Risk of cancer after assisted reproduction: a review of the available evidences and guidance to fertility counselors

Infertile women requiring ovarian stimulation and assisted reproduction techniques (ART) are faced with difficult issues. The fear that using hormones could increase their risk of cancer is the most significant. One of the main challenges for assessing cancer risk after ART is the difficulty to separate it from the underlying condition of infertility per se. The delay or the inability to achieve a pregnancy is an important risk factor for breast, endometrial and ovarian cancer. We analyzed the current literature on the topic

Rubbing effects on the structural and optical properties of poly(3­hexylthiophene) films

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ISO investigates the nature of extremely-red hard X-ray sources responsible for the X-ray background

We analyse very deep X-ray and mid-IR surveys in common areas of the Lockman Hole and the HDF North to study the sources of the X-ray background (XRB) and to test the standard obscured accretion paradigm. We detect with ISO a rich population of X-ray luminous sources with red optical colours, including a fraction identified with Extremely Red Objects (R-K > 5) and galaxies with SEDs typical of normal massive ellipticals or spirals at z ~ 1. The high 0.5-10 keV X-ray luminosities of these objects (1E43-1E45 erg/s) indicate that the ultimate energy source is gravitational accretion, while the X-ray to IR flux ratios and the X-ray spectral hardness show evidence of photoelectric absorption at low X-ray energies. An important hint on the physics comes from the mid-IR data at 6.7 and 15 um, well reproduced by model spectra of completely obscured quasars under standard assumptions and l.o.s. optical depths tau ~ 30-40. Other predictions of the standard XRB picture, like the distributions of intrinsic bolometric luminosities and the relative fractions of type-I and -II objects (1:3), are also consistent with our results. Obscured gravitational accretion is then confirmed as being responsible for the bulk of the X-ray background, since we detect in the IR the down-graded energy photoelectrically absorbed in X-rays: 63% of the faint 5-10 keV XMM sources are detected in the mid-IR by Fadda et al. (2001). However, although as much as 90% of the X-ray energy production could be converted to IR photons, no more than 20% of the Cosmic IR Background can be attributed to X-ray loud AGNs.Comment: 7 pages, 5 postscript figures, ApJ submitte

Low-Frequency study of two clusters of galaxies: A2744 and A2219

Spectral index images can be used to constraint the energy spectrum of relativistic electrons and magnetic field distribution in radio halos and relics, providing useful information to understand their formation, evolution and connection to cluster merger processes. We present low-frequency images of the two clusters of galaxies: A2744 and A2219, in which a wide diffuse emission is detected. Observations were made with the Very Large Array at the frequency of 325 MHz. For both clusters deep Very Large Array 1.4 GHz observations are available. Combining the 325 MHz and 1.4 GHz data, we obtained the spectral index images and the brightness radial profiles of the diffuse radio emission with a resolution of ~ 1'. The azimuthally averaged spectral index in A2744 is constant to a value close to alpha ~ 1 up to a distance of 1 Mpc from the cluster center. However, the spectral index image shows the presence of localized regions in which the radio spectrum is significantly different from the average. The observed spectral index variations range from a minimum of alpha ~ 0.7 +/- 0.1 to a maximum alpha ~ 1.5 +/- 0.2. From the comparison of the spectral index with the X-rays data it is found for the first time that the flat spectrum regions of the radio halo tend to have higher temperature. In the case of A2219, the radio emission in the central regions of the cluster is dominated by the blend of discrete sources. The azimuthally averaged radio spectrum is alpha ~ 0.8 in the central region of the cluster and is close to a value of alpha ~ 1 in the radio halo. The limited sensitivity of the 325 MHz image does not allowed us to detect all the radio halo structure seen at 1.4 GHz and therefore no constrains on the point-to-point variations of the spectral index have been obtained for this cluster

Rs12979860 and rs8099917 single nucleotide polymorphisms of interleukin-28B gene: simultaneous genotyping in Caucasian patients infected with hepatitis C virus

Introduction. Recent studies have demonstrated the role of the interleukin 28B (IL28B) polymorphisms in predicting treatment induced and spontaneous clearance from Hepatitis C virus (HCV) infection, suggesting the possibility of tailored therapy in HCV infected patients. Genome-wide association studies have shown that single nucleotide polymorphisms (SNPs) near IL 28B gene on chromosome 19 are strong predictors of sustained virologic response (SVR) to pegylated interferon and ribavirin. This study was aimed at analyzing the co-prevalence of two common and clinically significant SNPs in a cohort of Ligurian patients. Methods. Two SNPs (rs12979860, rs8099917) were genotyped in the IL28B locus from 175 DNA samples collected from HCV- infected consecutive patients in a Laboratory of Liguria Region, northern Italy. A real-time polymerase chain reaction in a Cor- bett Research Termocycler (Rotor Gene 3000A) by fluorescent probes (Fast Set IL 28B©, Arrow Diagnostics) was used for the detection, according to the manufacturer?s instructions. Results. Carriers of rs12979860CT genotype predominated (87/175, 50%), homozygotes for allele C were 68/175 (39%) and the remaining were homozygotes for IFN-resistant allele T (11%). As for the rs8099917 SNP, genotypes were thus distributed: 96/175 (55%) carried the rs8099917 TT genotype, whereas 70/175 (40%) and 9/175 (5%), were heterozygotes or homozygotes for the G allele. The variants rs12979860CC and rs8099917TT were found in 39% and 54% of overall patients with HCV genotype 1, respec- tively. The combined assessment of examined SNPs resulted in three most prevalent genotypes (rs12979860CC/rs8099917TT, rs12979860CT/rs8099917TG and rs12979860CT/rs8099917TT) with a frequency of 35%, 31% and 18%, respectively. Discussion. Recent findings demonstrated that in carriers of rs12979860CT the determination of additional genotype of rs8099917 SNP could significantly improve the prediction of SVR. In our study cohort carriers of rs12979860CT represented 50% of all patients, who could take advantage with respect to SVR prediction by further determination of the rs8099917 SNP. The simultaneous genotyping of two IL28B SNPs should thus be recommended in HCV infected patients prior to treatment initiation

Measuring Moral Distress Among Critical Care Clinicians : Validation and Psychometric Properties of the Italian Moral Distress Scale-Revised

OBJECTIVES: Moral distress is a common experience among critical care professionals, leading to frustration, withdrawal from patient care, and job abandonment. Most of the studies on moral distress have used the Moral Distress Scale or its revised version (Moral Distress Scale-Revised). However, these scales have never been validated through factor analysis. This article aims to explore the factorial structure of the Moral Distress Scale-Revised and develop a valid and reliable scale through factor analysis. DESIGN: Validation study using a survey design. SETTING: Eight medical-surgical ICUs in the north of Italy. SUBJECTS: A total of 184 clinicians (64 physicians, 94 nurses, and 14 residents). INTERVENTIONS: The Moral Distress Scale-Revised was translated into Italian and administered along with a measure of depression (Beck Depression Inventory-Second Edition) to establish convergent validity. Exploratory factor analysis was conducted to explore the Moral Distress Scale-Revised factorial structure. Items with low (less than or equal to 0.350) or multiple saturations were removed. The resulting model was tested through confirmatory factor analysis. MEASUREMENTS AND MAIN RESULTS: The Italian Moral Distress Scale-Revised is composed of 14 items referring to four factors: futile care, poor teamwork, deceptive communication, and ethical misconduct. This model accounts for 59% of the total variance and presents a good fit with the data (root mean square error of approximation = 0.06; comparative fit index = 0.95; Tucker-Lewis index = 0.94; weighted root mean square residual = 0.65). The Italian Moral Distress Scale-Revised evinces good reliability (\u3b1 = 0.81) and moderately correlates with Beck Depression Inventory-Second Edition (r = 0.293; p < 0.001). No significant differences were found in the moral distress total score between physicians and nurses. However, nurses scored higher on futile care than physicians (t = 2.051; p = 0.042), whereas physicians scored higher on deceptive communication than nurses (t = 3.617; p < 0.001). Moral distress was higher for those clinicians considering to give up their position (t = 2.778; p = 0.006). CONCLUSIONS: The Italian Moral Distress Scale-Revised is a valid and reliable instrument to assess moral distress among critical care clinicians and develop tailored interventions addressing its different components. Further research could test the generalizability of its factorial structure in other cultures