Parisuhteen ja seksuaalisuuden muutokset raskausaikana -opas

Opinnäytetyö toteutettiin osana pikkulapsiperheiden terveyden edistämishanketta yhteistyössä Metropolia Ammattikorkeakoulun sekä Terveyden ja hyvinvoinnin laitoksen(THL) kanssa. Kyseisen hankkeen tavoitteena on tuottaa selkokielistä materiaalia lasta suunnitteleville, lasta odottaville sekä pikkulapsiperheille tarkoitettuun verkkosivustoon vauvastakouluikaan.fi. Hanke on jatkoa Urbaani -vanhemmuus hankkeelle. Tämän opinnäytetyön aiheena oli parisuhteen ja seksuaalisuuden muutokset raskausaikana. Opinnäytetyön idea oli työelämälähtöinen. Tarkoituksena oli tuottaa opas vauvastakouluikaan.fi verkkosivustolle ja kuvata parisuhteen ja seksuaalisuuden muutoksia raskausaikana. Tavoitteena oli vahvistaa omaa ammatillista osaamista pikkulapsiperheiden terveyden edistämisessä. Nykyaikana tietoa haetaan paljon Internetistä, minkä vuoksi tämä opinnäytetyö on tärkeä, sillä opas on helposti kaikkien luettavissa Metropolia Ammattikorkeakoulun ylläpitämällä verkkosivustolla vauvastakouluikaan.fi. Opinnäytetyö toteutettiin toiminnallisena opinnäytetyönä. Opas pohjautui kirjallisuushaun perusteella valittuihin tutkimuksiin (n=13). Oppaan sisältöä ohjasivat seuraavat tutkimuskysymykset: 1) miten parisuhde ja seksuaalisuus muuttuvat raskausaikana ja 2)mitkä tekijät ylläpitävät hyvinvoivaa parisuhdetta raskausaikana. Näiden pohjalta aineistoa hahmoteltiin aluksi käsitekartan avulla. Ulkoasuun saatiin apua media-assistenttiopiskelijalta, joka muotoili oppaan Adoben InDesign -ohjelman avulla. Valmis opas esitestattiin muutamalla raskaana olevilla pariskunnilla sekä alle 1-vuotiaan lapsen vanhemmilla (n=4), joilta saadun palautteen perusteella opas muokattiin lopulliseen muotoon yhteistyössä media-assistenttiopiskelijan kanssa. Jatkotutkimusaiheena voisi tutkia useamman lapsen perheitä sekä perheillä jo valmiiksi olevan tiedon tasoa aiheesta parisuhteen ja seksuaalisuuden muutokset raskausaikana. Kätilötyö vaatii jatkuvaa osaamisen kehittämistä. Toivomme, että opinnäytetyötämme voivat hyödyntää sekä lasta odottavat perheet että terveydenhuollon ammattilaiset, kuten äitiysneuvolan terveydenhoitajat ja kätilöt.This thesis was executed as a part of a project for promoting health in families with small children in cooperation with Metropolia University of Applied Sciences and the National Institute for Health and Welfare. The objective of the project is to produce material written in plain language for the website vauvastakouluikaan.fi, aimed at people planning to have a child, people who are expecting a child and families with toddlers. The subject of the thesis was the changes in the relationship and in sexuality during pregnancy. The idea of the thesis was work-based. The intention was to produce a guide for the website vauvastakouluikaan.fi, and describe the changes in the relationship and in sexuality during pregnancy. The objective was to improve your own professional know-how regarding the promotion of health of families with young children. Today much information is collected from the Internet, which is why this thesis is so important. The guide can easily be read on a website maintained by Metropolia University of Applied Sciences and the National Institute for Health and Welfare. This thesis was carried out as a functional final project. The guide was based on research chosen according to literature search (n=13). The contents of the guide were directed By the following research questions: 1) how the relationship and sexuality change during pregnancy and 2) which factors help maintain a healthy relationship during pregnancy. The data was at first sketched with the help of a conceptual map on the basis of these questions. A media assistant student assisted with the layout of the guide by using the program Adobe InDesign. The complete guide had been pre-tested on a few couples expecting a child, as well as on parents to children under the age of one. The guide had been edited to its final form in cooperation with the media assistant student on the basis of the feedback, which was given. A subject for further study might be the study of families with multiple children, and the families’ level of existing knowledge of the changes in the relationship and in sexuality during pregnancy. Midwifery requires continuous development. We hope that our thesis can be benefited by both expecting families and health care professionals, such as health nurses at maternity clinics, and midwives

Connecting operation-choice problems by the variation principle: Sixth graders’ operational or deeper relational pathways

Many empirical studies documented students’ challenges with operation-choice problems, in particular for multiplication and division with rational numbers. The design principle of problem variation was suggested to overcome these challenges by engaging students in making connections between inverse operation-choice problems of multiplication and division, and between problems with natural numbers and fractions/decimals, but so far, this approach was hardly investigated empirically. In this study, we investigate 17 sixth graders’ modelling pathways through sets of operation-choice problems that are systematically designed according to the variation principle. In the qualitative analysis, we identify five pathways by which students solve the problems and sometimes connect them. While one pathway uses deep relational connections, others only draw superficial and operational connections and others stay with informal strategies without connecting them to formal operations.This study is supported by an FPU grant FPU19/02965 from Ministerio de Universidades (Spain) to Cristina Zorrilla under the supervision of Ceneida Fernández and Salvador Llinares. The analytic approach and the paper have been developed collectively by the first, second and last author during the first author’s research stay in Dortmund, Germany, with Susanne Prediger and Anna-Katharina Roos. This stay was funded by the Ministerio de Universidades (EST21/00333)

PEEK Primary Crowns with Cobalt-Chromium, Zirconia and Galvanic Secondary Crowns with Different Tapers-A Comparison of Retention Forces

In prosthetic dentistry, double crown systems have proved their suitability as retainers for removable partial dentures. However, investigations in this context, regarding polyetheretherketone, are scarce. Therefore, the aim of this study was to test the retention force (RF) between polyetheretherketone (PEEK) primary and cobalt-chromium (CoCr), zirconia (ZrO2) and galvanic (GAL) secondary crowns with three different tapers. Primary PEEK-crowns were milled with the tapers 0 degrees, 1 degrees, and 2 degrees (n = 10/taper, respectively). Afterwards, 90 secondary crowns were fabricated: (i) 30 CoCr-crowns milled from Ceramill Sintron (AmannGirrbach, Koblach, Austria) (n = 10/taper), (ii) 30 ZrO2-crowns milled from Ceramill ZI (AmannGirrbach, Koblach, Austria) (n = 10/taper), and (iii) 30 GAL-crowns made using electroforming (n = 10/taper). RF was measured in a pull-off test (20 pull-offs/specimen) and data were analyzed using 2-/1-way Analysis of Variance (ANOVA) followed by the Tukey-Honestly Significant Difference (HSD) post hoc test and linear regression analyses (p 0.141). At 0 degrees taper, no differences in retention forces between GAL, CrCr, and ZrO2 crowns were found (p = 0.075). However, at 1 degrees and 2 degrees taper, lower RF for GAL-crowns were observed (p < 0.009, p < 0.001, respectively). According to this laboratory study, PEEK might be a suitable material for primary crowns, regardless of the taper and the material of secondary crown. Long-term results, however, are still necessary

Retention Load Values of Telescopic Crowns Made of Y-TZP and CoCr with Y-TZP Secondary Crowns: Impact of Different Taper Angles

This study aimed to examine and compare the retention load values (RL) of different telescopic crown assemblies (Y-TZP and CoCr primary crowns with electroformed and Y-TZP secondary crowns each) with three different taper angles (0 degrees, 1 degrees and 2 degrees). Thirty Y-TZP primary crowns with electroformed gold copings (Z/G group) and Y-TZP secondary crowns (Z/Z group) and 30 CoCr primary crowns with electroformed gold copings (C/G group) and Y-TZP secondary crowns (C/Z group), each with taper angles of 0 degrees, 1 degrees and 2 degrees, were fabricated, respectively. With the exception of the electroformed gold copings, all specimens were Computer-Aided-Design/Computer-Aided-Manufacturing (CAD/CAM)-milled, then sintered and afterwards manually adapted. In order to stabilize the gold copings, they were fixed in a tertiary structure. The secondary crowns were constructed with a hook, which ensured self-alignment with an upper chain. Afterwards, 20 pull-off test cycles were performed in a universal testing machine under artificial saliva and after weighing the secondary crowns with a 5 kg object for 20 s. Data were analyzed by one-way and two-way Analysis of Variance (ANOVA). C/Z with 1 degrees showed higher (p = 0.009) RL than 0 degrees and 2 degrees tapers. C/G at 1 degrees also showed higher (p = 0.001) RL than at tapers of 0 degrees and 2 degrees. Z/G and C/G at 0 degrees showed lower RL than Z/Z and C/Z (p < 0.001). Primary crowns had no impact on the 0 degrees group. Z/G showed lower RL as compared to C/Z within the 1 degrees group (p = 0.007) and Z/Z in the 2 degrees group (p = 0.006). The primary crown material had no influence on RL. Electroformed copings showed lower RL. Further investigations for 1 degrees as well as for the long-term performance after thermomechanical aging are necessary

Machine learning in Huntington’s disease:exploring the Enroll-HD dataset for prognosis and driving capability prediction

Background: In biomedicine, machine learning (ML) has proven beneficial for the prognosis and diagnosis of different diseases, including cancer and neurodegenerative disorders. For rare diseases, however, the requirement for large datasets often prevents this approach. Huntington’s disease (HD) is a rare neurodegenerative disorder caused by a CAG repeat expansion in the coding region of the huntingtin gene. The world’s largest observational study for HD, Enroll-HD, describes over 21,000 participants. As such, Enroll-HD is amenable to ML methods. In this study, we pre-processed and imputed Enroll-HD with ML methods to maximise the inclusion of participants and variables. With this dataset we developed models to improve the prediction of the age at onset (AAO) and compared it to the well-established Langbehn formula. In addition, we used recurrent neural networks (RNNs) to demonstrate the utility of ML methods for longitudinal datasets, assessing driving capabilities by learning from previous participant assessments. Results: Simple pre-processing imputed around 42% of missing values in Enroll-HD. Also, 167 variables were retained as a result of imputing with ML. We found that multiple ML models were able to outperform the Langbehn formula. The best ML model (light gradient boosting machine) improved the prognosis of AAO compared to the Langbehn formula by 9.2%, based on root mean squared error in the test set. In addition, our ML model provides more accurate prognosis for a wider CAG repeat range compared to the Langbehn formula. Driving capability was predicted with an accuracy of 85.2%. The resulting pre-processing workflow and code to train the ML models are available to be used for related HD predictions at: https://github.com/JasperO98/hdml/tree/main . Conclusions: Our pre-processing workflow made it possible to resolve the missing values and include most participants and variables in Enroll-HD. We show the added value of a ML approach, which improved AAO predictions and allowed for the development of an advisory model that can assist clinicians and participants in estimating future driving capability.</p

Immunogenicity of a bivalent BA.1 COVID-19 booster vaccine in people with HIV in the Netherlands

OBJECTIVE: We evaluated the immunogenicity of a bivalent BA.1 COVID-19 booster vaccine in people with HIV (PWH).DESIGN: Prospective observational cohort study.METHODS: PWH aged ≥45 years received Wuhan-BA.1 mRNA-1273.214 and those &lt; 45 years Wuhan-BA.1 BNT162b2. Participants were propensity score-matched 1:2 to people without HIV (non-PWH) by age, primary vaccine platform (mRNA-based or vector-based), number of prior COVID-19 boosters and SARS-CoV-2 infections, and spike (S1)-specific antibodies on the day of booster administration. The primary endpoint was the geometric mean ratio (GMR) of ancestral S1-specific antibodies from day 0 to 28 in PWH compared to non-PWH. Secondary endpoints included humoral responses, T-cell responses, and cytokine responses up to 180 days post-vaccination.RESULTS:Forty PWH received mRNA-1273.214 (N = 35) or BNT162b2 (N = 5) following mRNA-based (N = 29) or vector-based (N = 11) primary vaccination. PWH were predominantly male (87% vs 26% of non-PWH) and median 57 years (interquartile range [IQR] 53-59). Their median CD4+ T-cell count was 775 (IQR 511-965) and the plasma HIV-RNA load was &lt; 50 copies/mL in 39/40. The GMR of S1-specific antibodies by 28 days post-vaccination was comparable between PWH (4.48, 95% confidence interval [CI] 3.24-6.19) and non-PWH (4.07, 95% CI 3.42-4.83). S1-specific antibody responses were comparable between PWH and non-PWH up to 180 days, and T-cell responses up to 90 days post-vaccination. IFN-γ, IL-2, and IL-4 cytokine concentrations increased 28 days post-vaccination in PWH.CONCLUSION: A bivalent BA.1 booster vaccine was immunogenic in well-treated PWH, eliciting comparable humoral responses to non-PWH. However, T-cell responses waned faster after 90 days in PWH compared to non-PWH.</p

Frequent IgE recognition of Blomia tropicalis allergen molecules in asthmatic children and young adults in equatorial Africa

BackgroundAsthma is not well investigated in equatorial Africa and little is known about the disease-associated allergen molecules recognized by IgE from patients in this area. The aim was to study the molecular IgE sensitization profile of asthmatic children and young adults in a semi-rural area (Lambaréné) of an equatorial African country (Gabon), to identify the most important allergen molecules associated with allergic asthma in equatorial Africa.MethodsFifty-nine asthmatic patients, mainly children and few young adults, were studied by skin prick testing to Dermatophagoides pteronyssinus (Der p), D. farinae (Der f), cat, dog, cockroach, grass, Alternaria and peanut. Sera were obtained from a subset of 35 patients, 32 with positive and 3 with negative skin reaction to Der p and tested for IgE reactivity to 176 allergen molecules from different allergen sources by ImmunoCAP ISAC microarray technology and to seven recombinant Blomia tropicalis (Blo t) allergens by IgE dot blot assay.ResultsThirty-three of the 59 patients (56%) were sensitized to Der p and 23 of them (39%) were also sensitized to other allergen sources, whereas 9 patients (15%) were only sensitized to allergen sources other than Der p. IgE serology analyses (n=35) showed high IgE-binding frequencies to the Blo t allergens Blo t 5 (43%), Blo t 21 (43%) and Blo t 2 (40%), whereas the Der p allergens rDer p 2, rDer p 21 and rDer p 5 (34%, 29% and 26%) were less frequently recognized. Only few patients showed IgE reactivity to allergens from other allergen sources, except to allergens containing carbohydrate determinants (CCDs) or to wasp venom allergens (i.e., antigen 5).ConclusionOur results thus demonstrate that IgE sensitization to mite allergens is very prevalent in asthmatics in Equatorial Africa with B. tropicalis allergen molecules representing the most important ones associated with allergic asthma

Immunogenicity of a bivalent BA.1 COVID-19 booster vaccine in people with HIV in the Netherlands

OBJECTIVE: We evaluated the immunogenicity of a bivalent BA.1 COVID-19 booster vaccine in people with HIV (PWH).DESIGN: Prospective observational cohort study.METHODS: PWH aged ≥45 years received Wuhan-BA.1 mRNA-1273.214 and those &lt; 45 years Wuhan-BA.1 BNT162b2. Participants were propensity score-matched 1:2 to people without HIV (non-PWH) by age, primary vaccine platform (mRNA-based or vector-based), number of prior COVID-19 boosters and SARS-CoV-2 infections, and spike (S1)-specific antibodies on the day of booster administration. The primary endpoint was the geometric mean ratio (GMR) of ancestral S1-specific antibodies from day 0 to 28 in PWH compared to non-PWH. Secondary endpoints included humoral responses, T-cell responses, and cytokine responses up to 180 days post-vaccination.RESULTS:Forty PWH received mRNA-1273.214 (N = 35) or BNT162b2 (N = 5) following mRNA-based (N = 29) or vector-based (N = 11) primary vaccination. PWH were predominantly male (87% vs 26% of non-PWH) and median 57 years (interquartile range [IQR] 53-59). Their median CD4+ T-cell count was 775 (IQR 511-965) and the plasma HIV-RNA load was &lt; 50 copies/mL in 39/40. The GMR of S1-specific antibodies by 28 days post-vaccination was comparable between PWH (4.48, 95% confidence interval [CI] 3.24-6.19) and non-PWH (4.07, 95% CI 3.42-4.83). S1-specific antibody responses were comparable between PWH and non-PWH up to 180 days, and T-cell responses up to 90 days post-vaccination. IFN-γ, IL-2, and IL-4 cytokine concentrations increased 28 days post-vaccination in PWH.CONCLUSION: A bivalent BA.1 booster vaccine was immunogenic in well-treated PWH, eliciting comparable humoral responses to non-PWH. However, T-cell responses waned faster after 90 days in PWH compared to non-PWH.</p