Background: 10% - 15% of maternal deaths are statistically attributable to preeclampsia. Compared with late-onset PE, the severity of early-onset PE remains greater harm, with higher morbidity and mortality. Objective: To establish an early-onset preeclampsia prediction model by clinical characteristics, risk factors and routine laboratory indicators from 6 to 10 gestational weeks of pregnant women. Methods: The clinical characteristics, risk factors and 38 routine laboratory indicators (6 - 10 weeks of gestation) including blood lipids, liver and kidney function, coagulation, blood count and other indicators of 91 early-onset preeclampsia patients and 709 normal controls without early-onset preeclampsia from January 2010 to May 2021 in Peking University Third Hospital (PUTH) were retrospectively analyzed. Logistic regression, Decision tree model and Support vector machine (SVM) model were applied for establishing prediction models, respectively. ROC curves were drawn, and the area under the curve (AUCROC), sensitivity and specificity was calculated and compared. Results: There were statistically significant differences in the rates of diabetes, Antiphospholipid Syndrome (APS), kidney disease, Obstructive Sleep Apnea (OSAHS), primipara, history of preeclampsia and Assisted Reproductive Technology (ART) (p < 0.05). Among the 38 routine laboratory indicators, there were no significant differences in the levels of PLT/LYM, NEU/LYM, TT, D-Dimer, FDP, TBA, ALP, TP, ALB, GLB, UREA, Cr, P, Cystatin C, HDL- C, Apo-A1, and Lp(a) between the two groups (p > 0.05). The levels of the rest indicators were all statistically different between the two groups (p < 0.05). If only 12 risk factors of PE were analyzed by logistic regression, decision tree model, and the Support Vector Machine (SVM), the AUCROC were 0.78, 0.74 and 0.66 respectively, while 12 risk factors of PE and 38 routine laboratory indicators were analyzed by logistic regression, decision tree model and the support vector machine(SVM), the AUCROC were 0.86, 0.77 and 0.93 respectively. Conclusion: The efficacy of clinical risk factors alone in predicting early-onset preeclampsia is not high, while the efficacy increased significantly when PE risk factors were combined with routine laboratory indicators. The SVM model was better than the logistic regression model and decision tree model in the early prediction of early-onset preeclampsia incidence.

Introduction: Due to the COVID-19 pandemic and home confinement measures, many of our routines and daily habits have been both affected and modified. Have these factors conditioned a real increase in precocious (PP) and accelerated puberty (AP)? Objectives: This is an observational and retrospective study in which the incidence of medical consultations due to premature thelarche is compared between March to December 2019 and 2020. The medical consultations occurred in the Pediatric Endocrinology (PE) consultation of our hospital. Patients and methods: The analysis involved 75 cases of young girls consulted with premature thelarche in 2019 and 97 girls which were consulted in 2020. From each patient, different variables were analyzed, such as somatometry, hormones, eco, and treatment. Results: In 2019, 75 first visits of PE were due to premature thelarche in young girls (accounting for 2.46% of the total number of first visits carried out in Pediatrics Outpatient Clinics (POC) and 16.77% of PE first visits). However, in 2020, 97 first visits were due to PE (3.52% of the total first-time visits of OC and 23.3% in PE). It was found that in 2020 the number of first-time visits due to premature thelarche increased by 28% compared to 2019 (p: 0.0001 mean comparison). In 2019, out of the 75 consultations due to premature thelarche, 40% were diagnosed with an earlier physiological puberty. Conversely in 2020, out of the 97 consultations, 61.77% had normal physiological puberty. These figures represent an OR of 1.54 (p: 0.02 t Student for independent samples). It was evaluated whether the patients had experienced > 3kg weight gain above 6 months prior to the medical visit. In 2020, 31.57% of patients experienced weight gain, whereas 68.42% did not. In 2019 patients who experienced weight gain accounted for 12.16% and 87.83% did not experience significant weight gain (p: 0.01 t Student for independent samples). Conclusion: Our data demonstrates there has been an increase in the incidence of referrals from Primary Attention to Pediatric Endocrinology to examine advanced thelarche during the period of lockdown measures (2020), in addition to an increase in the number of diagnostics of PP and AP in young girls in our hospital when compared to figures for 2019. Furthermore, in 2020 there was a greater number of patients who experienced a weight gain increase 6 months prior to the medical consultations. We hypothesize that the lockdown inflicted sedentary lifestyles together with changes in dietary habits, promoting weight gain in patients. This effect could have caused a body fat mass increase in girls, suggesting a “trigger effect” in the activation of the gonadal axis, causing a rise in the number of early puberty cases. IRB: CIEC 01/2017.

Infertility and Adolescent Sexual and Reproductive Health (ASRH) are significant challenges worldwide, particularly in low- and middle-income countries. Teenagers living in urban slums that are quickly developing are frequently disregarded, despite the efforts of international organizations to enhance access to services and information for residents of these areas. It is common for women to blame for infertility, even when their spouse has clinical infertility; this contributes to a bias in the relevant body of research. In order to address these issues, policies on sexual and reproductive health need to be evidence-based, they need to take into account various points of view and they need to combat negative stereotypes and inequities. Comprehensive programs that prepare healthcare providers and non-clinical service providers are crucial. This review highlights the importance of addressing systemic issues, such as gender norms and economic disparities, in promoting sexual and reproductive health care to achieve desired reproductive outcomes.

Objective: The progressive development of lymphoma therapies has led to an important prolongation of patient survival. We aimed to investigate anxiety, depression, sexual satisfaction and health-related quality of life status in these lymphoma survivors. We examined the effects of depression, anxiety and sexual satisfaction on the quality of life. Materials and methods: In a prospective study, the data were collected from fifty lymphoma survivors. We used six forms. These forms consist of sociodemographic features, the Beck Depression Inventory (BDI), Beck Hopelessness Scala (BHS), State-Trait Anxiety Inventory (STAI I-II), Golombock-Rust Inventory of Sexual Satisfaction (GRISS) and European Organization for Research on the treatment of Cancer Questionnaires Quality of Life (QoL) - C30 questionnaires. Results: The mean age of the patients was 50,2 ± 14,8 (20 – 75) years, and 50% of them were females. In our study, we found that 26% of the patients had high depression values above the cutoff (≥ 17 of BDI score). The mean depression score of the patients was 10,6 ± 8 (0 - 32) and the mean hopelessness score was 5,7 ± 4,5 (0 - 19). The patients whose anxiety and depression scores were high role, cognitive and emotional functioning of EORTC-QLQ-C30 was found statistically significantly low. The mean STAI-I score of the patients was 35,6 ± 11,3 (22-73) and the mean STAI-II score was 41,4 ± 10,6 (23 - 67). Statistical significance in terms of emotional and social functioning was found in the patients with high anxiety scores. When all patients were evaluated with respect to GRISS, we found high scores (> 5) for frequency, communication, vaginusmus and premature ejaculation. We compared the EORTC-QoL-C30 scores and GRISS of the patients. There was an association between emotional dysfunction with high scores of frequency (p = 0.040). Also, there was an association between low scores of role functioning with high scores of avoidance and premature ejaculation (p = 0.015, p = 0.003). However, there was a significant correlation between low scores of global QoL with high scores of avoidance, communication, and touch. There was no statistically significant difference between the anxiety and depression levels of the patient according to gender. But, some functional scales including role function (p = 0.001), social function (p = 0.001) and cognitive function (p = 0.027) were lower in female patients. Conclusion: The lymphoma survivors had high anxiety and depression scores, reduced sexual functioning and low functioning scales of QoL. There was an association between sexual dysfunction low role, emotional functioning and global QoL scores in patients.

Young people’s Sexual and Reproductive Health (SRH) services in Nigeria are limited and there are issues of affordability and accessibility of these health services. Also, there are limited studies in Nigeria on the barriers to accessing and utilizing SRHS in the Nigerian healthcare sector. Furthermore, even when the services are provided they are not sensitive to the needs of young people. Hence, this study aims to assess the barriers to the availability and accessibility of sexual reproductive health services (SRHS) for young people living with sexually transmitted infections (STIs) in Abia State, Nigeria. Study Aim: To make recommendations for removing assess barriers to effective sexual and reproductive health services for young people living with STIs in southeast Nigeria. Methodology: A systematic review of 14 studies comprising 9 qualitative studies, 3 mixed methods, 1 quantitative and 1 cross-sectional study. The inclusion criteria were primary studies written in the English language which assessed barriers to SRH services while the exclusion criteria were the secondary studies and primary studies which did not access barriers to accessibility and availability of SRHS for young people. A total of 4, 705 participants from different African countries formed the sample size. Findings: Results showed that young people have little or no insight into STIs and their services. Moreover, they experienced different levels of barriers ranging from the negative and judgmental attitude of healthcare providers, stigma, cost, availability and accessibility of healthcare services as well as lack of integration of services and privacy and confidentiality. These are the major barriers that discourage young people from accessing SRH services. Also, experiences of fear and shame were reported as common barriers to utilizing care. Conclusion: Sensitizing the SRH needs of young people can enhance access to healthcare services. Therefore, there is a need to improve uptake and address the negative attitude of healthcare providers, as well as the issue of confidentiality, which will help to improve SRH service utilization among young people. Also, it is recommended that teaching health care professionals about these STI prevention centers will be the main solution to improve the preventive practice to reduce STI incidence in young people in Nigeria.

Background and aims: Based on the concept of “cuckolding” and “troilism”, it was hypothesized that underlying this paraphilia is a counterphobic attitude that positively reinforced produces the establishment of behavioural addiction. The purpose of this study is to confirm this hypothesis. Materials and methods: Clinical interview, based on narrative-anamnestic and documentary evidence and the basis of the Perrotta Human Emotions Model (PHEM) concerning their emotional and perceptual-reactive experience, and administration of the battery of psychometric tests published in international scientific journals by the author of this work: 1) Perrotta Integrative Clinical Interviews (PICI-2), to investigate functional and dysfunctional personality traits; 2) Perrotta Individual Sexual Matrix Questionnaire (PSM-Q), to investigate the individual sexual matrix; 3) Perrotta Affective Dependence Questionnaire (PAD-Q), to investigate the profiles of affective and relational dependence; 4) Perrotta Human Defense Mechanisms Questionnaire (PDM-Q), to investigate the defence mechanisms of the Ego. Results: In a population sample of 108 subjects (98 males and 10 females), the totality was found to exhibit at least 5 dysfunctional personality traits of the manic, borderline, narcissistic covert, masochistic, and dependent types, with secondary traits of the neurotic, bipolar, histrionic, and paranoid types. Always the totality of the sample shows the marked dysfunctionality of a sexual nature (especially in relational profiles) and the activation of defense mechanisms typical of psychopathological processes; in particular, at the PSM-Q the totality of the sample stated that the basis of their paraphilia is the establishment of a traumatic event of an affective, sentimental or sexual nature related to adolescence and adulthood that has generated in the person distrust in the relationship. Conclusions: At the origin of cuckolding and troilism, it is reasonable to deduce that there is a traumatic event of an affective, sentimental or sexual nature, occurring mainly in youth or early adulthood, which has negatively impacted the subject’s perception of the relational sphere. Such an event, capable of generating negative feelings of distressing origin, was then reworked and sublimated by the subject using a counterphobic attitude (the fear of being betrayed is replaced by the idea that granting the partner sexual freedom, after sharing, is sufficient to avoid the reoccurrence of the primary traumatizing event); the repetition of avoidant experiences of the danger of the primary phobia (betrayal) then generates in the subject the belief in the functioning of the mechanism, which therefore is repeated according to a cognitive-behavioural pattern of positive reinforcement, capable of establishing over time the behavioural dependence that underlies the paraphiliac disorder. Such a fear-prone psychopathological pattern, moreover, could be the same one that favours polygamous relational choice (at the expense of monogamous relational choice), net of environmental and social conditioning (e.g., Islamic contexts) that might naturally favour such choice. This counterphobic mechanism reinforced by positive reinforcement may underlie the onset of paraphilias and deserves further investigation.

Background: Since the outbreak of COVID-19 emerged in Wuhan, China, in December 2019, the epidemic has spread worldwide and posed a great threat to society. Despite great achievements in COVID-19 research, few studies have focused on the similarities and differences between SARS-CoV-2 and influenza viruses. Results: Through a review of the literature on SARS-CoV-2 and influenza viruses, we found that influenza occurs every year, and influenza pandemics occur irregularly. The uncomplicated human influenza viruses primarily affect the larger airways and rarely the alveoli. However, SARS-CoV-2 mainly involves the deep airways and lungs and can cause DAD, leading to severe hypoxemia. In general, SARS-CoV-2 is no less infectious than the influenza virus. However, its destructive power to the lungs is no less than the avian influenza virus. There is currently no clinical vaccine and specific inhibitor against SARS-CoV-2. Conclusions: SASR-CoV-2 damages lung function more severely than the influenza virus, with higher morbidity, mortality, and severe disease rates. Controlling the source of infection, cutting off the route of transmission, and protecting susceptible populations are critical to the fight against SARS-CoV-2.

Background: Although induced abortion is legally allowed on various grounds in several sub-Saharan African countries, health care providers in these countries often persist in viewing induced abortion as immoral. Providers’ attitudes may conflict with the national abortion law or their personal and or religious values. Abortion services are severely restricted and highly contentious in Uganda. This study, therefore, is aimed at determining attitudes among healthcare providers on induced abortion service provision in Gulu City. Procedures: A cross-section survey was conducted among health workers about attitudes toward induced abortion between September and November 2019 using a modified abortion attitudinal score. The study was conducted in the Hospitals and Health centers in Gulu City, in Northern Uganda, the participants were drawn from Public, Private non-for-profit faith-based, Private for Profit and, Private non-for-profit Non-Government Organisation health centers. Findings: A total of 252 health care providers were surveyed. The mean attitudinal score for generally in support, generally not in support, conditional in support, personal attitude, and beliefs against and toward abortion provision were 2.80, 2.71, 2.86, 3.239, and 3.35 respectively. Factors that were positively associated with general support included age 40 years and above; and being employed in private non-for-profit non-governmental health facilities, with coefficients of 0.85 and 0.67 respectively. Factors that were positively associated with conditional support were; age 40years or above; being employed in a non for profit non-governmental health facility; private for-profit and private not-for-profit faith-based health facilities coefficients 0.55, 0.54, 0.40, and 0.37 respectively. However, being a born-again Christian was negatively associated with general support for induced abortion provision. Conclusion: Healthcare providers’ attitude is an important element in the provision of quality stigma-free post-abortion care services. A clear national effort to improve post-abortion and comprehensive abortion care training should include value clarification and attitude transformation among all healthcare providers.

Introduction: Sexual violence is a series public of health problems and human right issues affecting millions of people each year throughout the world with short and long-term impacts on women and girls’ physical, mental, sexual, and reproductive health. Therefore, this study aims to assess the magnitude of sexual violence and associated factors among night school female students in the study area. Methods: Institution-based cross-sectional study design was conducted among 422 night junior school female students in Gondar town, Northwest, Ethiopia. Participants were selected by using simple random sampling and data were collected by self - administered structured questionnaire. Data entry and analysis was done by EPI info version 7 and SPSS statistical packages version 20 respectively and descriptive statistics were done. Moreover, binary logistic regression analyses were also carried out to identify factors associated with sexual violence. Results: In this study, the mean age (+_SD) study participants was 19.3±3.1years. The the proportion of school life sexual violence in this study was found to be 63.4% with a 95% the confidence interval of (57.9, 67.1). the overall 91 (21.9%) of the participants were faced attempted rape in their school life. Regarding sexual harassment at least one form of sexual harassment was reported among 244 (58.8%) from these 135 (32.5%) unwanted sexual Act/asked to have sex, about 152(36.6%) faced unwelcome touching body parts like breast, and 131 (31.6%) faced unwelcome kissing. School life sexual violence was positively associated with those females who had ever started sexual intercourse (AOR= 0.58, 95%CI, 0.362, 0.924), being rural child-hood residence (AOR=) 1.9, 95%CI 1.2,2.9) and traveling more than 30 minutes from school to home (AOR= 2.2,95%CI, 1.124, 4.452). Conclusion: The proportion of sexual violence in this study area was relatively high and it was significantly associated with being a rural child -hood residence. Therefore, appropriate intervention is needed Especially those students who grew up in a rural areas during the child-hood period.

Objectives: Assess the prevalence and associated factors of sexual coercion at first sexual debut among young females in rural areas of Boset district, Oromia Region, Ethiopia. Methods: Cross-sectional community-based study was conducted using qualitative and quantitative data collection methods. A sample of 632 young females aged 10-24 years was taken from six rural Kebeles by systematic random sampling for quantitative and data was collected using a pre-tested structured questionnaire. The collected data was analyzed using SPSS version 23. Principally Binary Logistic regression model was fitted. Moreover, eight focus group discussions targeting different groups were held and analyzed thematically. Results: Prevalence of sexual coercion at first sexual debut was 36.5% (95%CI: 34.6%-38.4%) among sexually active respondents. Married young female (AOR,0.71;95%CI: 0.42,0.81), living away from their parents (AOR,5.07;95%CI:1.07,24.01), age group of 15-19 (AOR,0.19; 95%CI:0.06,0.54), alcohol consumption (AOR,2.44;95%CI:1.17, 5.08) and Khat chewing (AOR, 8.30;95%CI:1.89, 36.38) were factors predicting the likelihood of having sexual coercion at sexual debut. Conclusion: Sexual coercion at fist sexual debut is a major public health problem among young females in the study community. The emerging program interventions need to take this problem into consideration.