Reduced interface effect of proton beam irradiation on the electrical properties of WSe2/hBN field effect transistors.

Two-dimensional transition metal dichalcogenide (TMDC) semiconductors are emerging as strong contenders for electronic devices that can be used in highly radioactive environments such as outer space where conventional silicon-based devices exhibit nonideal characteristics for such applications. To address the radiation-induced interface effects of TMDC-based electronic devices, we studied high-energy proton beam irradiation effects on the electrical properties of field-effect transistors (FETs) made with tungsten diselenide (WSe2) channels and hexagonal boron-nitride (hBN)/SiO2gate dielectrics. The electrical characteristics of WSe2FETs were measured before and after the irradiation at various proton beam doses of 1013, 1014, and 1015cm-2. In particular, we demonstrated the dependence of proton irradiation-induced effects on hBN layer thickness in WSe2FETs. We observed that the hBN layer reduces the WSe2/dielectric interface effect which would shift the transfer curve of the FET toward the positive direction of the gate voltage. Also, this interface effect was significantly suppressed when a thicker hBN layer was used. This phenomenon can be explained by the fact that the physical separation of the WSe2channel and SiO2dielectric by the hBN interlayer prevents the interface effects originating from the irradiation-induced positive trapped charges in SiO2reaching the interface. This work will help improve our understanding of the interface effect of high-energy irradiation on TMDC-based nanoelectronic devices.

Thrombopoietin receptor agonist antibody for treating chemotherapy-induced thrombocytopenia.

BACKGROUND: Thrombocytopenia is a common complication in cancer patients undergoing chemotherapy. Chemotherapy-induced thrombocytopenia (CIT) leads to dose reduction and treatment delays, lowering chemotherapy efficacy and survival rate. Thus, rapid recovery and continuous maintenance of platelet count during chemotherapy cycles are crucial in patients with CIT. Thrombopoietin (TPO) and its receptor, myeloid proliferative leukemia (MPL) protein, play a major role in platelet production. Although several MPL agonists have been developed to regulate thrombopoiesis, none have been approved for the management of CIT due to concerns regarding efficacy or safety. Therefore, the development of effective MPL agonists for treating CIT needs to be further expanded. METHODS: Anti-MPL antibodies were selected from the human combinatorial antibody phage libraries using phage display. We identified 2R13 as the most active clone among the binding antibodies via cell proliferation assay using BaF3/MPL cells. The effect of 2R13 on megakaryocyte differentiation was evaluated in peripheral blood CD34+ cells by analyzing megakaryocyte-specific differentiation markers (CD41a+ and CD42b+) and DNA ploidy using flow cytometry. The 2R13-induced platelet production was examined in 8- to 10-week-old wild-type BALB/c female mice and a thrombocytopenia mouse model established by intraperitoneal injection of 5-fluorouracil (150 mg/kg). The platelet counts were monitored twice a week over 14 days post-initiation of treatment with a single injection of 2R13, or recombinant human TPO (rhTPO) for seven consecutive days. RESULTS: We found that 2R13 specifically interacted with MPL and activated its signaling pathways. 2R13 stimulated megakaryocyte differentiation, evidenced by increasing the proportion of high-ploidy (≥ 8N) megakaryocytes in peripheral blood-CD34+ cells. The platelet count was increased by a single injection of 2R13 for up to 14 days. Injection of 5-fluorouracil considerably reduced the platelet count by day 4, which was recovered by 2R13. The platelets produced by 2R13 sustained a higher count than that achieved using seven consecutive injections of rhTPO. CONCLUSIONS: Our findings suggest that 2R13 is a promising therapeutic agent for CIT treatment.

Current and future utility of ultrasound imaging in upper extremity musculoskeletal rehabilitation: A scoping review.

STUDY DESIGN: This study was a scoping review. BACKGROUND: Continued advances in musculoskeletal sonography technology and access have increased the feasibility of point-of-care use to support day-to-day clinical care and decision-making. Sonography can help improve therapeutic outcomes in upper extremity (UE) rehabilitation by enabling clinicians to visualize underlying structures during treatment. PURPOSE OF THE STUDY: This study aimed to (1) evaluate the growth, range, extent, and composition of sonography literature supporting UE rehabilitation; (2) identify trends, gaps, and opportunities with regard to anatomic areas and diagnoses examined and ultrasound techniques used; and (3) evaluate potential research and practice utility. METHODS: Searches were completed in PubMed, CINAHL, SPORTDiscus, PsycINFO, and BIOSIS. We included data-driven articles using ultrasound imaging for upper extremity structures in rehabilitation-related conditions. Articles directly applicable to UE rehabilitation were labeled direct articles, while those requiring translation were labeled indirect articles. Articles were further categorized by ultrasound imaging purpose. Article content between the two groups was descriptively compared, and direct articles underwent an evaluation of evidence levels and narrative synthesis to explore potential clinical utility. RESULTS: Average publication rates for the final included articles (n = 337) steadily increased. Indirect articles (n = 288) used sonography to explore condition etiology, assess measurement properties, inform medical procedure choice, and grade condition severity. Direct articles (n = 49) used sonography to assess outcomes, inform clinical reasoning, and aid intervention delivery. Acute UE conditions and emerging sonography technology were rarely examined, while tendon, muscle, and soft tissue conditions and grayscale imaging were common. Rheumatic and peripheral nerve conditions and Doppler imaging were more prevalent in indirect than direct articles. Among reported sonography service providers, there was a high proportion of nonradiologist clinicians. CONCLUSION: Sonography literature for UE rehabilitation demonstrates potential utility in evaluating outcomes, informing clinical reasoning, and assisting intervention delivery. A large peripheral knowledge base provides opportunities for clinical applications; however, further research is needed to determine clinical efficacy and impact for specific applications.

Interferon-γ inhibits retinal neovascularization in a mouse model of ischemic retinopathy.

Interferon-γ (IFNG) is one of the key cytokines that regulates both innate and adaptive immune responses in the body. However, the role of IFNG in the regulation of vascularization, especially in the context of Vascular endothelial growth factor A (VEGFa)-induced angiogenesis is not clarified. Here, we report that IFNG shows potent anti-angiogenic potential against VEGFa-induced angiogenesis. IFNG significantly inhibited proliferation, migration, and tube formation of Human umbilical vein endothelial cells (HUVECs) both under basal and VEGFa-treated conditions. Intriguingly, Knockdown (KD) of STAT1 abolished the inhibitory effect of IFNG on VEGFa-induced angiogenic processes in HUVECs. Furthermore, IFNG exhibited potent anti-angiogenic efficacy in the mouse model of oxygen-induced retinopathy (OIR), an in vivo model for hypoxia-induced retinal neovascularization, without induction of functional side effects. Taken together, these results show that IFNG plays a crucial role in the regulation of VEGFa-dependent angiogenesis, suggesting its potential therapeutic applicability in neovascular diseases.

Proton irradiation effects on mechanochemically synthesized and flash-evaporated hybrid organic-inorganic lead halide perovskites.

A hybrid organic-inorganic halide perovskite is a promising material for developing efficient solar cell devices, with potential applications in space science. In this study, we synthesized methylammonium lead iodide (MAPbI3) perovskites via two methods: mechanochemical synthesis and flash evaporation. We irradiated these perovskites with highly energetic 10 MeV proton-beam doses of 1011, 1012, 1013, and 4 × 1013protons cm-2and examined the proton irradiation effects on the physical properties of MAPbI3perovskites. The physical properties of the mechanochemically synthesized MAPbI3perovskites were not considerably affected after proton irradiation. However, the flash-evaporated MAPbI3perovskites showed a new peak in x-ray diffraction and an increased fluorescence lifetime in time-resolved photoluminescence under high-dose conditions, indicating considerable changes in their physical properties. This difference in behavior between MAPbI3perovskites synthesized via the abovementioned two methods may be attributed to differences in radiation hardness associated with the bonding strength of the constituents, particularly Pb-I bonds. Our study will help to understand the radiation effect of proton beams on organometallic halide perovskite materials.

Radiology "forensics": determination of age and sex from chest radiographs using deep learning.

PURPOSE: To develop and test the performance of deep convolutional neural networks (DCNNs) for automated classification of age and sex on chest radiographs (CXR). METHODS: We obtained 112,120 frontal CXRs from the NIH ChestX-ray14 database performed in 48,780 females (44%) and 63,340 males (56%) ranging from 1 to 95 years old. The dataset was split into training (70%), validation (10%), and test (20%) datasets, and used to fine-tune ResNet-18 DCNNs pretrained on ImageNet for (1) determination of sex (using entire dataset and only pediatric CXRs); (2) determination of age < 18 years old or ≥ 18 years old (using entire dataset); and (3) determination of age < 11 years old or 11-18 years old (using only pediatric CXRs). External testing was performed on 662 CXRs from China. Area under the receiver operating characteristic curve (AUC) was used to evaluate DCNN test performance. RESULTS: DCNNs trained to determine sex on the entire dataset and pediatric CXRs only had AUCs of 1.0 and 0.91, respectively (p < 0.0001). DCNNs trained to determine age < or ≥ 18 years old and < 11 vs. 11-18 years old had AUCs of 0.99 and 0.96 (p < 0.0001), respectively. External testing showed AUC of 0.98 for sex (p = 0.01) and 0.91 for determining age < or ≥ 18 years old (p < 0.001). CONCLUSION: DCNNs can accurately predict sex from CXRs and distinguish between adult and pediatric patients in both American and Chinese populations. The ability to glean demographic information from CXRs may aid forensic investigations, as well as help identify novel anatomic landmarks for sex and age.

Long-term Neighborhood Effects on Adolescent Outcomes: Mediated through Adverse Childhood Experiences and Parenting Stress.

Past research suggests that neighborhood structural and social environments are important contextual factors associated with children's development; however, investigations of the long-term effects of neighborhood environments in early childhood on subsequent adolescents' social and behavioral outcomes remain limited. Further, it is unclear whether and how the home environment as a mediating mechanism links neighborhood conditions and adolescents' outcomes. Using national surveys from multi-stressed families and census datasets, the present study aims to examine the longitudinal associations between neighborhood concentrated poverty and collective efficacy, mothers' parenting stress, exposure to adverse childhood experiences (ACEs), and later adolescent outcomes. Participants included 4898 children (52% boys) and their mothers (48% black, 25 years of age, on average, 64% living in poverty); children born in unmarried families (75% unmarried) were oversampled. The results suggest that neighborhood collective efficacy is associated directly and indirectly (via parenting stress and ACEs) with adolescents' behavior problems and social skills, and indirectly with their delinquency. Neighborhood concentrated poverty was indirectly related to adolescents' behavior problems, delinquency, and social skills transmitted through collective efficacy and family processes. Both mothers' parenting stress and exposure to ACEs were identified as significant mediators. This study highlights the importance of early intervention for high-risk children, programs to build community resilience and reinforce social support for vulnerable families, and policy efforts to create safe and nurturing relationships and environments.

Automated semantic labeling of pediatric musculoskeletal radiographs using deep learning.

BACKGROUND: An automated method for identifying the anatomical region of an image independent of metadata labels could improve radiologist workflow (e.g., automated hanging protocols) and help facilitate the automated curation of large medical imaging data sets for machine learning purposes. Deep learning is a potential tool for this purpose. OBJECTIVE: To develop and test the performance of deep convolutional neural networks (DCNN) for the automated classification of pediatric musculoskeletal radiographs by anatomical area. MATERIALS AND METHODS: We utilized a database of 250 pediatric bone radiographs (50 each of the shoulder, elbow, hand, pelvis and knee) to train 5 DCNNs, one to detect each anatomical region amongst the others, based on ResNet-18 pretrained on ImageNet (transfer learning). For each DCNN, the radiographs were randomly split into training (64%), validation (12%) and test (24%) data sets. The training and validation data sets were augmented 30 times using standard preprocessing methods. We also tested our DCNNs on a separate test set of 100 radiographs from a single institution. Receiver operating characteristics (ROC) with area under the curve (AUC) were used to evaluate DCNN performances. RESULTS: All five DCNN trained for classification of the radiographs into anatomical region achieved ROC AUC of 1, respectively, for both test sets. Classification of the test radiographs occurred at a rate of 33 radiographs per s. CONCLUSION: DCNNs trained on a small set of images with 30 times augmentation through standard processing techniques are able to automatically classify pediatric musculoskeletal radiographs into anatomical region with near-perfect to perfect accuracy at superhuman speeds. This concept may apply to other body parts and radiographic views with the potential to create an all-encompassing semantic-labeling DCNN.

Tracking Cognitive Decline in Amnestic Mild Cognitive Impairment and Early-Stage Alzheimer Dementia: Mini-Mental State Examination versus Neuropsychological Battery.

BACKGROUND/AIMS: Although the Mini-Mental State Examination (MMSE), Clinical Dementia Rating-Sum of Boxes (CDR-SOB), and neuropsychological batteries are widely used for evaluating cognitive function, it remains elusive which instrument best reflects the longitudinal disease progression in amnestic mild cognitive impairment (aMCI) and probable Alzheimer disease (AD). We investigated whether changes in these three instruments over time correlate with loss of cortical gray matter volume (cGMV). METHODS: We retrospectively investigated 204 patients (aMCI, n = 114; AD, n = 90) who had undergone MMSE, CDR-SOB, the dementia version of the Seoul Neuropsychological Screening Battery (SNSB-D), and 3-dimensional T1-weighted magnetic resonance images at least twice. We investigated the partial correlation between annual decline in test scores and percent change of cGMV. RESULTS: In aMCI patients, changes in the SNSB-D total score (r = 0.340, p < 0.001) and CDR-SOB (r = 0.222, p = 0.020), but not MMSE, showed a correlation with cGMV loss, with the SNSB-D total score showing the strongest correlation. In AD patients, decline in all three test scores correlated significantly with cGMV loss, with MMSE exhibiting the strongest correlation (r = 0.464, p < 0.001). CONCLUSION: In aMCI patients, neuropsychological battery, though time-consuming, was the most adequate tool in tracking disease progression. In AD patients, however, MMSE may be the most effective longitudinal monitoring tool when considering cost-effectiveness.

Analysis of noise generation and electric conduction at grain boundaries in CVD-grown MoS2 field effect transistors.

Grain boundaries in a chemical vapour deposition (CVD)-grown monolayer of MoS2 induce significant effects on the electrical and low frequency noise characteristics of the MoS2. Here, we investigated the electrical properties and noise characteristics of MoS2 field effect transistors (FETs) made with CVD-grown monolayer MoS2. The electrical and noise characteristics of MoS2 FETs were analysed and compared for the MoS2 channel layers with and without grain boundaries. The grain boundary in the CVD-grown MoS2 FETs can be the dominant noise source, and dependence of the extracted Hooge parameters on the gate voltage indicated the domination of the correlated number-mobility fluctuation at the grain boundaries. The percolative noise characteristics of the single grain regions of MoS2 were concealed by the noise generated at the grain boundary. This study can enhance understanding of the electrical transport hindrance and significant noise generation by trapped charges at grain boundaries of the CVD-grown MoS2 devices.

[Japanese response bias: Cross-level and cross-national comparisons on response styles].

This study attempts to identify response styles of Japanese students by cross-level and cross-national analyses. Tasaki and Ninomiya (2013) demonstrated the existence of an acquiescence response behavior of Japanese students based on the model by Billet and McClendon(2000), who measured latent response characteristics as "style factor." In this study, we used a different response style measurement model proposed by Weijters, Schillewaert, & Geuens (2008) positing that response styles are psychological constructs and observed response style variables are summary indicators derived from sets of various, but independent, test items. Results of cross-national analyses indicated that Japanese and Korean participants were more likely to choose a mid-point response (MRS) and less likely to choose an acquiescence response (ARS) than American counterparts, but no significant difference was observed for an extreme response (ERS) among participants from the three nations. Within the Japanese response style model, cross-level analyses showed that ARS scores were significantly higher than ERS scores, indicating that Japanese participants had an acquiescence response style, consistent with the findings from Tasaki & Ninomiya (2013).

The effects of neck and trunk stabilization exercises on cerebral palsy children's static and dynamic trunk balance: case series.

[Purpose] The purpose of this case series was to examination the effects of trunk and neck stabilization exercise on the static, dynamic trunk balance abilities of children with cerebral palsy. [Subjects and Methods] The study included 11 school aged children diagnosed with paraplegia due to a premature birth. Each child engaged in exercise treatments twice per week for eight weeks; each treatment lasted for 45 minutes. After conducting a preliminary assessment, exercise treatments were designed based on each child's level of functioning. Another assessment was conducted after the eight weeks of treatment. [Results] The Trunk Control Measurement Scale evaluation showed that the exercise treatments had a significant effect on static sitting balance, selective movement control, dynamic reaching, and total Trunk Control Measurement Scale scores. [Conclusion] The results indicate that neck and trunk stabilization exercises that require children's active participation are helpful for improving static and dynamic balance ability among children diagnosed with cerebral palsy.

The effects of neck and trunk stabilization exercises on upper limb and visuoperceptual function in children with cerebral palsy.

[Purpose] The present study aimed to investigate the effects of neck and trunk stabilization exercises on upper limb and visuoperceptual function in children with cerebral palsy. The Jebson-Taylor hand function test and the Korean Developmental Test of Visual Perception-2 (K-DTVP-2) test were utilised. [Subjects and Methods] The study subjects were 11 schoolchildren who had paraplegia caused by premature birth, and who had been diagnosed with periventricular leukomalacia. Kinesitherapy was implemented in individual children for eight weeks, twice a week, for 45 minutes at a time. After a preliminary evaluation, kinesitherapy, including neck and trunk stabilization exercises common to all the children, was implemented for eight weeks according to the functioning and level of each child. A post evaluation was performed after the eight weeks of kinesitherapy. [Results] The intervention showed a significant effect in five subcategories of the Jebson-Taylor hand function test, as well as according to the K-DTVP-2 test. [Conclusion] Because neck and trunk stabilization exercises requiring positive participation by the children included fundamental elements of daily living motion, the exercises might have had a positive effect on upper limb and visuoperceptual function.

High doses of caffeine reduce in vivo osteogenic activity in prepubertal rats.

Caffeine adversely affects endochondral ossification during fetal skeletal growth, and results in increased incidence of delayed and abnormal fetal skeletal development. Chronic caffeine intake also decreases growth hormone secretion. Thus, it is conceivable that caffeine may disrupt bone growth during the peripubertal period. This study aimed to investigate the impact of high-caffeine consumption on bone growth throughout puberty. A total of 51 male rats (21 days old) were divided randomly into three groups: a control group and two groups fed caffeine via gavage with 120 and 180 mg kg(-1)  day(-1) for 4 weeks. After death, the final length and weight of leg bones were measured, and the tibia processed for histomorphometric analysis. Caffeine caused a significant decrease in body mass gain. This was accompanied with proportional decreases in lean body mass and body fat. In addition, bone mass and osteogenic activity in vivo were assessed using dual-energy X-ray absorptiometry and (18) F-NaF positron emission tomography. The results showed significant decreases of bone mass and in vivo osteogenic activity in the caffeine-fed groups. Rats fed with caffeine showed a significantly shorter and lighter tibia and femur and the vertebral column compared with controls. In addition, caffeine does not increase the width of the growth plates (GPs), it slows the rate at which the GP closes due to a slower rate of growth. These results demonstrated that caffeine altered osteogenic activity, leading to delayed peripubertal longitudinal bone growth and maturation. Given that osteogenic cells undergo dynamic changes in metabolic activity and that the pubertal growth spurt is mainly stimulated by growth hormone/insulin-like growth factor-1 and sex steroids during pubertal development, caffeine could suppress ossification by interfering with both physiological changes in hormonal secretion and osteogenic activity during this critical period. Further study will be needed to investigate the cellular/molecular mechanism by which caffeine affects osteogenesis using in vitro experimental models.

Religion, sense of calling, and the practice of medicine: findings from a national survey of primary care physicians and psychiatrists.

OBJECTIVES: A sense of calling is a concept with religious and theological roots; however, it is unclear whether contemporary physicians in the United States still embrace this concept in their practice of medicine. This study assesses the association between religious characteristics and endorsing a sense of calling among practicing primary care physicians (PCPs) and psychiatrists. METHODS: In 2009, we surveyed a stratified random sample of 2016 PCPs and psychiatrists in the United States. Physicians were asked whether they agreed with the statement, "For me, the practice of medicine is a calling." Primary predictors included demographic and self-reported religious characteristics, (eg, attendance, affiliation, importance of religion, intrinsic religiosity) and spirituality. RESULTS: Among eligible respondents, the response rate was 63% (896/1427) for PCPs and 64% (312/487) for psychiatrists. A total of 40% of PCPs and 42% of psychiatrists endorsed a strong sense of calling. PCPs and psychiatrists who were more spiritual and/or religious as assessed by all four measures were more likely to report a strong sense of calling in the practice of medicine. Nearly half of Muslim (46%) and Catholic (45%) PCPs and the majority of evangelical Protestant PCPs (60%) report a strong sense of calling in their practice, and PCPs with these affiliations were more likely to endorse a strong sense of calling than those with no affiliation (26%, bivariate P < 0.001). We found similar trends for psychiatrists. CONCLUSIONS: In this national study of PCPs and psychiatrists, we found that PCPs who considered themselves religious were more likely to report a strong sense of calling in the practice of medicine. Although this cross-sectional study cannot be used to make definitive causal inferences between religion and developing a strong sense of calling, PCPs who considered themselves religious are more likely to embrace the concept of calling in their practice of medicine.

Effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy.

[Purpose] The purpose of the study was to evaluate the effects of conventional neurological treatment and a virtual reality training program on eye-hand coordination in children with cerebral palsy. [Subjects] Sixteen children (9 males, 7 females) with spastic diplegic cerebral palsy were recruited and randomly assigned to the conventional neurological physical therapy group (CG) and virtual reality training group (VRG). [Methods] Eight children in the control group performed 45 minutes of therapeutic exercise twice a week for eight weeks. In the experimental group, the other eight children performed 30 minutes of therapeutic exercise and 15 minutes of a training program using virtual reality twice a week during the experimental period. [Results] After eight weeks of the training program, there were significant differences in eye-hand coordination and visual motor speed in the comparison of the virtual reality training group with the conventional neurological physical therapy group. [Conclusion] We conclude that a well-designed training program using virtual reality can improve eye-hand coordination in children with cerebral palsy.

A chitosan/alginate coated nano-liposome to improve intestinal absorption of curcumin for oral administration.

Attempts to improve low absorption and rapid metabolic conversion of curcumin were made by developing curcumin-loaded bilayer nanoliposomes coated with chitosan and alginate for intestinal-specific drug delivery. A curcumin-loaded nano-liposome was prepared with optimized formulations with phosphatidylcholine, curcumin, chitosan, and alginate. The particle size of the optimized formulation was approximately 400 nm, and the encapsulation efficiency was more than 99%. In the in vitro release study, curcumin release from the curcumin-loaded nanoliposome with double layers of chitosan/alginate (CNL-CH/AL) was suppressed in the simulated gastric fluid (SGF, pH 1.2) and enhanced in the simulated intestinal fluid (SIF, pH 6.8). In the in vivo pharmacokinetic study in rats, the CNL-CH/AL-treated group showed a prolonged absorption pattern of curcumin and the area under the plasma concentration-time curve from 0 to 24 h (AUC0-24) was improved 109-fold compared to the control group treated with a curcumin solution without a nanocarrier.

A spiritual problem? Primary care physicians' and psychiatrists' interpretations of medically unexplained symptoms.

BACKGROUND: Patients commonly present to their physicians with medically unexplained symptoms (MUS), and there is no consensus about how physicians should interpret or treat such symptoms. OBJECTIVE: To examine how variations in physicians' interpretations of MUS are associated with physicians' religious characteristics and with physician specialty (primary care vs. psychiatry). DESIGN AND PARTICIPANTS: A national survey of a stratified random sample of 1,504 primary care physicians and 512 psychiatrists in 2009-2010. MAIN MEASURES: The extent to which physicians believe MUS reflect a root problem that is spiritual in nature or result from conditions that scientific research will eventually explain, and whether such patients would benefit from attention to their relationships, attention to their spiritual life, taking medications, and/or treatment by physicians. KEY RESULTS: Response rate was 63 % (1,208/1,909). More religious/spiritual physicians were more likely to believe that MUS reflect a spiritual problem (55 % for high vs. 24 % for low spirituality; OR = 2.8, 1.7-4.5) and that these patients would benefit from paying attention to their spiritual life (79 % for high vs. 55 % for low spirituality; OR = 3.1, 1.8-5.3). Psychiatrists were more likely to believe that scientific research will one day explain MUS (66 % vs. 52 %; OR = 1.9, 1.4-2.5) and that these symptoms will improve with treatment by a physician (54 % vs. 35 %; OR = 2.4, 1.8-3.3). They were less likely to believe that MUS reflect a spiritual problem (23 % vs. 38 %; OR = 0.5, 0.4-0.8). CONCLUSIONS: Physicians' interpretations of MUS vary widely, depending in part on physicians' religious characteristics and specialty. One in three physicians believes that patients with MUS have root problems that are spiritual in nature. Physicians who are more religious or spiritual are more likely to think of MUS as stemming from spiritual concerns. Psychiatrists are more optimistic that these patients will get better with treatment by physicians.

Association of senescence-associated secretory phenotype proteins with ovarian reserve among middle-aged/older women.

OBJECTIVE: This study aimed to examine the association of circulating senescence-associated secretory phenotype proteins, secreted by senescent cells, with indicators of women's ovarian reserve. METHODS: This secondary analysis of cross-sectional baseline survey data was undertaken by the Korean Genome and Epidemiology Study Cardiovascular Disease Association Study. A total of 223 women (aged 40-82 y), without any history of oophorectomy, hysterectomy, or other medical conditions that could lower the ovarian reserve, were enrolled in this analysis. Chronological age (years), menopausal status, and serum anti-müllerian hormone (ng/mL) level were used to assess the associations among biological aging, accelerated menopausal aging, and ovarian reserve. RESULTS: Of the 223 women participants (53.4 ± 11.0 y), 147 (46.4 ± 3.9 y) and 76 (67.0 ± 6.9 y) were premenopausal and postmenopausal, respectively. Serum levels of senescence-associated secretory phenotype proteins were generally higher in postmenopausal, than in premenopausal, women. In the analyses adjusted for chronological age and body mass index, 17 senescence-associated secretory phenotype proteins were associated with menopausal status. However, in premenopausal women, no association trends with the level of anti-müllerian hormone were detected for a total of 28 senescence-associated secretory phenotype proteins. CONCLUSIONS: In a cohort of middle-aged/older women, the level of circulating senescence-associated secretory phenotype proteins indicated chronological age and menopausal status. Yet, serum levels of senescence-associated secretory phenotype protein potentially have limited predictive value for ascertaining ovarian reserve in premenopausal women.