Assessing infertility-related stress: the factor structure of the Fertility Problem Inventory in Italian couples undergoing infertility treatment

Abstract

The factor structure of the Fertility Problem Inventory (FPI) and its invariance across gender were examined in Italian couples undergoing infertility treatment. About 1000 subjects (both partners of 500 couples) completed two questionnaires prior to commencing infertility treatment at a private Clinic in Palermo, Italy. Confirmatory Factor Analysis demonstrated that the original factor structure of the FPI was partially confirmed. Two correlated factors (Infertility Life Domains and Importance of Parenthood) were obtained via a post hoc Exploratory Factor Analysis. Finally, the invariance of this factor structure across gender was confirmed. The study supported the relevance of two interrelated factors specific to infertility stress which could help clinicians to focus on the core infertility-related stress domains of infertile couples.     

刘嘉湘治疗癌性发热经验

刘嘉湘认为本病病机往往由于患者阴阳气血虚损,或气血痰湿郁滞,癌毒内蓄,蕴积化热而成。临床上要根据患者脉证辨析其病因病机以治病求本。临床以中晚期患者并发此证较多,此时患者多以正气亏虚为主要矛盾,尤以阴虚或者气阴两虚者多见。总体上从内伤发热辨治较为适合,临床应详辨病机,辨证论治,多从阴虚发热、气虚发热、气郁发热、湿郁发热、热毒炽盛5型论治,同时要明辨标本,退热抗癌。     

正确理解“精准医学”在临床实践中的意义

2015年初在美国正式提出一个在研究基因序列的基础上,探索疾病的根源,预防和治疗的规划并被定名为Precision medicine,译称"精确医学"或"精准医学"。该定义在临床医生中引起了不同的意见和疑虑,因为这涉及到临床医学研究和实践中的导向问题。精准医学应该是对医学服务的一种要求,要求医学服务从行为和方法上达到精准,以基因序列和表达调控为基础的分子医学是狭义的精准医学,与临床医学所要求的精准相互关联又有所不同。临床工作者直接面对大多数病人,须要运用符合现代医学认可的各种各样的方法(包括基因系列的成果)解决病人的问题,而不管这种方法是否基于基因分析的结果。这种以循证医学为基础的临床医学属广义的精准医学。     

Traditional vs wireless intragastric pH monitoring: are the two techniques comparable?

Background Few data are available comparing intragastric pH measured with the traditional catheter‐based and the more recent wireless system (Bravo), and also comparing intraesophageal and intragastric pH during reflux events. Aims of our study were to elucidate these points. Methods Eleven subjects with functional dyspepsia underwent placement of a Bravo capsule 9 cm below the squamo‐columnar junction (SCJ) and of a dual‐electrode catheter, so that the distal electrode was located 9 cm below and the proximal one 6 cm above the SCJ. Key Results The wireless system showed lower intragastric pH than the traditional catheter in the postprandial period (median 2.2 wireless vs 2.7 catheter, P < 0.05) but not in the whole 24 h. Moreover, during the 24 h, minimum intraesophageal pH during reflux events was lower than the simultaneous pH in the gastric body recorded using the catheter (2.2 vs 2.4, P < 0.01) and in the postprandial period lower than the one recorded using both techniques (2.3 vs 2.8 wireless and 3.2 catheter, P < 0.001). Conclusions & Inferences (i) after meals, in the 1st 2 h postprandial pH in the gastric body is significantly lower when measured with the wireless capsule than with the traditional catheter, presumably because of less buffering by food in proximity of the mucosa, (ii) during reflux events intraesophageal pH is lower than pH in the gastric body, in accordance with the notion of greater intragastric acidity in the subcardial region.     

Influence of various irradiation processes on the mechanical properties and polymerisation kinetics of bulk-fill resin based composites

ObjectivesTo assess the effect of irradiation time and distance of the light tip on the micro-mechanical properties and polymerisation kinetics of two bulk-fill resin-based composites at simulated clinically relevant filling depth.MethodsMicro-mechanical properties (Vickers hardness (HV), depth of cure (DOC) and indentation modulus (E)) and polymerisation kinetics (real-time increase of degree of cure (DC)) of two bulk-fill resin-based composites (Tetric EvoCeram^® Bulk Fill, Ivoclar Vivadent and x-tra base, Voco) were assessed at varying depth (0.1–6 mm in 100 μm steps for E and HV and 0.1, 2, 4 and 6 mm for DC), irradiation time (10, 20 or 40 s, Elipar Freelight2) and distances from the light tip (0 and 7 mm). Curing unit's irradiance was monitored in 1 mm steps at distances up to 10 mm away from the light tip on a laboratory-grade spectrometer.ResultsMultivariate analysis (α = 0.05), Student's t-test and Pearson correlation analysis were considered. The influence of material on the measured mechanical properties was significant (η² = 0.080 for E and 0.256 for HV), while the parameters irradiation time, distance from the light tip and depth emphasise a stronger influence on Tetric EvoCeram^® Bulk Fill. The polymerisation kinetics could be described by an exponential sum function, distinguishing between the gel and the glass phase. The above mentioned parameters strongly influenced the start of polymerisation (gel phase), and were of less importance for the glass phase.ConclusionsBoth materials enable at least 4 mm thick increments to be cured in one step under clinically relevant curing conditions.Clinical significanceThe susceptibility to variation in irradiance was material dependent, thus properties measured under clinically simulated curing conditions might vary to a different extent from those measured under ideal curing conditions.