Notes

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Gonadotropins can be administered every five days under intradermal injection in in vitro fertilization (IVF) treatment.

To explore the effectiveness of intradermal injection of recombinant human FSH (rhFSH) for women undergoing IVF.

Women who received their first time IVF enrolled in this prospective intervention in 2018. All women received a bolus of 900 IU rhFSH intradermally at day 2 of the treatment cycle followed by additional dosage of rhFSH at day 7 and/or day 10. The main outcome measures included the total dose of rhFSH and number of injections required, sequential serum FSH level detected, and number of mature oocytes retrieved.

Seventy women completed the study. On average, 2.31±0.73 injections and 1662±397 IU of rhFSH were administered. While the baseline FSH level was 5.6±2.2 IU/L, the serum concentrations of FSH after rhFSH administration were 35.3±7.0 on the first day (24 hours) and 10.7±3.7 IU/L on the fifth day (120 hours). A total of 10.5±6.6 mature oocytes were retrieved, resulting in 7.3±5.1 pronuclear embryos; and 1.8±0.6 embryos were transferred to the uterus. Our findings resulted in 72% fertilization, 91% cleavage, 31% implantation, and 36% live birth rates. Although less larger follicles were found, non-inferiority results were noted in the mature oocytes retrieved, good embryos available and clinical pregnancy rate compared to those received conventional daily subcutaneous rhFSH administration.

Intradermal administration of rhFSH, with less dose of rhFSH and numbers of injection, may achieve the goal of a cost-effective and more patient-friendly regimen.
Intradermal administration of rhFSH, with less dose of rhFSH and numbers of injection, may achieve the goal of a cost-effective and more patient-friendly regimen.
What were the utilization, effectiveness and safety of practices in assisted reproductive technologies (ART) globally in 2014 and what global trends could be observed?

The estimated total number of ART cycles conducted in 76 participating countries in 2014 was 1.93 million representing ∼66% of global activity, with 5-year trends including an increase in success rates and proportion of frozen embryo transfer (FET) cycles, improvement in cumulative live birth rates per aspiration, a continued increase in single embryo transfer (SET) and thus a reduction in multiple birth rates, an increase in preimplantation genetic testing and stabilization in the use of intracytoplasmic sperm injection (ICSI).

ART is widely practiced throughout the world but continues to be characterized by significant disparities in utilization, practice, effectiveness and safety. The International Committee for Monitoring Assisted Reproductive Technologies (ICMART) annual world report series provides an important instrument for tracki. S.D. reports industry sponsorship for attendance of conference from Ferring, and research grants to support African Network and Registry of ART from Ferring and Merck outside the submitted work. F.Z.-H. reports lectures at organized webinars for Ferring and Merck. O.I. reports honoraria for consulting from Ferring, Merck and ObsEva, as well as honoraria for lectures from Ferring and Merck. G.M.C., J.d.M., M.B., M.S.K. and G.D.A. have nothing to disclose.

N/A.
N/A.
Gestational diabetes mellitus (GDM) can adversely affect the health of the developing foetus. Women of South Asian origin are particularly at risk of developing GDM. Insulin resistance (IR) contributes to the aetiology of GDM, and whilst studies have shown associations of vitamin B12 (B12) and folate status with GDM and IR, only a limited number of B12 and folate markers have been used.

To use a comprehensive panel of B12 and folate markers to examine their association with IR in pregnant women with diet-controlled GDM and normal glucose tolerance (NGT).

In this cross-sectional study, 59 British-Bangladeshi women (24 GDM and 35 NGT) with a mean age 29 years, BMI 26.7kg/m2 and gestational age 33 weeks were recruited. Serum total B12, holotranscobalamin, folate, methylmalonic acid, plasma homocysteine and 5-methyltetrahydrofolate, and red cell folate (RCF) were measured along with other parameters. Independent sample t-test and chi-squared test were used to assess differences in markers between GDM and NGher.
Significant associations between markers of B12 and folate status with HOMA-IR were found during the third trimester in British-Bangladeshi women. B12 markers correlated poorly with each other.
The optimal analgesia regimen after open cardiac surgery was unclear. The aim of this study was to investigate the beneficial effects of continuous Pecto-Intercostal Fascial Block (PIFB) blocks initiated before surgery on outcomes following open cardiac surgery.

A group of 116 patients were randomly allocated to either receive bilateral continuous PIFB (PIF group) or the same block with saline (SAL group). The primary endpoint was postoperative pain at 4, 8, 16, 24, 48, and 72 h after extubation at rest and exercise. The secondary outcome measures included analgesia requirements (sufentanil and flurbiprofen consumption), time to extubation, length of stay in the ICU, incidence of postoperative nausea and vomiting (PONV), time until return of bowel function, time to mobilization, urinary catheter removal and the length of hospital stay.

The length of stay in the ICU (29 ± 7 h vs 13 ± 4 h, p < 0.01) and length of hospital stay (8.9 ± 0.9 d vs 6.5 ± 1.1 d, p < 0.01) was significantly longer in the SAiprofen consumption (350 ± 100 mg vs 100 ± 100 mg, p < 0.01) than the SAL groups. Time to extubation (8.9 ± 2.4 h vs 3.2 ± 1.3 h, p < 0.01), time to first flatus (43 ± 6 h vs 30 ± 7 h, p < 0.01), time until mobilization (35 ± 5 h vs 24 ± 7 h, p < 0.01), time until urinary catheter removal (47 ± 9 h vs 31 ± 4 h, p < 0.01) was significantly earlier in the PIF group than in the SAL group. The incidence of PONV was significantly lower in the PIF group (9.1% vs 27.3%, p < 0.01).

Bilateral continuous PIFB reduced the length of hospital stay and provided effective postoperative pain for three days.
Bilateral continuous PIFB reduced the length of hospital stay and provided effective postoperative pain for three days.
Milk proteins contain many encrypted bioactive peptides. Whether these bioactive peptides are released in the infant intestine and exert immunomodulatory activity remains unknown.

This study examined in vitro immunomodulatory activities of peptides from in vitro- and in vivo-digested human milk.

Peptides were extracted from in vitro-digested human milk and pooled intestinal samples from eight infants fed human milk. Peptides extracted from in vitro-digested samples were fractionated. The in vitro effects of these peptides and fractions on the secretion of TNFα and IL-8 in LPS-treated human immune THP-1 macrophages were evaluated. The significance of differences between in vitro peptide fraction treatment and control on cytokine production were analyzed by t-test. LC-MS/MS-based peptidomics was conducted to identify the peptides. The peptides were screened for potential bioactivity using a sequence homology search against Milk Bioactive Peptide Database (MBPDB).

Six fractions of the peptide mixture ext the peptide mixtures.
Peptides released by in vitro and in vivo infant digestion of human milk were immunomodulatory in human immune cells, fractions F4, F8, and F11 were anti-inflammatory, and F6/7 and F18 were pro-inflammatory. Thirteen peptides were present in all fractions with anti-inflammatory activity, and 38 peptides were present in all fractions with pro-inflammatory activity. These peptides potentially contributed to the observed immunomodulatory activity of the peptide mixtures.
Observational studies have suggested that better protein nutritional status may contribute to prevention of frailty.

To examine this hypothesis using a Mendelian randomization (MR) analysis.

We conducted a two-sample MR study using GWAS summary statistics data of the UK Biobank. Hexamethonium Dibromide We applied genetically predicted serum albumin as a primary exposure measure and serum total protein as a secondary exposure measure. The outcome measure was the Rockwood frailty index (FI) based on 49 deficits from 356,432 individuals (53.3% of them were women, with a mean [SD] age of 56.7 [8.0] years. The association between serum protein measures and FI was mainly analyzed by the inverse variance weighted method.

A genetically predicted serum albumin level was not statistically significantly associated with FI in the full sample. link2 However, in women, we observed a preventive association between genetically predicted serum albumin and FI (beta = -0.172 per g/L; 95% confidence interval = -0.336 to -0.007; P = 0.041). In the full sample, genetically predicted serum total protein was inversely associated with FI (beta = -0.153 per g/L; 95% confidence interval = -0.251 to -0.056; P = 0.002). In both women and men, higher serum total protein was significantly inversely associated with FI; regression coefficients were -0.148 per g/L (95% confidence interval = -0.287 to -0.009; P = 0.037) for women, -0.154 per g/L (95% confidence interval = -0.290 to -0.018; P = 0.027) for men.

The present MR study implies that better protein nutritional status modestly contributes to reducing the risk of frailty.
The present MR study implies that better protein nutritional status modestly contributes to reducing the risk of frailty.
The causal role of endogenous estradiol in cancers other than breast and endometrial cancer remains unclear.

To assess the causal associations of endogenous 17β-estradiol (E2), the most potent estrogen, with cancer risk in women through Mendelian randomization.

As primary genetic instrument, we used a genetic variant in the CYP19A1 gene that is strongly associated with serum E2 levels. Summary statistics genetic data for the association of the E2 variant with breast, endometrial, and ovarian cancer were obtained from large-scale consortia. link3 We additionally estimated the associations of the E2 variant with any and 20 site-specific cancers in 198 825 women of European descent in UK Biobank. Odds ratios (OR) of cancer per 0.01 unit increase in log-transformed serum E2 levels in pmol/L were estimated using the Wald ratio.

Genetic predisposition to higher serum E2 levels was associated with increased risk of estrogen receptor positive breast cancer (OR 1.02; 95% confidence interval [CI] 1.01-1.03; P=2.5×10 -3), endometrial cancer overall (OR 1.09; 95% CI 1.06-1.11; P=7.3×10 -13), and endometrial cancer of the endometrioid histology subtype (OR 1.10; 95% CI 1.07-1.13; P=2.1×10 -11). There were suggestive associations with breast cancer overall (OR 1.01; 95% CI 1.00-1.02; P=0.02), ovarian cancer of the endometrioid subtype (OR 1.05; 95% CI 1.01-1.10; P=0.02), and stomach cancer (OR 1.12; 95% CI 1.00-1.26; P=0.05), but no significant association with other cancers.

This study supports a role of E2 in the development of estrogen receptor positive breast cancer and endometrioid endometrial cancer, but found no strong association with other cancers in women.
This study supports a role of E2 in the development of estrogen receptor positive breast cancer and endometrioid endometrial cancer, but found no strong association with other cancers in women.
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