fathers spent less time in defensive concealing,whereas the offspring of postconception CO-exposed fathers showed more in response to acute cat urine exposure.Correspondingly,baseline corticosterone levels were decreased and increased in these offspring,respectively.Our results indicate that in biparental species,paternal predation risk exposure affects offspring phenotypes in pathway-dependent and age-specifc manners and that only the presence of both parents can elicit adaptive responses to a high predation-risk environment.
文摘Breast cancer’s heterogeneous progression demands innovative tools for accurate prediction.We present a hybrid framework that integrates machine learning(ML)and fractional-order dynamics to predict tumor growth across diagnostic and temporal scales.On the Wisconsin Diagnostic Breast Cancer dataset,seven ML algorithms were evaluated,with deep neural networks(DNNs)achieving the highest accuracy(97.72%).Key morphological features(area,radius,texture,and concavity)were identified as top malignancy predictors,aligning with clinical intuition.Beyond static classification,we developed a fractional-order dynamical model using Caputo derivatives to capture memory-driven tumor progression.The model revealed clinically interpretable patterns:lower fractional orders correlated with prolonged aggressive growth,while higher orders indicated rapid stabilization,mimicking indolent subtypes.Theoretical analyses were rigorously proven,and numerical simulations closely fit clinical data.The framework’s clinical utility is demonstrated through an interactive graphics user interface(GUI)that integrates real-time risk assessment with growth trajectory simulations.
文摘Introduction: Uterine rupture is certainly one of the most serious, as it immediately jeopardises the vital prognosis of the mother and foetus. It is a common obstetric tragedy in our delivery rooms in countries with limited resources, reflecting the poor quality of obstetric care and, consequently, an unmet obstetric need. Methods: This was a descriptive and analytical cross-sectional study with prospective data collection over a four-year period from 1 January 2020 to 31 December 2023 at the University Hospital Centre (CHU) of Bouaké, in the Obstetrics and Gynaecology Department. The variables studied were epidemiological characteristics, therapeutic aspects and factors associated with maternal. Results: The prevalence of uterine rupture was 0.63%. The average age was 32, with patients aged 35 and over accounting for 33.68%, married 44.21% and 70% not in education. Patients with uterine rupture had been evacuated in 85.26% of cases. Uterine rupture was diagnosed in 97.89% of cases during labour. Maternal lethality due to rupture was 15.79%. The causes of maternal death were dominated by haemorrhagic shock (53.33%). Factors statistically associated with death were age ≥ 35 years (OR: 3.14), duration of labour ≥ 12 hours (OR: 5.8), multiparity (OR: 19.04), admission delay beyond 2 hours (OR: 4.36), haemoglobin level ≤ 7 g/dl (OR: 36.84), coma or obnubilation (OR: 71.82), haemorrhagic shock (OR: 243.94) and occurrence of post-operative complications (OR: 76.45). Conclusion: The frequency of uterine rupture remains significant in the department (0.63%), with maternal mortality still high (15.79%). The key to reducing uterine rupture and its consequences lies in timely referral and early, appropriate management.
基金Collaborative Innovation Project of Zigong Medical Big Data and Artificial Intelligence Research Institute,Grant/Award Number:2023-YGY-1-02 and 2024-YGY-02-04National Natural Science Foundation of China,Grant/Award Number:31900950+4 种基金Project Supported by the Natural Science Basic Research Plan in Shaanxi Province of China,Grant/Award Number:2024JCYBMS-706National Key Research and Development Program of China,Grant/Award Number:2022YFC2009900Zigong Science and Technology Program,Grant/Award Number:2023YKY11Scientific Research Project of Zigong Health Commission,Grant/Award Number:22yb001 and 24zd008Key Science and Technology Plan Projects in Zigong,Grant/Award Number:2022ZCNKY07,2023-NKY-01-02,2023-NKY-02-13 and 2023-NKY-02-14。
文摘Background:Maternal viral infection during pregnancy can lead to maternal immune activation(MIA),increasing the risk of neurodevelopmental disorders in offspring.Amantadine(AMA)exhibits antiviral activity and is widely employed in the management of neurologic conditions.Nevertheless,the efficacy of AMA in treating MIA is currently not established.Methods:MIA was induced by polyinosinic acid-polycytidylic acid(poly(I:C));AMA was administered from embryonic(E)day 11.5 for 3 days.BV-2 cells were stimulated using poly(I:C)and treated with AMA.Behavior was assessed via open field test,elevated plus maze test,three-chamber sociability test,and marble burying test.Neuronal morphology was vizualized using Nissl stain;apoptosis via TUNEL(terminal deoxynucleotidyl transferase dUTP nick-end labeling)stain;protein expression(Iba1,NeuN,CD68,TNF-α[tumor necrosis factor-alpha],IL-1β[interleukin-1β])using immunofluorescence(IF);interleukin-6(IL-6)levels using enzyme-linked immunosorbent assay;reactive oxygen species using staining;Iba1,NeuN,Bcl-2,Bax,and cleaved caspase 3 using Western blot;and gene expression changes using RNA-seq.Results:AMA treatment reduced the levels of IL-6 in maternal blood,improved autism-like behaviors in MIA offspring,and effectively prevented neuronal damage and neuroinflammation.In vitro cellular studies have demonstrated that AMA effectively downregulates the expression levels of pro-inflammatory cytokines,including IL-6,TNF-α,and IL-1β.RNA-seq analysis indicated that AMA mitigates abnormal activation of microglia by modulating inflammatory pathways associated with IL-6.Conclusion:AMA can prevent the development of neuropsychiatric disorders in MIA offspring.This effect may be related to its ability to attenuate neuronal damage,reduce neuronal apoptosis,and inhibit neuroinflammation,indicating that the antiviral drug AMA may be a potential treatment for MIA.
文摘Objective:To evaluate the impact of a group embryo culture approach for women of advanced age.Methods:In this prospective study,two embryo culturing strategies—group and individual—were compared in women who were older(≥35 years)and younger(<35 years).Data was collected from 450 embryos over 291 intracytoplasmic sperm injection(ICSI)cycles performed on 291 patients.A grouped embryo culture group and an individual embryo culture group were generated by selecting the zygotes into two groups based on the type of culture that was used.The main outcomes compared between the groups were the pregnancy and the live birth rates.Results:The pregnancy,and live births rates were significantly higher when group culture was carried out in an advanced-aged women group(41.5%vs.25.0%,P=0.04;14.3%vs.6.6%,P=0.04;respectively).Similarly,the cleavage rate was better in the same group(98.6%vs.91.2%,P=0.001).However,in the group of young women,there were not significant differences in these rates.Conclusions:Group embryo culturing seems to be a promising strategy to improve embryo development and live births for patients over 35 years of age.
