205 research outputs found

    Comparative efficacy of exercise, diet and/or pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity: a systematic review and network meta-analysis

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    Supplementary data are available at Human Reproduction Update online: https://academic.oup.com/humupd/article-lookup/doi/10.1093/humupd/dmae008#supplementary-dataBACKGROUND The increasing prevalence of obesity worldwide poses a significant threat to reproductive function owing, in part, to hormonal disturbances caused by negative feedback between excess adiposity and the hypothalamic–pituitary–ovarian axis. Consequently, finding the most appropriate strategies to lose weight and improve ovulation in women with overweight or obesity is a clinically relevant matter that needs to be investigated. A comprehensive comparison of the independent and combined efficacy of lifestyle and/or pharmacological interventions on BMI, ovulation, and hormonal profile in women with overweight or obesity at risk of anovulatory infertility would facilitate improving fertility strategies in this population. OBJECTIVE AND RATIONALE This study aimed to evaluate the comparative efficacy of exercise, diet, and pharmacological interventions on BMI, ovulation, and hormonal profile in reproductive-aged women with overweight or obesity. SEARCH METHODS A systematic review was performed by searching PubMed, Scopus, Web of Science, PsycINFO, and Cochrane Library up to 14 December 2023, for randomized controlled trials assessing the effects of exercise, diet and/or pharmacological interventions (i.e. weight-lowering drugs or ovulation inducers) on BMI, ovulation, and/or hormonal profile in reproductive-aged women with overweight or obesity. We performed frequentist random-effect network meta-analyses and rated the certainty of the evidence. The primary outcomes were BMI and ovulation rate, and the secondary outcomes were serum reproductive hormone levels (gonadotrophins, androgens, or oestrogens). We performed sensitivity analyses, including the studies that only involved women with PCOS. OUTCOMES Among 1190 records screened, 148 full texts were assessed for eligibility resulting in 95 trials (9910 women), of which 53% presented a high or unclear risk of bias. The network meta-analyses revealed that, compared to control: diet combined with weight-lowering drugs (mean difference (MD) −2.61 kg/m2; 95% CI −3.04 to −2.19; τ2 = 0.22) and adding exercise (MD −2.35 kg/m2; 95% CI −2.81 to −1.89; τ2 = 0.22) led to the greatest decrease in BMI; exercise combined with diet and ovulation inducers (risk ratio (RR) 7.15; 95% CI 1.94–26.40; τ2 = 0.07) and exercise combined with diet and weight-lowering drugs (RR 4.80; 95% CI 1.67–13.84; τ2 = 0.07) produced the highest increase in ovulation rate; and exercise combined with diet and weight-lowering drugs was the most effective strategy in reducing testosterone levels (standardized mean difference (SMD) −2.91; 95% CI −4.07 to −1.74; τ2 = 2.25), the third most effective strategy in increasing sex hormone-binding globulin levels (SMD 2.37; 95% CI 0.99–3.76; τ2 = 2.48), and it was coupled with being ranked first in terms of free androgen index reduction (SMD −1.59; 95% CI −3.18 to 0.01; τ2 = 1.91). The surface under the cumulative ranking curve scores suggested that: diet combined with weight-lowering drugs is the strategy most likely (94%) to produce the highest BMI reduction; and exercise combined with diet and ovulation inducers is the strategy most likely (89%) to produce the highest ovulation rate improvement. The sensitivity analyses, which exclusively included studies involving women diagnosed with PCOS, were consistent with the results presented above. WIDER IMPLICATIONS Overall, the findings of this network meta-analysis indicate that the combination of exercise, diet, and pharmacological interventions is effective for weight loss, improving ovulation, and normalizing the androgen levels of women with overweight or obesity. Although higher quality studies are needed, these results support that the optimal treatment strategy for women with overweight or obesity wishing to conceive must consider exercise, diet, and pharmacological interventions during the shared decision-making process.Ministerio de Economía y Competitividad (MINECO), Plan Nacional de IþDþi call RETOS 2018 (grant number RTI2018-093302-A-I00).Ministry of Science, Innovation and Universities of the government of Spain Grant number FPU20/05746 Grant number FPU21/04573Plan Propio de Investigación, ‘Gerty Cori program’, from University of Almería, SpainProjects Endo-Map PID2021- 12728OB-100 and ROSY CNS2022-135999 funded by MICIU/AEI/ 10.13039/501100011033 and by FEDER, EUFunding for open access charge: Universidad de Almería (Spain)/CBU

    Transmission electron microscopy study of vertical quantum dots molecules grown by droplet epitaxy

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    3 páginas, 3 figuras.-- Progress in Applied Surface, Interface and Thin Film Science - SURFINT SREN II.-- PACS codes: 68.37.Lp; 81.05.Ea; 81.15.HiThe compositional distribution of InAs quantum dots grown by molecular beam epitaxy on GaAs capped InAs quantum dots has been studied in this work. Upper quantum dots are nucleated preferentially on top of the quantum dots underneath, which have been nucleated by droplet epitaxy. The growth process of these nanostructures, which are usually called as quantum dots molecules, has been explained. In order to understand this growth process, the analysis of the strain has been carried out from a 3D model of the nanostructure built from transmission electron microscopy images sensitive to the composition.This work was supported by the Spanish MCI (TEC2008-06756-C03-02/TEC), CONSOLIDER CSD2009-00013, and the Junta de Andalucia (PAI research groups TEP-120 and TIC-145, project P08-TEP-03516).Peer reviewe

    Fail-aware LIDAR-based odometry for autonomous vehicles

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    Autonomous driving systems are set to become a reality in transport systems and, so, maximum acceptance is being sought among users. Currently, the most advanced architectures require driver intervention when functional system failures or critical sensor operations take place, presenting problems related to driver state, distractions, fatigue, and other factors that prevent safe control. Therefore, this work presents a redundant, accurate, robust, and scalable LiDAR odometry system with fail-aware system features that can allow other systems to perform a safe stop manoeuvre without driver mediation. All odometry systems have drift error, making it difficult to use them for localisation tasks over extended periods. For this reason, the paper presents an accurate LiDAR odometry system with a fail-aware indicator. This indicator estimates a time window in which the system manages the localisation tasks appropriately. The odometry error is minimised by applying a dynamic 6-DoF model and fusing measures based on the Iterative Closest Points (ICP), environment feature extraction, and Singular Value Decomposition (SVD) methods. The obtained results are promising for two reasons: First, in the KITTI odometry data set, the ranking achieved by the proposed method is twelfth, considering only LiDAR-based methods, where its translation and rotation errors are 1.00% and 0.0041 deg/m, respectively. Second, the encouraging results of the fail-aware indicator demonstrate the safety of the proposed LiDAR odometry system. The results depict that, in order to achieve an accurate odometry system, complex models and measurement fusion techniques must be used to improve its behaviour. Furthermore, if an odometry system is to be used for redundant localisation features, it must integrate a fail-aware indicator for use in a safe manner

    Profiles of lateral violence in nursing personnel of the Spanish public health system

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    Background Workplace violence in healthcare settings has long been studied in scientific literature, particularly in the nursing profession. Research has explored mostly user violence probably for its high prevalence and impact on health and job satisfaction. Yet this focus may overshadow another dangerous type of workplace violence: coworker violence. Exerted by co-workers with similar status, lateral violence differs from that yielded by a co-worker with a higher rank, known as vertical. This study aims to deepen the knowledge about lateral violence perceived by nurses and its interaction with other variables commonly associated with workplace violence in healthcare: burnout, job satisfaction, and self-perceived health. Method A random block sampling was performed, prompting a total sample of 925 nursing professionals from 13 public hospitals located in the southeast of Spain. The sample distribution (mean and standard deviation) and the response percentages according to the study variables of the ad-hoc questionnaire were analyzed and classified with cluster analysis. Results Through the cluster analysis, two subgroups were obtained: Cluster 1, composed of 779 participants, with low scores in the variables used for the classification, high levels of both extrinsic and intrinsic satisfaction, low levels of emotional exhaustion and cynicism, and low rates of somatization, anxiety, social dysfunction and depression; and Cluster 2, composed of 115 participants and characterized by moderate-high scores in the variables used for the classification, moderate extrinsic satisfaction, and low intrinsic satisfaction, high emotional exhaustion and cynicism and lower somatization, anxiety, social dysfunction, and depression scores. Excluded cases amounted to 31. Conclusion Nursing professionals who experience lateral violence reveal a lower intrinsic satisfaction, feeling less self-accomplished in their job, and less positive work experience. Emotional exhaustion rises as a concerning progressive and long-term outcome of experiencing this type of violence

    Electrical properties of biomorphic SiC ceramics and SiC/Si composites fabricated from medium density fiberboard

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    A study has been made of the dependences of the electrical resistivity and the Hall coefficient on the temperature in the range 1.8–1300 K and on magnetic fields of up to 28 kOe for the biomorphic SiC/Si (MDF-SiC/Si) composite and biomorphic porous SiC (MDF-SiC) based upon artificial cellulosic precursor (MDF – medium density fiberboards). It has been shown that electric transport in MDF-SiC is effected by carriers of n-type with a high concentration of ∼1020 cm−3 and a low mobility of ∼0.4 cm2 V−1 s−1. The specific features in the conductivity of MDF-SiC are explained by quantum effects arising in disordered systems and requiring quantum corrections to conductivity. The TEM studies confirmed the presence of disordering structural features (nanocrystalline regions) in MDF-SiC. The conductivity of MDF-SiC/Si composite originates primarily from Si component in the temperature range 1.8–500 K and since ∼500 to 600 K the contribution of MDF-SiC matrix becomes dominant

    Tough Love Lessons: Lateral Violence among Hospital Nurses

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    Background: Workplace violence is a growing social problem among many professions, but it particularly affects the health sector. Studies have mainly focused on evaluating user violence toward health professionals, with less attention being paid to other sources of conflict, such as co-workers themselves. There are different manifestations of this violence in what has been called a context of tolerated or normalized violence among co-workers. However, its effects are far from being tolerable, as they have an impact on general health and job satisfaction and contribute to burnout among professionals. Based on this idea, and following the line of the previous literature, nursing staff are a population at high risk of exposure to workplace violence. For this reason, the present study aims to evaluate exposure to lateral violence or violence among co-workers in nursing staff in public health services and the relationship of this exposure with some of the most studied consequences. (2) Methods: A cross-sectional associative study was carried out in which scales of workplace violence (HABS-CS), burnout (MBI-GS), job satisfaction (OJS), and general health (GHQ-28) were applied to a sample of 950 nursing staff from 13 public hospitals located in the southeast of Spain. (3) Results: The results show that nursing staff have a high exposure to violence from their co-workers, which is more common in male nurses. Greater exposure is observed in professionals with between 6 and 10 years of experience in the profession, and it is not characteristic of our sample to receive greater violence when they have less experience or are younger. A positive correlation is observed with high levels of burnout and a negative correlation with general health and job satisfaction. (4) Conclusions: The results of this work contribute to increasing the scientific evidence of the consequences of a type of workplace violence frequent among nursing staff and to which less attention has been paid in relative terms to other types of prevalent violence. Organizations should be aware of the importance of this type of workplace violence, its frequency and impact, and implement appropriate prevention policies that include the promotion of a culture that does not reward violence or minimize reporting. A change of mentality in the academic environment is also recommended in order to promote a more adequate training of nursing staff in this field

    Users’ perception of violence and conflicts with professionals in primary care centers before and during covid-19. a qualitative study

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    Background: Workplace violence is a social problem of special interest in both intervention and research. Among the sectors that most perceive this type of violence, health care professionals stand out. The most common type of violence for this professional group is the one perpetrated by the users or patients themselves. It has been reported that one out of every four acts of violence in the workplace occurs in the healthcare setting. Within the health sector, the Mental Health, Emergency and Primary Care services have been widely reported as being among the most vulnerable, with Primary Care being the least addressed of the three. Although the available literature is extensive, there are hardly any studies that explore from a qualitative perspective what are the sources of conflict in this sector from the perspective of the users, the most common being to work with professionals. Objective: The aim of this study is to examine those aspects derived from the organization, the professionals or the users of Primary Care that, from the users’ point of view, cause violent situations and how they think these could be avoided. Method: The sample consisted of 80 users of the Primary Care services of the Health Service of Murcia. For data collection, a qualitative study was conducted through 10 focus groups and a subsequent thematic analysis of the data. Results: The results have allowed us to identify that, from an organizational point of view, the uncertainty in waiting times, the need to adapt the telematic or telephone appointment to the different types of users, or the management of emergencies in Primary Care are the aspects that cause most conflicts between users and professionals. In this sense, suggested improvements are aimed at providing information in the mobile application updated on the opening hours or maintaining the telephone appointment for those who need or request it, among many others. As for the professionals, users point out that the medical staff is perceived as distant and sometimes does not provide

    ANTOLOGÍA DE MERCADOTECNIA SOCIAL Y DE SERVICIOS

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    Entendiendo que el valor es un beneficio percibido, se pueden crear diferentes valores mediante un solo proceso comercial, esto provoca una un acercamiento a la eficiencia comercial, ya que en un solo proceso se satisfacen a los diferentes implicados en la comercialización. La empresa, los clientes y la sociedad, son los 3 elementos a los cuales se debe de proveer de un valor mediante el proceso comercial, los clientes buscan recibir un beneficio, la satisfacción de una necesidad, la empresa busca recibir otro beneficio, recurso económico, la sociedad, ¿qué valor busca la sociedad?, ¿Por qué es importante generar valor en la sociedad?, ¿Cómo generamos valor a la sociedad?; estas cuestiones son las que se abordan en la unidad de aprendizaje Mercadotecnia social y de servicios.La empresa, los clientes y la sociedad, son los 3 elementos a los cuales se debe de proveer de un valor mediante el proceso comercial, los clientes buscan recibir un beneficio, la satisfacción de una necesidad, la empresa busca recibir otro beneficio, recurso económico, la sociedad, ¿qué valor busca la sociedad?, ¿Por qué es importante generar valor en la sociedad?, ¿Cómo generamos valor a la sociedad?; estas cuestiones son las que se abordan en la unidad de aprendizaje Mercadotecnia social y de servicios. La mercadotecnia es la encargada de crear, diseñar, utilizar y administrar estratégicamente las herramientas, la información, las técnicas y las tácticas adecuadas para lograr comercializar productos, servicios e ideas, de manera eficiente. El logro de comercializar de manera óptima es alcanzado no solo mediante la transacción de bienes, es alcanzado mediante la creación de valor para todos los elementos implicados en las acciones de transacción
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