Social Support and Mental Health in the Postpartum Period in Times of SARS-CoV-2 Pandemic: Spanish Multicentre Cohort Study

BACKGROUND

To explore the depression and anxiety symptoms in the postpartum period during the SARS-CoV-2 pandemic and to identify potential risk factors.

METHODS

A multicentre observational cohort study including 536 women was performed at three hospitals in Spain. The Edinburgh Postnatal Depression Scale (EPDS), the State-Trait Anxiety Inventory (STAI) Scale, the Medical Outcomes Study Social Support Survey (MOS-SSS), and the Postpartum Bonding Questionnaire (PBQ) were assessed after birth. Depression (EPDS) and anxiety (STAI) symptoms were measured, and the cut-off scores were set at 10 and 13 for EPDS, and at 40 for STAI.

RESULTS

Regarding EPDS, 32.3% (95% CI, 28% to 36.5%) of women had a score ≥ 10, and 17.3% (95% CI, 13.9% to 20.7%) had a score ≥ 13. Women with an STAI score ≥ 40 accounted for 46.8% (95% CI, 42.3% to 51.2%). A lower level of social support (MOS-SSS), a fetal malformation diagnosis and a history of depression (p = 0.000, p = 0.019 and p = 0.043) were independent risk factors for postpartum depression. A lower level of social support and a history of mental health disorders (p = 0.000, p = 0.003) were independent risk factors for postpartum anxiety.

CONCLUSION

During the SARS-CoV-2 pandemic, an increase in symptoms of anxiety and depression were observed during the postpartum period.

How to Choose between the Implant Materials Steel and Titanium in Orthopedic Trauma Surgery: Part 1 - Mechanical Aspects

When choosing between metal implants of different materials the surgeon mainly needs to balance the pros and cons of steel and titanium. Economic constraints often do not permit both to be kept in stock and it is necessary to decide beforehand which to choose. The arguments for the use of the "preferred metal" vary. The present paper elucidates the practical aspects based on the complex scientific background that has identified the differences between the two metals in their mechanical, electrochemical, biological and application behavior. The data presented here are intended to help the surgeon when he is confronted with different and often complex clinical situations and problems. The following is an overview of different aspects to help with selection of the proper material for the clinical application. The first part concerns mechanical aspects the second part the biological aspects. Both aspects are discussed with the practical application in mind. Nonmetallic implant materials have seen an increasing interest in the recent past. Plastic materials needed improvement to achieve good strength and avoid creep with loss of e.g. compression and minimizing leakage of chemicals.

How to Choose between the Implant Materials Steel and Titanium in Orthopedic Trauma Surgery: Part 2 - Biological Aspects

BIOLOGICAL ASPECTS OF STEEL AND TITANIUM AS IMPLANT MATERIAL IN ORTHOPEDIC TRAUMA SURGERY The following case from the ICUC database, where a titanium plate was implanted into a flourishing infection, represents the clinical experience leading to preferring titanium over steel. (Fig. 1) (6). Current opinions regarding biological aspects of implant function. The "street" opinions regarding the biological aspects of the use of steel versus titanium as a surgical trauma implant material differ widely. Statements of opinion leaders range from "I do not see any difference in the biological behavior between steel and titanium in clinical application" to "I successfully use titanium implants in infected areas in a situation where steel would act as foreign body "sustaining" infection." Furthermore, some comments imply that clinical proof for the superiority of titanium in human application is lacking. The following tries to clarify the issues addressing the different aspects more through a practical clinical approach than a purely scientific one, this includes simplifications. Today's overall biocompatibility of implant materials is acceptable but: As the vast majority of secondary surgeries are elective procedures this allows the selection of implant materials with optimal infection resistance. The different biological reactions of stainless steel and titanium are important for this segment of clinical pathologies. Biological tole - rance (18) depends on the toxicity and on the amount of soluble implant material released. Release, diffusion and washout through blood circulation determine the local concentration of the corrosion products. Alloying components of steel, especially nickel and chromium, are less than optimal in respect to tissue tolerance and allergenicity. Titanium as a pure metal provides excellent biological tolerance (3, 4, 16). Better strength was obtained by titanium alloys like TiAl6V4. The latter found limited application as surgical implants. It contains Vanadium (9). Today's high strength titanium alloys contain well tolerated alloying components1 like Zr, Nb, Mo and Ta (ISO 5832-14) (7, 15). The corrosion rate of surgical implants is kept low by the passive layer formed when immerged in body fluids (13, 14). The passive layer may be locally destroyed, for instance, by mechanical fretting or by local corrosion conditions like in pitting; it is renewed by an electrochemical corrosion process which releases alloying components like Ni and Cr (Fig. 2) (10). The amount of soluble component may vary markedly depending on the local electrochemical conditions (see below).

A cancer-causing gene is positively correlated with male aggression in Xiphophorus cortezi

The persistence of seemingly maladaptive genes in organisms challenges evolutionary biological thought. In Xiphophorus fishes, certain melanin patterns form malignant melanomas because of a cancer-causing gene (Xiphophorus melanoma receptor kinase; Xmrk), which arose several millions years ago from unequal meiotic recombination. Xiphophorus melanomas are male biased and induced by androgens however male behaviour and Xmrk genotype has not been investigated. This study found that male X. cortezi with the spotted caudal (Sc) pattern, from which melanomas originate, displayed increased aggression in mirror image trials. Furthermore, Xmrk males (regardless of Sc phenotype) bit and performed more agonistic displays than Xmrk deficient males. Male aggressive response decreased when males viewed their Sc image as compared with their non-Sc image. Collectively, these results indicate that Xmrk males experience a competitive advantage over wild-type males and that intrasexual selection could be an important component in the evolutionary maintenance of this oncogene within Xiphophorus.

Health habits and risk factors among truck drivers visiting a health booth during a trucker trade show

PURPOSE

The purpose of this report is to provide general information on the personal characteristics, health status, and health interests reported by long-haul truck drivers.

DESIGN

A cross-sectional survey was conducted based on a convenience sample. Statistical independence between comparison groups for driver type, age, and gender were tested with the Pearson chi-square test.

SETTING

The study population consisted of truck drivers who stopped at one of 65 truck stops participating in a trucker trade show.

SUBJECTS

Subjects were 2,945 male self-identified truck drivers and 353 female self-identified truck drivers who visited health booths at the trade show. It was estimated that two thirds of visitors to the health booth participated.

MEASURES

A self-administered, close-ended questionnaire recorded the participant's personal characteristics, health status, and health interests. Blood pressure was measured by trained volunteers.

RESULTS

A large percentage of male truck drivers smoked cigarettes (54% vs. 30% of U.S. white males), did not exercise regularly (92%), were overweight (50% vs. 25% of U.S. white males), and/or were not aware they had high blood pressure (66% vs. 46% of U.S. population). Also, 23% of surveyed truck drivers tested positive on one measure of alcoholism.

CONCLUSIONS

Although a scientific sample frame was not used, the health status and lifestyle observed in this study suggest truck drivers would clearly benefit from a health education and promotion program. The truck stops should be evaluated as a possible setting for such a program.

Interrelations of the various mathematical approaches to radioimmunoassay

Equations used for calculation of radioimmunoassay data are derived and compared. We show that the equation developed by Fernandez and Loeb is the most general of these. Those of Ekins et al., Hales and Randle, and Rodbard et al. are all derived here from this basic equation by neglecting certain of its terms. The logit-log plot of Rodbard et al. is a logarithmic transformation of the linear Hales-Randle equation. The basic equation, derived here solely from the mass-action law, approaches linearity under certain conditions without complex mathematical transformations of analyte concentrations or observable parameters. Applications are also presented.

Interrelations of the various mathematical approaches to radioimmunoassay

Equations used for calculation of radioimmunoassay data are derived and compared. We show that the equation developed by Fernandez and Loeb is the most general of these. Those of Ekins et al., Hales and Randle, and Rodbard et al. are all derived here from this basic equation by neglecting certain of its terms. The logit-log plot of Rodbard et al. is a logarithmic transformation of the linear Hales-Randle equation. The basic equation, derived here solely from the mass-action law, approaches linearity under certain conditions without complex mathematical transformations of analyte concentrations or observable parameters. Applications are also presented.

Practical applications of radioimmunoassay theory. A simple procedure yielding linear calibration curves

The fundamental equation describing radioimmunoassays under equilibrium conditions has been recast into a "working equation" in a form more directly applicable to the requirements of the analytical laboratory. Plotting total counts over counts bound vs. ligand concentration, which is conveniently linear over most of its course, is shown readily to yield quantitative data relative to binding site concentration and the equilibrium constant and to provide a means for deriving apparent labeled ligand concentration. Such data are helpful in establishing optimum assay conditions and can serve a continuing quality-control function. The working equation also characterizes the binder and tracer reagents used in the assay. The determination of working-equation parameters has been illustrated for the vitamin B-12 assay. Data are presented for seven different assay procedures, involving more than 600 calibration curves and 100 different lots of binding agent and tracer reagent, showing a consistently high correlation coefficient (r greater than 0.990), between ligand concentration and the response variable.