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1.
Human reproduction (Oxford, England) ; 37(Suppl 1), 2022.
Artigo em Inglês | EuropePMC | ID: covidwho-1999097

RESUMO

Study question What is currently being taught in United Kingdom (UK) secondary schools relating to sex and fertility and what are students’ experiences of this education? Summary answer There are large gaps in the UK’s biology curriculum relating to sex and fertility education with important topics being neglected. What is known already Sex and fertility education is essential to enable people to make informed choices about family building. This is especially important as maternal and paternal age is increasing globally. School is an important source of this education but sex and fertility education is often minimal. In order to optimise people’s contraceptive behaviour and fertility planning, an understanding of the reproductive cycle, basic physiology of fertility and preconception health is required. Fertility education interventions have been shown to improve fertility knowledge and decrease planned ages of childbearing among young adults but only if repeated. Study design, size, duration This study aimed to evaluate the current biology curricula relating to sex and fertility education at GCSE (General Certificate of Secondary Education) and A level (Advanced Level) in the UK and to determine 16-17-year-old students’ experiences of their sex and fertility education. This year group was chosen as we are interested in what students have learnt by the end of their mandatory education (years 1 to 11), and their experiences of this education. Participants/materials, setting, methods The analysis of the curricula was conducted using the most recently published specifications for science and biology at GCSE and biology at A level for the Awarding Bodies that dominate the GCSE and A-level market in the UK. The school survey included a 47-item online survey distributed to year 12 students in four secondary schools across England. In total, 244 students participated in the survey. Main results and the role of chance There are six Awarding Bodies in the UK that set the examinations for GCSE and A-level students. At GCSE level, the hormonal control of the menstrual cycle, contraception and ART are taught within the human reproduction section of the biology curriculum. STIs are used as examples of communicable diseases, but pregnancy does not feature other than as a consequence of contraceptive failure. At A level, there is generally less teaching of relationships, sexuality and fertility-related topics than at GCSE. The results of the school survey showed that some topics, notably puberty, the menstrual cycle, contraception and STIs, were more likely to be learnt in school. However, topics such as endometriosis, menopause, miscarriage and polycystic ovarian syndrome were more likely to be learnt outside school. Abortion was the most common topic learnt outside school, followed by puberty. The most popular sources of sex education outside school were the internet and social media. In the students’ responses to how they think sex and fertility education can be improved, six themes became apparent: LGBTQ + (lesbian, gay, bisexual, transgender, queer and others) inclusivity;topic variety;logistical improvements;attitudes towards sex;gender equality;and applicability to real life. Limitations, reasons for caution The COVID-19 pandemic significantly disrupted schools during the 2020/2021 academic year. Consequently, we were unable to distribute the survey to as many schools as planned. We hope to continue this study in the 2021/2022 academic year to allow further comparison between the experiences of different groups of students. Wider implications of the findings Ideally, school sex and fertility education would involve a comprehensive and holistic programme and would provide young people with full, accurate information to prepare them for later life. We hope that the results of our study can be used to improve sex and fertility education for young people. Trial registration number NA

2.
Human reproduction (Oxford, England) ; 37(Suppl 1), 2022.
Artigo em Inglês | EuropePMC | ID: covidwho-1998446

RESUMO

Study question What are the views of men from Greece, Nepal, and the UK on having children and what is their knowledge of fertility? Summary answer Between countries, there were similarities and differences in men’s views to having children. Men showed limited fertility knowledge, and access to fertility information varied. What is known already The global total fertility rate (TFR) has dropped to below 2.5 compared to 5 in 1950, currently being 1.61 in the EU. Internationally, the age at which people are having children has increased and is over 30 in many countries. Delaying parenthood is leaving many with smaller family sizes than desired or involuntary childlessness due to age-related infertility. Although many men are keen to be fathers, existing studies relating to fertility knowledge and having children focus heavily on women. Compared to women, men’s fertility knowledge is limited as fertility education is rarely taught or tailored for men. Study design, size, duration Two anonymous surveys were conducted. The UK survey (live from 25 April – 1 December 2021) was launched via social media. Men internationally could complete the survey, and high numbers of men from Nepal participated. The Greek survey (live from 11 – 26 May 2021) was launched in Greece through a market research company. The end sample size was n = 244 for Greece, n = 205 for Nepal and n = 128 for the UK. Participants/materials, setting, methods Men aged 25 to 45 years old, who wanted children but were currently childless, were included. There were four parts to the survey: basic demographics;their attitude to having a family;their fertility concerns;and their fertility knowledge. For the UK survey, since one of the authors had a link with Nepal, particular effort was made to recruit from Nepal as well as from the UK. Main results and the role of chance When asked how many children men wanted, most Greek (59%), Nepalese (66%) and UK (58%) men wanted two children, but higher levels of Greek (24%) and UK (25%) men wanted three children compared to Nepalese men (9%)(p < 0.001). The ideal age men wanted to have had/have their first child was 35 years in Greece (23%), but it was 30 years in Nepal (24%) and in the UK (30%). The COVID-19 pandemic had not affected most men’s decision to have children: Greece’s (64%), Nepal (48%), UK (70%). But it had affected 21% Greek, 27% Nepalese and 16% UK men who are now intending to delay having children. Greek (46%), Nepalese (48%) and UK (47%) men felt moderately informed on female fertility. Greek (45%), Nepalese (50%) and UK (45%) men felt more informed about male than female fertility. When questioned on when they think a woman is fertile in her menstrual cycle, 50% Greek, 38% Nepalese, and 42% UK men answered incorrectly. The internet was the most common source men accessed fertility information from: Greece (67%), Nepal (30%) and the UK (26%). The second most common source for Greece (18%) was doctors, but for Nepalese (18%) and UK (18%) men, it was school. Limitations, reasons for caution The study had a relatively small sample size (n = 577). It is well documented that men typically do not show high engagement with surveys. It was only promoted on social media. Respondents were typically highly educated, active on social media and knew English or Greek to an adequate level. Wider implications of the findings The International Fertility Education Initiative is developing resources to deliver tailored fertility education across different populations. This survey shows that there are cultural differences that need to be considered when designing such resources. Trial registration number Not applicable

3.
Topics in Antiviral Medicine ; 30(1 SUPPL):250, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-1880741

RESUMO

Background: The World Health Organization (WHO) ordinal scale (OS) is used to evaluate participant outcomes in clinical trials. We modified the WHO OS to enable assessment of patient outcomes associated with various treatment agents using the National COVID Cohort Collaborative (N3C), a national database containing electronic Health Record (EHR) data from > 2.7 million persons with a COVID-19 diagnosis from > 55 U.S. sites. Methods: Modified OS severity scores (Table 1) were assigned in the first through fourth weeks following COVID-19 diagnosis for a sample of patients in N3C. To adjust for disease severity at patient hospitalization, we developed separate models to examine OS levels of 3, 5, 7, and 9. Elastic net penalized multinomial logistic regression was used to simultaneously identify risk factors and predict the probability of each level of the ordinal scale at week 4. We studied groups of anticoagulants (AC), steroids, antibiotics, antiviral agents (AA), monoclonal antibodies (MA), and a miscellaneous group that included all other treatments. Other factors considered were presence of comorbid conditions using the Charlson Comorbidity Index (CCI), ethnicity, age, gender, and time of diagnosis (by quarter). Results: We included 1,489,191 COVID-19 (161,385 outpatients were excluded) patients. Patient characteristics and treatment approaches applied to each OS level were analyzed (Table 1). For hospitalized patients with a Week 1 OS score of 3,5,7, or 9, we found that increased CCI values are associated with higher probabilities of a worsened OS score at Week 4. Given that MAs are a standard treatment for patients at OS levels 3 and 5, and that steroids are typically used at OS 7 and 9, we studied treatment combinations related to MA and steroids given during Week 1. Improved outcomes by Week 4 were demonstrated with AA+MA for OS 3 and for AC+MA for OS 5 (Table 1). Patients at OS 7 in Week 1 had improved Week 4 outcomes with steroids alone while OS 7 patients with CCI>10 had better outcomes with steroids+AC. OS 9 patients treated with steroids+MA had better outcomes compared with those not given that combination. Conclusion: Our analyses identify relationships between COVID-19 serverity, specific treatments and outcomes at 4 weeks after diagnosis. Use of MA at lower levels of severity, and steroids at higher severity levels were associated with survival to hospital discharge.

4.
Ann N Y Acad Sci ; 1510(1): 79-99, 2022 04.
Artigo em Inglês | MEDLINE | ID: covidwho-1822055

RESUMO

Targeted protein degradation is critical for proper cellular function and development. Protein degradation pathways, such as the ubiquitin proteasomes system, autophagy, and endosome-lysosome pathway, must be tightly regulated to ensure proper elimination of misfolded and aggregated proteins and regulate changing protein levels during cellular differentiation, while ensuring that normal proteins remain unscathed. Protein degradation pathways have also garnered interest as a means to selectively eliminate target proteins that may be difficult to inhibit via other mechanisms. On June 7 and 8, 2021, several experts in protein degradation pathways met virtually for the Keystone eSymposium "Targeting protein degradation: from small molecules to complex organelles." The event brought together researchers working in different protein degradation pathways in an effort to begin to develop a holistic, integrated vision of protein degradation that incorporates all the major pathways to understand how changes in them can lead to disease pathology and, alternatively, how they can be leveraged for novel therapeutics.


Assuntos
Complexo de Endopeptidases do Proteassoma , Ubiquitina , Autofagia/fisiologia , Humanos , Organelas , Complexo de Endopeptidases do Proteassoma/metabolismo , Proteínas/metabolismo , Proteólise , Ubiquitina/metabolismo
5.
Open Forum Infectious Diseases ; 8(SUPPL 1):S23-S24, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1746806

RESUMO

Background. Rural communities are among the most vulnerable and resourcescarce populations in the United States. Rural data is rarely centralized, precluding comparability across regions, and no significant studies have studied this population at scale. The purpose of this study is to present findings from the National COVID Cohort Collaborative (N3C) to provide insight into future research and highlight the urgent need to address health disparities in rural populations. N3C Patient Distribution This figure shows the geospatial distribution of the N3C COVID-19 positive population. N3C contains data from 55 data contributors from across the United States, 40 of whom include sufficient location information to map by ZIP Code centroid spatially. Of those sites, we selected 27 whose data met our minimum robustness qualifications for inclusion in our study. This bubble map is to scale with larger bubbles representing more patients. A. shows all N3C patients. B. shows only urban N3C distribution. C. shows the urban-adjacent rural patient distribution. D. shows the nonurban-adjacent rural patient distribution, representing the most isolated patients in N3C. Methods. This retrospective cohort of 573,018 patients from 27 hospital systems presenting with COVID-19 between January 2020 and March 2021, of whom 117,897 were admitted (see Data Analysis Plan diagram for inclusion/exclusion criteria), analyzes outcomes and 30-day survival for the hospitalized population by the degree of rurality. Multivariate Cox regression analysis and mixed-effects models were used to estimate the association between rurality, hospitalization, and all-cause mortality, controlling for major risk factors associated with rural-urban health discrepancies and differences in health system outcomes. The difference in distribution by rurality is described as well as supplemented by population-level statistics to confirm representativeness. Data Analysis Plan This data analysis plan includes an overview of study inclusion and exclusion criteria, the matrix for data robustness to determine potential sites to include, and our covariate selection, model building, and residual testing strategy. Results. This study demonstrates a significant difference between hospital admissions and outcomes in urban versus urban-adjacent rural (UAR) and nonurban-adjacent rural (NAR) lines. Hospital admissions for UAR (OR 1.41, p< 0.001, 95% CI: 1.37 - 1.45) and NAR (OR 1.42, p< 0.001, 95% CI: 1.35 - 1.50) were significantly higher than their urban counterparts. Similar distributions were present for all-cause mortality for UAR (OR 1.39, p< 0.001, 95% CI: 1.30 - 1.49) and NAR (OR 1.38, p< 0.001, 95% CI: 1.22 - 1.55) compared to urban populations. These associations persisted despite adjustments for significant differences in BMI, Charlson Comorbidity index Score, gender, age, and the quarter of diagnosis for COVID-19. Baseline Characteristics Hospitalized COVID-19 Positive Population by Rurality Category, January 2020 - March 2021 Survival Curves in Hospitalized Patients Over 30 Days from Day of Admission This figure shows a survival plot of COVID-19 positive hospitalized patients in N3C by rural category (A), Charlson Comorbidity Index (B), Quarter of Diagnosis (C), and Age Group (D) from hospital admission through day 30. Events were censored at day 30 based on the incidence of death or transfer to hospice care. These four factors had the highest predictive power of the covariates evaluated in this study. Unadjusted and Adjusted Odds Ratios for Hospitalization and All-Cause Mortality by Rural Category, January 2020 - March 2021 This figure shows the adjusted and unadjusted odds ratios for being hospitalized or dying after hospitalization for the COVID-19 positive population in N3C. Risk is similar between adjusted and unadjusted models, suggesting a real impact of rurality on all-cause mortality. A shows the unadjusted odds ratios for admission to the hospital after a positive COVID-19 diagnosis for all N3C patients. B shows the unadjusted odds ratios for all-cause mortalit at any point after hospitalization for COVID-19 positive patients. C shows the adjusted odds ratios for being admitted to the hospital after a positive COVID-19 diagnosis for all N3C patients. D shows the adjusted odds ratios for all-cause mortality for all-cause mortality at any point after hospitalization for COVID-19 positive patients. Adjusted models include adjustments for gender, race, ethnicity, BMI, age, Charlson Comorbidity Index (CCI) composite score, rurality, and quarter of diagnosis. The data provider is included as a random effect in all models. Conclusion. In N3C, we found that hospitalizations and all-cause mortality were greater among rural populations when compared to urban populations after adjustment for several factors, including age and co-morbidities. This study also identified key demographic and clinical disparities among rural patients that require further investigation.

6.
Open Forum Infectious Diseases ; 8(SUPPL 1):S293, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1746612

RESUMO

Background. It is estimated that 18% of adults in the U.S. take Vitamin D supplements. Some observational studies suggest that vitamin D supplementation activates the innate immune system and reduces the incidence and severity of viral infections. During the SARS-CoV-2 pandemic, vitamin D supplements were touted as a potential therapy to prevent the disease and/or complications. However, supportive evidence is lacking. Methods. The National COVID Cohort Collaborative (N3C) enclave is the largest COVID-19 data base with nearly 1.4 million positive patients at 56 sites in the U.S. We performed a retrospective analysis of vitamin D supplementation, either prescribed before or during hospitalization for SARS-CoV-2. Results. 137,399 people took vitamin D supplements out of 1.4 million. Females prescribed vitamin D outnumbered males by almost 2:1, whereas in non-users there were no sex differences. Most supplement users were older than 50. African Americans constituted 13% of the non-users, but 23% of those prescribed vitamin D. Infected individuals with any vitamin D supplementation, pre-Covid, post-Covid or both, had a 6.66% mortality rate vs 2% mortality in non-users. Similarly, nearly a third of the supplement users were hospitalized compared to 11% in the non-users. The Charlson Co-Morbidity Index was 3.0±3 (SD) in users vs 1.0±2 (SD) in non-users. Conclusion. 10% of SARS-CoV-2 infected patients were taking vitamin D. They tended to be older, more likely to be African American and have significant co-morbidities. Hospitalization and mortality were higher among those taking Vitamin D in this cohort. Vitamin D is widely used to prevent and treat SARS-CoV-2 but without evidence of efficacy.

7.
Journal of Endourology ; 35(SUPPL 1):A135-A136, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-1569532

RESUMO

Introduction & Objective: The Coronavirus pandemic led to wide-spread reductions in surgical volume. Many patients were hesitant to undergo surgery, despite appropriate hospital precautions. Kidney stone patients pending surgical intervention have distinct risks associated with surgical delay including pain, infection, and loss of renal function. It is important to understand the risks of surgical delay during the pandemic and to better understand patient concerns and preferences for undergoing surgery. Methods: A prospective, multi-institutional patient survey during April and May 2020 was performed. Nephrolithiasis patients pending stone removal surgery including ureteroscopy, shockwave lithotripsy, percutaneous nephrolithotomy, and nephrectomy were interviewed at clinical encounters regarding their symptoms, unplanned clinical events, presence of nephrostomy tubes /double J stents, concerns and reassurances for coming to the hospital, and willingness to undergo surgery. The association of patient demographics, stone burden, renal function, stonerelated symptoms, and COVID risk factors with willingness to undergo surgery, and concerns for contracting COVID were examined. Results: 142 patients pending stone surgery completed surveys, with 66% willing to proceed with surgery, while 34% requested to delay. There was no statistical difference in patients willing versus unwilling to proceed with surgery, with regards to patient demographics, type of surgical procedure, stone burden, stonerelated symptoms, renal function compromise, presence of hydronephrosis, unplanned clinical events, or COVID risk factors. Those willing to proceed were more likely to have a ureteral stone (32% vs 15%, p = 0.03) or have a ureteral stent or nephrostomy tube in place (35% vs 6%, p < 0.01). Willingness to proceed with surgery was inversely correlated with COVID19 concerns. COVID19 concern was not impacted by age, sex, clinical site, distance to hospital, or COVID 19 risk factors. Conclusions: Kidney stone patients pending surgical treatment weremore willing to proceed with surgery based on the presence of a ureteral stone, upper urinary tract drainage tube, or low concern for COVID. Patient demographic, symptoms, kidney function, and other stone risk factors were not associated with willingness for surgery. Patients that are hesitant to proceed with surgery, despite appropriate hospital precautions should be educated appropriately regarding their risks with regards to COVID and nephrolithiasis.

8.
Leisure Sciences ; 43(1/2):12-16, 2021.
Artigo em Inglês | CAB Abstracts | ID: covidwho-1269422

RESUMO

The coronavirus pandemic, for all of its damage to human health and well-being, has brought to light the wisdom underlying the idea of One Health, whose advocates reason that health is a reciprocal relationship between our species and the environment that sustains us. What is good for people should also be good for the environment, and what is good for the environment should also be good for people. Their preferred future is one in the same. As the recent days, weeks, and months have also shown, leisure is not necessarily a cure for what ails us. Indeed, leisure pursuits may have contributed to the pandemic's spread. What, then, are we to make of leisure in the time of the coronavirus? We believe it is a fundamental lesson in ecology.

9.
Proc Natl Acad Sci U S A ; 118(17)2021 04 27.
Artigo em Inglês | MEDLINE | ID: covidwho-1172591

RESUMO

In order to understand the transmission and virulence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is necessary to understand the functions of each of the gene products encoded in the viral genome. One feature of the SARS-CoV-2 genome that is not present in related, common coronaviruses is ORF10, a putative 38-amino acid protein-coding gene. Proteomic studies found that ORF10 binds to an E3 ubiquitin ligase containing Cullin-2, Rbx1, Elongin B, Elongin C, and ZYG11B (CRL2ZYG11B). Since CRL2ZYG11B mediates protein degradation, one possible role for ORF10 is to "hijack" CRL2ZYG11B in order to target cellular, antiviral proteins for ubiquitylation and subsequent proteasomal degradation. Here, we investigated whether ORF10 hijacks CRL2ZYG11B or functions in other ways, for example, as an inhibitor or substrate of CRL2ZYG11B While we confirm the ORF10-ZYG11B interaction and show that the N terminus of ORF10 is critical for it, we find no evidence that ORF10 is functioning to inhibit or hijack CRL2ZYG11B Furthermore, ZYG11B and its paralog ZER1 are dispensable for SARS-CoV-2 infection in cultured cells. We conclude that the interaction between ORF10 and CRL2ZYG11B is not relevant for SARS-CoV-2 infection in vitro.


Assuntos
COVID-19/metabolismo , Proteínas de Ciclo Celular/metabolismo , Proteínas Culina/metabolismo , Complexos Multiproteicos/metabolismo , Fases de Leitura Aberta , SARS-CoV-2/metabolismo , Proteínas Virais/metabolismo , COVID-19/genética , Proteínas de Ciclo Celular/genética , Proteínas Culina/genética , Células HEK293 , Humanos , Complexos Multiproteicos/genética , SARS-CoV-2/genética , Proteínas Virais/genética
10.
Parameters ; 50(4):99-111, 2020.
Artigo em Inglês | Scopus | ID: covidwho-1094931

RESUMO

The novel coronavirus is only the latest in a series of global crises with implications for the regional order in the Middle East. These changes and the diverging interests of actors in the region have implications for US strategy and provide an opportunity to rethink key US relationships there. © 2020, United States Army War College. All rights reserved.

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