Background: Accumulating evidence suggests that the COVID-19 pandemic has negatively impacted the mental health of individuals. However, the susceptibility of individuals to be impacted by the pandemic is variable, suggesting potential influences of specific factors related to participants’ demographics, attitudes, and practices. Objective: We aimed to identify the factors associated with psychological symptoms related to the effects of the first wave of the pandemic in a multicountry cohort of internet users. Methods: This study anonymously screened 13,332 internet users worldwide for acute psychological symptoms related to the COVID-19 pandemic from March 29 to April 14, 2020, during the first wave of the pandemic amidst strict lockdown conditions. A total of 12,817 responses were considered valid. Moreover, 1077 participants from Europe were screened a second time from May 15 to May 30, 2020, to ascertain the presence of psychological effects after the ease down of restrictions. Results: Female gender, pre-existing psychiatric conditions, and prior exposure to trauma were identified as notable factors associated with increased psychological symptoms during the first wave of COVID-19 (P<.001). The same factors, in addition to being related to someone who died due to COVID-19 and using social media more than usual, were associated with persistence of psychological disturbances in the limited second assessment of European participants after the restrictions had relatively eased (P<.001). Optimism, ability to share concerns with family and friends like usual, positive prediction about COVID-19, and daily exercise were related to fewer psychological symptoms in both assessments (P<.001). Conclusions: This study highlights the significant impact of the COVID-19 pandemic at the worldwide level on the mental health of internet users and elucidates prominent associations with their demographics, history of psychiatric disease risk factors, household conditions, certain personality traits, and attitudes toward COVID-19.
20 July 2023 in Waste Management & Research: The Journal for a Sustainable Circular Economy
Biomedical waste management (BMWM) is vital in facilitating safe providing of healthcare. Developing countries suffer from the impact of mishandled biomedical waste (BMW) on the general public in addition to healthcare practitioners. Thus, this study aims to investigate the awareness and compliance of dental facilities to BMW regulations. Through a questionnaire designed as per the WHO guidelines on BMWM, we randomly recruited a total of 421 dental facilities representative of Jordan’s capital. Mean BMWM practice scores were relatively high for the studied sample (0.748 ± 0.12). Nonetheless, while collection, transportation and storage standards were acceptable, those pertaining to segregation and disposal demonstrated lack of compliance to BMWM safety measures. An alarming number of participants dispose of infectious waste (40%), extracted teeth (48.5%), expired pharmaceuticals (44.4%), liquid chemicals (53.2%), X-ray films (35.0%) and solutions (48.7%) in the general trash or draining system. Such is attributed to either lack of resources, lack of proper equipment or poor awareness with BMWM guidelines. Moreover, it appears that location of the clinic ( p < 0.001), occupation ( p = 0.026) and presence of regulatory instructions ( p = 0.048) were associated with higher BMWM scores. Overall, dental practitioners require proper training in terms of handling hazardous dental, chemical and radioactive wastes. Moreover, regulatory bodies should actively enforce regulations and monitoring, update current compliance legislations and subsidize eco-friendly practices.
Background/Objectives: Cervical mesonephric adenocarcinomas (MNACs) are among the rarest neoplasms of the female genital tract. Unlike the majority of cervical cancers, which are predominantly squamous in origin and strongly associated with HPV seropositivity, MNACs are distinct in both histology and pathophysiology. Despite their unique characteristics, MNACs have historically been managed in parallel with squamous cell carcinomas, resulting in a lack of optimised, evidence-based treatment protocols. In this systematic review, we aim to evaluate the current management strategies for MNACs and their associated clinical outcomes. Additionally, we critically appraise existing surgical and adjuvant therapies and propose embryologically oriented surgical techniques to achieve optimal tumour resection. Methods: We performed a systematic search across the MEDLINE, CENTRAL, EMBASE, and ClinicalTrials.gov databases from 1960 to June 2024. The search strategy employed a combination of keywords and MeSH terms, including “Uterine Cervical Neoplasms” [MeSH], “mesonephric tumour”, “mesonephric neoplasm”, and “mesonephric cancer”. All relevant publications, including case reports and case series, were considered. Results: A total of 49 publications were finally included in the analysis, involving a thorough description of 91 MNAC cases. Most patients had stage I disease (70.8%) (n = 51). Hysterectomy was performed in 77 patients. The median follow-up was 29 months (range 1–199 months). Disease recurrence was observed in 35.2% (n = 25) of the cases, with the median disease-free survival (DFS) being 24 months (range 1–199). At the follow-up, 64.8% (n = 46) of patients remained in remission irrespective of the treatment modality, while 27.4% (n = 20) died due to disease progression. Conclusions: Mesonephric neoplasms of the uterine cervix are rare and clinically aggressive cancers that signify poor prognosis. Accurate identification and effective management can be challenging due to their particular anatomic and immunohistochemical characteristics. Therefore, a more tailored embryological-based approach should be considered for an optimal oncologic outcome.
Background: Intraoperative ultrasound (IOUS) is revolutionizing gynecologic oncology surgery by overcoming the limitations of traditional imaging and intraoperative assessment. Its real-time, high-resolution capabilities address critical needs in tumor localization, fertility preservation, refined intraoperative decisions, and complete cytoreduction. Methods: We reviewed clinical studies (1998–2024) evaluating IOUS applications, analyzing data on detection accuracy, surgical outcomes, and implementation challenges from peer-reviewed literature and institutional experiences. Results: IOUS demonstrates 88–93% sensitivity for subcentimeter metastases, refining surgical decisions in 25–40% of cases. Key outcomes include increased complete resection rates (68% to 87%), a 38% reduction in unnecessary lymphadenectomies, and successful fertility preservation in 92% of cases. Limitations include learning curves, 12% false-negative rate for micrometastases, and significant capital investment cost barriers. Conclusions: IOUS represents a transformative advance in precision surgery, improving both oncologic outcomes and quality of life. While standardization and accessibility challenges remain, ongoing technological innovations promise to solidify its role as a surgical standard.