The Next Frontier for Men\u27s Contraceptive Choice: College Men\u27s Willingness to Pursue Male Hormonal Contraception

Unplanned pregnancy is a concern for emerging adult men, but their contraceptive options are limited. With male hormonal contraception clinical trials in progress, it is important to investigate men’s attitudes toward alternative contraception. Many social factors, such as masculine norms, may hinder their interest. This study used the prototype–willingness model to investigate college men’s willingness to pursue hormonal contraception. Male college students (N = 160; Mage = 19.37, SD = 1.33; 61.9% White) read a description of male contraception clinical trials and filled out a questionnaire assessing prototype–willingness and masculinity constructs. Multinomial logistic regression revealed that men perceiving greater male contraceptive use and more favorable prototypes of a typical user had higher odds of having high willingness compared with no willingness (norms: odds ratio [OR] = 29.78, 95% confidence interval [CI] [5.79, 153.18]; prototypes: OR = 3.93, 95% CI [1.96, 7.87]). Men rating higher avoidance of femininity had lower odds of having high willingness compared with no willingness (OR = .60, 95% CI [.40, .92]). Perceived risk of unplanned pregnancy failed to associate with willingness to use contraception, suggesting the importance of men’s social cognitions (norms and favorable images) and identity (masculinity) when promoting male hormonal contraception. Men’s avoidance of femininity may hinder their willingness, but promotion of male norms and favorable male users may enhance clinical trial recruitment and eventual public health campaigns to expand men’s contraceptive options. Future studies should examine diverse college and noncollege samples to determine the generalizability of these results to the broader emerging adult male population

The Next Frontier for Men\u27s Contraceptive Choice: College Men\u27s Willingness to Pursue Male Hormonal Contraception

Unplanned pregnancy is a concern for emerging adult men, but their contraceptive options are limited. With male hormonal contraception clinical trials in progress, it is important to investigate men’s attitudes toward alternative contraception. Many social factors, such as masculine norms, may hinder their interest. This study used the prototype–willingness model to investigate college men’s willingness to pursue hormonal contraception. Male college students (N = 160; Mage = 19.37, SD = 1.33; 61.9% White) read a description of male contraception clinical trials and filled out a questionnaire assessing prototype–willingness and masculinity constructs. Multinomial logistic regression revealed that men perceiving greater male contraceptive use and more favorable prototypes of a typical user had higher odds of having high willingness compared with no willingness (norms: odds ratio [OR] = 29.78, 95% confidence interval [CI] [5.79, 153.18]; prototypes: OR = 3.93, 95% CI [1.96, 7.87]). Men rating higher avoidance of femininity had lower odds of having high willingness compared with no willingness (OR = .60, 95% CI [.40, .92]). Perceived risk of unplanned pregnancy failed to associate with willingness to use contraception, suggesting the importance of men’s social cognitions (norms and favorable images) and identity (masculinity) when promoting male hormonal contraception. Men’s avoidance of femininity may hinder their willingness, but promotion of male norms and favorable male users may enhance clinical trial recruitment and eventual public health campaigns to expand men’s contraceptive options. Future studies should examine diverse college and noncollege samples to determine the generalizability of these results to the broader emerging adult male population

Pretreatment malnutrition and quality of life - association with prolonged length of hospital stay among patients with gynecological cancer: a cohort study

Background Length of hospital stay (LOS) is a surrogate marker for patients' well-being during hospital treatment and is associated with health care costs. Identifying pretreatment factors associated with LOS in surgical patients may enable early intervention in order to reduce postoperative LOS. Methods This cohort study enrolled 157 patients with suspected or proven gynecological cancer at a tertiary cancer centre (2004-2006). Before commencing treatment, the scored Patient Generated - Subjective Global Assessment (PG-SGA) measuring nutritional status and the Functional Assessment of Cancer Therapy-General (FACT-G) scale measuring quality of life (QOL) were completed. Clinical and demographic patient characteristics were prospectively obtained. Patients were grouped into those with prolonged LOS if their hospital stay was greater than the median LOS and those with average or below average LOS. Results Patients' mean age was 58 years (SD 14 years). Preoperatively, 81 (52%) patients presented with suspected benign disease/pelvic mass, 23 (15%) with suspected advanced ovarian cancer, 36 (23%) patients with suspected endometrial and 17 (11%) with cervical cancer, respectively. In univariate models prolonged LOS was associated with low serum albumin or hemoglobin, malnutrition (PG-SGA score and PG-SGA group B or C), low pretreatment FACT-G score, and suspected diagnosis of cancer. In multivariable models, PG-SGA group B or C, FACT-G score and suspected diagnosis of advanced ovarian cancer independently predicted LOS. Conclusions Malnutrition, low quality of life scores and being diagnosed with advanced ovarian cancer are the major determinants of prolonged LOS amongst gynecological cancer patients. Interventions addressing malnutrition and poor QOL may decrease LOS in gynecological cancer patients

Antenatal corticosteroids impact the inflammatory rather than the antiangiogenic profile of women with preeclampsia

Circulating antiangiogenic factors and proinflammatory cytokines are implicated in the pathogenesis of preeclampsia. This study was performed to test the hypothesis that steroids modify the balance of inflammatory and proangiogenic and antiangiogenic factors that potentially contribute to the patient's evolving clinical state. Seventy singleton women, admitted for antenatal corticosteroid treatment, were enrolled prospectively. The study group consisted of 45 hypertensive women: chronic hypertension (n=6), severe preeclampsia (n=32), and superimposed preeclampsia (n=7). Normotensive women with shortened cervix (<2.5 cm) served as controls (n=25). Maternal blood samples of preeclampsia cases were obtained before steroids and then serially up until delivery. A clinical severity score was designed to clinically monitor disease progression. Serum levels of angiogenic factors (soluble fms-like tyrosine kinase-1 [sFlt-1], placental growth factor [PlGF], soluble endoglin [sEng]), endothelin-1 (ET-1), and proinflammatory markers (IL-6, C-reactive protein [CRP]) were assessed before and after steroids. Soluble IL-2 receptor (sIL-2R) and total immunoglobulins (IgG) were measured as markers of T- and B-cell activation, respectively. Steroid treatment coincided with a transient improvement in clinical manifestations of preeclampsia. A significant decrease in IL-6 and CRP was observed although levels of sIL-2R and IgG remained unchanged. Antenatal corticosteroids did not influence the levels of angiogenic factors but ET-1 levels registered a short-lived increase poststeroids. Although a reduction in specific inflammatory mediators in response to antenatal steroids may account for the transient improvement in clinical signs of preeclampsia, inflammation is unlikely to be the major contributor to severe preeclampsia or useful for therapeutic targeting. © 2014 American Heart Association, Inc

Solitary neurofibroma in the male breast

BACKGROUND: Neurofibroma of the male breast outside of neurofibromatosis is extremely rare with only one previous case having been reported. CASE PRESENTATION: A 48 year old male patient with a neurofibroma in the breast presenting with gynaecomastia is reported. Clinical and mammogram findings with fine needle aspiration cytology and full histology are presented. CONCLUSION: To our knowledge this is only the second case of a neurofibroma in a male breast in the English literature and the first report to include the mammographic findings

Spacecraft potential control for Double Star

International audienceThe spacecraft potential of Double Star TC-1 is positive in large parts of the orbits due to the photo-effect from solar EUV irradiation. These positive potentials typically disturb low energy plasma measurements on board. The potential can be reduced, and thereby the particle measurements improved, by emitting a positive ion beam. This method has successfully been applied on several other spacecraft and it has also been chosen for TC-1. The instrument TC-1/ASPOC is a derivative of the Cluster/ASPOC instruments, from which it has inherited many features. The paper describes the adaptations and further developments made for the ion emitters and the electronics. The instrument performs very well and can support higher beam currents than on Cluster. The expected significant improvement of the low energy particle measurements on board was indeed observed. The modifications of the electron distributions are analysed for a one-time interval when the spacecraft was located in the magnetosheath. The change in the potential due to the ion beam was determined, and first studies of the 3-D electron distributions in response to the spacecraft potential control have been performed, which indicate that the method works as expected

The annual recurrence risk model for tailored surveillance strategy in patients with cervical cancer

Purpose: Current guidelines for surveillance strategy in cervical cancer are rigid, recommending the same strategy for all survivors. The aim of this study was to develop a robust model allowing for individualised surveillance based on a patient's risk profile. Methods: Data of 4343 early-stage patients with cervical cancer treated between 2007 and 2016 were obtained from the international SCCAN (Surveillance in Cervical Cancer) consortium. The Cox proportional hazards model predicting disease-free survival (DFS) was developed and internally validated. The risk score, derived from regression coefficients of the model, stratified the cohort into significantly distinctive risk groups. On its basis, the annual recurrence risk model (ARRM) was calculated. Results: Five variables were included in the prognostic model: maximal pathologic tumour diameter; tumour histotype; grade; number of positive pelvic lymph nodes; and lymphovascular space invasion. Five risk groups significantly differing in prognosis were identified with a five-year DFS of 97.5%, 94.7%, 85.2% and 63.3% in increasing risk groups, whereas a two-year DFS in the highest risk group equalled 15.4%. Based on the ARRM, the annual recurrence risk in the lowest risk group was below 1% since the beginning of follow-up and declined below 1% at years three, four and >5 in the medium-risk groups. In the whole cohort, 26% of recurrences appeared at the first year of the follow-up, 48% by year two and 78% by year five. Conclusion: The ARRM represents a potent tool for tailoring the surveillance strategy in early-stage patients with cervical cancer based on the patient's risk status and respective annual recurrence risk. It can easily be used in routine clinical settings internationally

Notch-induced T cell development requires phosphoinositide-dependent kinase 1

Phosphoinositide-dependent kinase l (PDK1) phosphorylates and activates multiple AGC serine kinases, including protein kinase B (PKB), p70Ribosomal S6 kinase (S6K) and p90Ribosomal S6 kinase (RSK). PDK1 is required for thymocyte differentiation and proliferation, and herein, we explore the molecular basis for these essential functions of PDK1 in T lymphocyte development. A key finding is that PDK1 is required for the expression of key nutrient receptors in T cell progenitors: CD71 the transferrin receptor and CD98 a subunit of L-amino acid transporters. PDK1 is also essential for Notch-mediated trophic and proliferative responses in thymocytes. A PDK1 mutant PDK1 L155E, which supports activation of PKB but no other AGC kinases, can restore CD71 and CD98 expression in pre-T cells and restore thymocyte differentiation. However, PDK1 L155E is insufficient for thymocyte proliferation. The role of PDK1 in thymus development thus extends beyond its ability to regulate PKB. In addition, PDK1 phosphorylation of AGC kinases such as S6K and RSK is also necessary for thymocyte development

Association of nutritional status and serum albumin levels with development of toxicity in patients with advanced non-small cell lung cancer treated with paclitaxel-cisplatin chemotherapy: a prospective study

<p>Abstract</p> <p>Background</p> <p>A frequent manifestation of advanced NSCLC is malnutrition, even though there are many studies which relate it with a poor survival, its relation with toxicity has not yet been consistently reported. The aim of this study was to associate malnutrition and albumin serum levels with the occurrence of chemotherapy-induced toxicity in cisplatin plus paclitaxel chemotherapy-treated NSCLC.</p> <p>Methods</p> <p>We prospectively evaluated 100 stage IV NSCLC patients treated with paclitaxel (175 mg/m²) and cisplatin (80 mg/m²). Malnutrition was assessed using SGA prior treatment. Neutrophil Lymphocyte Ratio (NLR) and the Platelet Lymphocyte Ratio (PLR) were used to determine the presence of systemic inflammatory response (SIR) and were related to the development of toxicity. Toxicity was graded according to NCI CTCAE version 3.0 after two chemotherapy cycles.</p> <p>Results</p> <p>Median age was 58 ± 10 years, 51% of patients were malnourished, 50% had albumin ≤3.0 mg/mL. NLR ≥ 5 was associated with basal hypoalbuminemia (mean ranks, 55.7 vs. 39 p = 0.006), ECOG = 2 (47.2 vs. 55.4 p = 0.026) and PLR ≥ 150 were significantly related with a basal body mass index ≤20 (56.6 vs. 43.5; p = 0.02) and hypoalbuminemia (58.9 vs. 41.3; p = 0.02). Main toxicities observed after 2 cycles of chemotherapy were alopecia (84%), nausea (49%), neuropathy (46%), anemia (33%), lymphopenia (31%), and leukopenia (30%). Patients malnourished and with hypoalbuminemia developed more chemotherapy-induced toxicity overall when compared with those without malnutrition (31 vs 22; <it>p </it>= 0.02) and normal albumin (mean ranks, 62 vs 43; <it>p </it>= 0.002), respectively. Hypoalbuminemia was associated with anemia (56 vs 47; <it>p </it>= 0.05), fatigue (58 vs 46; <it>p </it>= 0.01), and appetite loss (57.1 vs 46.7; <it>p </it>= 0.004) compared with normal albumin. PLR ≥ 150 was related with the development of toxicity grade III/IV (59.27 vs. 47.03 p = 0.008) and anemia (37.9 vs 53.8 p = 0.004).</p> <p>Conclusion</p> <p>SIR parameters were associated with malnutrition, weight loss and hypoalbuminemia. Chemotherapy-induced toxicity in NSCLC patients treated with paclitaxel and cisplatin was associated with malnutrition and hypoalbuminemia. Early nutritional assessment and support might confer beneficial effects.</p