Search

This study investigated whether polycystic ovary syndrome (PCOS) affected early embryo development assessed by time-lapse analysis of embryo kinetics from fertilization to the blastocyst stage. This was a prospective cohort study of two pronuclei (2PN) embryos from 25 hyperandrogenic PCOS patients (110 2PN embryos), 26 normoandrogenic PCOS patients (140 2PN embryos) and 20 healthy, regularly cycling women (controls, 97 2PN embryos). Patients underwent the same baseline evaluation and the same ovarian stimulation from April 2010 to February 2013. Oocytes were fertilized by intracytoplasmic sperm injection and incubated in an EmbryoScope with pictures taken every 20 rain in seven focal planes. Time to 2PN breakdown, first cleavage and cleavage to 3, 4, 5, 6, 7 and 8 cells, morula and blastocyst (t2, t3, t4, t5, t6, t7, t8, tM, tB) were annotated. Differences in embryo kinetics between groups were assessed by mixed modelling. Compared with controls, embryos from hyperandrogenic PCOS patients were significantly delayed at 2PN breakdown, t2, t3, t4 and t7 but not at t5, t6, t8, tM or tB. Embryos from hyperandrogenic PCOS women had developed slower from fertilization to the 8-cell stage compared with embryos from controls. [ABSTRACT FROM AUTHOR]

Meaningfulness as experienced by a group of South Africans In the field of positive psychology, or psychofortology, there are many theories and explanations about the nature of psychological well-being and how it can be enhanced, yet little is known about lay people's experiences and definitions of happiness, meaningfulness and other facets of well-being. The focus of this study is on meaningfulness as a facet of psychological well-being. In the search for an encompassing conceptualisation of psychological well-being two schools of thought have emerged, namely the hedonic and eudaimonic perspectives. Meaningfulness is a core component of well-being as conceptualised in the eudaimonic perspective. Little is known about how important various life domains are in people's experiences of meaningfulness, and whether there are differences among life domains in this regard. Therefore, the aim of this study was to explore what the most meaningful things were in the lives of a group of South Africans as experienced by them on ground level, and what the role of different life domains were in their experience of meaningfulness. As cultural factors may influence the importance of various expressions of psychological well-being, it was decided to select a culturally homogeneous (relatively individualistic) group of Afrikaans and English-speaking participants in early adulthood for this explorative study. This study forms part of the international Eudaimonic-Hedonic Happiness Investigation project (EHHI) conducted in seven countries, and is linked to the FORT3 project (The prevalence of levels of psychosocial health: dynamics and relationships with biomarkers of (ill)health in South African social contexts). The current study reports on the South African data with regard to meaningfulness as experienced by a relatively individualistic cultural group. Equal numbers of males and females (N=104) between the ages 30 and 50 years with secondary or tertiary education training were selected. Respondents were identified by the researchers, after which the "snowball" method was used to reach other possible participants. After giving informed consent, participants completed the Eudaimonic-Hedonic Happiness Instrument (EHHI-i) with open-ended questions on, amongst others, the most meaningful things for people, and why they are meaningful. Rating scales on the degree of meaningfulness experienced in various life domains were also completed. A richness of information was thus sought through triangulation of quantitative and qualitative data-gathering methods. The qualitative data were coded, and codes were abstracted into higher order categories and transformed into percentage responses per category. For the quantitative data the average score per life domain was calculated. Qualitative as well as quantitative findings show that family (1st) and spirituality (2nd) are the two life domains that gave the most meaning in life. It was indicated that meaning was found in the mere belonging to a family and the influence family has on one's personal life. Spirituality gave meaning in knowing that a God exists and that life has a purpose. It may be that, in the South African context, spirituality is used as a coping mechanism to feel in control and to understand difficulties in life. None of the other participating countries in the EHHI project indicated that spirituality was such an important part of meaning in their lives. The other domains that played a valuable role in giving meaning in life were: work, health, interpersonal relations and personal growth. The life domains that proved relatively less meaningful in the respondents' lives were leisure/relaxation, life standard and activities involving the community and society. The lack of meaningful involvement in the community could probably be traced back to South Africa's history, and there are indications suggesting that at present Afrikaans and English speaking South Africans may tend to focus internally on themselves and their families. However, this seems to be a global trend. The results showed that intrinsic rather than external motivations give meaning to life. Theoretically it is important to note that the degree of meaningfulness experienced differs in various life domains and that the content of meaningfulness in a person's life should be evaluated accordingly. A better knowledge of psychological well-being and meaningfulness can be valuable in the development of interventions and therapeutic programmes. Psychological well-being can be enhanced and pathology prevented by taking into account and implementing methods that involve the most important specific meaningful life domains in people's lives. [ABSTRACT FROM AUTHOR]

A continuous assessment and a categorical diagnosis of the presence of mental health, described as flourishing, and the absence of mental health, characterized as languishing, is applied to a random sample of 1050 Setswana-speaking adults in the Northwest province of South Africa. Factor analysis revealed that the mental health continuum-short form (MHC-SF) replicated the three-factor structure of emotional, psychological and social well-being found in US samples. The internal reliability of the overall MHC-SF Scale was 0.74. The total score on the MHC-SF correlated 0.52 with a measure of positive affect, between 0.35 and 0.40 with measures of generalized self-efficacy and satisfaction with life, and between 0.30 and 0.35 with measures of coping strategies, sense of coherence, and community collective self-efficacy. The total score on the MHC-SF correlated -0.22 with the total score on the General Health Questionnaire. Criteria for the categorical diagnosis were applied, and findings revealed that 20% were flourishing, 67.8% were moderately mentally healthy, and 12.2% were languishing. Confirmatory factor analysis supported the hypothesized two-continua model of mental health and mental illness found in the USA. Copyright © 2008 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The aim of the current study was to evaluate the effect of a prenatal hypnotherapeutic programme on the postnatal psychological well-being of first-time mothers. The developed programme integrated principles from developmental psychology, Ericksonian and ego state therapy, and from positive psychology. Results indicated that the experimental group (n = 23) showed a significant improvement on most measures of psychological well-being at two weeks postpartum, while the psychological well-being of the comparison group (n = 23) remained unchanged. At ten weeks postpartum mothers in the experimental group showed significantly less general symptoms of psychopathology and less depression. These results suggest that the hypnotherapeutic programme focussing on the enhancement of strengths contributed to the enhancement of psychological well-being and alleviation of depression of first-time mothers. [ABSTRACT FROM AUTHOR]

Associations between selfmanagement and biopsychosocial variables in a group of Afrikaans- (n = 102) and Sotho-speaking (n = 94) patients with essential hypertension (EH) were investigated. Self-management in terms of predetermined criteria for medical and lifestyle prescriptions was achieved by only 30.6 per cent of the participants. Significant differences were found between self-managing and non selfmanaging participants regarding language and culture, doctor-patient fit, complexity of prescriptions, medication sideeffects, aspects of health beliefs, illness behaviour and health locus of control. In addition, a first empirical indication was found that self-management is also linked with psychological wellbeing, as manifested in a sense of coherence. The significantly accurate prediction of self-management by various biopsychosocial variables endorses the relevance of a biopsychosocial perspective in the treatment of patients with EH. [ABSTRACT FROM AUTHOR]

Background: Many black persons in South Africa have been subjected to urbanisation and urbanisation has led to a significant increase in diseases of lifestyle. The determinants of hypertension in a population in transition have not been well-defined and there is a pressing need for observational epidemiological studies as well as randomised-controlled trials in populations from Africa. The aim of this study was to investigate the association between blood pressure and factors known to contribute to hypertension. Methods: The study sample consisted mainly of Setswana speaking people, divided into different levels (strata) of urbanisation, namely stratum 1 (rural) to stratum 5 (urbanised). A total of 1821 black subjects, which included 1040 woman, were recruited and randomly selected from 37 sites from the four geographical quarters of the North West Province of South Africa. The following questionnaires were used: demographic, anthropometric, quantitative food frequency, physical activity and scales to measure psychosocial variables. Biochemical analysis (standardised methods) were done on the serum and plasma of the subjects and the blood pressure was measured with a sphygmomanometer. Results: Of the total sample, 22.8% of the subjects had systolic and 20.7% diastolic blood pressures above 140/90 mm Hg. Males and females from stratum 3 showed the highest rate of hypertension (32.9% systolic and 25.1% diastolic) and stratum 5 the lowest. Blood pressure correlated positively with age, level of urbanisation, WHR (waist:hip ratio) and smoking. In the woman the diastolic blood pressure correlated the best with body mass index (BMI), serum triglycerides, total serum cholesterol, low-density lipoprotein (LDL) cholesterol and s-GGT. Coping strategies, experience of social support, cultural aspects and affect balance are related to blood pressure, especially in the case of women. Conclusions: It seems that factors associated with urbanisation are related to the... [ABSTRACT FROM AUTHOR]

We studied the impact of urbanization and the resultant demographic transition on the physical, physiological and mental health of Africans in the North West Province of South Africa in order to inform health policies and programmes. Thirty-seven randomly selected sites were investigated in rural and urban areas covering all the districts of the province. A cross-sectional comparison was made of a sample in terms of gender, age (15 years and older) and five levels of urbanization (deep rural tribal areas, farms, informal housing areas or squatter camps, established urban townships and `upper' urban areas). A total of 1854 'apparently healthy' men, and non-pregnant and non-lactating African women without identified diseases and not taking chronic medication, were recruited. Demographic information, health history and behaviour, psychological profiles and dietary intakes were obtained during individual interviews in the language of the subject's choice, using culturally sensitive and validated questionnaires. Anthropometric and blood pressure measurements and a 2-hour glucose tolerance test with a 75-g glucose load were taken. Serum, citrated and EDTA plasma and blood cell samples were analysed for biochemical variables with enzymatic, colorimetric and immunological methods. Anonymous HIV testing was also done. The improved socioeconomic circumstances observed in the wealthiest urban areas were accompanied by superior nutritional status, lower mean blood pressure, better health behaviours (lower smoking, drinking and HIV infection rates), lower measures of all indices of psychological pathology and higher scores of psychological well-being. These subjects also had the highest fat intake and serum cholesterol levels. Farm workers were identified as the most vulnerable group, having inadequate diets, highest scores for psychological symptomatology and the lowest scores for psychological well-being. Subjects in the transitional groups had the highest blood pre... [ABSTRACT FROM AUTHOR]

BALB/c mice made tolerant to A/J alloantigens by neonatal injection of (A/J × BALB/c)F1 spleen cells develop a host-versus-graft (HVG) disease due to the activation of donor B cells by a subset of host alloreactive helper T cells. We have investigated the effects of a single neonatal injection of the 145-2C11 anti-mouse CD3 monoclonal antibody (MoAb) on the establishment of allotolerance and on the development of the immunopathological features of HVG disease. First, this treatment did not modify the specific anti-donor cytotoxic T lymphocyte (CTL) unresponsiveness or the persistence of circulating immunoglobulins bearing donor allotype. Second, the hyper IgE, the hyper IgG 1 and the increased expression of Ia antigens on B cells found in untreated HVG mice were not observed after injection of the 145-2C11 MoAb. Likewise, treated mice displayed lower levels of anti-DNA IgG antibodies and less glomerular immune deposits as compared with untreated HVG mice. We conclude that the administration of the anti-CD3 MoAb did not interfere with the induction of allotolerance but exerts a pronounced inhibitory effect on the associated immunopathological syndrome. [ABSTRACT FROM AUTHOR]

The detrimental effects of obesity in Caucasians and African- Americans have been the focus of many recent publications, but data on Africans are still lacking. The aim of this study was to assess the health determinants of urban, obese African women by comparing the lifestyle and risk factors associated with the metabolic syndrome of lean, overweight and obese subjects. This case-case-control study included 102 urban African women (aged 20-50 years), consisting of three groups (39 lean [body mass index (BMI): 18.5-24.9 kg/m2], 25 overweight [BMI: 25-29.9 kg/m2], and 38 obese [BMI ≥ 30 kg/m2]). Measurements included various questionnaires (including demographic, psychological, and quantitative food consumption questionnaires), anthropometric measurements (including skinfolds and fat percentage), cardiovascular performance with a Finometer device (recording parameters such as blood pressure and arterial compliance), and an oral glucose tolerance test. Different biochemical analyses were conducted to determine levels of lipids, haemostatic factors, leptin, C-reactive protein and liver enzymes. Results indicated that the obese group had the worst exposures, namely the poorest living conditions, smallest income, lowest levels of education, least sense of spiritual well-being and highest self-reported alcohol intake. They also presented the most adverse health outcomes, such as significantly higher (P<0.05) blood pressure, significantly higher gamma-glutamyl transferase (GGT), leptin, triglycerides, fasting blood glucose, fibrinogen, and PAI-1 levels. An elevated GGT level (GGT > 45 IU/l) was identified as one of the most distinctive conditions for being obese as well as having high-normal blood pressure (age-adjusted odds ratio = 4.10 for being obese, and 5.31 for having high-normal blood pressure). We conclude that the obese group showed the most vulnerable health profile compared to the lean and overweight groups. These results represent an important challenge facing South Africa and other low income countries, particularly regarding their urban populations. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the International Society of Urological Pathology (ISUP) 5-tier grade grouping (GG) system of prostate cancers as well as previously proposed optimizations., Patients and Methods: The PROCURE biobank is a prospective cohort study of patients with localized prostate cancer who underwent radical prostatectomy in Quebec province between 2005 and 2013. Surgical specimens were graded by experienced genitourinary pathologists using 2019 ISUP criteria. Follow-up was conducted until November 2021. The current 5-tier and a proposed 6-tier GG system were evaluated, the latter having two changes: 1) Gleason 3 + 4 and 4 + 3 tumors with minor/tertiary Gleason 5 patterns were upgraded to GG 3 and 4, respectively; and 2) patients in GG5 were separated based on primary Gleason pattern (4 or 5). Cox proportional hazards models and Harrell's concordance (C) indices were used for statistical analyses., Results: 2003 patients were included (median follow-up: 8.7 years). The current 5-tier GG system predicted time to recurrence (hazard ratio [HR] 2.12, 95% confidence interval [95%CI] 1.99-2.25, C 0.717), androgen-deprivation therapy (HR 2.58, 95%CI 2.38-2.80, C 0.790), metastasis (HR 2.48, 95%CI 2.17-2.83, C 0.806), castration-resistant prostate cancer (HR 2.67, 95%CI 2.28-3.13, C 0.829), and cancer-specific mortality (HR 2.80, 95%CI 2.27-3.44, C 0.835). Goodness-of-fit further improved with the proposed 6-tier GG system, with Harrell's C of 0.733, 0.807, 0.827, 0.853, and 0.853, respectively., Conclusions: The 5-tier GG system predicted short- and long-term outcomes for patients with localized prostate cancer, and the proposed 6-tier GG system further improved its accuracy., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Professional medical publications writers (PMWs) cover a wide range of biomedical writing activities that recently includes translation of biomedical publications to plain language summaries (PLS). The consumer health informatics literature (CHI) consistently describes the importance of incorporating health literacy principles in any natural language processing (NLP) app designed to communicate medical information to lay audiences, particularly patients. In this stepwise systematic review, we searched PubMed indexed literature for CHI NLP-based apps that have the potential to assist PMWs in developing text based PLS. Results showed that available apps are limited to patient portals and other technologies used to communicate medical text and reports from electronic health records. PMWs can apply the lessons learned from CHI NLP-based apps to supervise development of tools specific to text simplification and summarization for PLS from biomedical publications., (©2023 AMIA - All rights reserved.)

Competing Interests: The authors declare no funding and conflicts of interest.

Light-mediated coupling of acylsilanes with indoles is reported. This photo click reaction occurs under mild conditions (415 nm) mostly in quantitative yield and provides stable silylated N,O-acetals via light mediated siloxycarbene generation with subsequent indole-N-H insertion. We show that this very efficient and fully atom economic coupling process can be applied to conjugate complex systems, as documented by the clicking of carbohydrates with indole alkaloids. The method is also applicable to the conjugation of polymer chains. The linking acetal moiety can be readily cleaved and it is also shown that wavelength-selective coupling and cleavage with acyl silanes bearing a second photoactive moiety is possible. This is documented by a successful polymerization/depolymerization sequence and by a polymer folding/unfolding process., (© 2021 The Authors. Angewandte Chemie International Edition published by Wiley-VCH GmbH.)

Objective: To evaluate the impact of surgical wait times on outcome of patients with grade 3 endometrial cancer., Methods: All consecutive patients surgically treated for grade 3 endometrial cancer between 2007 and 2015 were included. Patients were divided into two groups based on the time interval between endometrial biopsy and surgery: wait time from biopsy to surgery ≤12 weeks (84 days) vs more than 12 weeks. Survival analyses were conducted using log-rank tests and Cox proportional hazards models., Results: A total of 136 patients with grade 3 endometrial cancer were followed for a median of 5.6 years. Fifty-one women (37.5%) waited more than 12 weeks for surgery. Prolonged surgical wait times were not associated with advanced stage at surgery, positive lymph nodes, increased lymphovascular space invasion, and tumor size (P = .8, P = 1.0, P = .2, P = .9, respectively). In multivariable analysis adjusted for clinical and pathological factors, wait times did not significantly affect disease-specific survival (adjusted hazard ratio [HR]: 1.2, 95% confidence interval [CI], 0.6-2.5, P = .6), overall survival (HR: 1.1, 95% CI, 0.6-2.1, P = .7), or progression-free survival (HR: 0.9, 95% CI, 0.5-1.7, P = .8)., Conclusion: Prolonged surgical wait time for poorly differentiated endometrial cancer seemed to have a limited impact on clinical outcomes compared to biological factors., (© 2020 Wiley Periodicals, Inc.)

Objective: To evaluate long-term oncological outcomes and the added value of sentinel lymph node sampling (SLN) compared to pelvic lymph node dissection (LND) in patients with endometrial cancer (EC)., Methods: During the evaluation phase of SLN for EC, we performed LND and SLN and retrospectively compared the oncologic outcome with the immediate non-overlapping historical era during which patients underwent LND., Results: From 2007 to 2010, 193 patients underwent LND and from December 2010 to 2014, 250 patients had SLN mapping with completion LND. Both groups had similar clinical characteristics. During a median follow-up period of 6.9 years, addition of SLN was associated with more favorable oncological outcomes compared to LND with 6-year overall survival (OS) of 90% compared to 81% (p = 0.009), and progression free survival (PFS) of 85% compared to 75% (p = 0.01) respectively. SLN was associated with improved OS (HR 0.5, 95% CI 0.3-0.8, p = 0.004), and PFS (HR 0.6, 95% CI 0.4-0.9, p = 0.03) in a multivariable analysis, adjusted for age, ASA score, stage, grade, non-endometrioid histology, and LVSI. Patients who were staged with SLN were less likely to have a recurrence in the pelvis or lymph node basins compared to patients who underwent LND only (6-year recurrence-free survival 95% vs 90%, p = 0.04)., Conclusion: Addition of SLN to LND was ultimately associated with improved clinical outcomes compared to LND alone in patients with endometrial cancer undergoing surgical staging, suggesting that the data provided by the analysis of the SLN added relevant clinical information, and improved the decision on adjuvant therapy., Competing Interests: Declaration of competing interest The authors report no conflict of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: The sequential use of a number of new agents (NAs) have improved the overall survival (OS) of patients with metastatic castration-resistant prostate cancer whose disease progresses after docetaxel (DOC) treatment. The aim of this study was to assess the cumulative survival outcomes of different sequencing strategies by evaluating the individual data from published studies of patients treated with a post-DOC treatment sequence of 2 NAs., Patients and Methods: The patients' individual data were analyzed to investigate whether different sequencing strategies lead to differences in OS., Results: We analyzed the data of 1099 evaluable patients. Among the patients treated with a second-line new hormone agent (NHA), median OS from the start of third-line treatment was significantly longer in the patients treated with cabazitaxel (CABA) than in those treated with abiraterone acetate or enzalutamide. Median cumulative OS (cumOS) from the start of second-line treatment was 21.1 months in the patients who received NHA then NHA, 22.1 months in those who received NHA then CABA, and 21.0 months in those who received CABA then NHA. Among the patients with a second-line progression-free survival of ≥6 months, median cumOS was significantly longer in patients who received CABA-including sequences than in those treated with NHA then NHA sequences (29.5 vs. 24.8 months; P = .03)., Conclusion: Our findings suggest that the sequential use of NAs with different mechanisms of action improves cumOS regardless of the order in which they are administered, thus supporting the hypothesis of cross-resistance between the 2 NHAs., (Copyright © 2019. Published by Elsevier Inc.)