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Willingness to use female permanent contraception among married women and male partners support in Benue, Nigeria
Get PDFINTRODUCTION: there is a paucity of community-based studies on the acceptability of female permanent contraception (FPC), particularly among men. We examined the willingness of married women to use FPC and their male partners to support its use in Nigeria. METHODS: we conducted a cross-sectional study among pregnant women and their male partners who participated in the Healthy Beginning Initiative (HBI) program in Benue, Nigeria. The HBI was an integrated, feasible, and culturally adaptive platform for screening, linkage, and follow-up of pregnant women attending churches. Data on sociodemographic characteristics and reproductive intentions were collected from 10,168 pregnant women and 6,766 male partners independently through pre-tested semi-structured interviewer-administered questionnaires. We performed univariate and multivariate logistic regression analyses to examine factors associated with the willingness to use FPC among women and male partners to support the use of FPC. Our analysis was restricted to married participants. RESULTS: of the 10,046 married women and 6,759 men included in this study, 80% and 87% indicated willingness to use and support the use of FPC, respectively. In the adjusted model, women with no formal, primary, and secondary education (vs tertiary education) and those with an income level of </= ₦20,000 (vs > ₦50,001) had significantly higher odds of willingness to use FPC, while women with no living children (vs >/= 5) and 0-2 desired children (vs >/= 5) had significantly lower odds of intending to use FPC. Except for no formal education and the number of living children, similar factors were associated with the willingness of married men to support the use of FPC. CONCLUSION: there was a high willingness to use or support the use of FPC among married women and men in this study. Increasing access to FPC services in this setting may improve its informed and voluntary uptake.Echezona Edozie Ezeanolue received funding from the Fogarty International Center of the US National Institutes of Health (NIH) (grant no. R21TW010252) and the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the NIH (grant numbers - R01HD087994 & R01HD087994S1). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH
Alzheimer's disease plasma biomarkers and physical functioning in a diverse sample of adults
No full textINTRODUCTION: The relationship between Alzheimer's disease (AD) plasma biomarkers, and physical functioning (PF) across diverse races and ethnicities remains unclear. This study aims to explore this association in an ethno-racially diverse sample of cognitively unimpaired community-dwelling adults. METHODS: Data clinical examinations, neuropsychological tests, blood draws, and PF exams (Timed Up and Go [TUG] and Short Physical Performance Battery [SPPB]) were analyzed. Multivariable linear regressions assessed the association between PF and AD plasma biomarkers (amyloid beta [Abeta]40, Abeta42, total tau [t-tau], neurofiliament light chain [NfL]). RESULTS: The sample (n = 2358; mean age 64.7 years; 65.9% female), was 20% African American, 41.9% non-Hispanic White, and 38.1% Hispanic. Findings indicate that worse PF is linked to higher biomarker levels (p < 0.05). Associations differed by race and ethnicity group. TUG time was associated (p < 0.05) with Abeta40, Abeta42, and tau among non-Hispanic Whites, whereas SPPB scores were associated (p < 0.05) with t-tau and NfL among African Americans. DISCUSSION: PF, ethnic/racial, and plasma AD biomarker data should be used to aid in developing risk profiles for neurodegenerative diseases. HIGHLIGHTS: Alzheimer's disease (AD) biomarkers are associated with physical functioning (PF) Ethno-racial variation exists in AD biomarker and PF associations Race and ethnicity should considered when assessing neurodegenerative disease risk.The research team thanks the local Fort Worth community and theparticipants of the Healthy Aging and Brain Study-Health Disparities(HABS-HD) study. Research reported on this publication was sup-ported by the National Institute on Aging of the National Institutesof Health under Award Numbers R01AG054073, R01AG058533,R01AG070862, and U19AG078109. The content is solely the respon-sibility of the authors and does not necessarily represent the officialviews of the National Institutes of Health
Chronic Intermittent Hypoxia Dysregulates the Hypothalamic-Pituitary-Gonadal Axis in a Sex Specific Manner
No full textPoster Highlight: HSC College of Pharmacy, RAD 2025 Award Winning Posters & Oral PresentationsBackground: Obstructive sleep apnea (OSA) affects approximately 10- 26% of adults in the United States. OSA is characterized by intermittent cycles of hypoxia followed by rapid episodes of reoxygenation and is clinically classified by the apnea-hypopnea index (AHI). The prevalence of OSA is higher in males and menopausal females who typically presents with a high ratio of androgens to estrogens, suggesting sex hormones may play a role in the pathophysiology of OSA. Circulating sex hormones are secreted by the hypothalamic-pituitary gonadal (HPG) axis. However, it is unclear to what extent OSA modulates the HPG axis. The objective of this study was to evaluate the HPG axis in male and female rats exposed to chronic intermittent hypoxia (CIH), an in vivo model of OSA. We hypothesized that CIH would decrease circulating sex hormones and impair the HPG axis in a sex-dependent manner. Methods: A model of CIH was used to simulate a mild form of OSA (10 hypoxic events per one hour, AHI= 10) in young adult Long Evans male and female rats. To measure the HPG axis, we quantified circulating steroid hormones using Milliplex technology and assessed protein concentrations of follicle stimulating hormone receptors (FSH-R) in the pituitary gland. Additionally, we performed histological analysis on gonadal tissues to examine changes in cellular morphology. Results: There were significant interaction effects of sex and CIH on circulating estradiol and progesterone. Post-hoc analysis demonstrated that CIH decreased estradiol in female rats and progesterone in male rats. Additionally, male rats had higher circulating testosterone compared to females. Notably, there were significant sex and CIH differences in the pituitary FSH-R where CIH decreased pituitary FSH-R in female rats. However, there were no significant main effects of sex or CIH on the concentrations of circulating follicle stimulating hormone. Exposure to CIH decreased the average number of secondary ovarian follicles in female rats, but did not affect the number of corpus luteum or antral follicles present in the ovary. In male rats, exposure to CIH did not affect the area of Sertoli cells or the distance between seminiferous vesicles. Conclusions: Our findings suggest that both males and females have impairments in the HPG axis following exposure to CIH. However, the mechanisms driving these differences are sex dependent, such that females demonstrated changes in circulating hormones, pituitary hormone receptors, and gonadal cell morphology, whereas males demonstrated changes in circulating hormones. These findings may provide a potential mechanism where OSA negatively impacts reproductive function by dysregulating the HPG axis in young adult males and females
Sexual Violence, Stress, and Suicidality: Examining Mental Health Risks Among Undergraduate Students
No full textPurpose: Undergraduate students face unique challenges that increase their vulnerability to mental and sexual health issues, including depression and sexual violence. Approximately 24.6% of undergraduate females and 6.8% of undergraduate males experience sexual violence during college, while roughly 17.6 per 100,00 undergraduate students die by suicide each year. Despite these concerning trends, limited research explores the intersection of sexual violence, common stressors, and suicidality among undergraduate students in the current social climate. This study aimed to examine the relationship between various forms of sexual violence, common stressors, and suicidality among undergraduate students. Understanding these associations is crucial for informing future interventions that promote the utilization of and accessibility to trauma-informed mental health support in higher education settings. Methods: The American College Health Association-National College Health Assessment (ACHA-NCHA) is a nationally recognized survey that collects data on a wide range of health and wellness factors (e.g. mental health, sexual health, and violence victimization) among undergraduate, graduate, and professional students. Undergraduate students from the Spring 2024 ACHA-NCHA III survey were included in the analytic sample (N=103,639). Logistic regression models, adjusted for covariates, were utilized to examine the relationships between stressors, stressors, and suicidality (positive/negative). Covariates of interest were identified a priori given their association with suicidality in previous literature as well as their significance in unadjusted models. Suicidality was assessed using the validated 4-item Suicide Behaviors Questionnaire-Revised (SBQ-R), which aims to measure suicidal thoughts and behaviors. Results: Experiencing sexual violence was significantly associated with odds of increased suicidality. Being forced (aOR=1.33, 95% CI: 1.12-1.59, p=.0012) or pressured (aOR=1.38, 95% CI: 1.21-1.57), p<.0001) into unwanted sexual contact by an intimate partner, or being sexually touched without consent by a non-partner (aOR=1.33, 95% CI: 1.21-1.46, p<.0001), were significant predictors. Among stressors, financial insecurity (aOR=1.29, 95% CI: 1.25-1.34, p<.0001), academic stress (aOR= 1.41, 95% CI: 1.35-1.46, p<.0001), sexual harassment (aOR= 1.66, 95% CI: 1.55-1.78, p<.0001), and discrimination (aOR= 1.32, 95% CI: 1.25-1.40, p<.0001) were significantly associated with increased odds of suicidality. Additionally, students identifying as female (aOR=0.73, 95% CI: 0.70-0.76, p<0.0001) were significantly less likely to experience suicidality, while a sex other than male or female (aOR=1.45, 95% CI: 1.34-1.57, p<.0001), LGBTQIA+ (aOR=2.39, 95% CI: 2.30-2.48, p<0.0001), or scoring positively on the UCLA Loneliness Scale (aOR=2.31, 95% CI: 2.22-2.39, p<0.0001) were significantly more likely to experience suicidality. Conclusions: These findings emphasize the significant role of sexual violence, stressors, and identity-based factors in shaping undergraduate students’ mental health. Future research should incorporate qualitative approaches to explore the nuanced impacts of these stressors and inform the development of targeted interventions. Addressing these challenges requires tangible support through trauma-informed mental health programming, stigma reduction initiatives, and the cultivation of safer campus environments
Improving caregiver communication in the pediatric acute care setting by implementing a care journal.
No full textPoster Highlight: College of Nursing, RAD 2025 Award Winning Posters & Oral PresentationsPurpose: Improving clinician-to-caregiver communications is critical in clinical settings, and most specifically crucial in pediatric care settings. The need for innovative ways to enhance communications in the context of pediatric acute care is even more critical given the vulnerability of the population and caregivers, who experience high stress during their child's acute hospital admission. The purpose of this study is to examine the state of the science relative to the use of a diary/journal in pediatric acute care units by caregivers as a way of fostering stronger communication between the caregivers and providers, which would, in turn, improve outcomes. Methods: A literature review was conducted by searching CINAHL, Cochrane, Ovid, and MEDLINE, then forward searching with CitationChaser and Rayyan for terms “care journal”, “care diary”, “caregiver diary”, “caregiver journal”, “unit diary”, and “unit journal”. An initial search produced 67 titles for screening, which, after removing duplicates, produced 32 articles. Following a title and subsequent full-text review, 4 studies were included. Using CitationChaser and Rayyan to assess the reference of each article, 2 additional studies were included for a total of 6 studies in the final article pool. Data extraction was performed, and the findings were synthesized for this paper. Results: The included studies largely supported the use of diaries or journals by caregivers in a pediatric intensive care unit (PICU) setting to improve communication. A quasi-experimental study found the journal to be a simple and cost-effective method to gain insight from caregivers about their stay and to enhance communication. Both qualitative studies involved the same PICU and concluded that the use of a journal was both feasible and useful, and 100% of both parents and health care providers would recommend it to be used by other admitted families. Quality improvement studies further supported the feasibility and benefit of diaries, specifically in regard to communication. Conclusion: While all these studies reported data on the utility and benefit of journals, none were conducted in the context of acute care. Expanding the use of a care journal to more pediatric caregivers outside of the PICU may greatly benefit this larger pediatric population. The use of journals for the caregivers of acute care pediatric patients seems to be an underutilized and understudied area and further work is warranted. Key words: care journal, care diary, caregiver diary, caregiver journal, unit diary, unit journa
Pseudopheochromocytoma: An Endothelial Cyst of the Adrenal Gland Case Study
No full textBackground: Benign endothelial cyst of the adrenal gland (ECAG) with pheochromocytoma-like symptoms, also called pseudopheochromocytoma (pseudoPHEO), is an extremely rare condition. Adrenal cysts are extremely rare with an incidence of 0.06% in the general population. ECAG represents approximately 45% of all cystic tumors involving the adrenal glands. There are two subtypes of ECAG: angiomatous and lymphangiomatous. These cysts occur predominately in females. The association of adrenal cysts with pseudopheochromocytoma is a rare but well-documented relationship. Occasionally these cysts can create pressure symptoms in the medulla and cause elevated metanephrines. PseudoPHEO is a diagnosis of exclusion, with pheochromocytoma being an important differential diagnosis and must be ruled out. Patients usually present like pheochromocytoma with symptomatic paroxysmal hypertension. Catecholamine-secreting tumors are diagnosed in fewer than 0.5% of patients with hypertension. If adrenal cortical tumors are involved, elevated catecholamines can be found on evaluation. Treatment of pseudoPHEO is dependent on the severity and etiology of the disease process. Because patients can be normotensive between symptomatic episodes, medical management may lead to unpredictable hypotensive episodes. In cases of pseudopheochromocytoma caused by ECAG, adrenalectomy is indicated. Case Information: A 63-year-old female with a history of an adrenal nodule, first discovered in 2017 during a colon resection for diverticulitis, and poorly controlled hypertension, presented for a planned adrenalectomy due to suspected pheochromocytoma. The patient was followed by general surgery prior to the planned procedure. Patient’s normetanephrine levels were 342 with metanephrine of 50. A CT of the abdomen revealed a 3 cm adrenal lesion with features suggestive of benign etiology. She underwent robot-assisted laparoscopic right adrenalectomy with corresponding ICU post-operative care. The adrenal gland showed a 3 cm cyst arising in the adrenal medulla and abutting the adrenal cortex (figure available). Microscopic examination revealed a multilocular cyst associated with hemorrhage involving the adrenal medulla (figure available). The cells were positive for CD31 and negative for calretinin, confirming their endothelial origin. Biopsy was consistent with benign ECAG. The cyst can create pressure symptoms in the adrenal medulla and cause elevated metanephrines, as seen in this patient. Results were negative for pheochromocytoma. Two days postoperatively, the patient had regular bowel function, stable hemodynamics, and was cleared for discharge. Conclusions: The patient’s biopsy results were consistent with benign endothelial cyst of the adrenal gland. The criteria for diagnosing pseudopheochromocytoma include negative tests ruling out pheochromocytoma and symptomatic paroxysmal hypertension with or without elevated catecholamines. The criteria for diagnosing ECAG include biopsy with hematoxylin and eosin staining. Immunohistochemistry may show CD31 and calretinin, which is consistent with endothelial cells. While the prognosis for ECAG is generally favorble, ECAG with associated pseudopheochromocytoma can cause life-threatening complications. For this reason, surgical intervention is indicated for patients with adrenal cysts presenting with pheochromocytoma-like symptoms
Impact of NFL Hip Drop Tackle Ban on Lower Extremity Injuries: A Comparative Analysis of Calf, Foot, and Toe Injuries
No full textPurpose: The NFL banned the hip drop tackle before the 2024-2025 season to reduce injury risk. This study examines the impact of the ban on calf, foot, and toe injuries during the 2024 season compared to pre-ban seasons (2021-2023). Methods: Using publicly available NFL injury data, isolated calf, foot, and toe injuries leading to missed games were identified from 2021-2024. The 2024 season was designated as the index year post-ban, while the 2021-2023 seasons were averaged for pre-ban comparison. A Student’s t-test was conducted using Jeffrey’s Amazing Statistics Program (JASP) to evaluate significance. Results: Total calf, foot, and toe injuries in pre-index seasons averaged X, compared to Y in the index year. Calf injuries showed a nearly significant decrease post-ban (p = 0.052), while foot injuries increased slightly. Toe injuries exhibited a nonsignificant decline. Conclusions: Calf injuries demonstrated a trend toward reduction post-ban, while foot injuries increased slightly. These findings suggest that the ban may have influenced injury patterns, but additional seasons of data are needed to draw definitive conclusions on the long-term effects of the rule change
Experimentally investigating sex-based differences in thermoregulatory responses to cold environments in human subjects
No full textDespite sex-based differences in human body size and composition, most ecogeographic research tends to focus on male subjects, with limited female representation. Accordingly, this study investigated thermoregulatory responses in core and peripheral body temperatures in both male (n=12) and female (n=12) human subjects exposed to room temperature (RT = 22°C, 50% relative humidity) and cold-dry (CD = 5°C, 80% RH) conditions for 45 minutes in a climate chamber. Core temperature was measured continuously via ingestible thermometer capsules while peripheral skin temperature was measured on the dorsal aspect of the left hand (LH) via an iButton surface thermometer. Both were averaged across 5-minute intervals. Performing a two-way repeated measures ANOVA of the RT exposure indicated a statistically significant core temperature decrease over time (F=3.23, p=0.002) and between the sexes (F=2.63, p=0.010), while LH skin temperature significantly decreased over time (F=318.18, p<0.001) without sex differences (F=0.18, p=0.993). During the CD exposure, there was a significant increase in core temperature over time (F=9.91, p<0.001) with no sex differences (F=1.10, p=0.368), along with a significant decrease in LH skin temperature over time (F=448.18, p<0.001) and between the sexes (F=3.17, p=0.002). Females consistently exhibited lower LH temperatures (20.47°C) than males (21.31°C) in the cold. Although both sexes followed the same general increase in core temperature in the cold, males had a larger change than females between the five to ten minute (0.06°C) and forty to forty-five minute intervals (0.10°C). Furthermore, females exhibited a rise and fall in their core temperature in RT, while males only had a decrease in core temperature throughout the exposure. These results suggest that both sexes physiologically respond to cold exposure by protecting core body temperature at the expense of peripheral skin temperatures and may reflect differences in hand size and composition dynamics. Additional research with a larger sample size and evaluation of additional factors may help to clarify this issue
Post-Traumatic Bronchial Transection: A Delayed Diagnosis
No full textBackground: A bronchial transection is an often fatal injury that can occur due to severe blunt chest trauma. Tracheobronchial injuries are uncommonly diagnosed or treated because 80% of patients die before transport to the hospital. We report a rare case of a left mainstem bronchus transection seen with radiological imaging. This report adds to the current understanding of the proper diagnosis and treatment of tracheobronchial injuries. Case Information: We report a case of a delayed diagnosis of a post-traumatic left mainstem bronchus transection. The patient, a 27-year-old male, was ejected from his motorcycle after a high-speed motor vehicle collision. Emergency medical services found him crawling on the ground, unable to walk, and in an altered mental state. The patient exhibited trauma to the head, chest, and extremities. He was hypotensive and dyspneic. The patient was treated with a supraglottic airway device, transported to the hospital, and then given bilateral chest tubes. Computed tomography showed aortic dissection, hemorrhage, subcutaneous emphysema, pneumomediastinum, and pneumothorax. Physicians also reported fractures of the patient’s ribs, sternum, and clavicles. However, a bronchial transection was not noted in the initial radiological report. The patient was transported to the operating room for thoracic endovascular aortic repair. Surgeons noted poor oxygenation during and after repair. They performed an emergent bronchoscopy and discovered a transection in the left mainstem bronchus. The patient was taken back to the operating room for bronchoplasty. Attempts to repair the airway were unsuccessful, and the surgeons performed a pneumonectomy. The patient was placed on extracorporeal membrane oxygenation for cardiorespiratory support. His condition slowly degraded in the intensive care unit until his death. Conclusion: Post-traumatic bronchial transections have a high prehospital mortality rate and are not often seen in radiological imaging. When diagnosed, restoring the airway is crucial and bronchoplasty is standard treatment. In this case, the surgeons first treated the patient's aortic dissection, but bronchoplasty was delayed due to the delayed diagnosis. While surviving a bronchial transection is uncommon, increased awareness of bronchial transections and more prompt diagnosis and treatment could potentially improve patient outcomes
Preventative Treatment for Bronchopulmonary Dysplasia (BPD) via AVR-48 Induced Toll-Like Receptor MyD88 Protein Stimulation
No full textPurpose: Bronchopulmonary dysplasia (BPD) is a preventable lung disease that primarily affects premature newborns, as their lungs are underdeveloped at the time of birth. Due to their underdeveloped lungs, exogenous oxygen must be supplied, which furthers the immunogenic inflammatory response. Treatment for this condition is limited to steroid treatments, which do not resolve the condition. AVR-48 shows that action stimulates TLR-initiated immune response but with limited inflammatory side effects, which is beneficial for the neonate. Chitin-derived immunomodulatory molecules have demonstrated success in therapy for various diseases and have shown promise with BPD. AVR-48 is a chitin analog being investigated for potential use in BPD therapy. One of its plausible mechanisms of action involves binding to toll-like receptor (TLR) 4, which stimulates MyD88, a TLR adaptor protein. This study will help determine whether AVR-48 stimulated TLR4 receptor response on cord blood-derived mononuclear cells (CBMC)s to regulate immune response by tracking phosphorylated- MyD88 (pMyD88) activation. Methods: CBMCs were cultured in 6-well plates and incubated for 72 hours. Cells were dosed as follows: LPS [50 ng/mL], TAK-242 [1 μM], and AVR-48 [100 μM]. Varying combinations of the three were also used to examine their effects. After a 20-minute incubation, the cells were scrapped, lysed, and analyzed via Western blot. Results: Western blot results exhibited activated pMyD88 with the independent administration of LPS and AVR-48. In combination, there was significantly less activation. This implies that AVR-48 inhibited LPS activation of TLR4, which would be beneficial in mitigating inflammation and combating disease. However, AVR-48 can also stimulate an immune response through TLR4 and MyD88. Conclusion: The activation of pMyD88 from CBMCs suggests that AVR-48 stimulates TLR4 activation. This data suggests that the TLR/MyD88-dependent signaling pathway is a mechanism by which AVR-48 may modulate immune response