Fertility education: recommendations for developing and implementing tools to improve fertility literacy†.

Many recent societal trends have led to the need for fertility education, including the age at which individuals become parents, the development of new reproductive technologies, and family diversity. Fertility awareness has emerged as a concept very recently and is increasingly gaining recognition. However, fertility education is often neglected as there is no consensus on the appropriate content, target populations, or on who should provide it. This article attempts to provide an overview of the use of interventions to improve fertility education. We emphasize the importance of delivering evidence-based information on fertility and reproductive health through various methods while providing guidelines for their standardization and systematization. Recommendations are provided to aid the development and implementation of fertility education tools, including: the establishment of a comprehensive understanding of the target populations; the incorporation of theories of behavioural change; the inclusion of the users' perspectives and the use of participatory research; and the use of specific guidelines for increasing engagement. By following these recommendations, it is expected that fertility education resources can contribute to improving fertility literacy, empowering individuals and couples to make informed reproductive decisions, and ultimately reducing the incidence of infertility and need for fertility treatment.

Metabolic and morphostructural plasticity of environmental and animal strains of Nannizzia gypsea.

Nannizzia gypsea is a geophylic agent of human and animal dermatophytosis. This study compares the metabolic and morphostructural plasticity of N. gypsea strains isolated from moss, sand, and a dog. The in vitro metabolic plasticity included the detection of extracellular enzymes, thermotolerance, resistance to oxidative stress, and assessment of fungal growth. Structural plasticity studies included cell surface hydrophobicity, electronegativity, and size of macroconidia. Virulence was assessed on Tenebrio mollitor model. The strains showed low thermotolerance, susceptibility to oxidative stress, and were producers of keratinase, lipase and catalase. N. gypsea strains were unable to produce hemolysin, esterase, and phospholipase although they were able to grow with different carbon sources. The electronegative properties of the surface did not vary between the strains under study. The knowledge about N. gypsea metabolic and morphostructural plasticity could be crucial for the development of therapeutic strategies and control of dermatophytosis.

Nannizzia gypsea causes dermatophytosis due to its metabolic and morphostructural plasticity. Investigations on the fungus-host interaction are essential for the development of therapeutic intervention strategies and control of this important zoonoses in the world Public Health scenario.

Obtaining 2,3-Dihydrobenzofuran and 3-Epilupeol from Ageratina pichinchensis (Kunth) R.King & Ho.Rob. Cell Cultures Grown in Shake Flasks under Photoperiod and Darkness, and Its Scale-Up to an Airlift Bioreactor for Enhanced Production.

Ageratina pichinchensis (Kunth) R.King & Ho.Rob. is a plant used in traditional Mexican medicine, and some biotechnological studies have shown that its calluses and cell suspension cultures can produce important anti-inflammatory compounds. In this study, we established a cell culture of A. pichinchensis in a 2 L airlift bioreactor and evaluated the production of the anti-inflammatory compounds 2,3-dihydrobenzofuran (1) and 3-epilupeol (2). The maximum biomass production (11.90 ± 2.48 g/L) was reached at 11 days of culture and cell viability was between 80% and 90%. Among kinetic parameters, the specific growth rate (µ) was 0.2216 days-1 and doubling time (td) was 3.13 days. Gas chromatography coupled with mass spectrometry (GC-MS) analysis of extracts showed the maximum production of compound 1 (903.02 ± 41.06 µg/g extract) and compound 2 (561.63 ± 10.63 µg/g extract) at 7 and 14 days, respectively. This study stands out for the significant production of 2,3-dihydrobenzofuran and 3-epilupeol and by the significant reduction in production time compared to callus and cell suspension cultures, previously reported. To date, these compounds have not been found in the wild plant, i.e., its production has only been reported in cell cultures of A. pichinchensis. Therefore, plant cell cultured in an airlift reactor can be an alternative for the improved production of these anti-inflammatory compounds.

Full polarization random drift compensation method for quantum communication.

Long-term quantum key distribution (QKD) using polarization encoding requires a random drift compensation method. We propose a method to compensate any state of polarization based on the quantum bit error rate (QBER) of two states from two non-orthogonal mutually unbiased bases. The proposed method does not require dedicated equipment, and through a simple but highly efficient feedback loop it compensates the polarization random drift suffered by photons while transmitted over the optical fiber quantum channel. A QBER lower than 2% was observed even considering imperfect single photon detectors. Besides, we verify a 82% secret key rate generation improvement in a finite-key size BB84 implementation for a 40 km fiber-optics quantum channel.

Anti-Sporothrix Antibody Detection in Domestic Cats as an Indicator of a Possible New Occurrence Area for Sporotrichosis in North Brazil.

Feline sporotrichosis has emerged as an important public health issue in some countries, especially Brazil. Currently, zoonotic transmission of Sporothrix brasiliensis by domestic cats is the major sporotrichosis spread form throughout this country. Sporotrichosis in Brazil is a good model for the One Health concept application, which connects the environment, human and animal health. Under this thinking, the aim of this study was to investigate the seroprevalence of sporotrichosis in cats from Rolim de Moura, Rondônia, Brazil, using antibody detection by an ELISA test previously validated for human diagnosis. For the standardization of this test, 30 serum samples from cats with proven sporotrichosis and 11 sera from healthy cats were used. The assay showed 87% sensitivity and 100% specificity for the diagnosis of feline sporotrichosis. After the standardization, 202 serum samples from distinct cats from Rolim de Moura were evaluated. The test was positive in 63 (31.19%) cats from the studied area. A multivariate analysis revealed that living far from forest or agricultural areas as well as pure breed animals had higher odds ratios (3.157 and 2.281, respectively) for the presence of detectable levels of anti-Sporothrix antibodies. These results show the applicability of this assay in the detection of anti-Sporothrix antibodies in feline serum samples and point to a putative new occurrence area of urban sporotrichosis dispersing to the North region of Brazil.

Minigene-Based Splice Assays Reveal the Effect of Non-Canonical Splice Site Variants in USH2A.

Non-canonical splice site variants are increasingly recognized as a relevant cause of the USH2A-associated diseases, non-syndromic autosomal recessive retinitis pigmentosa and Usher syndrome type 2. Many non-canonical splice site variants have been reported in public databases, but an effect on pre-mRNA splicing has only been functionally verified for a subset of these variants. In this study, we aimed to extend the knowledge regarding splicing events by assessing a selected set of USH2A non-canonical splice site variants and to study their potential pathogenicity. Eleven non-canonical splice site variants were selected based on four splice prediction tools. Ten different USH2A constructs were generated and minigene splice assays were performed in HEK293T cells. An effect on pre-mRNA splicing was observed for all 11 variants. Various events, such as exon skipping, dual exon skipping and partial exon skipping were observed and eight of the tested variants had a full effect on splicing as no conventionally spliced mRNA was detected. We demonstrated that non-canonical splice site variants in USH2A are an important contributor to the genetic etiology of the associated disorders. This type of variant generally should not be neglected in genetic screening, both in USH2A-associated disease as well as other hereditary disorders. In addition, cases with these specific variants may now receive a conclusive genetic diagnosis.

Medicines for Malaria Venture COVID Box: a source for repurposing drugs with antifungal activity against human pathogenic fungi.

BACKGROUND: Treatment of mycoses is often ineffective, usually prolonged, and has some side effects. These facts highlight the importance of discovering new molecules to treat fungal infections. OBJECTIVES: To search the Medicines for Malaria Venture COVID Box for drugs with antifungal activity. METHODS: Fourteen human pathogenic fungi were tested against the 160 drugs of this collection at 1.0 µM concentration. We evaluated the ability of the drugs to impair fungal growth, their fungicidal nature, and morphological changes caused to cells. FINDINGS: Thirty-four molecules (21.25%) presented antifungal activity. Seven are antifungal drugs and one is the agricultural fungicide cycloheximide. The other drugs with antifungal activity included antibiotics (n = 3), antimalarials (n = 4), antivirals (n = 2), antiparasitcs (n = 3), antitumor agents (n = 5), nervous system agents (n = 3), immunosuppressants (n = 3), antivomiting (n = 1), antiasthmatic (n = 1), and a genetic disorder agent (n = 1). Several of these drugs inhibited Histoplasma capsulatum and Paracoccidioides brasiliensis growth (15 and 20, respectively), while Fusarium solani was not affected by the drugs tested. Most drugs were fungistatic, but niclosamide presented fungicidal activity against the three dimorphic fungi tested. Cyclosporine affected morphology of Cryptococcus neoformans. MAIN CONCLUSIONS: These drugs represent new alternatives to the development of more accessible and effective therapies to treat human fungal infections.

Exploring Innovative Leishmaniasis Treatment: Drug Targets from Pre-Clinical to Clinical Findings.

Leishmaniasis is a group of tropical diseases caused by parasitic protozoa belonging to the genus Leishmania. The disease is categorized in cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (MCL), and visceral leishmaniasis (VL). The conventional treatment is complex and can present high toxicity and therapeutic failures. Thus, there is a continuing need to develop new treatments. In this review, we focus on the novel molecules described in the literature with potential leishmanicidal activity, categorizing them in pre-clinical (in vitro, in vivo), drug repurposing and clinical research.

On the Impact of the Data Acquisition Protocol on ECG Biometric Identification.

Electrocardiographic (ECG) signals have been used for clinical purposes for a long time. Notwithstanding, they may also be used as the input for a biometric identification system. Several studies, as well as some prototypes, are already based on this principle. One of the methods already used for biometric identification relies on a measure of similarity based on the Kolmogorov Complexity, called the Normalized Relative Compression (NRC)-this approach evaluates the similarity between two ECG segments without the need to delineate the signal wave. This methodology is the basis of the present work. We have collected a dataset of ECG signals from twenty participants on two different sessions, making use of three different kits simultaneously-one of them using dry electrodes, placed on their fingers; the other two using wet sensors placed on their wrists and chests. The aim of this work was to study the influence of the ECG protocol collection, regarding the biometric identification system's performance. Several variables in the data acquisition are not controllable, so some of them will be inspected to understand their influence in the system. Movement, data collection point, time interval between train and test datasets and ECG segment duration are examples of variables that may affect the system, and they are studied in this paper. Through this study, it was concluded that this biometric identification system needs at least 10 s of data to guarantee that the system learns the essential information. It was also observed that "off-the-person" data acquisition led to a better performance over time, when compared to "on-the-person" places.

Intuitive eating is associated with glycemic control in type 2 diabetes.

PURPOSE: The intuitive eating approach has shown promise, but studies on its association with diabetics are scarce. The aim of this study is to identify the association between intuitive eating and glycemic control in individuals with type 2 diabetes mellitus. METHODS: This is an observational cross-sectional analytical study in patients at the endocrinology service of a university hospital in Vitória/ES, Brazil. For data collection, a semi-structured questionnaire was used and intuitive eating was assessed by Intuitive Eating Scale-2. RESULTS: A total of 179 individuals, mostly female and elderly, and predominantly taking oral antidiabetic drugs without association with insulin were evaluated. In adjusting for the total scale score, the most intuitive eating was associated with lower chances of patients presenting inadequate glycemic control by 89% (OR = 0.114; CI 0.024-0.540; p = 0.006), and a higher score on the Body-Food-Choice Congruence subscale was associated with lower chances of participants presenting this inadequacy by almost 66% (OR = 0.341; CI 0.131-0.891; p = 0.028), regardless of their body mass index. CONCLUSION: Eating intuitively, especially in accordance with body needs may be associated with lower chances of type 2 diabetics having inadequate glycemic control. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Reversal operator to compensate polarization random drifts in quantum communications.

A quantum bit error rate (QBER) based algorithm for polarization random drift compensation is proposed. For a transmission window of 8 ms, for instance in aerial fiber installations, the algorithm overhead is below 1%. In an extreme turbulent situation, where the transmission window is as shorter as 0.8 ms, the overhead is still below 10%. Besides being able to operate smoothly, even in a very extreme situation, the algorithm overhead is also insensitive to the length of the communication system. It is upper layer protocol agnostic, and it is based on the mapping of the QBER on the Poincaré sphere. The algorithm finds the polarization reversal operator, which results in much lower overhead contrary to the blind methods currently used. The algorithm reverts the polarization random drift performing two QBER estimations and applying three rotations, at most. The uncertainty on the two QBER estimations defines an area over the sphere surface that is related with upper-layer protocols QBER threshold.

Insights from qualitative research on NAFLD awareness with a cohort of T2DM patients: time to go public with insulin resistance?

BACKGROUND: It is estimated that around 70% of Type 2 Diabetes Mellitus patients (T2DM) have Non-Alcoholic Fatty Liver Disease (NAFLD). Awareness and education are amongst the major shortcomings of the public health response to the increasing threat of NAFLD. Characterizing the specific NAFLD-related information needs of particular high-risk metabolic communities, for instance, T2DM patients, might aid in the development of evidence-based health promotion strategies, ultimately promoting NAFLD-awareness, treatment adherence and therapeutic success rates. METHODS: Semi-structured interviews with T2DM patients were conducted to gain insight into their awareness of NAFLD, including its relationship with insulin resistance and T2DM. RESULTS: Awareness of NAFLD as a disease entity, as well as its progression to end-stage liver disease or its relationship with other metabolic conditions, including insulin resistance and T2DM was low. Surveillance behaviours were also suboptimal and perceptions on the self-management knowledge and praxis regarding lifestyle intervention components of T2DM treatment seemed detached from those of NAFLD. CONCLUSIONS: Our findings could inform the integration of NAFLD-related content in T2DM health promotion strategies. Rising awareness on NAFLD progression and its relationship with T2DM using culturally and community-relevant constructs might facilitate the development of primary and secondary prevention programmes to promote the adherence to lifestyle interventions by influencing NAFLD threat perceptions.

Comparative Analysis of Putative Virulence-Associated Factors of Microsporum canis Isolates from Human and Animal Patients.

Microsporum canis is a zoophilic dermatophyte and the most common fungus isolated from dogs and cats worldwide. To invade skin, this pathogen uses different enzymes, which may be associated with virulence, that contribute to the fungal pathogenicity. The aim of this study is to compare the expression of enzymes that may be associated with virulence, and thermotolerance of M. canis strains isolated from dogs, cats, and humans. The in vitro expression of the enzymes keratinase, catalase, urease, hemolysin, and aspartic protease was evaluated in 52 M. canis strains recently isolated from 14 human patients, 12 dogs, 15 symptomatic, and 11 asymptomatic cats. In addition, thermotolerance was assessed by comparative analysis of fungal growth at 25 °C and 35 °C. Keratinase activity was low in 34 and moderate in 18 strains. Aspartic-protease activity was low in 7, moderate in 33, and high in 12 strains. Hemolysin activity was low in 44 and moderate in 8 strains. All strains were classified as low producers of catalase. All but three strains produced urease in vitro, with a broad range of activity. The strains presented in vitro growth at the two studied temperatures were classified as presenting low (36.5%), medium (44.3%), or high (19.2%) thermotolerance. There was no statistically significant difference in the new putative virulence-associated factors studied among the different hosts, which suggests that they may have a similar role on human, cat, and dog infection. Also, no difference was observed between strains isolated from symptomatic and asymptomatic cats. This suggests that these factors have a limited impact on the fate of feline dermatophytosis caused by M. canis.

Infertility-related stress and depressive symptoms - the role of experiential avoidance: a cross-sectional study.

Objective: The current study aimed to explore the mediating role of experiential avoidance in the relationship between infertility-related stress (impact of infertility in women's life and representations about the importance of parenthood) and depressive symptoms.Background: Infertility is a stress inducing condition presenting many challenges to individuals facing this diagnosis, particularly to the ones who decide to pursue medical treatment. One of its consequences may be the experience of depressive symptoms which have also been associated with increased infertility-related stress. Moreover, experiential avoidance, conceptualised as an emotion regulation process, has also been connected to psychopathological symptoms, particularly depressive symptoms.Methods: The sample consisted of 124 women presenting an infertility diagnosis who were pursuing medical treatment for fertility problems. Participants were recruited through the national patients' association website and completed the following self-report instruments: a sociodemographic and clinical questionnaire, the Acceptance and Action Questionnaire-II (AAQ-II), the Fertility Problem Inventory (FPI) and the Depression, Anxiety and Stress Scales 21 (DASS-21).Results: Results showed that representations about the importance of parenthood were associated with depressive symptoms indirectly, throughout the association with the impact of infertility in women's life and use of experiential avoidance.Conclusions: Experiential avoidance can be considered a relevant emotion regulation process to be targeted in psychological intervention programs for women facing infertility.

A cluster of the first reported Plasmodium ovale spp. infections in Peru occuring among returning UN peace-keepers, a review of epidemiology, prevention and diagnostic challenges in nonendemic regions.

BACKGROUND: Plasmodium ovale curtisi and Plasmodium ovale wallikeri are regarded as less virulent forms of malaria with a geographic distribution including Southeast Asia, Central and West Africa, and is increasingly reported as an infection in returning travellers. A species of malaria that may have delayed or relapsing presentations similar to Plasmodium vivax, the clinical presentation of P. ovale spp. has been described to have prepatent periods of 2 weeks or slightly longer with reports of relapse following primary infection out to 8-9 months. This presentation may be obscured further in the setting of anti-malarial exposure, with report of delayed primary infection out to 4 years. Presented is a cluster of 4 imported P. ovale spp. cases in returning Peruvian military personnel assigned to United Nations peace-keeping operations in the Central African Republic. CASE PRESENTATION: From January to December 2016, Peruvian peace-keepers were deployed in support of United Nations (UN) operations in the Central African Republic (CAR). While serving abroad, Navy, Army, and Air Force members experienced 223 episodes of Plasmodium falciparum malaria following interruption of prophylaxis with mefloquine. Diagnosis was made using rapid diagnostics tests (RDTs) and/or smear with no coinfections identified. Cases of malaria were treated with locally-procured artemether-lumefantrine. Returning to Peru in January 2017, 200 peace-keepers were screened via thick and thin smear while on weekly mefloquine prophylaxis with only 1 showing nucleic acid within red blood cells consistent with Plasmodium spp. and 11 reporting syndromes of ill-defined somatic complaints. Between a period of 5 days to 11 months post return, 4 cases of P. ovale spp. were diagnosed using smear and polymerase chain reaction (PCR) following febrile complaints. All cases were subsequently treated with chloroquine and primaquine, with cure of clinical disease and documented clearance of parasitaemia. CONCLUSION: These patients represent the first imported cases in Peru of this species of malaria as well as highlight the challenges in implementing population level prophylaxis in a deployed environment, and the steps for timely diagnosis and management in a non-endemic region where risk of introduction for local transmission exists.

The time is now: An exploratory study regarding the predictors of female cancer patients' decision to undergo fertility preservation.

INTRODUCTION: This cross-sectional exploratory study aimed to examine the female cancer patients' personal and health care-related variables mostly associated with their decision whether to preserve or not their fertility, in order to know more about the influence of attitudinal and health care-related variables on this decision where fertility preservation (FP) is fully covered by the National Health System. METHODS: Childbearing attitudes, health care-related information, FP motivations and childbearing motivations were assessed, in a clinical setting, to female cancer patients in childbearing age, who were undergoing the FP decision-making process. RESULTS: This study included 89 participants (82% response rate). Those who decided to undergo FP attributed more value to the reasons for FP and less value to the reasons against FP than those who decided not to undergo FP. Not having children, strongly valuing pregnancy after cancer and attributing low value to the implications of the postponement of cancer treatments were significant and independently associated with deciding to preserve fertility. CONCLUSION: The decision to pursue FP is mainly influenced by three factors: the absence of children, attributing high value to trying to ensure future pregnancy and attributing low value to the possible postponement of cancer therapy in order to have time to preserve fertility.

The Role of Dyadic Coping on the Marital and Emotional Adjustment of Couples With Infertility.

Infertility is a challenging experience, affecting individual and couples' adjustment. However, the way the members of the couple support each other may affect the experience of infertility and their adjustment. This study aimed to investigate the role of dyadic coping by oneself and by the partner in the association between the impact of infertility and dyadic and emotional adjustment (anxiety and depression) to infertility. In this cross-sectional study, a total of 134 participants (67 couples with infertility) completed self-report questionnaires assessing infertility-related stress, dyadic coping, dyadic adjustment, and depression and anxiety symptoms. A path analysis examined the direct and indirect effects between the impact of infertility in one's life and dyadic and emotional adjustment. There is an indirect effect of the impact of infertility in one's life on dyadic adjustment through men's perceived dyadic coping efforts employed by the self (dyadic coping by oneself) and women's perceived dyadic coping efforts of the partner (dyadic coping by the partner). Regarding the emotional adjustment of infertile couples, infertility stress impact had an indirect effect only on depressive symptoms through men's dyadic coping by oneself. The results highlight the importance of men's dyadic coping strategies for the marital adjustment of couples as well as for men's emotional adjustment. Findings emphasize the importance of involving men in the fertility treatment process, reinforcing the dyadic nature of infertility processes.

La infertilidad es una experiencia difícil que afecta la adaptación de los individuos y de las parejas. Sin embargo, la manera en la que los miembros de la pareja se apoyan entre sí puede afectar la experiencia de infertilidad y su adaptación. Este estudio tuvo como finalidad investigar el papel que desempeña el afrontamiento diádico por parte de uno mismo y de la pareja en la asociación entre el efecto de la infertilidad y la adaptación diádica y emocional (ansiedad y depresión) a la infertilidad. En este estudio transversal, un total de 134 participantes (67 parejas con infertilidad) contestaron cuestionarios de autoinforme que evaluaron el estrés relacionado con la infertilidad, el afrontamiento diádico, la adaptación diádica y los síntomas de depresión y ansiedad. Un análisis de ruta analizó los efectos directos e indirectos entre la influencia de la infertilidad en la vida de uno y su adaptación diádica y emocional. Hay un efecto indirecto de la influencia de la infertilidad en la vida de uno sobre la adaptación diádica a través de los esfuerzos de afrontamiento diádico percibidos por los hombres empleados por el yo (afrontamineto diádico por uno mismo) y los esfuerzos de afrontamiento diádico percibidos por las mujeres empleados por la pareja (afrontamiento diádico por la pareja). Con respecto a la adaptación emocional de las parejas infértiles, la influencia del estrés por la infertilidad tuvo un efecto indirecto solo en los síntomas depresivos a través del afrontamiento diádico de los hombres por uno mismo. Los resultados destacan la importancia de las estrategias de enfrentamiento diádico de los hombres para la adaptación conyugal de las parejas así como para la adaptación emocional de los hombres. Además, los resultados enfatizan la importancia de hacer participar a los hombres en el proceso de tratamiento de la fertilidad, lo cual refuerza la índole diádica de los procesos de infertilidad.

Female cancer patients' perceptions of the fertility preservation decision-making process: An exploratory prospective study.

PURPOSE: To assess female cancer patients' perceptions of the fertility preservation decision-making process and to examine the effect of clinicians' support on the decision quality. METHODS: A total of 71 patients participated in this longitudinal study with two assessment time points (before cancer therapy, after cancer therapy). Self-report measures assessed the decision-making process, the decision quality and the clinicians' support. RESULTS: A less positive experience in the decision-making process was associated with higher decisional regret and lower decisional satisfaction. In the group that decided not to pursue FP, participants who perceived higher oncologist's support reported higher decisional satisfaction. CONCLUSIONS: A higher quality decision is positively associated with a better experience in the decision-making process. The oncologist's support is crucial for the decisional satisfaction of patients who decide not to pursue FP. Implications for psychosocial providers: Psychologists may be important in helping patients to adequately cope with the FP decision so that they can make a high-quality decision.

Attachment and Mental Help-Seeking in the Perinatal Period: The Role of Stigma.

This study aimed at (1) examining how women's attachment representations influence their intentions to seek formal help for their emotional problems, either directly or by affecting attitudes towards professional help-seeking (stigma and psychological openness), and (2) examining whether these effects are moderated by the presence of clinically significant psychopathological symptoms. A cross-sectional online survey including 226 women during the perinatal period was conducted. Results showed that, when clinically significant psychopathological symptoms were present, women's more insecure attachment representations were associated with lower intentions to seek professional help, and this influence occurred throughout a decrease in women's indifference to stigma associated with mental healthcare. These results support both the intra and interpersonal nature of the help-seeking process, and highlight the importance of implementing stigma reduction strategies (e.g., awareness campaigns, health professional's non-judgmental questioning of emotional difficulties), particularly in women with clinically significant psychopathological symptoms.