In this series of 80 cases, the pregnancy rate (using the number of women who conceived) is 25% (20 of 80). Because some women delivered twice or three times after transplantation, the number of ...livebirths cannot be used as the numerator; only the number of women who conceived can be used as the numerator, whereas the number of transplanted women is the denominator to calculate pregnancy rates.
Overweight and obesity are a growing problem, especially among people with a low income. Policymakers aspire to alleviate this problem by implementing publicly funded projects. This study has three ...aims: 1) to explore citizen preferences regarding the public funding of projects promoting a healthy body weight among people with a low income, 2) to identify whether such preferences differ between citizens with a low income and those with a higher income, and 3) to identify the reasons underlying these preferences. We conducted a Participatory Value Evaluation (PVE) among 1053 Dutch citizens to achieve these aims. In an online choice experiment, respondents were asked to advise on the implementation of eight different projects that encourage a healthy body weight among citizens with a low income, with a total resource constraint of 100,000 euros. The projects were 1) lifestyle coaching including sports, 2) lifestyle coaching without sports, 3) local sports coach, 4) fruit and vegetable boxes, 5) bariatric surgery, 6) improving the living environment, 7) courses on healthy lifestyles, and 8) sports vouchers. We used the “Multiple Discrete-Continuous Extreme Value” model to estimate the preferences of respondents towards these eight projects. Fruit and vegetable boxes and sports vouchers were the most popular projects, while bariatric surgery was least popular. Respondents with a low income tended to spend less of the budget than respondents with a higher income. Respondent arguments for the choices they made were qualitatively analysed using inductive content analysis. They often mentioned the value judgements ‘importance’, ‘healthiness’ and ‘usefulness’, as well as project costs and efficacy, as reasons for their decisions. Policymakers could use the results to ensure their decisions on the allocation of public funding to projects that encourage a healthy weight among people with a low income are aligned with citizen preferences.
•Citizens mostly prefer projects that increase healthy lifestyle accessibility.•Citizens least prefer publicly funded bariatric surgery for people with low incomes.•Citizens with low incomes spent less of the budget than those with higher incomes.•Citizens deemed preferred projects to be important, healthy, useful and effective.•Citizen participation can inform policymakers' choices and increase public support.
Fetal growth restriction (FGR) increases cardiovascular risk by cardiac remodeling and programming. This systematic review and meta-analysis across species examines the use of echocardiography in FGR ...offspring at different ages. PubMed and Embase.com were searched for animal and human studies reporting on echocardiographic parameters in placental insufficiency-induced FGR offspring. We included six animal and 49 human studies. Although unable to perform a meta-analysis of animal studies because of insufficient number of studies per individual outcome, all studies showed left ventricular dysfunction. Our meta-analyses of human studies revealed a reduced left ventricular mass, interventricular septum thickness, mitral annular peak velocity, and mitral lateral early diastolic velocity at neonatal age. No echocardiographic differences during childhood were observed, although the small age range and number of studies limited these analyses. Only two studies at adult age were performed. Meta-regression on other influential factors was not possible due to underreporting. The few studies on myocardial strain analysis showed small changes in global longitudinal strain in FGR offspring. The quality of the human studies was considered low and the risk of bias in animal studies was mostly unclear. Echocardiography may offer a noninvasive tool to detect early signs of cardiovascular predisposition following FGR. Clinical implementation yet faces multiple challenges including identification of the most optimal timing and the exact relation to long-term cardiovascular function in which echocardiography alone might be limited to reflect a child's vascular status. Future research should focus on myocardial strain analysis and the combination of other (non)imaging techniques for an improved risk estimation.
Our meta-analysis revealed echocardiographic differences between fetal growth-restricted and control offspring in humans during the neonatal period: a reduced left ventricular mass and interventricular septum thickness, reduced mitral annular peak velocity, and mitral lateral early diastolic velocity. We were unable to pool echocardiographic parameters in animal studies and human adults because of an insufficient number of studies per individual outcome. The few studies on myocardial strain analysis showed small preclinical changes in FGR offspring.
Different hardening strategies were evaluated regarding their potential to improve the mechanical biofunctionality of the cast and solution-treated low modulus β-Ti alloy Ti 40Nb. The strategies are ...based on thermomechanical treatments comprised of different hot- and cold-rolling steps, as well as annealing treatments aiming at the successive exploitation of different hardening mechanisms (grain boundary hardening, work hardening and precipitation hardening). Quasi-static tensile testing revealed that grain refinement by one order of magnitude has only a small impact on improving the mechanical biofunctionality of Ti-40Nb. However, work hardening effectively improves the tensile strength by 30% to a value of 650MPa, while retaining Young׳s modulus at 60GPa. The α-phase precipitation hardening was verified to have an increasing effect on both, strength and Young׳s modulus. Thereby, the change of Young׳s modulus dominates the change of the strength, even at low α-phase fractions. The pseudo-elastic behavior of Ti 40Nb is discussed under consideration of the microstructural changes due to the thermomechanical treatment. The texture changes evolving upon cold-rolling markedly influence the recrystallization behavior. However, the present results do not show a significant effect of the texture on the mechanical properties of Ti-40Nb.
Exposure to traffic noise and air pollution have both been associated with cardiovascular disease, though the mechanisms behind are not yet clear.
We aimed to investigate whether the two exposures ...were associated with levels of cholesterol in a cross-sectional design.
In 1993–1997, 39,863 participants aged 50–64year and living in the Greater Copenhagen area were enrolled in a population-based cohort study. For each participant, non-fasting total cholesterol was determined in whole blood samples on the day of enrolment. Residential addresses 5-years preceding enrolment were identified in a national register and road traffic noise (Lden) were modeled for all addresses. For air pollution, nitrogen dioxide (NO2) was modeled at all addresses using a dispersion model and PM2.5 was modeled at all enrolment addresses using a land-use regression model. Analyses were done using linear regression with adjustment for potential confounders as well as mutual adjustment for the three exposures.
Baseline residential exposure to the interquartile range of road traffic noise, NO2 and PM2.5 was associated with a 0.58mg/dl (95% confidence interval: −0.09; 1.25), a 0.68mg/dl (0.22; 1.16) and a 0.78mg/dl (0.22; 1.34) higher level of total cholesterol in single pollutant models, respectively. In two pollutant models with adjustment for noise in air pollution models and vice versa, the association between air pollution and cholesterol remained for both air pollution variables (NO2: 0.72 (0.11; 1.34); PM2.5: 0.70 (0.12; 1.28) mg/dl), whereas there was no association for noise (−0.08mg/dl). In three-pollutant models (NO2, PM2.5 and road traffic noise), estimates for NO2 and PM2.5 were slightly diminished (NO2: 0.58 (−0.05; 1.22); PM2.5: 0.57 (−0.02; 1.17) mg/dl).
Air pollution and possibly also road traffic noise may be associated with slightly higher levels of cholesterol, though associations for the two exposures were difficult to separate.
•Traffic noise and air pollution are both associated with cardiovascular disease.•A potential mechanism includes raised levels of blood lipids.•Air pollution was associated with total cholesterol in a study of 36,039 elderly.•Noise was weakly associated with cholesterol before adjustment for air pollution.•It was difficult to separate effects of air pollution and noise in relation to cholesterol.
Tobacco smoke exposure increases the risk of cancer in the liver, but little is known about the possible risk associated with exposure to ambient air pollution.
We evaluated the association between ...residential exposure to air pollution and primary liver cancer incidence.
We obtained data from four cohorts with enrolment during 1985–2005 in Denmark, Austria and Italy. Exposure to nitrogen oxides (NO2 and NOX), particulate matter (PM) with diameter of less than 10µm (PM10), less than 2.5µm (PM2.5), between 2.5 and 10µm (PM2.5–10) and PM2.5 absorbance (soot) at baseline home addresses were estimated using land-use regression models from the ESCAPE project. We also investigated traffic density on the nearest road. We used Cox proportional-hazards models with adjustment for potential confounders for cohort-specific analyses and random-effects meta-analyses to estimate summary hazard ratios (HRs) and 95% confidence intervals (CIs).
Out of 174,770 included participants, 279 liver cancer cases were diagnosed during a mean follow-up of 17 years. In each cohort, HRs above one were observed for all exposures with exception of PM2.5 absorbance and traffic density. In the meta-analysis, all exposures were associated with elevated HRs, but none of the associations reached statistical significance. The summary HR associated with a 10-μg/m3 increase in NO2 was 1.10 (95% confidence interval (CI): 0.93, 1.30) and 1.34 (95% CI: 0.76, 2.35) for a 5-μg/m3 increase in PM2.5.
The results provide suggestive evidence that ambient air pollution may increase the risk of liver cancer. Confidence intervals for associations with NO2 and NOX were narrower than for the other exposures.
•Tobacco smoke increases liver cancer risk but risk of air pollution is less studied.•Residential exposure to ambient air pollution for 4 European cohorts was assessed.•Exposure to ambient air pollution at residence may increase the risk of liver cancer.
To explore the experiences and consequences of bariatric surgery stigma from the perspective of bariatric surgery patients and to identify knowledge gaps in the literature.
A scoping review.
Studies ...published between December 2002 and January 2022 were identified from the following databases: PubMed, Web of Science, PsycINFO and MEDLINE.
We screened 3092 records and included 28 studies. Findings were grouped thematically using the health stigma discrimination framework.
Patients experienced several types of stigmas, including perceived, experienced, anticipated and internalized stigma, related to undergoing bariatric surgery. Patients were confronted with negative comments and judgement from others when they disclosed their decision to have surgery or when they revealed that they had undergone surgery. These experiences led to conflicts in the decision-making process, such as delaying the choice for surgery, seeking surgery abroad or opting out. Patients who internalized stigma often reported feelings of shame and embarrassment for choosing surgery and felt the need for secrecy or selective disclosure. Stigma experiences were influenced by gender and differed between different subgroups of patients.
The stigma surrounding bariatric surgery has detrimental consequences for eligible individuals and bariatric surgery patients. However, the evidence from patients' perspective remains limited. More research into patient's experiences is needed to improve patient care and further educate healthcare professionals. In addition, to better understand the nature and implications of bariatric surgery stigma, future research should be founded on stigma theories and distinguish between the different types of stigmas.
This scoping review contributes to a better understanding of the implications the stigma surrounding bariatric surgery has for bariatric surgery patients before and after surgery. The knowledge generated by this review can inform improvements in the education and management of people living with obesity and bariatric surgery patients.
The scoping review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews checklist.
No Patient or Public Contribution.
A protocol was not registered for this scoping review.
Purpose
To report another two successful pregnancies and deliveries resulting from autotransplanted cryopreserved ovarian tissue several years after the autotransplantation procedure took place. ...Further, to review the literature on the treatment history, number of live births and their outcome so far reported worldwide.
Methods
Two women underwent fertility preservation with cryopreservation of their ovarian tissue prior to a potentially sterilizing treatment with bone marrow transplantation. One woman suffered from paroxystic nocturnal hemoglobinuria and one woman from relapse of Hodgkin′s lymphoma. Both suffered from premature ovarian insufficiency after treatment. Because of a pregnancy wish they later had pieces of thawed cortical tissue transplanted to the remaining ovary and the anterior abdominal wall. PubMed was searched for reports of deliveries resulting from cryopreserved ovarian tissue in peer-reviewed papers.
Results
Five years after the autotransplantation the first patient became spontaneously pregnant and delivered a healthy baby boy at term. The second patient became pregnant after undergoing one cycle of in vitro fertilisation five years after the autotransplantation. She delivered a healthy baby boy at gestational week 36. Twenty healthy singletons and two sets of twins have been born according to peer-reviewed publications.
Conclusion
Contrary to most of the published deliveries our latest two cases occurred several years after the autotransplantation procedure took place. This proves that ovarian grafts are capable of functioning for several years after the autotransplantation has occurred. Today, a total of 26 healthy children have been born as a result of cryopreservation of ovarian tissue.
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