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2%) in mental disorders among healthcare workers. Since our study was done during the initial phase of the pandemic, development of mental issues due to the newly emerged infectious virus was expected. However, we recorded mild (41.4%) to moderate (31.5%) impact of this novel virus. The possibility of having mental problems was much higher in females, assistant nurses, individuals with lower education, and those who provided care for COVID-19 patients. Conclusion COVID-19 has brought about increased distress among healthcare workers. Noticeably, the forefront group in combating this virus bear the most emotional complications. Thus, efforts should be taken into practice to provide proper psychological support for this vulnerable group.Objective Marital satisfaction is considered as satisfaction with a marital relationship on which the presence of a child has different effects. Concerns about a childfree life and its effect on marital satisfaction in infertile couples are very critical. Therefore, this study was intended to characterize and compare concerns about a childfree lifestyle and the need for parenthood and their relationship with marital satisfaction in infertile couples. Method A total of 200 men and 200 women who referred to fertility centers in Tehran participated in this cross-sectional study. Convenience sampling method was used for sampling. Demographic survey, ENRICH Marital Satisfaction Scale, and Fertility Problem Inventory were used for data collection. The resulting data were analyzed using descriptive and analytical statistical tests (Pearson Correlation Coefficient and Stepwise Regression). Results The mean scores for concern about a childfree lifestyle and the need for parenthood in women were significantly higher than in men. The variables rejection of a childfree lifestyle and the need for parenthood were respectively predictors of marital satisfaction in women and men. Conclusion Since marital satisfaction in infertile couples is affected by their feelings about having a child and becoming a parent, it is therefore suggested that appropriate counseling be provided in supportive healthcare programs for infertile couples to promote their marital satisfaction.Meningococcal meningitis is a public health concern in Africa. Conjugated vaccine against serogroup A Neisseria meningitidis (MenAfriVac) was used in mass vaccination and was proved to have a good impact in the meningitis belt. There is a lack of information about the impact of this intervention in Cameroon after mass vaccination was undertaken. This study aimed at filling the gap in its unknown impact in Cameroon. AZD9291 mouse A retrospective longitudinal study using biological monitoring data of case-by-case-based surveillance for meningitis was obtained from the National Reference Laboratories from 1 January 2009 to 20 September 2015. Immunization coverage data were obtained from Regional Public Health Delegations where immunizations took place. We compared the risks of vaccine serogroup occurrence before and after vaccinations and calculated the global impact using Halloran's formula. Annual cases of meningitis A decreased gradually from 92 in 2011 to 34 in 2012 and then to 1 case in 2013, and since 2014, no cases have been detected. The impact was estimated at 14.48% (p=0.41) in 2012 and then at 98.63% (p less then 0.0001) after the end of vaccinations in 2013. This survey confirms the effectiveness of the MenAfriVac vaccine in Cameroon as expected by the WHO. The surveillance must be pursued and enhanced to monitor coming immunizations measures with multivalent conjugated vaccines for this changing threat.

The dimensional accuracy of casts is essential in the quality of fixed prosthesis treatment, whereby the impression method is a very crucial factor affecting it. The aim of this in vitro study is to compare the dimensional accuracy of casts resulting from two types of silicone impression materials in different impression techniques and frequent times of cast preparation.

A metal model was made from two prepared abutments, and 10 casts were prepared from each material technique (

 = 40). The impressions were made by condensation and addition silicone (one-stage and two-stage impressions). The casts were made from same impressions 1 h, 24 h, and 14 days. The diameter, height, and the distance between two dies were recorded. Data were analyzed by repeated measure ANOVA (

value <0.05).

The dimensional accuracy of all four materials techniques of impression (diameter, height, and the distance between dies) was the same in different times of impression. Dimensional accuracy of the die diameter and distance between dies in one-stage (Speedex) condensation silicon and one-stage (Panasil) addition silicone did not differ significantly, and their one-stage method developed more accurate casts compared to the two-stage method of the same impression material. The height of the casts prepared from the one-stage method through Speedex and Panasil did not differ significantly from the two-stage method of the same impression material.

One-stage condensation silicone and one-stage addition silicone material techniques offered the maximum dimensional accuracy in the obtained casts. The time of impression did not have any significant effect in the accuracy of any of the four impression material techniques.

One-stage condensation silicone and one-stage addition silicone material techniques offered the maximum dimensional accuracy in the obtained casts. The time of impression did not have any significant effect in the accuracy of any of the four impression material techniques.

Gastric cancer is a malignant tumor originating from gastric mucosal epithelium. Here, we aimed to investigate the analysis of the threshold change of gastric cancer tumor mutation burden (TMB) and its relationship with the prognosis of patients.

256 patients with gastric cancer were selected as subjects. All patients were in the advanced stage and received surgical resection of D2 lymph node dissection. After the operation, a follow-up was performed for 24 months, and the disease-free survival and overall survival of patients were counted. The NGS molecular biological was detected to obtain gastric cancer tumor mutation burden (TMB) data. Pearson correlation analysis software was used to analyze the correlation between TMB threshold and disease-free survival or overall survival of patients with gastric cancer, and the multivariate logistic analysis was performed as well.

The disease-free survival period and the overall survival period of patients in the low-to-medium TMB group were both longer than those in the high TMB group. Pearson correlation analysis results showed that the TMB threshold was negatively correlated with the disease-free survival and overall survival of gastric cancer patients. Results from multivariate logistic analysis showed that high TMB thresholds have a greater impact on disease-free survival and overall survival of patients, but the impact of medium and low TMB thresholds on disease-free survival and overall survival of patients is weakened.

The TMB threshold level has a predictive effect on the effect of surgical resection of D2 lymph node dissection, and high levels of TMB can significantly affect disease-free survival and overall survival of patients with advanced gastric cancer.

The TMB threshold level has a predictive effect on the effect of surgical resection of D2 lymph node dissection, and high levels of TMB can significantly affect disease-free survival and overall survival of patients with advanced gastric cancer.

Head and neck cancer (HNC) is the sixth most common malignancy globally, and many demographics and clinicopathological factors influence its prognosis. This study aimed to construct and validate a prognostic nomogram to predict the prognosis of HNC patients with bone metastasis (BM).

A total of 326 patients with BM from HNC were collected from the SEER database as the subjects of this study. In a ratio of 7 to 3, patients were randomly divided into training and validation groups. Independent prognostic factors for HNC patients with BM were identified by univariate and multivariate Cox regression analysis. The nomogram for predicting the prognosis was constructed, and the model was evaluated by receiver operating characteristic curves, calibration curves, and decision curve analysis.

The independent prognostic factors for HNC patients with BM included age, primary site, lung metastasis, and chemotherapy. The area under the curve predicting overall survival at 12, 24, and 36 months was 0.768, 0.747, and 0.723 in the training group and 0.729, 0.723, and 0.669 in the validation group, respectively. The calibration curves showed good agreement between the predicted and actual values for overall survival. In addition, the decision curve analysis showed that this prognostic nomogram model has a high clinical application.

This study developed and validated a nomogram to predict overall survival in HNC patients with BM. The prognostic nomogram has high accuracy and utility to inform survival estimation and individualized treatment decisions.

This study developed and validated a nomogram to predict overall survival in HNC patients with BM. The prognostic nomogram has high accuracy and utility to inform survival estimation and individualized treatment decisions.

Clear cell renal cell carcinoma (ccRCC) is a cancer with abnormal metabolism. The purpose of this study was to investigate the effect of metabolism-related genes on the prognosis of ccRCC patients.

The data of ccRCC patients were downloaded from the TCGA and the GEO databases and clustered using the nonnegative matrix factorization method. The limma software package was used to analyze differences in gene expression. A random forest model was used to screen for important genes. A novel Riskscore model was established using multivariate regression. The model was evaluated based on the metabolic pathway, immune infiltration, immune checkpoint, and clinical characteristics.

According to metabolism-related genes, kidney clear cell carcinoma (KIRC) datasets downloaded from TCGA were clustered into two groups and showed significant differences in prognosis and immune infiltration. There were 667 differentially expressed genes between the two clusters, of which 408 were screened by univariate analysis. Finally, 12 differentially expressed genes (

,

,

,

,

,

,

,

,

,

,

, and

) were filtered out using the random forest model. The model of Riskscore was obtained by multiplying the expression levels of these 12 genes with the corresponding coefficients of the multivariate regression. We found that the Riskscore correlated with the expression of these 12 genes; the high Riskscore matched the low survival rate verified in the verification set. The analysis found that the Riskscore model was associated with most of the metabolic processes, immune infiltration of cells such as plasma cells, immune checkpoints such as PD-1, and clinical characteristics such as M stage.

We established a new Riskscore model for the prognosis of ccRCC based on metabolism. The genes in the model provided several novel targets for the study of ccRCC.

We established a new Riskscore model for the prognosis of ccRCC based on metabolism. The genes in the model provided several novel targets for the study of ccRCC.

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