Relative Lack Research Articles

A systematic meta-analysis of the efficacy of treatments for a global honey bee pathogen - the Varroa mite.

The western honey bee Apis mellifera is the world's most important managed pollinator. However, globally honey bees have been facing increasing colony losses due to a combination of stress factors. Foremost among these is the invasive mite Varroa destructor, which is the pathogen most commonly linked to colony losses. Despite intensive research focus on this problem, V. destructor management remains extremely challenging, with no definitive treatment approach. A variety of synthetic chemical, agriculturally organic chemical, biological, and physical treatments have been trialled and used in V. destructor management, each with benefits and drawbacks. Here, we carried out a first systematic meta-analysis of the comparative effectiveness of V. destructor treatment methods. We incorporated data from 138 studies from 30 countries, across five continents and found that overall, synthetic chemicals show high effectiveness as a treatment due to their ability to suppress the V. destructor mite. In our analyses of honey bee responses, there was some evidence that synthetic chemicals may have an overall negative impact on them, even while suppressing V. destructor. For improving honey bee health measures, biological treatment methods showed the most positive effect, but with a relatively low sample size. Our study highlights that there is a relative lack of studies on biological management methods, with far more focus in the literature on chemical treatments. We show that, until biological methods receive greater research attention, agriculturally organic methods likely provide the best current treatment option, because they are well studied, nearly as effective at suppressing V. destructor as synthetic chemicals, and less associated with negative impacts on honey bees. Varroa destructor remains a major threat to honey bees globally, with the last large V. destructor free zone (Australia) having now been invaded, emphasising the need to fill these knowledge gaps.

The Role of Social Determinants of Health in Childhood Epilepsy.

Social determinants of health (SDHs) are significant and potentially modifiable drivers of neurologic diseases, including childhood epilepsy. Social determinants of health greatly influence the epidemiology, management, and outcomes associated with these conditions. Social determinants of health affect every aspect of a family's journey with epilepsy-from initial diagnosis to accessing effective treatments and ongoing care. Despite notable advancements in understanding the genetic and molecular underpinnings of pediatric epilepsies, there remains a relative lack of knowledge about the nature and impact of SDHs on these disorders. Epilepsy is a symptom of much more profound underlying determinants of health. Addressing the broader context of epilepsy can transform health outcomes. This narrative review appraises some available evidence and explores possible solutions.

Improving neuroendocrine tumor treatments with mathematical modeling: lessons from other endocrine cancers

Neuroendocrine tumors (NETs) occur sporadically or as part of rare endocrine tumor syndromes (RETS) such as Multiple Endocrine Neoplasia 1 and Von-Hippel Landau syndromes. Due to their relative rarity and lack of model systems, NETs and RETs are difficult to study, hindering advancements in therapeutic development. Causal, or mechanistic mathematical modeling, is widely deployed in disease areas such as breast and prostate cancers, aiding understanding of observations as well as streamlining in vitro and in vivo modeling efforts. Mathematical modeling, while not yet widely utilized in NETs research, offers an opportunity to accelerate NET research and therapy development. To illustrate this, we highlight examples of how mathematical modeling associated with more common endocrine cancers has been successfully used in the preclinical, translational, and clinical settings. We also provide a scope of the limited work that has been done in NETs and map how these techniques can be utilized in NET research to address specific outstanding challenges in the field. Finally, we include practical details such as hardware and data requirements, present advantages and disadvantages of various mathematical modeling approaches, and discuss challenges of using mathematical modeling. Through a cross-disciplinary approach, we believe that many currently difficult problems can be made more tractable by applying mathematical modeling and that the field of rare diseases in endocrine oncology is well-poised to take advantage of these techniques.

Are indicated prevention and effective early intervention achievable goals for youth with bipolar mood disorders?

Compared with other areas of mental health research that are focused on the active and early management of youth presenting in the early stages of major mental disorders, there has been a relative lack of focus on young people with emerging or established bipolar disorders. Recently, this has stimulated both international professional societies (e.g., International Society for Bipolar Disorders [ISBD] Early Intervention Task Force) and funding agencies from Canada, UK, Australia, and the USA – including the Daymark Foundation (Jain et al. 2023), Wellcome Trust (2022), National Health and Medical Research Council, and BD2 – to promote a focus on identifying the major challenges in this field and gathering support for novel research and clinical service programmes.

Expanding the Range of Epithelial Marker and SMA Staining of Superficial CD34+ Fibroblastic Tumors: A Case Report and Review of the Literature.

Superficial CD34+ fibroblastic tumor (SCD34FT) is a relatively recently described borderline mesenchymal neoplasm. Owing to a relative lack of specificity in clinical presentation, radiopathologic findings, and immunohistochemical staining, the diagnoses of SCD34FT can be challenging. In this study, we present a case of a 55-year-old woman with an indolent painless nodule on the right shin. Histopathologic evaluation of the resected specimen showed a moderately cellular, subcutaneous lesion composed of spindled cells with mild pleomorphism arranged in sheets and fascicles. Immunohistochemical staining demonstrated diffuse positivity for CD34. Surprisingly, the tumor also showed diffuse expression of smooth muscle actin (SMA) and more than focal (ranging from subset to diffuse) expression of AE1/AE3 and CAM5.2. DNA and RNA next-generation sequencing revealed a t(X; 11)(q13; q24) MED12::PRDM10 fusion, confirming the diagnosis of SCD34FT. To the best of our knowledge, this is the first reported case highlighting SCD34FT with more extensive immunoreactivity to epithelial markers (AE1/AE3 and CAM5.2) and SMA compared with the focal staining reported in the existing literature. We hope that adding this case to the existing literature will raise awareness among pathologists to recognize the more variable staining pattern of epithelial markers and SMA when considering the diagnosis of SCD34FT.

Numerical Study on Combustion Behavior of Tuyere and Raceway in Blast Furnace with Oxygen-Rich Blast and Hydrogen Injection

The injection of hydrogen into a blast furnace is a promising technology to fulfill the low-carbon ironmaking purpose. A three-dimensional computational fluid dynamic (CFD) model is developed to investigate the effect of hydrogen injection rate and blast oxygen enrichment rate on the tuyere, raceway, and surrounding coke bed behaviors. It was found that hydrogen injection leads to a higher water vapor volume fraction in the raceway and a higher hydrogen fraction in the coke bed. The magnitude of velocity and temperature near the tuyere only increase slightly due to the cold inlet temperature of hydrogen, which also results in lower coke bed temperature. The volume-averaged temperature decreases from 2146 K to 2129 K when the injection rate increases from 0 to 1000 Nm3/h. Oxygen enrichment rate presents a highly positive correlation with temperature in the raceway and coke bed, water vapor and carbon dioxide volume fraction in the raceway, and pulverized coal burnout rate. Because more carbon participates in the raceway reaction with an increase in oxygen enrichment rate from 0% to 10%, the final carbon monoxide fraction in the coke bed increases from 0.29 to 0.40, and the final hydrogen fraction decreases from 0.15 to 0.13. With the increase in hydrogen injection, the temperature of the raceway and the coke bed decreased slightly. Pulverized coal burnout changes little with the hydrogen injection rate increasing from 500 Nm3/h to 1500 Nm3/h, which is because hydrogen combustion promotes pulverized coal at the front part of the raceway but inhibits it at the end due to the relative lack of oxygen. These results will help better understand the combustion behavior in the tuyere and raceway of the blast furnace with oxygen-rich blast and hydrogen injection.

Two Clinically Implementable Digital PCR Assessments of DNA Methylation for Diagnosing Heavy Alcohol Consumption

Background: Heavy alcohol consumption (HAC) has a profound adverse effect on human health. Unfortunately, there is a relative lack of tools that are easily implementable in clinical settings and that can be used to supplement self-reporting in the diagnosis and management of HAC. In part, this paucity is due to limitations of currently available biological measures and a mismatch between available biological measures and the needs of clinicians managing HAC. Objectives: We first review the pros and cons of existing biological measures. Next, we review the underlying theory and the performance characteristics of two recently developed methylation-sensitive digital PCR (MSdPCR) assays, referred to as the Alcohol T Score (ATS) and ZSCAN25, for the assessment of chronic and recent HAC, respectively. Finally, we outline a paradigm for improving the clinical diagnosis and management of alcohol use disorders by utilizing these new markers of alcohol consumption. Conclusions: We conclude that further studies to understand the test performance characteristics of each of these epigenetic tools in larger, diverse populations are in order.

Readiness to implement contingency management to promote PrEP initiation and adherence among people who inject drugs: results from a multi-site implementation survey

BackgroundContingency management (CM), an incentive-based intervention to encourage target behaviors, effectively promotes medication adherence. However, efforts to extend CM to HIV pre-exposure prophylaxis (PrEP) have been lacking. As part of a randomized clinical trial to promote HIV Prevention among people who inject drugs (PWID), we examined the readiness of staff in community-based organizations serving PWID to implement CM for PrEP uptake and adherence in this population.MethodsFrom April to August 2022, we conducted a survey of staff from four community-based organizations providing HIV testing, harm reduction, and outreach services in the northeastern United States. We assessed knowledge and attitudes regarding PrEP for PWID on five-point Likert scales (e.g., Poor to Excellent, Not at all to Extremely). Using a modified version of the Contingency Management Beliefs Questionnaire, we assessed the degree to which attitudes about CM for HIV prevention influenced interest in its adoption on a scale from “1-No influence at all” to “5-Very strong influence”. We explored endorsement patterns, along with average values of individual items and subscale scores.ResultsAmong 271 staff invitations, 123 (45.4%) responded. The majority (88.6%) of respondents reported prior PrEP awareness, with a mean self-rated knowledge of 2.98 out of 5 (SD = 1.1). Attitudes towards PrEP, including its relevance to and importance for clients (both means = 4.3), efficacy (mean = 4.5), and safety (mean = 4.2), were positive. Items related to practicality and confidence in providing PrEP-related care had relatively lower ratings. Respondents endorsed influential generalized (mean = 2.1) and training-related (mean = 2.5) CM implementation barriers less frequently than positive attitudes towards CM (mean = 3.6). Staff favored adding CM to existing services (mean = 3.8), and highly endorsed it as “useful for targeting HIV prevention with PrEP” (mean = 3.7).ConclusionsRespondents generally supported the use of CM to promote HIV prevention among PWID and favored adding it to their existing services. Though respondents understood the value of both PrEP and CM to support HIV prevention activities, findings corroborate research citing relative lack of knowledge and confidence regarding PrEP management among clients, potentially detracting from implementation readiness.Trial Registration NumberNCT04738825.

A position and wave spectra dataset of Marginal Ice Zone dynamics collected around Svalbard in 2022 and 2023

Sea ice is a key element of the global Earth system, with a major impact on global climate and regional weather. Unfortunately, accurate sea ice modeling is challenging due to the diversity and complexity of underlying physics happening there, and a relative lack of ground truth observations. This is especially true for the Marginal Ice Zone (MIZ), which is the area where sea ice is affected by incoming ocean waves. Waves contribute to making the area dynamic, and due to the low survival time of the buoys deployed there, the MIZ is challenging to monitor. In 2022-2023, we released 79 OpenMetBuoys (OMBs) around Svalbard, both in the MIZ and the ocean immediately outside of it. OMBs are affordable enough to be deployed in large number, and gather information about drift (GNSS position) and waves (1-dimensional elevation spectrum). This provides data focusing on the area around Svalbard with unprecedented spatial and temporal resolution. We expect that this will allow to perform validation and calibration of ice models and remote sensing algorithms.

Graph pooling for graph-level representation learning: a survey

In graph-level representation learning tasks, graph neural networks have received much attention for their powerful feature learning capabilities. However, with the increasing scales of graph data, how to efficiently process and extract the key information has become the focus of research. The graph pooling technique, as a key step in graph neural networks, simplifies the graph structure by merging nodes or subgraphs, which significantly improves the computational efficiency and feature extraction ability of graph neural networks. Although various graph pooling methods have been proposed by numerous scholars, there is still a relative lack of systematic summaries of these works. In this paper, we comprehensively sort out the fundamentals and recent progress of graph pooling techniques in graph neural networks and discuss its wide range of application scenarios, as well as the current challenges and opportunities, which point out the direction for future research. Specifically, we first provide a detailed introduction to the basics of graph pooling, including its definition, principles, and its function in graph neural networks. Then, we categorize and summarize the research preliminaries of graph pooling, including various graph pooling methods proposed in recent years. Next, we explore the potential of graph pooling for a wide range of applications, which provides insightful insights for the promotion and practice of graph pooling technology in more fields. Furthermore, we conduct a comparative analysis of various graph pooling methods and evaluate their performance on a benchmark dataset, providing a comprehensive understanding of their strengths and weaknesses. Finally, we systematically analyze the challenges and opportunities of the current graph pooling methods and provide a prospective outlook on future research directions.

Gender, deprivation, and identity: Research informed practical implications

It has long been identified that there is an interaction between deprivation and lack of educational success, resulting in a lack of social mobility. The exploration of deprivation and social mobility has tended to be constrained to sociological and political research. This paper focuses on my PhD research which aimed to explore the role of identity in young women living in a deprived seaside town in the UK, and their relative lack of educational success. Although the research did not fully explore future educational and work aspirations, it offered an interesting insight into potential explanations for the lack of future identity work. By using Foucauldian Discourse Analysis, the research indicated that young women are actively engaged in ‘identity work’ managing identity threats, either due to the lived experiences of being a young woman in Blackpool or the stigma related to the seaside town. Prior to analysis, the research relied on creative methods of data collection and amplifying the voice of the young women. Here I will discuss the decisions I made and how effective they were in engaging the young people involved in the study. Issues that arose will also be discussed and how these indicated a sense of agency that the young people displayed through the research process.

Effect of exercise based on ACSM recommendations on blood pressure and heart rate in hypertensive patients: A systematic review and meta-analysis of randomized controlled trials.

Numerous studies have demonstrated the positive effects of exercise as a non-pharmacological treatment for hypertensive patients. However, there was a relative lack of research analyzing the effects of different exercise doses on hypertensive individuals. Therefore, the primary objective of this study was to evaluate the impact of different exercise doses on blood pressure (BP) and heart rate (HR) in hypertensive patients through a systematic review and meta-analysis. A systematic search was conducted across four electronic databases (PubMed, Embase, Web of Science, and Cochrane), focusing on the impact of exercise on BP and HR in hypertensive patients, followed by literature screening. Based on the American College of Sports Medicine (ACSM) recommendations for aerobic, resistance, and flexibility exercises in hypertensive patients, the intervention measures from 29 randomized controlled trials were evaluated and categorized as high adherence and low/uncertainty adherence groups according to ACSM recommendations. Differences in systolic blood pressure (SBP), diastolic blood pressure (DBP), and HR between ACSM high and low/uncertainty adherence exercises were reported and evaluated using standardized mean difference (SMD) and 95% confidence interval (95% CI). A total of 25 articles were included, comprising 29 studies, with 16 studies categorized as high adherence with ACSM recommendations and 13 categorized as low or uncertain adherence. For the three outcome measures, the SMD ratio of exercise interventions with high ACSM adherence to those with low or uncertain ACSM adherence was as follows: systolic blood pressure (- 1.20: - 0.75), diastolic blood pressure (- 0.84: - 0.78), and heart rate (- 0.37: - 0.40). The results suggest that exercise interventions with high adherence to ACSM recommendations had a more significant impact on SBP and DBP in hypertensive patients, while the impact on HR was less pronounced than that of interventions with low or uncertain adherence to ACSM recommendations. This systematic review and meta-analysis was registered in PROSPERO (CRD 42023460293).

Attitudes Towards Unhoused Park Users and Preferences for Public Space Management: Applying the Potential for Conflict Index2 Approach

While parks and other public spaces are important to people experiencing homelessness for many reasons, there is a relative lack of research focused on their equitable management for this vulnerable user group. We contextualize our work in this gap, through the application of the Potential for Conflict Index2 (PCI2) approach. Using community survey data, we sought to understand perceived acceptability of various responses to scenarios involving unhoused park users among members of the housed public. Results indicate that respondents largely view people experiencing homelessness as legitimate park users, support their right to use parks in a variety of ways that align with norms of acceptable behavior in public spaces, and favor a variety of responses specific to the scenario at hand. Potential for conflict was greatest with overnight occupation and daytime sleeping, where those with positive and negative attitudes toward people experiencing homelessness held different priorities and endorsed different responses.

Effects of cladribine on intrathecal and peripheral B and plasma cells.

Cladribine is a deoxyadenosine analogue that can penetrate the blood-brain barrier. It is used to treat multiple sclerosis (MS). However, the mechanistic understanding of the effect of this highly effective therapy on B cells and plasma cells in the central nervous system compartment is limited. The CLADRIPLAS study examined the effect of cladribine on peripheral and intrathecal B and plasma cell biology in people with MS. Thirty-eight people with progressive MS ineligible for- or rejecting- treatment with licenced therapies were recruited and supplied a baseline lumbar puncture. Those exhibiting gadolinium-enhancing or new/enlarging T2 magnetic resonance imaging lesions and/or elevated neurofilament levels were offered subcutaneous cladribine (Litak®). Seven people were eligible; one person died before treatment, and only five completed the first year of treatment. Twenty-two ineligible people were willing to provide a repeat lumbar puncture twelve months later. The CLADRIPLAS study found no evidence of a difference in the odds of a positive cerebrospinal fluid oligoclonal band (cOCB) result between the cladribine-treated and untreated group. This is probably explained by microarray and in vitro studies, which demonstrated that plasmablasts and notably long-lived plasma cells are relatively resistant to the cytotoxic effect of cladribine compared to memory B cells at physiological concentrations. This was consistent with the loss of intracellular deoxycytidine kinase during antibody-secreting cell differentiation. CLADRIPLAS indicates that cOCB are not rapidly eliminated in most people with MS. This may be explained by the relative lack of direct cytotoxic action of cladribine on long-lived plasma cells.

Registered Nurse Staffing and Inpatient Outcomes in Korean Long-Term Care Hospitals

Background/Objectives: There is a relative lack of specific research on registered nurse (RN) staffing in long-term care hospitals in the Republic of Korea. This study investigated the association between RN staffing levels and inpatient outcomes in long-term care hospitals in the Republic of Korea. Methods: Nationwide data of long-term care hospitals from the Health Insurance Review and Assessment Services website were used to analyze the association between registered nurse staffing levels and 7 inpatient outcome indicators. Results: The results indicated that in long-term care hospitals with higher RN staffing levels, there was an improvement in moderate-to-severe pain, activities of daily living enhancement, lower prevalence of indwelling catheters, reduction in the incidence of pressure ulcers, improvement in existing pressure ulcers, and increased rate of return to the community. Similar results were observed in analyses conducted according to disease classification groups. Conclusions: These findings suggest that increasing RN staffing levels can enhance patient safety and improve treatment outcomes. Furthermore, this study provided important foundational data for developing policies to optimize RN staffing in long-term care hospitals in the Republic of Korea.

Inversion and analysis of transparency changes in the eastern coastal waters of China from 2003 to 2023 by an improved QAA-based method

Transparency (Zsd) can most intuitively reflect changes in marine ecosystems, therefore; the data of Zsd is crucial to protect marine ecosystems. However, there is still a relative lack of long-term sequence data on Zsd for coastal turbid waters. Satellite remote sensing inversion provides an efficient means of obtaining long-term, large-scale Zsd. The method proposed by Lee et al. is currently one of the most widely used methods, which is divided into clear water and turbid water models based on the 670 nm remote sensing reflectance (Rrs). In this study, we employed an improved model building upon the aforementioned method. The improved model simulates the continuous transition from clear to turbid water, which allows for automatic adjustment of model weights based on a logistic curve. Utilizing this improved model, this study inverts Zsd within 100 km of the eastern coast of China from 2003 to 2023 using MODIS Aqua Level 2 Rrs data. Zsd shows an increasing trend with the distance from the coast, with high Zsd in the northern Yellow Sea, the southern Shandong Peninsula, and the far shore of the East China Sea, and the low Zsd in the coast of Bohai Sea and northern Jiangsu. As for the long-term changes, the number of pixels with significantly increased Zsd and those with significantly decreased Zsd and no significant changes accounted for 20.84%, 1.14%, and 78.02%, respectively. The order of seasonal Zsd is summer > autumn > spring > winter, and the seasonal variability amplitude increases synchronously with the offshore distance of seawater on the whole. Interestingly, the correlation between Zsd and the annual runoff of rivers exhibits spatial differentiation among six typical estuaries: there are positive correlations in northern, whereas negative correlations in the south. Additionally, the Zsd in five of six estuaries have negative correlations with annual sediment transport. Overall, this study not only provides more accurate and continuous data of Zsd for nearshore turbid waters compared to those obtained by the original model, but also offers valuable insights on the spatiotemporal variation in the Zsd of large-scale seawater.

Determinants of higher education graduates’ employability: a scoping review

PurposeGraduates’ employability has been recognised as a complex and multidimensional phenomenon in the theoretical literature. However, some critics have emerged around the lack of relation between structural, contextual and individual dimensions that have been acknowledged as relevant for the understanding of graduates’ employability. This study aims to map empirical research, grounded on a scoping and integrative review of the research published to date on the determinants of graduates’ employability and offer a wider perspective of the knowledge produced across different disciplinary fields, and theoretical and methodological approaches.Design/methodology/approachFollowing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses protocol for Scoping Reviews, a systematic and extensive search of the literature was carried out and 74 studies focusing on the determinants of graduates’ employability were selected through inclusion and exclusion criteria. Then, data were extracted, analysed and interpreted with quantitative and qualitative techniques.FindingsThe results evidence that multiple factors mainly related to higher education attributes, educational arrangement, personal and interpersonal attributes, and socioeconomic conditions predict the odds of obtaining a job after graduation. This review also demonstrates some fragmentation of knowledge produced in this field and identifies a lack of an integrative approach, calling for more multidisciplinary research that might favour a more comprehensive knowledge of graduates’ employability.Originality/valueBy considering the different factors together, from individual and contextual levels, the present review offers an original and clearer overall picture of what is currently known and what is still unresearched about the determinants of graduates’ employability.

A Study on the Effect of Drift Factor on Feature Optimization in Electronic Nose Detection

As an important instrument for olfactory detection in non-destructive testing (NDT), the electronic nose plays an important role in simulating olfactory detection. However, its performance is often affected by drift phenomena, including changes in sensor performance caused by environmental factors and olfactory fatigue due to long-term use. Although the effect of drift on the performance of electronic noses is widely recognized, there is still a relative lack of research on how drift affects feature optimization. This study presents a novel idea that drift factors not only affect the direct readings of the sensor but may also have a profound effect on the feature optimization process and hence the compensation of the electronic nose. To explore this concept, we chose temperature and humidity, the two most common environmental drift factors, for our experimental study. In our study, we verified the impact of drift factors on feature optimization and found a positive correlation between the concentration of sensor scores and the correct classification rate. Moreover, we adopted an innovative quadratic feature optimization method, which aims to reduce the influence of the drift factor on the feature optimization process and thus improve the drift resistance of the electronic nose. In our experiments, we found that the unweighted quadratic feature optimization method performs best in reducing the drift effect. After the optimization process, the recognition rate reaches 100% in the training set and 96% in the test set, which indicates that the electronic nose has improved significantly in terms of drift resistance. In summary, this study explores the effect of drift factors on feature optimization and proposes an effective treatment method, which provides a reference direction for the development and optimization of electronic nose technology.

Metalized Borylene in Boron-Gold Carbonyl Complexes: Infrared Spectra and Theoretical Calculations.

Borylenes (:B-R) that are built on a single B-R bond between boron and another nonmetallic atom or group are a heated subject of special interest due to their intriguing transition-metal-mimicking reactivity, but the relative lack of understanding for the electronic structure and chemical bonding of transition metal borides leads to lingering neglect of metalized borylenes (:B-M) based on covalent B-M bonding. Here we use infrared photodissociation spectroscopy in combination with density functional calculations to study the geometric structure and chemical bonding of boron-gold carbonyl complex cations. The structure and bonding analyses demonstrated that the BAu(CO)3 + and BAu2(CO)4 + complexes can be described as bis-carbonyl-trapped borylene adducts. While the metal-rich BAu3(CO)4 + complex represents an unusual multicenter-bond-stabilized borylene cation with excellent σ-acidity and π-backbonding capability for CO activation, featuring Cs symmetry with a quasi-T-shaped BAu3 + core. It is manifested that BAu3 + presents greater amphoteric reactivity and improved stability compared to BAu1,2 + due to the presence of the three-center-two-electron Au-B-Au bond. This study discloses a conceptually new platform for accessing reactive metalized borylenes by exploiting the boron-mediated multicenter-bond stabilization strategy and using more bench-stable and ubiquitous metal carbonyl fragments as starting materials, thus providing a broader opportunity for the design of novel chemical structures and catalytic reactions.

Decreased Social Functioning and Increased Perception of Stress in Adolescents with Abnormal Uterine Bleeding.

There is a relative lack of research on the association of mental health problems and menstrual-related concerns in adolescents. The objective of the current study was to compare anxiety, depression, quality of life, and perceived stress between adolescents with abnormal uterine bleeding (AUB) and control patients. We performed a cross-sectional study in which participants were recruited from a tertiary training and research hospital. Adolescents aged 12-18 years with a first diagnosis of abnormal uterine bleeding and healthy controls evaluated in adolescent, pediatric endocrinology and general pediatrics departments were included in the study. The Revised Child Anxiety and Depression Scale (RCADS), the Pediatric Quality of Life Inventory (PedsQL) and the Perceived Stress Scale (PSS) were used to assess mood, quality of life and perceived stress. Fifty-six participants from the AUB group and fifty participants from the control group were included in the study. Except for social functioning scores which were lower in the AUB group versus controls (86.42∓14.03 vs. 92.4∓10.41, p<0.05), there was no significant differences in PedsQL scores between groups. There was a significant difference between the Perceived Stress Scale total scores of the AUB and control groups (32.07 ∓ 6.49; 28.98 ∓ 5.55, p<0.05), but no difference between the RCADS scores. In our study, we found that abnormal uterine bleeding in adolescents was associated with reduced social functioning and increased perceived stress. Larger studies are needed to confirm our findings.