COVID-19 vaccine uptake and intention during pregnancy in Canada

ObjectiveTo investigate COVID-19 vaccine uptake and intent among pregnant people in Canada, and determine associated factors.MethodsWe conducted a national cross-sectional survey among pregnant people from May 28 through June 7, 2021 (n = 193). Respondents completed a questionnaire to determine COVID-19 vaccine acceptance (defined as either received or intend to receive a COVID-19 vaccine during pregnancy), factors associated with vaccine acceptance, and rationale for accepting/not accepting the vaccine.ResultsOf 193 respondents, 57.5% (n = 111) reported COVID-19 vaccine acceptance. Among those who did not accept the vaccine, concern over vaccine safety was the most commonly cited reason (90.1%, n = 73), and 81.7% (n = 67) disagreed with receiving a vaccine that had not been tested in pregnant people. Confidence in COVID-19 vaccine safety (aOR 16.72, 95% CI: 7.22, 42.39), Indigenous self-identification (aOR 11.59, 95% CI: 1.77, 117.18), and employment in an occupation at high risk for COVID-19 exposure excluding healthcare (aOR 4.76, 95% CI: 1.32, 18.60) were associated with vaccine acceptance. Perceived personal risk of COVID-19 disease was not associated with vaccine acceptance in the multivariate model.ConclusionVaccine safety is a primary concern for this population. Safety information should be communicated to this population as it emerges, along with clear messaging on the benefits of vaccination, as disease risk is either poorly understood or poorly valued in this population.     

Optimization of scan parameters in pulmonary partial pressure oxygen measurement by hyperpolarized 3He MRI.

The dependence of hyperpolarized (HP) (3)He T(1) on local oxygen concentration provides the basis for measuring the partial pressure of oxygen (pO(2)) and oxygen depletion rate (R) in the lungs. Precise measurements of this type are difficult because the oxygen effect manifests itself through a decay of signal, leading to noisy images at the end of the series. The depolarization caused by RF excitation pulses further complicates the problem. It is therefore important to optimize scan parameters, such as measurement timing and flip angle, to obtain accurate and reproducible measurements. This work presents a new single-acquisition technique in conjunction with the multiple regression fitting method for data evaluation. Analytical expressions for the measurement uncertainties are derived. A total of four types of single-acquisition timing schemes are investigated; simulation shows a large uncertainty variation between these schemes (pO(2): 7.5-30.2%; R: 47.4-173.7%). A basic procedure for optimizing scan parameters is then described. A phantom experiment was conducted to verify the simulation results. Repeated in vivo measurements with the optimal scheme in a rabbit experiment showed that average variation of global mean is 6.2% for pO(2) and 12.0% for R, and that the average variation of percentiles (10th, 25th, 50th, 75th, and 90th) is 8.7% for pO(2) and 19.0% for R.     

Detection of functional connectivity using temporal correlations in MR images

Functional connectivity among brain regions has been investigated via an analysis of correlations between regional signal fluctuations recorded in magnetic resonance (MR) images obtained in a steady state. In comparison with studies of functional connectivity that utilize task manipulations, the analysis of correlations in steady state data is less susceptible to confounds arising when functionally unrelated brain regions respond in similar ways to changes in task. A new approach to identifying interregional correlations in steady state data makes use of two independent data sets. Regions of interest (ROIs) are defined and hypotheses regarding their connectivity are generated in one data set. The connectivity hypotheses are then evaluated in the remaining (independent) data set by analyzing low frequency temporal correlations between regions. The roles of the two data sets are then reversed and the process repeated, perhaps multiple times. This method was illustrated by application to the language system. The existence of a functional connection between Broca's area and Wernicke's area was confirmed in healthy subjects at rest. An increase in this functional connection when the language system was actively engaged (when subjects were continuously listening to narrative text) was also confirmed. In a second iteration of analyses, a correlation between Broca's area and a region in left premotor cortex was found to be significant at rest and to increase during continuous listening. These findings suggest that the proposed methodology can reveal the presence and strength of functional connections in high-level cognitive systems.     

Role of exercise and nutrition in menopause

Menopause and the aging process itself cause many physiologic changes, which explain the increased prevalence of chronic diseases observed in postmenopausal women. Exercise and nutrition play important roles in the prevention and treatment of cardiovascular disease, cancer, obesity, diabetes, osteoporosis, and depression.     

Ectopic pregnancy in adolescents

PURPOSE OF REVIEW: Ectopic pregnancy continues to be an important cause of morbidity and mortality in women. Tubal damage is the likely cause of ectopic pregnancy. Healthcare providers who care for adolescents must screen for and treat sexually transmitted diseases like Chlamydia in order to decrease the risk of tubal damage and ectopic pregnancy. Smoking is a risk factor for ectopic pregnancy and teens should be encouraged to never start smoking or to quit if they already do smoke. Though ectopic pregnancy is more likely to occur in adults, teens are at risk as well, and early diagnosis allows for the possibility of conservative management. RECENT FINDINGS: Any teen who presents with amenorrhea, pain, or vaginal bleeding should be evaluated for a possible ectopic pregnancy. Adolescents are more likely to present with pain than adults. Transvaginal ultrasound should be performed and if an intrauterine pregnancy or ectopic pregnancy is not clearly seen, correlation with serum beta-human chorionic gonadotropin levels is done. If the beta-human chorionic gonadotropin level is above the 'discriminatory zone' of 1500 mIU and the transvaginal ultrasound does not show an intrauterine pregnancy, ectopic pregnancy should be suspected. SUMMARY: Unruptured ectopic pregnancy may be treated with expectant management, surgical management, or medical management (methotrexate). Healthy teens with unruptured ectopic pregnancies and who are able and willing to undergo close surveillance may be treated with methotrexate. There are case reports of successful treatment of ectopic pregnancy with methotrexate in adolescents.