Appendicular lean tissue mass and the prevalence of sarcopenia among healthy women.

Studies indicate that deficient skeletal muscle mass or sarcopenia is a major cause of disability and morbidity among the elderly. In part, due to the lack of generally applicable normal values, there is still insufficient epidemiologic data available on the frequency and severity of sarcopenia in health and under various disease-related conditions. The objectives of the present study were to (1) characterize the age- and menopause-related variations in appendicular lean tissue mass (LTM(A)), (2) provide young-normal means and estimate the age-specific prevalence of sarcopenia among healthy women. A total of 754 healthy women were included in the study of cross-sectional design. LTM(A) was estimated by dual-energy x-ray absorptiometry (DEXA). Physical characteristics and menopausal status were also registered. LTM(A) as well as height showed significant negative correlation with age with Pearson's r values of -0.43 and -0.06, respectively (P <.05). Trend of finding lower mean values with advancing age remained even when LTM(A) was adjusted for height(2) (ht(2)). Menopause did not seem to have any influence on LTM(A). Young-normal means were obtained from 216 premenopausal women aged 18 to 39 years. Prevalence rates of sarcopenia in healthy women were determined with reference to a cut-off line corresponding to LTM(A) or LTM(A)/ht(2) less than young-normal mean 2 SD and were found to be 40.2% and 12.3%, respectively, among the healthy elderly (>70 years of age). Results of the present study provide further evidence that sarcopenia exists even among otherwise healthy women with increasing age-specific prevalence. Further studies are needed (1) to estimate the prevalence of sarcopenia under various health and disease-related conditions with reference to the hereby given cut-off values and (2) to find therapeutic strategies with beneficial effects in conserving skeletal muscle mass.     

Nurses' knowledge of health literacy,communication techniques,and barriers to the implementation of health literacy programs: A cross‐sectional study

Nurses' health literacy knowledge and communication skills are essential for improving patients' health literacy. Yet, research on nurses' health literacy knowledge and perception is limited. The study aimed to evaluate nurses' health literacy knowledge, communication techniques, and barriers to the implementation of health literacy interventions. A cross‐sectional study was used, and a total of 1697 nurses in 104 community hospitals in Thailand completed self‐report measures. Approximately 55% of the participants had heard about the concept of health literacy; 9% had received formal training specific to interaction with patients with low health literacy. About 50% of the nurses were aware of their patients' low health literacy; therefore, they applied the recommended communication techniques for them. Delivery of effective health literacy training was hampered by a lack of assessment tools, health literacy training and specialists, educational materials, and health provider time. Hospital administrators, nurse managers, health leaders should develop strategies to create environments and resources supporting health literacy interventions.     

A National Study of Australian Nurse Practitioners’ Organizational Practice Environment

The nurse practitioner (NP) workforce in Australia plays a vital role in helping the country meet the current demand for health care. Data from Australian NPs using the Nurse Practitioner Primary Care Organizational Climate Questionnaire demonstrated that one-seventh of the overall Australian NP population completed the study. The response was overwhelmingly positive in the area of practice; 71.6% of NPs had no restriction on their practice and felt valued by their organization. The results of this study enable a benchmark for ongoing national evaluations in addition to international comparative data.     

The strength of combined cytogenetic and mate-pair sequencing techniques illustrated by a germline chromothripsis rearrangement involving FOXP2

Next-generation mate-pair sequencing (MPS) has revealed that many constitutional complex chromosomal rearrangements (CCRs) are associated with local shattering of chromosomal regions (chromothripsis). Although MPS promises to identify the molecular basis of the abnormal phenotypes associated with many CCRs, none of the reported mate-pair sequenced complex rearrangements have been simultaneously studied with state-of-the art molecular cytogenetic techniques. Here, we studied chromothripsis-associated CCR involving chromosomes 2, 5 and 7, associated with global developmental and psychomotor delay and severe speech disorder. We identified three truncated genes: CDH12, DGKB and FOXP2, confirming the role of FOXP2 in severe speech disorder, and suggestive roles of CDH12 and/or DGKB for the global developmental and psychomotor delay. Our study confirmes the power of MPS for detecting breakpoints and truncated genes at near nucleotide resolution in chromothripsis. However, only by combining MPS data with conventional G-banding and extensive fluorescence in situ hybridizations could we delineate the precise structure of the derivative chromosomes.     

Formation and Investigation of Physicochemical,Biological and Bacteriostatic Properties of Nanocomposite Foils Containing Silver Nanoparticles and Graphene Oxide in Hyaluronic Acid Matrix

Natural polysaccharides, including hyaluronic acid, find a wide range of applications in biomedical sciences. There is a growing interest in nanocomposites containing hyaluronic acid and nanoparticles such as nanometals or graphene. In this study, we prepared foils of pure sodium hyaluronate and sodium hyaluronate containing nanosilver, graphene oxide, nanosilver/graphene oxide and characterized their properties. UV-vis spectroscopy and scanning electron microscopy (SEM) confirmed the formation of 10–20 nm silver nanoparticles. The structural changes were investigated using Fourier transforms infrared (FTIR) spectra and size exclusion chromatography. The obtained results suggest changes in molecular weights in the samples containing nanoparticles, which was highest in a sample containing nanosilver/graphene oxide. We also assessed the mechanical properties of the foils (thickness, tensile strength and elongation at break) and their wettability. The foils containing nanosilver and nanosilver/graphene oxide presented bacteriostatic activity against E. coli, Staphylococcus spp. and Bacillus spp., which was not observed in the control and sample containing graphene oxide. The composites containing graphene oxide and nanosilver/graphene oxide exhibited a cytotoxic effect on human melanoma WM266-4 cell lines (ATCC, Manassas, VA, USA).     

We are here for you: infertility clinic communication during the first wave of the COVID-19 pandemic

Journal of Assisted Reproduction and Genetics - To study how SART-member fertility clinics communicated via clinic websites during the first wave of the COVID-19 pandemic following publication of...     

Autologous platelet-rich plasma treatment for moderate-severe Asherman syndrome: the first experience

Purpose

Treatment of Asherman syndrome (AS) presents a significant clinical challenge. Based on our in vitro data showing that PRP could activate endometrial cell proliferation and migration, we hypothesized that intrauterine infusion of autologous platelet-rich plasma (PRP) may improve endometrial regeneration and fertility outcomes in patients with moderate-severe AS.

Materials and methods

Subjects with moderate-severe AS were randomized to PRP or saline control administered following hysteroscopic adhesiolysis. Due to relative inability to randomize patients to the control group, after initial randomization of 10 subjects (6 in PRP and 4 in control groups), the remainder were prospectively enrolled in PRP group (n?=?9), with 11 historic controls added to control group, for a total of 30 subjects (PRP n?=?15; saline control n?=?15). Right after hysteroscopy, 0.5–1 mL of PRP or saline was infused into the uterus via a Wallace catheter, followed by estrogen therapy. The primary outcomes were changes in endometrial thickness (EMT, checked in 3 weeks) and in menstrual flow; secondary outcomes were pregnancy and live birth rates. EMT and menstrual bleeding pattern were assessed before and after the intervention. Pregnancy was assessed over a 6-month period.

Results

There were no statistically significant differences in age, gravidity/parity, cause of AS, preoperative menses assessment, AS hysteroscopy score, and intrauterine balloon placement between the groups. There was no statistically significant difference (p?=?0.79) in EMT pre-PRP infusion for control (5.7 mm, 4.0–6.0) and study arm (5.3 mm, 4.9–6.0). There was no statistically significant change (p?=?0.78) in EMT after PRP infusion (1.4 mm,???0.5–2.4) vs saline (1.0 mm, 0.0–2.5). Patients tolerated the procedure well, with no adverse effects. There was no difference in the predicted likelihood of pregnancy (p?=?0.45) between the control (0.67, 0.41–0.85) and study arm (0.53, 0.29–0.76).

Conclusions

PRP was well accepted and tolerated in AS patients. However, we did not observe any significant EMT increase or improved pregnancy rates after adding PRP infusion, compared to standard treatment only. The use of intrauterine PRP infusion may be a feasible option, and its potential use must be tested on a larger sample size of AS patients.

     

Factor structure of the Maslach burnout inventory: An analysis of data from large scale cross-sectional surveys of nurses from eight countries

Background

Job burnout is an important predictor of nurse retention. Reliable and valid measures are required to monitor this phenomenon internationally.

Objective

To evaluate the applicability of the Maslach burnout inventory (MBI) in international nursing research.

Design

Secondary analysis of cross-sectional hospital nurse survey data from eight countries.

Settings

Hospitals in the U.S., Canada, the U.K., Germany, New Zealand, Japan, Russia and Armenia.

Participants

54,738 direct care professional nurses from 646 hospitals in eight countries.

Methods

Confirmatory and exploratory factor analysis were undertaken to identify the factor structure of the MBI. The internal consistencies of the subscales were investigated.

Results

Exploratory factor analysis revealed three factors being extracted from the 22-item Maslach burnout inventory. In nearly all countries the two items (6 and 16) related to the “stress” and “strain” involved in working with people loaded on the depersonalization subscale rather than the emotional exhaustion subscale to which they were initially assigned. The three subscales exhibited high reliability with Cronbach alphas exceeding the critical value of 0.70. The correlation coefficients for the emotional exhaustion and depersonalization subscales were strong and positive.

Conclusions

The 22-item Maslach burnout inventory has a similar factor structure and, with minor modifications, performed similarly across countries. The predictive validity of the emotional exhaustion and depersonalization subscales might be improved by moving the two items related to stress and strain from the emotional exhaustion to the depersonalization subscale. Nevertheless, the MBI can be used with confidence as a burnout measure among nurses internationally to determine the effectiveness of burnout reduction measures generated by institutional and national policies.