Bowel Dysfunction after Hysterectomy for Benign Conditions: Meta-Analysis and Systematic Review

The aim of this study was to determine whether hysterectomy for a benign indication can cause functional gastrointestinal disorders (FGIDs). A systematic review was completed with the studies, which used a prospective design and validated quality of life questionnaires. A search strategy using Medline and Embase allowed the relevant studies published between 1950 and October 2010 to be found. Meta-analyses were also performed using the studies, which had similar research objectives. The search revealed 29 potentially suitable articles, of which 5 used a prospective design and validated quality of life questionnaires. The meta-analyses showed that the type of hysterectomy (total or subtotal) did not have an impact on whether a patient is likely to develop gastrointestinal symptoms post-surgery. The prospective studies did not show that hysterectomy for a benign indication causes FGIDs. The belief that hysterectomy can cause gastrointestinal dysfunction is based on the results of retrospective studies

Prenatal Exposure to Perfluoroalkyl Acids and Serum Testosterone Concentrations at 15 Years of Age in Female ALSPAC Study Participants

Background: Exposure to perfluorooctane sulfonic acid (PFOS) or to perfluorooctanoic acid (PFOA) increases mouse and human peroxisome proliferator–activated receptor alpha (PPARα) subtype activity, which influences lipid metabolism. Because cholesterol is the substrate from which testosterone is synthesized, exposure to these substances has the potential to alter testosterone concentrations. Objectives: We explored associations of total testosterone and sex hormone–binding globulin (SHBG) concentrations at age 15 years with prenatal exposures to PFOS, PFOA, perfluorohexane sulfonic acid (PFHxS), and perfluoronanoic acid (PFNA) in females. Methods: Prenatal concentrations of the perfluoroalkyl acids (PFAAs) were measured in serum collected from pregnant mothers at enrollment (1991–1992) in the Avon Longitudinal Study of Parents and Children (ALSPAC). The median gestational age when the maternal blood sample was obtained was 16 weeks (interquartile range, 11–28 weeks). Total testosterone and SHBG concentrations were measured in serum obtained from their daughters at 15 years of age. Associations between prenatal PFAAs concentrations and reproductive outcomes were estimated using linear regression models (n = 72). Results: Adjusted total testosterone concentrations were on average 0.18-nmol/L (95% CI: 0.01, 0.35) higher in daughters with prenatal PFOS in the upper concentration tertile compared with daughters with prenatal PFOS in the lower tertile. Adjusted total testosterone concentrations were also higher in daughters with prenatal concentrations of PFOA (β = 0.24; 95% CI: 0.05, 0.43) and PFHxS (β = 0.18; 95% CI: 0.00, 0.35) in the upper tertile compared with daughters with concentrations in the lower tertile. We did not find evidence of associations between PFNA and total testosterone or between any of the PFAAs and SHBG. Conclusions: Our findings were based on a small study sample and should be interpreted with caution. However, they suggest that prenatal exposure to some PFAAs may alter testosterone concentrations in females

An evaluation of stakeholder management approach for improving energy efficiency outcomes in housing

Context - Energy efficient housing is influenced by a number of attributes that describe the key players involved in its production. Stakeholders’ levels of interest, motivation, awareness and power to impose their decision can have an impact on housing energy performance. Understanding these stakeholder attributes can help resolve barriers to energy efficiency performance. Approach - This paper examines a number of stakeholder management approaches, compares their classification and prioritisation approaches and analyses each approach’s suitability to be adopted for managing energy efficiency stakeholders. Results - Energy efficiency stakeholders can be classified as internal and external, with the attributes of power, interest, proximity and knowledge. The most suitable stakeholder management approach enables these attributes to be quantified, and with the addition of a time management, could enable a better understanding and management of energy efficiency stakeholders. Implications - This approach may enable a correlation between stakeholder management strategies and the energy performance of housing, and manage the relationships between stakeholders in a way that ensures the achievement of both their individual interests and sustainability goals. Originality - This paper explores the possibility of applying stakeholders’ theories that are commonly used for managing organisations to one aspect of the housing industry (energy efficiency)

Birth Weight in Relation to Fetal and Maternal Leptin and Insulin: A Systematic Review and Meta-analysis

Abstract leptin and insulin have been implicated in fetal growth regulation and investigated repeatedly with controversial outcomes. A systematic review and meta-analysis were conducted according to MOOSE guidelines to establish if consistency exists in the reported literature so that the role of maternal and fetal insulin and leptin in fetal growth could be assessed. A robust recognised systematic methodology was used in the literature search and data extraction and analysis to avoid bias. SPSS version 16 and RevMan 4.2 were used for statistical analysis and the results presented as a Weighted Mean Difference (WMD) and 95% CI. Nineteen studies were included. Large for gestational age babies (LGA) had significantly higher cord serum insulin and leptin levels than was adequate for gestational age (AGA) ones[3.16 µIU/ml (0.85, 5.48) and -4.33 ng/ml (-5.30, -3.36) respectively]. Small for gestational age babies (SGA) had similar insulin levels but significantly lower cord leptin[21 µIU/ml (-5.69, 1.27)] than AGA babies [-3.07ng/ml (-4.57, -1.58)]. Maternal serum levels of leptin were similar between mothers of LGA, SGA and AGA babies. Conclusion: although both fetal insulin and leptin reflect the degree of fetal adiposity, leptin may have growth promoting properties

Do South Asian women with PCOS have poorer health-related quality of life than Caucasian women with PCOS? A comparative cross-sectional study.

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common chronic endocrine disorder affecting women of reproductive age. This study aimed to compare the HRQoL of South Asian and white Caucasian women with PCOS, given that it is particularly common among women of South Asian origin and they have been shown to have more severe symptoms. METHODS: The Polycystic Ovary Syndrome Questionnaire (PCOSQ) and the Short Form-36 (SF-36) were administered in a cross-sectional survey to 42 South Asian and 129 Caucasian women diagnosed with PCOS recruited from the gynaecology outpatient clinics of two university teaching hospitals in Sheffield and Leeds. Additional clinical data was abstracted from medical notes. Normative data, collected as part of the Oxford Health and Lifestyles II survey, was obtained to compare SF-36 results with ethnically matched women from the general UK population. Using the SF-36, normative HRQoL scores for women of South Asian origin were lower than for Caucasian women. Given this lower baseline we tested whether the same relationship holds true among those with PCOS. RESULTS: Although HRQoL scores for women with PCOS were lower than normative data for both groups, South Asian women with PCOS did not have poorer HRQoL than their Caucasian counterparts. For both the SF-36 and PCOSQ, mean scores were broadly the same for both Asian and Caucasian women. For both groups, the worst two HRQoL domains as measured on the PCOSQ were 'infertility' and 'weight', with respective scores of 35.3 and 42.3 for Asian women with PCOS compared to 38.6 and 35.4 for Caucasian women with PCOS. The highest scoring domain for South Asian women with PCOS was 'menstrual problems' (55.3), indicating best health, and was the only statistically significant difference from Caucasian women (p = 0.01). On the SF-36, the lowest scoring domain was 'Energy & Vitality' for Caucasian women with PCOS, but this was significantly higher for Asian women with PCOS (p = 0.01). The best health status for both groups was 'physical functioning', although this was significantly lower for South Asian women with PCOS (p = 0.005). Interestingly, only two domains differed significantly from the normative data for the Asian women with PCOS, while seven domains were significantly different for the Caucasian women with PCOS compared to their normative counterparts. CONCLUSIONS: The HRQoL differences that exist between South Asian and Caucasian women in the general population do not appear to be replicated amongst women with PCOS. PCOS reduces HRQoL to broadly similar levels, regardless of ethnicity and differences in the normative baseline HRQoL of these groups

Effect of ethnicity on live birth rates after in vitro fertilisation/intracytoplasmic sperm injection treatment: analysis of UK national database

Objective To evaluate the effect of ethnicity of women on the outcome of in vitro fertilisation (IVF) or intracytoplasmic sperm injection (ICSI) treatment. Design Observational cohort study. Setting UK National Database. Population Data from 2000 to 2010 involving 38 709 women undergoing their first IVF/ICSI cycle were analysed. Methods Anonymous data were obtained from the Human Fertilization and Embryology Authority (HFEA), the statutory regulator of IVF and ICSI treatment in the UK. Data analysis was performed by regression analysis with adjustment for age, cause and type of infertility and treatment type (IVF or ICSI) to express results as odds ratio (OR) and 95% confidence intervals (95% CI). Methods Live birth rate per cycle of IVF or ICSI treatment. Results While white Irish (OR 0.73; 95% CI 0.60–0.90), Indian (0.85; 0.75–0.97), Bangladeshi (0.53: 0.33–0.85), Pakistani (0.68; 0.58–0.80), Black African (0.60; 0.51–0.72), and other non-Caucasian Asian (0.86; 0.73–0.99) had a significantly lower odds of live birth rates per fresh IVF/ICSI cycle than White British women, ethnic groups of White European (1.04; 0.96–1.13), Chinese (1.12; 0.77–1.64), Black Caribbean (0.76; 0.51–1.13), Middle Eastern (0.73; 0.51–1.04), Mediterranean European (1.18; 0.83–1.70) and Mixed race population (0.94; 0.73–1.19) had live birth rates that did not differ significantly. The cumulative live birth rates showed similar patterns across different ethnic groups. Conclusion Ethnicity is a major determinant of IVF/ICSI treatment outcome as indicated by significantly lower live birth rates in some of the ethnic minority groups compared with white British women

Student groups of complementary skills developing artificial intelligence solutions for natural sciences -- an authentic research education approach suitable for wide adoption

We report a methodology in which students gain experience in authentic research by developing artificial intelligence (AI) solutions for researchers in natural sciences. While creating education benefits for students, our approach also directly benefits scientists, who get an opportunity to evaluate the usefulness of machine learning for their specific needs. In order to accomplish this, we work with research laboratories that reveal/specify the needs they have, and then our student teams work on the discovery, design, and development of an AI solution for unique problems using a consulting-like arrangement. Our design addresses common barriers which appear in most existing authentic research education approaches and thus is suitable for wide adoption at various schools. To date, our group has been operating at New York University (NYU) for five consecutive semesters and has engaged more than seventy students, ranging from first-year college students to master's candidates, and worked on more than 15 projects with 14 collaborators

Socioeconomic conditions across life related to multiple measures of the endocrine system in older adults:Longitudinal findings from a British birth cohort study

AbstractBackgroundLittle is known about how socioeconomic position (SEP) across life impacts on different axes of the endocrine system which are thought to underlie the ageing process and its adverse consequences. We examined how indicators of SEP across life related to multiple markers of the endocrine system in late midlife, and hypothesized that lower SEP across life would be associated with an adverse hormone profile across multiple axes.MethodsData were from a British cohort study of 875 men and 905 women followed since their birth in March 1946 with circulating free testosterone and insulin-like growth factor-I (IGF-I) measured at both 53 and 60–64 years, and evening cortisol at 60–64 years. Indicators of SEP were ascertained prospectively across life—paternal occupational class at 4, highest educational attainment at 26, household occupational class at 53, and household income at 60–64 years. Associations between SEP and hormones were investigated using multiple regression and logistic regression models.ResultsLower SEP was associated with lower free testosterone among men, higher free testosterone among women, and lower IGF-I and higher evening cortisol in both sexes. For example, the mean standardised difference in IGF-I comparing the lowest with the highest educational attainment at 26 years (slope index of inequality) was −0.4 in men (95% CI -0.7 to −0.2) and −0.4 in women (−0.6 to −0.2). Associations with each hormone differed by SEP indicator used and sex, and were particularly pronounced when using a composite adverse hormone score. For example, the odds of having 1 additional adverse hormone concentration in the lowest compared with highest education level were 3.7 (95% CI: 2.1, 6.3) among men, and 1.6 (1.0, 2.7) among women (P (sex interaction) = 0.02). We found no evidence that SEP was related to apparent age-related declines in free testosterone or IGF-I.ConclusionsLower SEP was associated with an adverse hormone profile across multiple endocrine axes. SEP differences in endocrine function may partly underlie inequalities in health and function in later life, and may reflect variations in biological rates of ageing. Further studies are required to assess the likely functional relevance of these associations

The Characteristics and Clinical Significance of Atypical Mitosis in Breast Cancer

Atypical mitosis is considered a feature of malignancy, however, its significance in breast cancer (BC) remains elusive. Here, we aimed to assess the clinical value of atypical mitoses in BC and to explore their underlying molecular features. Atypical and typical mitotic figures were quantified and correlated with clinicopathological variables in a large cohort of primary BC tissue sections (n = 846) using digitalized hematoxylin and eosin whole-slide images (WSIs). In addition, atypical mitoses were assessed in The Cancer Genome Atlas (TCGA) BC dataset (n = 1032) and were linked to the genetic alterations and pathways. In this study, the median of typical mitoses was 17 per 3 mm2 (range 0–120 mitoses), while the median of atypical mitoses was 4 (range 0–103 mitoses). High atypical mitoses were significantly associated with parameters characteristic of aggressive tumor behavior. The total number of mitoses, and a high atypical-to-typical mitoses ratio (>0.27) were associated with poor BC specific survival (BCSS), (p = 0.04 and 0.01, respectively). The atypical-to-typical mitoses ratio dichotomized triple negative-BC (TNBC) patients into two distinct groups in terms of the association with the outcome, while the overall number of mitoses was not. Moreover, TNBC patients with high atypical-to-typical mitoses ratio treated with adjuvant chemotherapy were associated with shorter survival (p = 0.003). Transcriptomic analysis of the TCGA-BRCA cohort dichotomized based on atypical mitoses identified 2494 differentially expressed genes. These included genes linked to pathways involved in chromosomal localization and segregation, centrosome assembly, spindle and microtubule formation, regulation of cell cycle and DNA repair. To conclude, the atypical-to-typical mitoses ratio has prognostic value independent of the overall mitotic count in BC patients and could predict the response to chemotherapy in TNBC