Pyrethroids are a class of widely used insecticides. Female animal studies suggested that pyrethroid exposure impaired ovarian function, which resulted in similar symptoms of primary ovarian insufficiency (POI). However, it is still unknown whether this association applies to women. In this case-control study, a total of 172 POI patients and 247 control women were recruited in Zhejiang, China. The urinary concentrations of metabolites of pyrethroids, 3-phenoxybenzoic acid (3-PBA) and 4-fluoro-3-phenoxybenzoic acid (4-F-3-PBA), as well as the serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH) and anti-Mullerian hormone (AMH) were determined. The associations of pyrethroid metabolites with POI and POI-related hormones were accessed using unconditional logistic regression. Higher urinary levels of 3-PBA were significantly associated with increased risk of POI [adjusted odds ratio (OR) = 2.344, 95% CI: 1.193-4.607 for the highest vs lowest quartile of 3-PBA, p = 0.013]. Stratified analyses showed that each log increase in urinary 3-PBA concentration was significantly associated with an induction in odds of 51.0% being in the highest quartile of FSH and 28.6% being in the highest quartile of LH levels, whereas a 25.9% reduction in odds of being in the highest quartile of AMH levels (All p for trend <0.05). To our knowledge, this is the first case-control study to report an association of pyrethroid exposure with increased risk of POI in women.
Background The traditional gynecological teaching model is not conducive to the cultivation of trainee doctors’ clinical skills, thinking patterns and doctor‒patient communication ability. This study aims to explore the effect of the application of the hybrid BOPPPS (bridge-in, objective, preassessment, participant learning, postassessment, summary) teaching model in clinical internships in gynecology. Methods This observational study was conducted among final-year undergraduate medical trainee doctors at Jiaxing Maternity and Child Health Care Hospital from September 2020 to June 2022. Members of the control group were introduced to the traditional teaching model, while members of the experimental group were introduced to the hybrid BOPPPS teaching model. Trainee doctors’ final examination scores and teaching satisfaction were compared. Results The control group consisted of 114 students who entered the university to pursue undergraduate degrees in 2017, and the experimental group consisted of 121 students who entered the university to pursue undergraduate degrees in 2018. The final examination scores attained by trainee doctors in the experimental group were higher than those attained by trainee doctors in the control group (P < 0.05). The final theoretical exam scores attained by members of the control group were significantly higher than their preassessment scores (P < 0.01). The scores differed significantly between female and male subjects before the internship (p<0.05) but not after the internship (p>0.05). In total, 93.4% of trainee doctors in the experimental group thought that the hybrid BOPPPS teaching model helped them improve their case analysis ability, and the difference in this measure between the experimental and control groups was statistically significant (P < 0.05). A total of 89.3% of trainee doctors in the experimental group supported the promotion and application of the hybrid BOPPPS model in practice in other disciplines. Conclusion The hybrid BOPPPS teaching model helps improve trainee doctors’ learning environment, stimulate their interest and initiative in learning, enhance their clinical practice ability and increase their satisfaction; therefore, this model is worth promoting and applying in practice in other disciplines.
BACKGROUND: The dural puncture epidural (DPE) and the programmed intermittent epidural bolus (PIEB) techniques are recent innovations for labor analgesia. The optimal volume of PIEB during traditional epidural analgesia has been investigated previously but it is unknown whether these findings are applicable to DPE. This study aimed to determine the optimal volume of PIEB for effective labor analgesia after initiation of analgesia using DPE. METHODS: Parturients requesting labor analgesia received dural puncture with a 25-gauge Whitacre spinal needle and then had analgesia initiated with 15 mL of ropivacaine 0.1% with sufentanil 0.5 μg/mL. Analgesia was maintained using the same solution delivered by PIEB with boluses given at a fixed interval of 40 minutes starting 1 hour after the completion of the initial epidural dose. Parturients were randomized to 1 of 4 PIEB volume groups: 6, 8, 10, or 12 mL. Effective analgesia was defined as no requirement for a patient-controlled or manual epidural bolus for 6 hours after the completion of the initial epidural dose or until full cervical dilation. The PIEB volumes for effective analgesia in 50% of parturients (EV50) and 90% of parturients (EV90) were determined using probit regression. RESULTS: The proportions of parturients with effective labor analgesia were 32%, 64%, 76%, and 96% in the 6-, 8-, 10-, and 12-mL groups, respectively. The estimated values for EV50 and EV90 were 7.1 (95% confidence interval [CI], 5.9−7.9) mL and 11.3 (95% CI, 9.9−15.2) mL, respectively. There were no differences in side effects, including hypotension, nausea and vomiting, and fetal heart rate (FHR) abnormalities among groups. CONCLUSION: Under the conditions of the study, after initiation of analgesia using DPE, the EV90 of PIEB for effective labor analgesia using ropivacaine 0.1% with sufentanil 0.5 μg/mL was approximately 11.3 mL.
Background The traditional gynecological teaching model is not conducive to the cultivation of interns’ clinical skills, thinking patterns and doctor-patient communication ability. This study is aim to explore the application effect of hybrid BOPPPS (Bridge-in, Objective, Pre-assessment, Participant learning, Post assessment, Summary) teaching model in a clinical internship in gynecology. Methods This observational study was conducted among the final year undergraduate medical interns from September 2020 to June 2022 at Jiaxing Maternity and Child Health Care Hospital. The control group consisted 114 interns of grade 2017 who received the traditional teaching model. The experimental group consisted 121 interns of grade 2018 were introduced to the hybrid BOPPPS teaching model. interns’ final examination scores and teaching satisfaction were compared. Results The final examination scores of interns in the experimental group were significantly higher than those of interns in the control group (P <0.05). In the experimental group, the final theoretical exam scores were significantly higher than the pre-assessment scores (P <0.01). Compared with the control group, 93.4% of interns in the experimental group thought the hybrid BOPPPS teaching model could help them to improve case analysis ability, and the difference is statistically significant (P < 0.05). 89.3% of interns in the experimental group supported the promotion and application of hybrid BOPPPS model in the practice of other disciplines. Conclusion The hybrid BOPPPS teaching model helps to stimulate interns' learning interest and learning initiative, improve interns’ clinical skills, and have high interns’ satisfaction, which is worth of promotion and application in the practice of other disciplines.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.