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Background Brief lifestyle interventions targeting diet and physical activity play a critical role in the prevention and management of noncommunicable diseases (NCDs). However, healthcare providers often report feeling inadequately prepared to deliver such interventions, as there is limited guidance available to inform their practice. Objective To define and describe the concept of “brief lifestyle intervention” within the context of NCDs. Design A concept analysis. Methods A systematic literature review, including PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, PsycINFO and Scopus, was conducted from inception to 11 August 2023 to yield studies related to brief lifestyle interventions, encompassing brief dietary and physical activity interventions. The Walker and Avant’s method was used to analyse the extracted data to determine the defining attributes, antecedents and consequences of the term “brief lifestyle intervention”. Results The 49 eligible studies were finally included, and the findings were categorized into defining attributes, antecedents and consequences. The defining attributes of brief lifestyle interventions were identified as healthy lifestyle, provider-led, patient-centered, counseling, assessment, feedback and time-limited. The antecedents were the necessity and importance of lifestyle interventions, the important role of healthcare providers in patients’ lifestyle changes, and the urgent need for a brief, cost-effective and easier-to-implement intervention, respectively. The consequences were categorized into consequences related to patients, consequences related to healthcare providers and healthcare system. Conclusion This study developed a universal definition and conceptual model of the term “brief lifestyle intervention” in the context of NCDs, including the theoretical relationships between its antecedents, defining attributes and consequences. The findings highlight the leading role of healthcare providers in delivering brief lifestyle interventions and offer guidance for their effective implementation.

Objective Ovarian cancer is a serious malignant tumor threatening women’s health. The early diagnosis and effective treatments of ovarian cancer remain inadequate, and about 70% of ovarian cancers are in advanced stages when discovered. This study aimed to use the decision tree method of artificial intelligence machine learning to build a model for predicting the benign and malignant degree of ovarian cancer patients. Study design A total of 758 patients were included in the study. These patients were diagnosed by B-ultrasound, CT or MR. The clinicopathological features and circulating blood cell indexes were recorded and analyzed. The prediction model of benign and malignant ovarian tumors was constructed by CART decision tree, and the receiver operating characteristic (ROC) curve was drawn to evaluate the predictive value of the decision tree model. Results It was found that significant predictor variables included age, disease duration, patient general condition and menopausal status, ascites, tumor size, HE4, CA125, ROMA index, and blood routine related indicators (except for basophil count percentage and absolute value). In the constructed decision tree model, ROMA_after was the root node with the maximum information gain. ROMA_after, Mass size (MR/CT), HE4, CA125, platelet number, lymphocyte ratio, white blood cell count, post-menopause, hematocrit and mean platelet volume were important indicators in the decision tree model. The area under the receiver operating characteristic curve of this model for predicting benign and malignant ovarian cancer was 0.86. Conclusions The decision tree model was successfully constructed based on clinical indicators and preoperative circulating blood cells, and showed better results in predicting benign and malignant ovarian cancer than alone imaging indicators or biomarkers among our data, which means that our model can more accurately predict benign and malignant ovarian cancer.

Background Intrauterine adhesions (IUAs) can easily cause female infertility or recurrent abortion, but there is still no effective treatment to improve the pregnancy and live birth rates in patients with IUAs. In recent years, great advances have been made in stem cell therapy; however, additional clarity is needed on the clinical efficacy of endometrial stem cells in the treatment of IUAs. Materials and methods Fifteen patients with moderate-to-severe IUAs were included in the study at Xiangtan Central Hospital from 2018 to 2020. Patients were treated with endometrial stem cells and sodium hyaluronate gel by intrauterine perfusion in combination with estrogen and acetylsalicylic acid support therapy. Then, data on the pregnancy and live birth status was collected within two years after treatment. To explore the underlying mechanism, primary endometrial stem cells from healthy individuals and IUA patients, as well as fifth-generation endometrial stem cells from IUA patients, were further conducted with RNA sequencing to screen for differentially expressed genes, which were subsequently used for functional enrichment analysis. Results After endometrial stem cell transplantation into the uterine cavity, the American Fertility Society scores of all patients decreased, and hysteroscopy revealed an improvement in the uterine condition and a reduction in adhesion symptoms. The total pregnancy rate of the 15 patients was 60.0% and the live birth rate was 53.3%. In addition, RNA sequencing analysis revealed that the cytokine − cytokine receptor interaction was associated with endometrial repair by endometrial stem cells. Conclusions Intrauterine infusion of autologous endometrial stem cells is highly effective for patients with moderate-to-severe IUA, and is a promising treatment strategy. Trial registration Chinese Clinical Trial Registry, CHICTR1800016769, Registered 22 June 2018- Retrospectively registered, https://www.chictr.org.cn/showproj.html?proj=27042 .

Purpose To investigate factors influencing embryo implantation and clinical pregnancy in patients with severe IUA undergoing IVF-ET and to develop a predictive model. Methods This retrospective study analyzed 229 patients with severe IUA who underwent IVF-ET at Xiangtan Central Hospital between January 2020 and June 2024. All participants received transcervical resection of adhesions (TCRA) before embryo transfer. Clinical characteristics, endometrial repair protocols, medication types, and dosages were evaluated. Binary logistic regression was used to assess correlations between these factors and post-transfer embryo implantation or clinical pregnancy. Results The number of TCRA procedures emerged as a risk factor for both embryo implantation and clinical pregnancy. Additional risk factors for embryo implantation included years of infertility, initial and final American Fertility Society (AFS) scores, and the presence of endometrial cavity fluid (ECF). For clinical pregnancy, cumulative and daily average estrogen doses before transformation were identified as risk factors. Protective factors for both outcomes included endometrial thickness (EMT) on the day of transformation/ultrasound, regularly treat patients with CD138 positivity, and reduced endometrial peristalsis. Uterine artery resistance index (RI) and the use of a down-regulated hormone replacement therapy (HRT) protocol also favored embryo implantation, while transferring two high-quality embryos improved clinical pregnancy rates. Stepwise backward multivariate logistic regression was performed on variables with potential significance in univariate analysis. Using statistically significant variables, LightGBM prediction models were developed, yielding area under the curve (AUC) values of 0.892 for embryo implantation and 0.821 for clinical pregnancy. Conclusions Severe IUA negatively impacts embryo implantation and clinical pregnancy. Optimizing clinical management—by minimizing TCRA frequency, reducing pre-transformation estrogen exposure, treating concurrent endometritis with antibiotics, suppressing endometrial peristalsis, and lowering uterine artery resistance—can enhance post-transfer outcomes. ECF adversely affects success rates, and while transferring more embryos may improve clinical pregnancy rates, it reduces implantation efficiency.

PurposeThe discontinuation of fertility treatment could decrease the chances of achieving parenthood for infertile patients and often leads to economic loss and medical resource waste. However, the evidence on the factors associated with discontinuation is unclear and inconsistent in the context of fertility treatment. This scoping review aimed to summarize the evidence on factors associated with discontinuation in fertility treatment, identify the current knowledge gap, and generate recommendations for future research.MethodsWe searched PubMed, Embase, The Cochrane Library, Web of Science, CINAHL, American Psychological Association, and http://clinicaltrials.gov from inception to June 2023 without language or time restrictions. We also searched the grey literature in Open Grey and Google Scholar and hand-searched the reference lists of relevant studies to identify potentially eligible studies. Publications that studied factors associated with discontinuation in fertility treatment were included. The identified factors were mapped to the World Health Organization’s treatment adherence model.ResultsThirty-seven articles involving 41,973 infertile patients from 13 countries were included in this scoping review. All studies identified the factors from the perspective of patients, except for one that described the factors from the healthcare providers’ perspective. A total of 42 factors were identified, with most of them belonging to the patient-related dimension, followed by socio-economic-related, treatment-related, condition-related, and healthcare system-related dimensions. Female education level, social support, and insurance coverage decreased the likelihood of treatment discontinuation, whereas multiparous women, male infertility, depression, higher infertility duration, and treatment duration increased the likelihood of treatment discontinuation. Age, education level, and ethnicity are the commonly nonmodifiable factors for treatment discontinuation, while insurance coverage, depression, and anxiety symptoms are among some of the more commonly reported modifiable factors.ConclusionThis is the first scoping review examining and synthesizing evidence on the factors influencing of discontinuation in fertility treatment. This review could inform researchers, clinicians, and policymakers to address modifiable barriers and facilitators to develop personalized and multicomponent interventions that could improve the discontinuation in fertility treatment.