Analysis of factors that influence the quality of sexual life of climacteric women in China

OBJECTIVE

The study aimed to identify the factors associated with the sexual lives of perimenopausal and postmenopausal women in China.

METHODS

A total of 426 participants were approached about this study from May 2012 to August 2013. In total, 252 cases were included in this study. One hundred and ninety-seven women who filled out the Quality of Sexual Life Questionnaire for Women (QSLQW) and the modified Kupperman Menopausal Index (KMI) had an active sexual life. Pearson's coefficient index was used to determine the correlation between the KMI and different domains of the QSLQW. Multivariable statistical analysis was performed to determine the correlation between different factors and the sexual life of perimenopausal and postmenopausal women.

RESULTS

When the participants reported a higher KMI, they suffered lower sexual satisfaction (r = -0.16, p = 0.035), more severe sexual anxiety (r = -0.367, p = 4.9 × 10^-7), and less sexual response (r = -0.21, p = 0.004). No correlation was found between the KMI and sexual communication, sexual attitude, and self-image. Multivariable statistical analysis showed that menopause status and higher KMI scores are associated with a decrease in sexual satisfaction among Chinese women (β = -9.76, 95% CI -16.89 to -2.64 and β = -0.41, 95% CI -0.68 to -0.15, respectively), and that the better the spousal relationship, the fewer deliveries and the higher the scores of sexual life quality (β = 8.86, 95% CI -0.91 to 18.63 and β = -6.65, 95% CI -11.83 to -1.48, respectively).

CONCLUSION

Factors including parity, spousal relationship, menopausal status, and menopausal symptoms are associated with the quality of sexual life of perimenopausal and postmenopausal women in China.

Clinical and echocardiographic predictors of embolism in infective endocarditis: systematic review and meta-analysis

OBJECTIVES

Prediction of embolic events (EEs) in infective endocarditis (IE) could inform clinical decisions, such as surgical timing. We conducted a systematic review to more precisely define associations between risk factors and EEs.

METHODS

We searched two bibliographic databases (1994-2018) for observational studies that reported EEs in IE patients and considered clinical, microbiological or echocardiographic risk factors. Studies that did not use Duke criteria or only investigated a subset of IE patients were excluded. Study quality was assessed using the Newcastle-Ottawa scale. A pooled risk ratio (RR) for each risk factor was estimated using random-effects models; statistical heterogeneity was estimated using I².

RESULTS

Of 3862 unique citations, 47 cohort studies (11 215 IE cases) were included; 54 risk factors were analysed in at least two studies, with nine studies reporting other individual factors. Most studies were of high methodological quality. Major predictors of EEs were intravenous drug use (RR 1.69, 95% CI 1.32-2.17; I² = 46%), Staphylococcus aureus infection (RR 1.64, 95% CI 1.45-1.86, I² = 32%), mitral valve vegetation (RR 1.24, 95% CI 1.11-1.37, I² = 30%), and vegetation size >10 mm (RR 1.87, 95% CI 1.57-2.21, I² = 48%). EE risk was also higher with human immunodeficiency virus, chronic liver disease, elevated C-reactive protein, Staphylococcus spp. infection, vegetation presence, and multiple, mobile or prosthetic mechanical valve vegetation, and lower with Streptococcus spp. infection. Most findings were unchanged in sensitivity analyses that removed studies with pulmonary EEs from the outcome.

CONCLUSIONS

Given the serious consequences of embolism, surgical evaluation may be considered in patients with these risk factors.

Evidence-based dentistry can effectively be taught to dental care professional students - A mixed methods study

BACKGROUND

Little research exists in the teaching of evidence-based dentistry (EBD) to students in the fields of dental hygiene, dental nursing and orthodontic therapy. This study aims to analyse the effect of a 1-day EBD programme on knowledge and confidence whilst also gaining insight into students' experience of the intervention.

METHOD

A mixed methods study was utilised with explanatory sequential design. The population consisted of dental hygiene (DH), dental nursing (DN) and orthodontic therapy (OT) students (N = 44). The intervention consisted of a 1-day active learning EBD programme, delivered via group projects and lectures. In the initial quantitative phase, a standardised questionnaire pre- and post -intervention measured changes in confidence for all participants, whilst change in knowledge was measured for DH and OT students only. Following this, focus groups were scheduled for all members of each discipline 3 months post-intervention for DN and 2 months post-intervention for DH and OT students. Semi-structured focus group schedules were drawn up, and groups organised according to the outcomes of quantitative data analysis. Qualitative results were analysed using a deductive adaptation of Burnard's thematic content analysis.

RESULTS

Forty-two students took part (94.45%) in this study. Median knowledge scores increased from zero to two of five (P < .001), whilst median confidence score doubled from four to eight of eight (P < .001). Results of thematic content analysis were coincident with quantitative results; however, it also provided constructive feedback regarding design and content of the course.

CONCLUSIONS

A 1-day bespoke programme in EBD increased students' confidence and knowledge in EBD skills. However, the findings further suggest that two successive half-day training sessions instead of one full-day training, tied in with coursework that requires the application of the acquired skills, may increase the learning experience further.

Identification and interaction analysis of key genes and microRNAs in atopic dermatitis by bioinformatics analysis

BACKGROUND

Atopic dermatitis (AD) is a skin disease that carries a major health burden, but the exact mechanism of the disease is not yet known.

AIM

To identify the key genes and micro (mi)RNAs in AD, and to explore their potential molecular mechanisms.

METHODS

From the Gene Expression Omnibus (GEO) database, we downloaded microarray data for GSE32924 (mRNA profile) and GSE31408 (miRNA profile), which were analysed using GEO2R. Functional and pathway enrichment analyses were performed using the DAVID database, and the protein-protein interaction network was constructed with Cytoscape software. In addition, targets of differentially expressed miRNAs (DEMs) were predicted by the online resource miRDB.

RESULTS

In total, 328 differentially expressed genes (DEGs) were identified, including 121 upregulated and 207 downregulated genes. Gene Ontology analyses showed that upregulated genes were significantly enriched in immune responses, while downregulated genes were mainly involved in epidermis development. In addition, we identified three DEMs, all of which were downregulated. Hsa-let-7a-5p may target CCR7, and hsa-miR-26a-5p probably targets HAS3.

CONCLUSIONS

We identified lists of DEGs and DEMs in AD. Bioinformatics and interaction analysis may provide new clues for further studies of AD.

Binder-free Sn–Si heterostructure films for high capacity Li-ion batteries

This study fabricated and demonstrated a functional, stable electrode structure for a high capacity Li-ion battery (LIB) anode. Effective performance is assessed in terms of reversible lithiation for a significant number of charge–discharge cycles to 80% of initial capacity. The materials selected for this study are silicon and tin and are co-deposited using an advanced manufacturing technique (plasma-enhanced chemical vapour deposition), shown to be a scalable process that can facilitate film growth on 3D substrates. Uniform and hybrid crystalline–amorphous Si nanowire (SiNW) growth is achieved via a vapour–liquid–solid mechanism using a Sn metal catalyst. SiNWs of less than 300 nm diameter are known to be less susceptible to fracture and when grown this way have direct electrical conductivity to the current collector, with sufficient room for expansion. Electrochemical characterisation shows stable cycling at capacities of 1400 mA h g⁻¹ (>4 × the capacity limit of graphite). This hybrid system demonstrates promising electrochemical performance, can be grown at large scale and has also been successfully grown on flexible carbon paper current collectors. These findings will have impact on the development of flexible batteries and wearable energy storage.

This study fabricated and demonstrated a functional, stable electrode structure for a high capacity Li-ion battery (LIB) anode.

Hemispheric asymmetry of the frontolimbic cortex in young adults with borderline personality disorder

OBJECTIVE

Although the frontolimbic cortex has been implicated in borderline personality disorder (BPD), information about possible asymmetries in this region in patients with BPD is limited. This study aimed to examine whether frontolimbic cortex asymmetries differ between patients with BPD and healthy individuals.

METHODS

The brains of 30 young adult patients with BPD and 32 healthy control subjects were scanned with magnetic resonance imaging (MRI). The participants completed self-report scales assessing impulsivity, affect intensity and other psychological variables. Gray matter volume, surface area, and cortical thickness in regions of interest (ROIs), namely anterior insula (AI) and anterior cingulate cortex (ACC) were determined and the data were probed for hemisphere-group interactions.

RESULTS

Relative to controls, patients with BPD had reduced cortical thickness in left ACC and less surface area and gray matter volume in left AI. Significant group-hemisphere interactions were observed for gray matter volume and surface area of AI and for cortical thickness of ACC. Post hoc analysis showed that the BPD patients had greater frontolimbic cortex asymmetry than healthy controls; furthermore, greater asymmetry of AI&ACC correlated with a higher score in attention subscale of Barratt Impulsiveness Scale.

CONCLUSION

Patients with BPD have greater frontolimbic asymmetry than healthy individuals.

Extracellular matrix protein 1 promotes cell metastasis and glucose metabolism by inducing integrin β4/FAK/SOX2/HIF-1α signaling pathway in gastric cancer

Extracellular matrix protein 1 (ECM1) is related to strong invasiveness and poor prognosis in major malignancies, but the underlying mechanism remains unknown. Here we aimed to elucidate the function of ECM1 on cell metastasis and glucose metabolism in gastric cancer (GC). The level of ECM1 in sera and tissues of patient with GC were positively correlated with tumor invasion and recurrence. Genetic manipulation of ECM1 expression affected cell metastasis and glucose metabolism in GC cell lines. Enhanced ECM1 expression facilitated gene expression levels associated with epithelial-mesenchymal transition (EMT) and glucose metabolism. Interestingly, our results indicated that ECM1 directly interacted with integrin β4 (ITGB4) and activated ITGB4/focal adhesion kinase (FAK)/glycogen synthase kinase 3β signaling pathway, which further induced the expression of transcription factor SOX2. Aberrant expression of SOX2 altered gene expression of EMT factors and glucose metabolism enzymes. Furthermore, SOX2 enhanced hypoxia-inducible factor α (HIF-1α) promoter activity to regulate glucose metabolism. The micro-positron emission tomography/computed tomography imaging of xenograft model showed that ECM1 substantially increased ¹⁸F-fluorodeoxyglucose uptake in xenograft tumors. Using in vivo mouse tail vein injection experiments, ECM1 was also found to increase in lung surface metastasis. These findings provide evidence that ECM1 regulates GC cell metastasis and glucose metabolism by inducing ITGB4/FAK/SOX2/HIF-1α signal pathway and have important implications for the development of therapeutic target to prevent tumor metastasis and recurrence.

Membranous staining of β-catenin and E-cadherin expression in patients with gastric cancer

BACKGROUND

β-catenin and E-cadherin are adhesion molecules that promote metastatic potential through epithelial-mesenchymal transition (EMT). Although they have not been extensively studied in gastric cancers, they represent potential testable prognostic markers.

METHODS

We explored the association between the immunohistochemical expression of these markers and clinicopathologic parameters by retrospectively reviewing 205 cases of gastric cancer from tissue microarrays (TMA). A method was developed to evaluate for membranous staining of β-catenin and E-cadherin using grading criteria that characterized both the intensity of staining and the percentage of cells with loss of staining.

RESULTS

Weak membranous expression of E-cadherin and β-catenin were associated with worse overall survival (p<0.05). Abnormal expression of E-cadherin and β-catenin were significantly associated with each other (p<0.01). Loss of and/or weak membranous staining for both E-cadherin and β-catenin was significantly associated with advanced cancer stage T2-T4 (versus stage T1, p<0.05) and tumors that are negative for H pylori infection (p<0.05). In addition, loss of and/or weak membranous staining for β-catenin was significantly associated with poorly differentiated tumors (p<0.05), diffuse Lauren-type gastric tissue (p=0.02), and tumors with a significantly higher rate of lymphovascular invasion (p=0.02).

CONCLUSION

Loss of/weak membranous expression of both E-cadherin and β-catenin was associated with poorer overall survival rates and clinicopathologic parameters that indicated an aggressive clinical behavior. β-catenin shows significant associations with more clinical parameters, making it a better biomarker than E-cadherin. In our multivariate analysis, weak intensity of staining of β-catenin was an independent prognostic factor for survival and may be a useful immunohistochemical prognostic marker for patients with gastric cancer.

Left ventricular outflow tract velocity time integral outperforms ejection fraction and Doppler-derived cardiac output for predicting outcomes in a select advanced heart failure cohort

BACKGROUND

Left ventricular outflow tract velocity time integral (LVOT VTI) is a measure of cardiac systolic function and cardiac output. Heart failure patients with low cardiac output are known to have poor cardiovascular outcomes. Thus, extremely low LVOT VTI may predict heart failure patients at highest risk for mortality.

METHODS

Patients with heart failure and extremely low LVOT VTI were identified from a single-center database. Baseline characteristics and heart failure related clinical outcomes (death, LVAD) were obtained at 12 months. Correlation between clinical endpoints and the following variables were analyzed: ejection fraction (EF), pulmonary artery systolic pressure (PASP), NYHA class, renal function, Doppler cardiac output (CO), and LVOT VTI.

RESULTS

Study cohort consisted of 100 patients. At the 12-month follow up period, 30 events (28 deaths, 2 LVADs) were identified. Occurrence of death and LVAD implantation was statistically associated with a lower LVOT VTI (p = 0.039) but not EF (p = 0.169) or CO (p = 0.217). In multivariate analysis, LVOT VTI (p = 0.003) remained statistically significant, other significant variables were age (p = 0.033) and PASP (p = 0.022). Survival analysis by LVOT VTI tertile demonstrated an unadjusted hazard ratio of 4.755 (CI 1.576-14.348, p = 0.006) for combined LVAD and mortality at one year.

CONCLUSIONS

Extremely low LVOT VTI strongly predicts adverse outcomes and identifies patients who may benefit most from advanced heart failure therapies.