Search Results (4,016)

Background: Emergency contraception (EC), also known as postcoital contraception, is a method used to prevent an unintended pregnancy following unprotected or inadequately protected sexual intercourse. The available options include emergency contraceptive pills or the insertion of an intrauterine device (IUD). Emergency contraception pills contain either levonorgestrel (a single 1.5 mg dose, effective within 72 h) or ulipristal acetate (a single 30 mg dose, effective within 120 h), both of which are most effective when taken as soon as possible after unprotected intercourse. Another highly effective option is the insertion of a copper or levonorgestrel-releasing intrauterine device, although IUDs are not registered for EC use in all countries. The aims of this cross-sectional, comparative, observational study were to collect data on the emergency contraception methods used by adolescent girls and young women to examine their association with various factors, such as religious beliefs, and to evaluate the effectiveness of different emergency contraception methods, including hormonal options and intrauterine devices. Methods: Data were collected from 240 women who attended our Family Planning Clinic using a structured questionnaire that included items on their demographic characteristics, religious beliefs, medical history, lifestyle factors, contraceptive use and side effects, prior use of emergency contraception, method selected, and reasons for seeking emergency contraception. Descriptive statistics were used to summarize the data, comparisons between religious groups were conducted using chi-square tests, and factors related to the timing of emergency contraceptive use were investigated using multinomial logistic regression analysis. Results: Most of the reasons for emergency contraception use did not differ significantly between Christian and Muslim participants. However, Christians were significantly more likely to use emergency contraception due to missed contraceptive doses (20.9% vs. 6.7%, p = 0.004) or the failure to take a progesterone-only pill (19.1% vs. 3.3%, p = 0.001). Levonorgestrel was the most frequently used method in both groups (48.9% of Christians vs. 60% of Muslims, p = 0.132), followed by ulipristal acetate (30.9% vs. 40%, p = 0.180). Notably, 18.5% of Christian participants used an intrauterine device (IUD) for emergency contraception, while no Muslim participants reported IUD use (p < 0.001), indicating a significant difference potentially influenced by cultural or religious factors. Conclusions: Both religious and individual sociodemographic factors affect not only the choice of emergency contraception but also the urgency with which the emergency contraception is used. Interventions aimed at improving contraception education, addressing partner-related challenges, and promoting timely access could improve reproductive health outcomes. Full article

Vector-borne infectious diseases transmitted by vector organisms (e.g., mosquitoes, rodents, and ticks) are recognized as key priorities in global public health. The construction of host–vector interaction frameworks within bipartite networks enables a clearer depiction of the transmission mechanisms underlying vector-borne infectious diseases. Compared with traditional models, the effective influence of historical information on vector-borne infectious diseases is more critical. In this study, the long-term memory behavior of infected populations during the recovery phase is regarded as a power-law tail distribution, a result that is consistent with fractional calculus. Thus, a fractional-order model for vector-borne diseases on bipartite networks is established.The basic reproduction number is derived about network topology and fractional order. With stability analysis, the conditions governing the global extinction and global persistence of vector-borne infectious diseases are determined. Furthermore, the validity of the proposed model is confirmed through numerical simulation results obtained from Barabási–Albert (BA) networks and Watts–Strogatz (WS) networks. Full article

Background/Objectives: Pelvic exenteration is a complex surgery considered for locally advanced or recurrent pelvic malignancies, entailing a radical en-block resection of multiple adjacent pelvic organs, followed by reconstructive surgery. Achieving R0 resection (complete removal of macroscopic and microscopic disease) is critical for improving survival outcomes. This study aimed to define patient, tumour, and surgical predictors of R0 resection in an irradiated field, thereby optimising patient selection and establishing a surgical roadmap for pelvic exenterations. Methods: Our retrospective observational cohort study includes consecutive patients undergoing exenteration post-radiotherapy for non-ovarian gynaecological malignancies at Oxford University Hospitals between 1 January 2011 and 31 December 2024. The primary outcome was margin status. Secondary outcomes were intraoperative and postoperative complications. Results: Twenty-seven patients were identified, with a median age of 63 years (range 41–81) and median BMI of 27 (range 17–45). Primary tumour sites included the vulva (11.1%), vagina (14.8%), cervix (40.7%), and uterus (33.3%). R0 was achieved in 77.8% (n = 21) of cases. Intraoperative complications occurred in 29.6%, and significant postoperative complications (Clavien-Dindo IIIA/IIIB) in 22.2% of patients. R0 resection was significantly associated with younger age (median 61 vs. 70 years, p = 0.035) and primary cervical tumours (p = 0.036). On univariable logistic regression, tumour size on imaging (p = 0.038, OR 2.9) and on histology (p = 0.020, OR 2.01), and estimated blood loss (p = 0.048, OR 1.002) were significant predictors of R0 resection. None of these variables retained significance in multivariable logistic regression. Conclusions: Tumour size, primary tumour site, and patient age should be considered when selecting patients for pelvic exenteration following radiotherapy, and blood loss should be kept minimal in order to maximise the chances of achieving R0 resection. Full article

Introduction: Neurodevelopmental disorders (NDs), including autism spectrum disorder and related conditions, are increasingly recognized among women of reproductive age, yet their unique needs during pregnancy and childbirth remain poorly studied. Communication differences, sensory sensitivities, and co-occurring psychiatric conditions may complicate maternity care, leading to higher risks of adverse outcomes and ethical challenges in clinical practice. This study aimed to examine pregnancy complications, delivery outcomes, and postpartum characteristics in women with NDs, compared with a control group, and to identify specific barriers in perinatal care. Methods: A retrospective observational study was conducted at the National Medical Research Center for Obstetrics, Gynecology and Perinatology, Moscow, including 18 pregnant women with confirmed NDs and 21 matched controls with uncomplicated pregnancies. Data were extracted from medical records and included demographic parameters, pregnancy course, complications, labor management, neonatal outcomes, and documented communication or ethical issues. Comparative analyses were performed using chi-square or Fisher’s exact tests for categorical variables and Student’s t-test or Mann–Whitney U test for continuous variables. Results: Pregnant women with NDs had significantly higher rates of pelvic girdle pain (66.7% vs. 23.8%, p = 0.01), vaginal bleeding (44.4% vs. 14.3%, p = 0.04), anxiety (61.1% vs. 19.0%, p = 0.007), and depression (50.0% vs. 14.3%, p = 0.02) compared with controls. Persistent daily nausea was also more common (50.0% vs. 14.3%, p = 0.03). Attendance of prenatal physician visits was lower in the ND group (66.7% vs. 95.2%, p = 0.02). Cesarean delivery occurred in 83.3% of ND women versus 23.8% of controls (p < 0.001), with psychiatric recommendations often cited as the indication. Breastfeeding was declined in 94.4% of ND cases versus 4.8% of controls. Labor duration was prolonged, and neonatal anthropometrics were lower in the ND group. Communication difficulties were documented in 83.3% of ND participants, and postpartum depressive symptoms were identified in 77.8%. Conclusions: Pregnant women with NDs face a multidimensional vulnerability in maternity care, including higher frequencies of pain, bleeding, nausea, anxiety, and depression, prolonged labor, markedly increased cesarean rates, reduced breastfeeding initiation, and smaller neonatal anthropometrics. Frequent communication barriers, guardian decision-making, and postpartum separation further complicate care. These findings underscore the necessity of neurodiversity-informed, individualized perinatal strategies, integrating sensory accommodations, trauma-informed communication, and proactive mental health support to improve both clinical outcomes and patient experiences. Full article

Unintended pregnancies among adolescent and young women in low- and middle-income countries pose major public health challenges, underscoring the need for improved access to modern contraceptives. This study examined prevalence, preferences, and correlates of modern contraceptive use among young women living in urban slums of Kampala, Uganda, to inform targeted interventions. We analyzed baseline data from The Onward Project On Wellbeing and Adversity (TOPOWA), an NIH-funded, multi-component prospective cohort study on mental health among women aged 18–24 years. In 2023, 300 participants were recruited from three sites (Banda, Bwaise, Makindye). Interviewer-administered surveys assessed contraceptive choices, lifestyle, and demographic factors. Modified Poisson regression was used to examine correlates of contraceptive use. Among participants, 66.0% had ever used contraception, 40.0% were current users, and 38.0% reported modern contraceptive use. Multivariable analyses showed that having a consistent partner (PR = 3.28; 95% CI: 1.90–5.67), engaging in sex work (PR = 2.10; 95% CI: 1.46–3.02), older age (PR = 1.08; 95% CI: 1.01–1.16), and having children (PR = 1.72; 95% CI: 1.12–2.66) were associated with higher modern contraceptive use. Findings highlight important gaps in sustained contraceptive use and the need for tailored interventions addressing economic, social, and educational barriers to improve reproductive health in this low-resource setting. Full article

Equines play a crucial role in global food security, economic development, and recreation, particularly in regions such as Central Asia, parts of Africa, and South America. However, parasitic infections significantly impact their health, productivity, and reproductive performance, leading to economic losses and reduced animal welfare. This review synthesizes the effects of parasitic infections, including protozoan, helminthic, and ectoparasitic species, on equines. These infections cause hematological alterations like anemia, leukocytosis, leukopenia, and thrombocytopenia, compromising overall health and resilience. Protozoan parasites, such as Trypanosoma spp., Theileria equi, and Babesia caballi, directly affect semen quality and fertility by causing testicular lesions, orchitis, and hormonal disruptions. Helminths like Cyathostomins and Strongyles reduce nutrient absorption, impairing productivity, while some protozoan species can cause abortion through transplacental transmission. Zoonotic parasites, including Sarcocystis spp. and Toxoplasma gondii, pose a human health risk through contaminated meat and milk consumption. Despite the effectiveness of conventional anthelmintics, emerging biological control methods like Duddingtonia flagrans (BioWorma^® and Bioverm^®) show promise. However, the development of standardized herbal anthelmintics and vaccines is hindered by limited efficacy validation, complex parasite biology, and inadequate funding. The need for better diagnostic tools and sustainable treatments remains critical for the long-term sustainability of the equine industry. Full article

Native plant species show significant promise for the remediation and rehabilitation of mine tailings contaminated with heavy metals (HM). Nonetheless, the harmful impact of HM can decrease plant survival, growth and reproduction, thereby diminishing the effectiveness of phytoremediation. Consequently, incorporating organic amendments into mine tailings, like biochar, can promote plant growth, decreasing the bioavailability of HM and their eventual potential to alter the food chain. This study aims to evaluate the capability of coconut fiber biochar in combination with Sanvitalia procumbens to phytostabilize HM in mine tailings by analyzing the effect of coconut fiber biochar on HM bioaccumulation levels (roots and leaves), as well as on morphological, physiological, and genotoxic parameters of S. procumbens grown in mine tailing substrate and mine tailing/biochar. Also, a physicochemical analysis of coconut fiber biochar was conducted. This research was conducted over 100 days on plants grown in greenhouse settings using two different substrates (mine tailing and agrolite [75/25 v/v] and mine tailing and coconut fiber biochar [75/25 v/v]). Every 25 days, 12 plants were selected per treatment for analysis. The bioaccumulation pattern exhibited by S. procumbens was Zn > Pb > Cu > Cd, in root and leaf tissues for both treatments. S. procumbes grown in mine tailing/biochar substrate showed the lowest HM bioaccumulation levels in both tissues in comparison to mine tailing substrate: Zn from 2.95 to 2.50 times lower; Pb 3.04 to 2.82; Cu 3.10 to 2.12; and Zn 2.12 to 3.00 in roots and leaves, respectively. The coconut fiber biochar was rich in functional groups, such as carboxyl and hydroxyl groups, which could favor HM adsorption. Immobilization percentage of HM by coconut fiber biochar showed the following pattern: Pb (66.33%) > Zn (64.50%) > Cu (62.82%) > Cd (55.39%). Incorporating coconut fiber biochar as an amendment improves HM phytostabilization efficiency by reducing their bioaccumulation, increasing biomass production and chlorophyll concentration, and reducing genetic damage levels. This strategy represents a sustainable approach towards reducing the ecological risk of HM biomagnification, alleviating the adverse effects of HM exposure on ecosystem health. Full article

Background: Preconception care (PCC) is a key element of preventive reproductive health, aiming to optimise maternal and child outcomes by addressing biomedical, behavioural, psychosocial, and genetic risks before conception. International frameworks provide clear guidance, yet implementation in many low- and middle-income countries remains inconsistent. Methods: A structured narrative review was conducted across PubMed, Web of Science, Cochrane Library, and Google Scholar, focusing on literature published between 2010 and 2025. Eligible sources included empirical studies, clinical guidelines, policy documents, and high-quality grey literature from health authorities. Quality, relevance, and applicability were assessed, with particular emphasis on European and Bulgarian contexts. Results: Evidence from diverse settings demonstrates that PCC interventions—such as chronic disease management, vaccination, lifestyle optimisation, and expanded carrier screening (ECS)—can reduce adverse pregnancy outcomes and prevent severe genetic disorders. Effective international models integrate PCC into primary care, leverage digital health tools, and ensure equitable access through public funding. In Bulgaria, PCC remains underdeveloped: genetic screening is not part of routine care, there are no national guidelines or surveillance systems, and only ~4% of women initiate folic acid supplementation before pregnancy. NGOs and EU-funded digital initiatives provide partial outreach but cannot replace state-supported services. Conclusions: Bulgaria urgently requires a coordinated national PCC strategy, incorporating standardised guidelines, provider training, digital platforms, and phased ECS introduction. Strengthening PCC delivery can reduce preventable maternal and neonatal morbidity, advance reproductive justice, and enhance the long-term sustainability of public health systems. These findings support the development of a publicly funded, guideline-driven national PCC strategy with phased introduction of expanded carrier screening under NHIF to improve equity and long-term system sustainability. Full article

Mitochondrial dysfunction contributes to female reproductive endocrine disorders and is frequently associated with multisystem symptoms. Insulin resistance (IR) is a common metabolic disorder strongly linked to polycystic ovary syndrome (PCOS), while premature ovarian insufficiency (POI) also impairs fertility. Mitochondrial DNA (mtDNA) deletions and the stress-responsive cytokine growth differentiation factor 15 (GDF-15) have recently emerged as complementary biomarkers of mitochondrial impairment. In this retrospective observational study, we examined reproductive hormones, plasma GDF-15, mtDNA deletions, and clinical symptoms in insulin-resistant women, including those with PCOS or POI. Eighty-one patients were divided into three subgroups: IR-only (n = 49), IR-PCOS (n = 19), and IR-POI (n = 13). IR was defined based on elevated insulin levels during oral glucose tolerance testing (>10 mU/L at 0 min, >50 mU/L at 60 min, >30 mU/L at 120 min) according to national gynecological endocrinology guidelines, acknowledging that IR is not universally accepted as a distinct clinical entity. POI was defined as reduced ovarian reserve before age 40 with anti-Müllerian hormone (AMH) <1.0 ng/mL. Clinical symptoms were assessed using a questionnaire, medical record, and physical examination. MtDNA deletions were detected by long-range PCR, and GDF-15 was measured by ELISA. Free thyroxine (T4) emerged as an independent predictor of GDF-15, suggesting that thyroid function modulates mitochondrial stress signaling in insulin-resistant women. MtDNA deletions and/or elevated GDF-15 correlated with endocrine, gastrointestinal, and neuropsychiatric symptoms, and reduced AMH/FSH ratios indicated impaired ovarian function. Cross-sectional analysis further revealed lower AMH and AMH/FSH ratios in older women with mtDNA deletions, consistent with a trend toward accelerated reproductive aging. Overall, these findings support the role of GDF-15 and mtDNA deletions as complementary biomarkers of mitonuclear stress, with potential relevance for both systemic and reproductive health. Full article

Silver nanoparticles (Ag-NPs) are emerging as natural antimicrobial growth promoters in poultry, known for enhancing gut health, immunity, and productivity. This study assessed the effects of Ag-NPs and silver nitrate (AgNO₃) on sexual behavior, productivity, and silver bioaccumulation in the reproductive tissues of Japanese quails (Coturnix japonica). A total of 600 quails (8 weeks old) were randomly assigned to five groups (120 birds/group), each with six replicates (sex ratio 5 male: 15 females). Group 1 (control) received a basal diet, while Groups 2 and 3 were supplemented with Ag-NPs at 10 mg/kg and 20 mg/kg, respectively. Groups 4 and 5 received AgNO₃ at the same doses for eight weeks. Quails receiving 10 mg/kg Ag-NPs showed significantly improved male mating behavior, increased egg weight and mass, and enhanced egg quality, resulting in the highest fertility and hatchability performance. Silver accumulation in ovaries and testes increased dose-dependently, with the highest deposition observed in the 20 mg/kg Ag-NPs group. Correlation and regression analyses revealed weak and statistically non-significant relationships between ovarian silver levels and fertility and hatchability outcomes. These findings suggested that supplementation with 10 mg/kg Ag-NPs was a safe and effective feed additive for improving both productive and reproductive performance in Japanese quails. Full article

Given that building energy consumption accounts for a significant portion of total energy consumption, passive building technologies have demonstrated tremendous potential in addressing energy crises and the greenhouse effect. As a passive building technology, the Trombe wall (TW) can utilize solar energy to enhance building energy efficiency. However, due to their reliance on direct solar radiation patterns and limited thermal inertia characteristics, traditional TW systems exhibit inherent efficiency limitations. By integrating phase change materials (PCMs), TW systems can achieve high thermal storage performance and temperature control flexibility within a narrow temperature gradient range. By integrating functional materials, PCM-TW systems can be made multifunctional (e.g., through thermal catalysts for air purification). This has significant engineering implications. Therefore, this paper systematically reviews the development timeline of TWs, focusing on the evolution of PCM-TW technology and its performance. Based on this, the paper particularly emphasizes the roles of three key operational parameters: structural characteristics, thermophysical material design, and operational management. Importantly, through comparative analysis of existing systems, this paper identifies the shortcomings of current PCM-TW systems and proposes future improvement directions based on the review results. Full article

Glyphosate, a widely used non-selective herbicide, has been a subject of intense scientific debate due to its environmental persistence and potential health risks. This review examines glyphosate’s mechanisms of action, its effects on crop production, and its broader environmental impact, including soil degradation, water contamination, and biodiversity loss. Furthermore, it examines the expanding body of research linking glyphosate exposure to various human health concerns, including metabolic, neurological, reproductive, and oncological disorders. The review also assesses glyphosate’s role in hindering the achievement of the Sustainable Development Goals (SDGs), particularly those related to food security, health, access to clean water, and the protection of marine ecosystems. Finally, potential alternatives to glyphosate-based weed control, including organic and non-chemical methods, are discussed to promote sustainable agricultural practices that balance productivity with ecological and public health considerations. The evidence reviewed highlights glyphosate’s pervasive presence across ecosystems and its potential to disrupt both environmental and human health. The findings underscore the urgent need to regulate glyphosate use, prioritize soil and water protection, and accelerate the transition toward sustainable, low-toxicity weed management strategies that align with global sustainability objectives. Full article

Background: Maternal mortality remains a significant public health challenge in Brazil, reflecting persistent social, racial, and regional inequalities. Objectives: This study aimed to analyze trends and characteristics of maternal deaths in Brazil from 2000 to 2020, identifying sociodemographic and clinical risk factors. Methods: A retrospective, population-based study was conducted using secondary data from the Sistema de Informações sobre Mortalidade (SIM) of the Brazilian Ministry of Health. Descriptive and comparative statistical analyses were performed, including chi-square (χ²) goodness-of-fit tests and 95% confidence intervals calculated by the Wilson method. Variables were stratified by region, age, race, education, type and period of death, and investigation status. Results: A total of 40,907 maternal deaths were recorded. From 2000 to 2020, Brazil recorded 40,907 maternal deaths. The maternal mortality ratio decreased from approximately 74 deaths per 100,000 live births in 2000 to 57 per 100,000 in 2020, representing a 23% reduction over two decades. Most deaths occurred among young, Brown women with low education levels, particularly in the Southeast and Northeast regions. Direct obstetric causes accounted for two-thirds of cases, and most deaths occurred in hospital settings, mainly during the early puerperium. Conclusions: Despite progress, maternal mortality in Brazil remains above the WHO target and is strongly influenced by social inequities. Strengthening primary care, improving referral networks, expanding postpartum follow-up, and enhancing surveillance systems are essential for preventing avoidable deaths and achieving reproductive justice. Full article

Autosomal recessive (AR) disorders represent a significant public health challenge, as asymptomatic carriers are often unaware of their reproductive risks. This study provides the first comprehensive assessment of AR gene variant frequencies and their molecular landscape in a fertile Western Romanian population. Genetic results from 604 unrelated, unaffected Caucasian individuals of reproductive age, tested at a single genetic center between 2020 and 2024, were retrospectively analyzed. Next-generation sequencing (NGS) with a multi-gene panel targeting 300 AR-associated genes was used for molecular profiling. Variants were identified in 156 genes, with 75% of individuals carrying at least one AR variant (mean 1.77 variants/person). A subgroup with >3 pathogenic variants comprised 7.5%, posing a notable risk for future offspring. The most frequent variants were detected in HFE (1:5), CFTR (1:9), BTD (1:16), GJB2 (1:17), and CYP21A2 (1:19). Four variants (HFE, c.187C>G; BTD, c.1330G>C; CFTR, c.1210-34TG[11]T[5]; GALT, c.-119_-116del) were particularly prevalent, each exceeding 3% frequency. Considerable allelic heterogeneity was observed for distrinctive variants in CFTR (14), PAH (12), USH2A (12), and ATP7B (9). Several variants were linked to severe disorders, with CFTR, GALT, ATP7B, and SMN1 identified as “red zone” genes associated with high morbidity and mortality. Low-frequency variants formed a “long tail” (83.9%), reflecting marked population heterogeneity and potential hidden disease risks. The study reveals high allelic diversity and a strong prevalence of AR variants in Western Romania. Variant-based gene classification supports population-level screening, highlighting the public health value of a national program to identify carriers and prevent severe inherited disorders. Full article

Although aging is an irreversible process, the rate of aging can be delayed by a reasonable diet. As a nutrient-dense natural product, royal jelly (RJ) has an enormous potential for applications in medicine and health promotion. However, the exact physiological activity of RJ with varying freshness and concentration has not been fully clarified, and more investigation is needed to determine their precise contributions. Here, fresh RJ (just produced recently) and RJ stored for 2 weeks at −20 °C, 4 °C or 25 °C were tested at concentrations of 100, 50, 25 and 12.5 μg/mL on Caenorhabditis elegans. Fresh RJ, with concentrations of 100 μg/mL, 50 μg/mL and 25 μg/mL, could extend the lifespan of C. elegans by 16.37%, 9.53% and 4.32%, while RJs stored at 4 °C and 25 °C were ineffective. In terms of body length, treatment with fresh RJ significantly enlarged the body size by around 48%. Although RJ stored at 4 °C and 25 °C could also promote nematode growth, its activity diminishes as storage temperature increases. RJs stored at −20 °C and 4 °C with concentrations of 100 μg/mL significantly increased the pumping rate of nematodes by 58% and 50%. But non-fresh RJ or low-concentration RJ (≤25 μg/mL) had no effects on the motility of C. elegans. In addition, fresh RJ could improve the reproductive capacity of C. elegans, with the highest increase reaching approximately 25%. Even when stored at 25 °C, RJ also significantly enhanced the reproductive capacity of C. elegans, increasing it by approximately 14.8%. Moreover, qPCR showed that RJ could significantly affect the expression of multiple genes associated with aging and vitality. Fresh RJ significantly up-regulated bec1 and hsp16.2 3.19- and 2.80-fold, while RJ stored at 25 °C significantly up-regulated sod3 and gpd1 3.80- and 3.40-fold. Our results suggested that the activity of RJ on C. elegans is related to its freshness and concentration, while RJ also contains active components that are independent of freshness. Therefore, it is necessary to explore effective methods for accurately assessing the freshness of RJ. Full article