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RESEARCH QUESTION: What is the association between endometrial thickness (EMT) and the birthweight of singleton infants born from frozen-thawed embryo transfer cycles? DESIGN: This retrospective cohort study was conducted from January 2016 to December 2019. Participants were categorized into a natural cycle (NC, nâ¯=â¯8132) group and hormone replacement therapy (HRT, nâ¯=â¯4975) group. Only singleton deliveries were included. The primary outcomes were measures of birthweight and relevant indexes. Multivariable logistic regression and multivariable-adjusted linear regression models that incorporated restricted cubic splines were used. RESULTS: In the HRT group, the risk of delivering a small for gestational age (SGA) infant was increased in women with an EMT <8.0 mm (adjusted odds ratio [aOR] 1.85, 95% confidence interval [CI] 1.17-2.91) compared with women with an EMT of 8.0 to <12.0 mm, and increased with an EMT ≥12.0 mm (aOR 1.85, 95% CI 1.03-3.33). An inverted U-shaped relationship was found between EMT and birthweight in women with HRT. No significant differences were shown in birthweight z-score, or being SGA or large for gestational age, in singletons among the three EMT groups in the natural cycles. CONCLUSIONS: A thinner endometrium seen in women undergoing HRT cycles was associated with a lower birthweight z-score, as well as a higher risk of SGA. However, no significant association was observed between EMT and birthweight z-score or SGA in the NC group. It is noteworthy that a thicker endometrium was not associated with a higher birthweight in frozen-thawed embryo transfer (FET) cycles. Women with a thin endometrium who achieve pregnancy require specialized attention, particularly if they are undergoing FET with HRT cycles.
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Peso al Nacer , Transferencia de Embrión , Endometrio , Humanos , Femenino , Estudios Retrospectivos , Endometrio/anatomía & histología , Adulto , Embarazo , Transferencia de Embrión/métodos , Recién Nacido , Vitrificación , Criopreservación , Terapia de Reemplazo de Hormonas , Resultado del Embarazo/epidemiología , Recién Nacido Pequeño para la Edad GestacionalRESUMEN
Recapitulating the natural extracellular physical microenvironment has emerged as a promising method for tissue regeneration, as multiple physical interventions, including ultrasound, thermal and electrical therapy, have shown great potential. However, simultaneous coupling of multiple physical cues to highly bio-mimick natural characteristics for improved tissue regeneration still remains formidable. Coupling of intrinsic electrical and mechanical cues has been regarded as an effective way to modulate tissue repair. Nevertheless, precise and convenient manipulation on coupling of mechano-electrical signals within extracellular environment to facilitate tissue regeneration remains challengeable. Herein, a photothermal-sensitive piezoelectric membrane was designed for simultaneous integration of electrical and mechanical signals in response to NIR irradiation. The high-performance mechano-electrical coupling under NIR exposure synergistically triggered the promotion of osteogenic differentiation of stem cells and enhances bone defect regeneration by increasing cellular mechanical sensing, attachment, spreading and cytoskeleton remodeling. This study highlights the coupling of mechanical signals and electrical cues for modulation of osteogenesis, and sheds light on alternative bone tissue engineering therapies with multiple integrated physical cues for tissue repair.
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Regeneración Ósea , Diferenciación Celular , Osteogénesis , Animales , Ratones , Ingeniería de Tejidos/métodos , Células Madre Mesenquimatosas/citología , HumanosRESUMEN
The fetal brains experience rapid and complex development in utero during the second and third trimesters. In utero MRI of the fetal brain in this period enables us to quantify normal fetal brain development in the spatiotemporal domain. In this study, we established a high-quality spatiotemporal atlas between 23 and 38 weeks gestational age (GA) from 90 healthy Chinese human fetuses of both sexes using a pairwise and groupwise registration pipeline. We quantified the fetal cortical morphology indices and characterized their spatiotemporal developmental pattern. The cortical thickness exhibited a biphasic pattern that first increased and then decreased; the curvature fitted well into the Gompertz growth model; sulcal depth increased linearly, while surface area expanded exponentially. The cortical thickness and curvature trajectories consistently pointed to a characteristic time point around GA of 31 weeks. The characteristic GA and growth rate obtained from individual cortical regions suggested a central-to-peripheral developmental gradient, with the earliest development in the parietal lobe, and we also observed a superior-to-inferior gradient within the temporal lobe. These findings may be linked to biophysical events, such as dendritic arborization and thalamocortical fibers ingrowth. The proposed atlas was also compared with an existing fetal atlas from a white/mixed population. Finally, we examined the structural asymmetry of the fetal brains and found extensive asymmetry that dynamically changed with development. The current study depicted a comprehensive profile of fetal cortical development, and the established atlas could be used as a normative reference for neurodevelopmental and diagnostic purposes, especially in the Chinese population.SIGNIFICANCE STATEMENT We generated a high-quality 4D spatiotemporal atlas of the normal fetal brain development from 23 to 38 gestational weeks in a Chinese population and characterized the spatiotemporal developmental pattern of cortical morphology. According to the cortical development trajectories, the fetal cerebral cortex development follows a central-to-peripheral developmental gradient that may be related to the underlying cellular events. The majority of cortical regions already exhibit significant asymmetry during the fetal period.
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Feto , Imagen por Resonancia Magnética , Masculino , Femenino , Humanos , Embarazo , Feto/diagnóstico por imagen , Neurogénesis , Encéfalo , Desarrollo Fetal , Corteza CerebralRESUMEN
OBJECTIVE: We investigated differentially expressed proteins (DEPs) in human glioblastoma U87 cells after treatment with hederagenin as a therapeutic screening mechanism and provided a theoretical basis for hederagenin in treating glioblastoma. METHODS: The Cell Counting Kit 8 assay was used to analyze the inhibitory effect of hederagenin on the proliferation of U87 cells. Protein was identified by tandem mass tags and LC-MS/MS analysis techniques. Annotation of DEPs, Gene Ontology enrichment and function, and Kyoto Encyclopedia of Genes and Genomes pathways and domains were all examined by bioinformatics. According to the TMT results, hub protein was selected from DEPs for WB verification. RESULTS: Protein quantitative analysis found 6522 proteins in total. Compared with the control group, 43 DEPs (P < 0.05) were involved in the highly enriched signaling pathway in the hederagenin group, among which 20 proteins were upregulated, and 23 proteins were downregulated. These different proteins are mainly involved in the longness regulating pathway-WORM, the hedgehog signaling pathway, Staphylococcus aureus infection, complement, coagulation cascades, and mineral absorption. KIF7 and ATAD2B expression were significantly down-regulated and PHEX and TIMM9 expression were significantly upregulated, according to WB analysis, supporting the TMT findings. CONCLUSION: Hederagenin inhibition of GBM U87 cells may be related to KIF7, which is mainly involved in the hedgehog signaling pathway. Our findings lay a foundation for additional study of the therapeutic mechanism of hederagenin.
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ABSTRACT: This study aimed to explore coping strategy profiles used by frontline medical workers and the psychological stress reactions associated with each category, in the COVID-19 pandemic context. Participants were 651 frontline medical workers recruited between February and March 2020. Psychological stress reactions (e.g., anxiety, depression) and coping strategies were assessed and analyzed using latent profile analysis and linear regression. Participants had three coping strategy profiles: coping inadequately (28.9%), coping appropriately (64.4%), and coping excessively (6.7%). Compared with coping appropriately, those who coped inadequately and excessively had higher psychological stress reactions levels. Levels of anxiety, depression, and posttraumatic stress disorder in excessive-coping individuals were higher than those who coped inadequately. Our findings elucidate the effectiveness of different coping strategy profiles and provide insights for developing targeted interventions to mitigate stress among medical workers. In light of these results, we recommend implementing stress management programs tailored to specific coping strategy profiles.
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COVID-19 , Pandemias , Humanos , Estrés Psicológico/etiología , Adaptación Psicológica , Ansiedad/epidemiologíaRESUMEN
BACKGROUND: Maternal psychological distress during pregnancy is associated with unfavorable outcomes in infants. Mindfulness-based interventions (MBIs) can effectively alleviate psychological distress, but there are often barriers to the access of face-to-face interventions. OBJECTIVE: This study aimed to investigate the effectiveness of a digital guided self-help (GSH) MBI (GSH-MBI) in reducing maternal psychological distress and improving infant neuropsychological performance. METHODS: This was a randomized controlled trial. We recruited 160 women who were 12 to 20 weeks pregnant and exhibited psychological distress. We randomized them into a digital GSH-MBI group and a control group (usual perinatal care). The digital GSH-MBI consisted of a 6-week intervention through a WeChat mini program, with a daily reminder sent to the participants by a research assistant via WeChat. The primary outcomes consisted of maternal psychological distress, including depression, anxiety, and pregnancy-related anxiety symptoms, which were assessed at 6 time points from baseline to 6 months post partum (only pregnancy-related anxiety symptoms were assessed 3 times during pregnancy). The secondary outcomes were infant neuropsychological outcomes, including temperament and developmental behaviors, which were assessed at 6 weeks and 6 months post partum. RESULTS: Compared with the control group, the digital GSH-MBI group showed a significant reduction in depression, anxiety, and pregnancy-related anxiety symptoms. In addition, the scores of the digital GSH-MBI group were lower than those of the control group for the 3 types of infant temperament at 6 weeks post partum, including quality of mood, distractibility, and adaptability. CONCLUSIONS: Digital GSH-MBIs are effective in alleviating psychological distress among pregnant women and protecting infant outcomes. TRIAL REGISTRATION: Chinese Clinical Trial Register ChiCTR2000040717; https://www.chictr.org.cn/showproj.aspx?proj=65376.
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Atención Plena , Distrés Psicológico , Femenino , Lactante , Embarazo , Humanos , Periodo Posparto , Conductas Relacionadas con la Salud , Ansiedad/psicología , Depresión/terapiaRESUMEN
BACKGROUND: Prenatal stress is a pressing issue. However, there is a lack of robust evidence for psychosocial interventions to manage this problem. AIMS: This study aimed to examine the effectiveness of a mindfulness-based intervention on reducing prenatal stress compared to participation in health education groups. METHODS: A randomized controlled trial was conducted in a prenatal clinic of comprehensive tertiary care from April to October 2017. A total of 108 pregnant women were randomly assigned to an intervention or a control group. Participants completed self-report measures of depression, anxiety, perceived stress, fatigue, positive and negative affect, and mindfulness before, immediately after, and 15 weeks after the 4-week intervention period. Generalized estimating equations were used to analyze the intervention outcomes. RESULTS: The results supported greater improvement in terms of perceived stress (Wald χ2=26.94, p<0.001), fatigue (Wald χ2=17.61, p<0.001), positive affect (Wald χ2=9.03, p = 0.011), negative affect (Wald χ2=11.37, p = 0.003), and mindfulness (Wald χ2=24.97, p<0.001) in the intervention group than in the control group. CONCLUSIONS: The self-help mindfulness intervention decreased prenatal stress and negative affect and improved positive affect and mindfulness.
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Atención Plena , Medios de Comunicación Sociales , Femenino , Embarazo , Humanos , Atención Plena/métodos , Estrés Psicológico/prevención & control , Estrés Psicológico/psicología , Mujeres Embarazadas/psicología , Ansiedad/psicología , Fatiga , Depresión/prevención & control , Depresión/psicologíaRESUMEN
Among many nanomaterials, electrospun carbon nanofibers (CNFs) have become one of the hot spots in nanoscience research because of their interesting physicochemical and biological properties such as large specific surface area, easy functionalization and biocompatibility. Polyacrylonitrileï¼PAN) has also become the most widely used precursor fiber for CNF manufacturing. In this paper, the latest advances in the synthesis of CNF by electrospinning were reviewed, including using template method, heat treatment, coaxial spinning technology to control the morphology and aperture, as well as the functionalization of electrospinning doped with chemical substances such as heteroatoms, nanoparticles (NPs), carbon nanotubes (CNTs) and grapheme (Gr), in order to further expand its application scope. The application of electrospun CNFs as electrochemical sensing platform for toxic and harmful substances in food and environment was also briefly introduced.
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Nanofibras , Nanotubos de Carbono , Nanofibras/químicaRESUMEN
RATIONALE: Atherosclerotic cardiovascular diseases are the leading cause of mortality worldwide. Atherosclerotic cardiovascular diseases are considered as chronic inflammation processes. In addition to risk factors associated with the cardiovascular system itself, pathogenic bacteria such as the periodontitis-associated Porphyromonas gingivalis (P gingivalis) are also closely correlated with the development of atherosclerosis, but the underlying mechanisms are still elusive. OBJECTIVE: To elucidate the mechanisms of P gingivalis-accelerated atherosclerosis and explore novel therapeutic strategies of atherosclerotic cardiovascular diseases. METHODS AND RESULTS: Bmal1-/- (brain and muscle Arnt-like protein 1) mice, ApoE-/- mice, Bmal1-/-ApoE-/- mice, conditional endothelial cell Bmal1 knockout mice (Bmal1fl/fl; Tek-Cre mice), and the corresponding jet-legged mouse model were used. Pgingivalis accelerates atherosclerosis progression by triggering arterial oxidative stress and inflammatory responses in ApoE-/- mice, accompanied by the perturbed circadian clock. Circadian clock disruption boosts P gingivalis-induced atherosclerosis progression. The mechanistic dissection shows that P gingivalis infection activates the TLRs-NF-κB signaling axis, which subsequently recruits DNMT-1 to methylate the BMAL1 promoter and thus suppresses BMAL1 transcription. The downregulation of BMAL1 releases CLOCK, which phosphorylates p65 and further enhances NF-κB signaling, elevating oxidative stress and inflammatory response in human aortic endothelial cells. Besides, the mouse model exhibits that joint administration of metronidazole and melatonin serves as an effective strategy for treating atherosclerotic cardiovascular diseases. CONCLUSIONS: P gingivalis accelerates atherosclerosis via the NF-κB-BMAL1-NF-κB signaling loop. Melatonin and metronidazole are promising auxiliary medications toward atherosclerotic cardiovascular diseases.
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Factores de Transcripción ARNTL/metabolismo , Aterosclerosis/metabolismo , Infecciones por Bacteroidaceae/complicaciones , Estrés Oxidativo , Factores de Transcripción ARNTL/genética , Animales , Antibacterianos/uso terapéutico , Antioxidantes/uso terapéutico , Apolipoproteínas E/genética , Aterosclerosis/tratamiento farmacológico , Aterosclerosis/etiología , Aterosclerosis/microbiología , Proteínas CLOCK/metabolismo , Ritmo Circadiano , ADN (Citosina-5-)-Metiltransferasa 1/metabolismo , Regulación hacia Abajo , Endotelio Vascular/metabolismo , Femenino , Masculino , Melatonina/uso terapéutico , Metronidazol/uso terapéutico , Ratones , Ratones Endogámicos C57BL , FN-kappa B/metabolismo , Porphyromonas gingivalis/patogenicidad , Transducción de Señal , Receptores Toll-Like/metabolismoRESUMEN
Infertility affects about 10-15% couples over the world, among which a large number of cases the underlying causes are still unclear. Recent studies suggest that environmental factors may play an important role in these idiopathic infertilities. Arsenic is a heavy metal found in drinking water over the world. Its effect on the development of female reproductive system at the environmental-relevant levels is still largely unknown. To test the hypothesis that arsenic exposure during juvenile and puberty may affect sex maturation and female reproductive system development, SD rats of 3 weeks of age were exposed to arsenic with environmental-relevant levels (0, 0.02, 0.2, or 2 mg/L, n = 16/group) through drinking water for about 44 days until the rats reached adulthood (65 days of age). Arsenic exposure significantly reduced the weights of both ovary and uterus without affecting the body weight. Also, arsenic exposure disturbed estrus cycles and reduced the numbers of primordial follicles and corpora lutea while increased atretic follicles. In addition, arsenic reduced serum levels of estradiol, progesterone and testosterone but increased LH and FSH levels in dose-dependent manners. QPCR and Western blot experiments indicated arsenic selectively down-regulated ovarian steroidogenic-related proteins FSHR, STAR, CYP17A1, HSD3B1 and CYP19A1 and signaling molecules PKA-ERK-JNK-cJUN, without affecting AKT and CREB. As about reproductive capacity, arsenic-exposed dams had smaller pups, reduced litter size and lower number of male pups without a change in female pups. In conclusion, juvenile and pubertal arsenic exposures at environmental-relevant levels significantly reduced reproductive functions and capacity by adult. Since the lowest effective dose is very close to the government safety standards, the relevancy of arsenic over exposure to reproductive defects in human deserves further study.
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Arsénico , Agua Potable , Adulto , Animales , Arsénico/metabolismo , Femenino , Humanos , Masculino , Ovario , Ratas , Ratas Sprague-Dawley , Maduración SexualRESUMEN
The current study aimed to identify the main stressors inherent to caring for patients with coronavirus disease 2019 (COVID-19) and associated mental health outcomes among frontline health care workers. Data were collected via an online questionnaire from 651 frontline health care workers providing direct medical services for patients with suspected or confirmed COVID-19. Participants reported the stressors inherent to caring for patients with COVID-19, including depression, anxiety, and insomnia. Data were analyzed using descriptive statistics and multivariable logistic regression analysis. The most common stressors were "Worry about being negligent and endangering coworkers" (76.2%), "Worry about getting infected" (74.7%), and "Protective gear causing physical discomfort" (73.6%). "Conflict between duty and safety" and "Protective gear causing physical discomfort" were linked to high risk of depression, anxiety, and insomnia. Findings suggest that frontline health care workers may develop adverse mental health outcomes in the face of certain stressors, requiring targeted interventions. [Journal of Psychosocial Nursing and Mental Health Services, 60(1), 17-22.].
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COVID-19 , Ansiedad , China , Estudios Transversales , Depresión , Personal de Salud , Humanos , Salud Mental , Evaluación de Resultado en la Atención de Salud , SARS-CoV-2RESUMEN
BACKGROUND: Mindfulness-based interventions (MBIs) can alleviate psychological distress in patients with cancer. However, face-to-face MBIs may be inconvenient for patients. Therefore, guided self-help interventions may be more accessible. The authors investigated the effects of a guided self-help MBI for depression, anxiety, and sleep disorder symptoms in patients with breast cancer and explored the potential underlying mechanisms. METHODS: One hundred forty-four postoperative patients with breast cancer were randomly assigned to an intervention group (6-week guided self-help MBI; n = 72) or a wait-list control group (routine treatment; n = 72). Self-reported depression, anxiety, sleep disorder symptoms, and rumination and worry as potential mediators were assessed at baseline and postintervention. Outcomes were then assessed at 1-month and 3-month follow-up. The intervention's effects over time and the potential mediating effect were analyzed using generalized estimating equations. The trial was registered at the Chinese Clinical Registry (ChiCTR-IOR-16008073). RESULTS: Significant improvements in depression and sleep disorder symptoms occurred in the intervention group compared with wait-list controls, and the improvements were maintained at 1-month and 3-month follow-up. Changes in rumination and worry mediated the intervention's effects on changes in depression and sleep disorder symptoms. CONCLUSIONS: A guided self-help MBI reduced depressive and sleep disorder symptoms by mitigating rumination and worry in patients with breast cancer. These findings support benefits of this accessible psychological intervention in oncology and provide insight into possible mechanisms of action. The current research contributes to discovering effective and widely accessible means for people with physical health conditions and may remove barriers that otherwise would have precluded participation in face-to-face psychological interventions.
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Ansiedad/terapia , Neoplasias de la Mama/psicología , Depresión/terapia , Atención Plena/métodos , Autocuidado/métodos , Trastornos del Inicio y del Mantenimiento del Sueño/terapia , Adulto , Femenino , Humanos , Análisis de Intención de Tratar , Persona de Mediana Edad , Pacientes Desistentes del Tratamiento , Distrés Psicológico , Rumiación Cognitiva , Autoaprendizaje como Asunto , Factores Socioeconómicos , Resultado del Tratamiento , Listas de Espera , Adulto JovenRESUMEN
BACKGROUND: SARS-CoV-2, which has brought a huge negative impact on the world since the end of 2019, is reported to invade cells using the spike (S) protein to bind to angiotensin-converting enzyme II (ACE2) receptors on human cells while the transmembrane protease serine 2 (TMPRSS2) is the key protease that activates the S protein, which greatly facilitates the entry of SARS-CoV-2 into target cells. In our previous study, it was observed that the positive rate of SARS-CoV-2 nucleic acids in saliva was higher in male and the elderly COVID-19 patients, suggesting that the susceptibility of oral tissues to SARS-CoV-2 may be related to gender and age. This research aimed to further investigate the SARS-CoV-2 susceptibility in oral tissues and influencing factors from the perspective of ACE2 and TMPRSS2, which were two proteins closely associated with SARS-CoV-2 infection. METHODS: Immunofluorescence was used to find the localization of ACE2 and TMPRSS2 in oral mucosal tissues. Transcriptomic sequencing data of several datasets were then collected to analysis the relationship between the expressions of ACE2 and TMPRSS2 with the age and gender of patients. Furthermore, oral tissues from patients with different ages and genders were collected. Immunohistochemistry staining, qRT-PCR and western blot were performed to explore the relationship between expression levels of ACE2 and TMPRSS2 and patient age as well as gender. RESULTS: The results showed that the two proteins were able to be co-expressed in the epithelial cells of oral tissues, and their expression levels were higher in the relatively elderly group than those in relatively younger group. Male oral epithelial cells exhibited higher level of TMPRSS2. CONCLUSIONS: Our findings comprehensively confirmed the existence of ACE2 and TMPRSS2 in oral tissues and clarify the relationship between the expression levels with human age and gender for the first time, providing evidence for possible entry routes of SARS-CoV-2 and the influencing factors of SARS-CoV-2 colonization in oral cavity. Thus, the oral mucosa might be at potential risk of infection by SARS-CoV-2, especially in male or elderly patients. Using saliva to detect the nucleic acids of SARS-CoV-2 may be more accurate for elder male COVID-19 patients.
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COVID-19 , Peptidil-Dipeptidasa A , Anciano , Enzima Convertidora de Angiotensina 2 , Células Epiteliales , Femenino , Humanos , Masculino , Peptidil-Dipeptidasa A/genética , SARS-CoV-2 , Serina Endopeptidasas/genética , Factores Sexuales , Glicoproteína de la Espiga del Coronavirus , Internalización del VirusRESUMEN
BACKGROUND: Parenting styles play a critical role in children's development, especially for those in families with a depressed parent. To date, no study has explored whether youth perceptions of parenting style are heterogeneous in families with a depressed parent or whether heterogeneous parenting styles are associated with children's internalizing symptoms. METHODS: Participants were children aged 8-16 years who had a parent with major depressive disorder; they were enrolled through their parents, who were outpatients at two hospitals in Ningxia. Parenting styles were measured using the Parental Bonding Instrument. Youth depression and anxiety were measured using the Depression Self-Rating Scale for Children and the Screen for Child Anxiety-Related Emotional Disorders, respectively. We applied latent profile analysis to identify the subtypes of parenting styles with similar patterns. Differences between subtypes in relation to demographic variables and parenting style scores were calculated using one-way ANOVAs, Wilcoxon rank sum tests, and chi-squared tests. Bivariate logistic analyses were conducted to examine the associations between parental bonding subtypes and children's depression and anxiety. RESULTS: Four parenting styles were identified through latent profile analysis: care-autonomy, overprotection-indifference, indifference, and undifferentiated parenting. Youth with care-autonomy parents had a lower risk of depression (OR: 0.16; 95% CI: 0.06-0.41) and anxiety (OR: 0.22; 95% CI: 0.10-0.48), while indifference parenting increased children's risk of depression (OR: 5.29; 95% CI: 1.30-21.54) more than undifferentiated parenting. CONCLUSIONS: Children with a depressed parent had heterogeneous perceptions of parenting styles. Mothers' and fathers' parenting styles were largely congruent. Care-autonomy parenting (high care and high autonomy) may decrease children's risk of depression, whereas indifference parenting (low care and autonomy) may increase their risk of depression.
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Trastorno Depresivo Mayor , Responsabilidad Parental , Adolescente , Ansiedad , Estudios Transversales , Depresión , Femenino , Humanos , Relaciones Padres-Hijo , PadresRESUMEN
STUDY QUESTION: What is the effect of two guided self-administered interventions on psychological distress in women undergoing IVF or ICSI? SUMMARY ANSWER: A brief mindfulness intervention significantly reduced depression and improved sleep quality, while the gratitude journal intervention showed no significant effect on any outcome variables. WHAT IS KNOWN ALREADY: Mindfulness and gratitude journal interventions have been found to be beneficial in reducing negative affect and improving well-being. However, there are very few mental health professionals who implement such interventions in low- and middle-income countries. Therefore, two guided self-administered interventions for women with infertility were designed to help them cope with their psychological distress. STUDY DESIGN, SIZE, DURATION: A three-armed, randomized controlled trial was designed to evaluate the mindfulness and gratitude journal interventions for women undergoing IVF/ICSI. Between May 2016 and November 2017, at the reproductive center in a public hospital, 234 women were randomly assigned to the brief mindfulness group (BMG, n = 78), gratitude journal group (GJG, n = 78) or control group (CG, n = 78). The inclusion criteria were being a woman undergoing her first cycle of IVF, having at least junior middle school education and having no biological or adopted children. PARTICIPANTS/MATERIALS, SETTING, METHODS: Female infertility patients (n = 346) were approached, and 112 did not meet the inclusion criteria. All three randomized groups completed questionnaires on the day of down-regulation (T1), the day before embryo(s) transfer (T2), and 3 days before the pregnancy test (T3). The BMG completed four sessions and listened to a 20-minute audio daily, including guided mindfulness breathing and body scan. The GJG completed four sessions and wrote three gratitude journals daily. The CG received routine care. A generalized estimating equation was used in an intention-to-treat analysis. The primary outcome was depression. Secondary outcomes were anxiety, sleep quality, infertility-related stress, mindfulness and gratitude. MAIN RESULTS AND THE ROLE OF CHANCE: Participants of the BMG showed decreased depression (mean difference (MD) = -1.69, [-3.01, -0.37], d = 0.44) and improved sleep quality (MD = -1.24, [-1.95, -0.39], d = 0.43) compared to the CG, but the effect was not significant for anxiety, Fertility Problem Inventory totals, mindfulness, gratitude scores or pregnancy rates. The BMG showed a significant reduction in depression and improvement in sleep quality between T1 and T2, a continuous significant reduction between T1 and T3 and no reduction between T2 and T3. There were no significant effects on any of the variables for the GJG. LIMITATIONS, REASONS FOR CAUTION: The inclusion criteria may result in bias because some participants with low education were excluded and only women with infertility were included. A low compliance rate occurred in the gratitude journals group. Moreover, men were not included in this study. Further research should consider including spouses of the target population. WIDER IMPLICATIONS OF THE FINDINGS: The brief mindfulness intervention was beneficial in decreasing depression and improving sleep quality. Implementation of guided self-administered mindfulness could make the psychological counseling service more accessible for patients with infertility in resource-poor settings. The efficiency and feasibility of the gratitude journal intervention needs to be investigated further. STUDY FUNDING/COMPETING INTEREST(S): This study was funded by the National Social Science Foundation (17BSH054). The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER: ChiCTR-IOR-16008452. TRIAL REGISTRATION DATE: 9 May 2016. DATE OF FIRST PATIENT'S ENROLMENT: 15 May 2016.
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Ansiedad/terapia , Depresión/terapia , Infertilidad Femenina/psicología , Atención Plena , Distrés Psicológico , Adulto , Ansiedad/etiología , Depresión/etiología , Femenino , Humanos , Aceptación de la Atención de Salud , Embarazo , Índice de Embarazo , SueñoRESUMEN
Executive impairments have been observed both in patients with schizophrenia and in their unaffected first-degree relatives. Very few studies have investigated neurocognitive subgroups in unaffected first-degree relatives and in healthy participants using data-driven methods. The study included a high-risk group consisting of 100 unaffected young offspring and siblings of patients with schizophrenia and 198 healthy controls, all aged between 9 and 23 years. Executive function, victimization, and emotional and behavioral problems of participants were assessed by a series of self-report scales. Neurocognitive subgroups were investigated using latent class analysis of executive function measures. Four neurocognitive clusters were identified: a good performance cluster, a good self-control cluster, a low self-control cluster, and a severe impairment cluster. Participants in severe impaired executive function cluster reported a significantly higher level of victimization and had more prominent emotional and behavioral problems than the good performance cluster. Neurocognitive differences between high-risk young people and healthy controls were driven by individuals who have severe and global, rather than selective, executive deficits. Our results may provide clues to an explanation of the mechanisms behind executive impairments in young individuals at genetic risk and help to identify new targets for early interventions.
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Función Ejecutiva/fisiología , Esquizofrenia/genética , Psicología del Esquizofrénico , Hermanos , Adolescente , Estudios de Casos y Controles , Niño , Femenino , Predisposición Genética a la Enfermedad , Humanos , Análisis de Clases Latentes , Masculino , Pruebas Neuropsicológicas , Medición de Riesgo , Factores de Riesgo , Esquizofrenia/fisiopatología , Hermanos/psicología , Análisis y Desempeño de Tareas , Adulto JovenRESUMEN
AIMS: To clarify gender differences in the demographic variables and infertility problems associated with depression among men and women undergoing infertility treatment. DESIGN: A cross-sectional study. METHODS: We surveyed 380 women and 360 men undergoing infertility treatment at the reproductive medicine center of a hospital in China's Ningxia Province from March - September 2016. RESULTS: For women, ethnicity, the number of clinic visits, social concern, and sexual concern were factors linked with depression symptoms. For men, treatment cost pressure and social concern were significantly associated with depression symptoms. CONCLUSION: Psychological counseling and intervention programs should be integrated into in-vitro fertilization treatments and interventions should be targeted based on gender differences. IMPACT: The provision of treatment-related sexual knowledge by nurses is indispensable for infertile participants. Mental health policies should be developed to facilitate the implementation of psychological services. Psychological counseling and intervention programs should be integrated into in vitro fertilization treatment to help men and women with infertility cope with psychological distress.
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Depresión/epidemiología , Infertilidad Femenina/psicología , Infertilidad Masculina/psicología , Técnicas Reproductivas Asistidas/psicología , Adulto , China/epidemiología , Consejo , Estudios Transversales , Femenino , Fertilización In Vitro/psicología , Humanos , Infertilidad Femenina/epidemiología , Infertilidad Femenina/terapia , Infertilidad Masculina/epidemiología , Infertilidad Masculina/terapia , Masculino , Factores Sexuales , Factores Socioeconómicos , Estrés Psicológico , Encuestas y CuestionariosRESUMEN
AIMS: To investigate clinically relevant subtypes of perinatal depressive symptoms. DESIGN: Cross-sectional study. METHODS: A sample of 2,783 women at different prenatal and postnatal periods was recruited between August 2015 - August 2017. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms. Data analyses consisted of latent class analysis (LCA), analysis of variance and multinomial logistic regression. RESULTS: (a) Five latent subtypes (Classes 5/4/3/1/2) were identified: 'no symptoms', 'mild physio-somatic symptoms', 'severe physio-somatic symptoms and moderate anhedonia', 'moderate-to-severe symptoms' and 'severe symptoms'; (b) Postpartum women were more likely to belong to the severe depressive symptoms group, whereas pregnant women were likely to report severe physio-somatic symptoms; and (c) History of abortion and perinatal complications increased the likelihood of belonging to all moderate-to-severe classes. Lower levels of education increased the probability of belonging to Class 2. Younger women were more likely to be categorized into Classes 1 and 2. CONCLUSIONS: This is the first study to examine heterogeneity of perinatal depressive symptoms and delineate the characteristics of subtypes at different prenatal and postnatal periods via the PHQ-9, using LCA in a Chinese general population. IMPACT: This research details the heterogeneity of perinatal depressive symptoms and delineates the characteristics of subtypes at different prenatal and postnatal periods in a Chinese general population.
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Depresión Posparto/clasificación , Adolescente , Adulto , Estudios Transversales , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
PURPOSE: Catechol-O-methyltransferase (COMT) Val158Met functional polymorphisms play a crucial role in the development of executive function (EF), but their effect may be moderated by environmental factors such as childhood adversity. The present study aimed at testing the divergent impact of the COMT Val158Met genotype on EF in non-clinical adolescents with discrete patterns of childhood adversity. METHODS: A total of 341 participants completed the Childhood Trauma Questionnaire, the self-reported version of the Behavior Rating Inventory of Executive Function, and self-administered questionnaires on familial function. The participants' COMT Val158Met genotype was determined. Associations among the variables were explored using latent class analysis and general linear models. RESULTS: We found that Val/Val homozygotes showed significantly worse performance on behavioral shift, relative to Met allele carriers (F=5.921, p=0.015, Partial η2=0.018). Moreover, three typical patterns of childhood adversity, namely, low childhood adversity (23.5%), childhood neglect (59.8%), and high childhood adversity (16.7%), were found. Both childhood neglect and high childhood adversity had a negative impact on each aspect of EF and on global EF performance. Importantly, these results provided evidence for significant interaction effects, as adolescents with the Val/Val genotype showed inferior behavioral shift performance than Met carriers (F=6.647, p=0.010, Partial η2=0.020) in the presence of high childhood adversity. Furthermore, there were no differences between the genotypes for childhood neglect and low childhood adversity. CONCLUSIONS: Overall, this is the first study to show that an interaction between the COMT genotype and childhood adversity affects EF in non-clinical adolescents. These results suggest that the COMT genotype may operate as a susceptibility gene vulnerable to an adverse environment.
Asunto(s)
Conducta del Adolescente/fisiología , Experiencias Adversas de la Infancia , Catecol O-Metiltransferasa/genética , Función Ejecutiva/fisiología , Polimorfismo Genético/genética , Adolescente , Experiencias Adversas de la Infancia/tendencias , Alelos , Estudios Transversales , Femenino , Humanos , Masculino , Metionina/genética , Autoinforme , Encuestas y Cuestionarios , Valina/genéticaRESUMEN
BACKGROUND: Stressful situations can increase the likelihood of nurses experiencing negative emotions, especially burnout. AIMS: To explore the association of cumulative exposure to occupational stressors and emotion regulation strategies with nurses' burnout. METHODS: Participants were 602 nurses from three general hospitals in Jinan, China. Social demographic characteristics, occupational stress, burnout, and emotion regulation strategies (cognitive reappraisal, expressive suppression, and rumination), were assessed. RESULTS: Nearly 70% of nurses reported that they were burnt out. Those with a moderate level and high level of stressors were 3.203 times and 26.444 times more likely to have burnout, respectively (x2trend = 62.732). Logistic regression revealed that nurses had higher cognitive reappraisal score (odds ratios (OR) = 0.941), scored lower for burnout. Those who had higher expressive suppression score (OR = 1.054), higher rumination score (OR = 1.037), and a higher level of stressors (OR = 2.779-18.259) scored higher for burnout. The results of sensitivity analysis were similar. CONCLUSIONS: A non-linear relationship exists between the cumulative exposure to occupational stressors and nurses' burnout. Those who less frequently use cognitive reappraisal, more frequently use rumination and expressive suppression, and have a high level of stressors may be more likely to experience burnout.