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This article discusses a study that used machine learning to develop a clinical decision support tool for predicting the success of expectant or medical management of miscarriage. The study involved a retrospective analysis of 1075 patients across two hospital early pregnancy units, and 14 clinical variables were collected, including patient demographics, history, and ultrasound features. The study found that the machine learning algorithms performed well in predicting outcomes, with area under the curve (AUC) scores ranging from 0.63 to 0.71. The authors conclude that this method could be used in future clinical trials to provide personalized outcome predictions for patients deciding on their miscarriage management. [Extracted from the article]

This article discusses a study that aimed to identify radiomic ultrasound features from early pregnancy images that could predict subsequent loss. The study included 500 cases of early pregnancy of unknown viability (PUV) and used a combination of machine learning models and traditional radiomics features to develop a prediction model. The best performing model achieved a recall of 0.81 and an AUC of 0.68, indicating its potential to predict miscarriage from early pregnancy ultrasound images. The study suggests that this machine learning method could help patients navigate the uncertainty of a PUV early pregnancy diagnosis. [Extracted from the article]

This article discusses a study that compared the performance of handheld point of care ultrasound (POCUS) with high-specification ultrasound in gynecology. The study involved 155 patients at a London teaching hospital, with one sonologist using POCUS and another using the standard high-specification machine. The results showed moderate correlation in uterine measurements, fair agreement for endometrial thickness, and slight agreement on ovary visualization. However, POCUS had improved performance when a cyst was present. The article concludes that POCUS may be a useful adjunct in gynecology, particularly in settings with limited access to ultrasound, but more data is needed for certain populations. [Extracted from the article]

This article discusses a pilot study that aimed to evaluate the use of virtual reality (VR) as a distraction technique during manual vacuum aspiration (MVA) treatment of miscarriage. The study found that most women who used VR reported a reduction in procedural anxiety and pain, as well as an improved overall experience. However, there was no significant difference in pain or anxiety scores between the VR group and the group without VR during or after the procedure. Overall, the study suggests that VR can be a useful tool in improving patient experience during MVA, but further research is needed to eliminate potential biases. [Extracted from the article]

A study conducted at a London teaching hospital compared the performance of handheld Point of Care Ultrasound (POCUS) to standard care with transvaginal ultrasound (TVUS) in early pregnancy. The study found that there was almost perfect agreement between POCUS and TVUS in identifying the presence or absence of a gestational sac, embryo, fetal heart motion, and diagnostic outcome. There was also a very high correlation between the two methods for measuring mean sac diameter and Crown-rump length. The study concludes that while POCUS can provide similar diagnosis and management plans, it should be used for triage purposes and not as a replacement for standard care. [Extracted from the article]

This article discusses the validation of a machine learning model for classifying adnexal masses using ultrasonography. The model was tested on two cohorts of women with adnexal masses, one in London and one in Seoul. The model's performance was compared to the Assessment of Different NEoplasia's in the adneXa (ADNEX) model. The results showed that the machine learning model had comparable performance to the ADNEX model in both cohorts. However, further validation is needed before the model can be integrated into clinical practice. [Extracted from the article]

Zebrafish (Danio rerio), a freshwater fish, has become a favoured animal model to assess the teratogenicity effects of various compounds. Momordica charantia is a fruit traditionally used as a functional food to treat various ailments. In the present work, 80% ethanolic extract of M. charantia fruit was investigated for its teratogenicity effects on the zebrafish embryos. The embryos of 12 h post-fertilisation were immersed in the ethanolic extract at various concentrations of 250, 500, 750, 1,000, and 1,250 mg/L prepared in 2% DMSO. Microscopic observation was carried out every 24 h. Results showed an increased mortality rate, and a delayed hatching rate with increasing concentration. Some of the deformities observed included hyperactivity, crooked backbone, reduced pigmentation, awkward positioning, and coagulation at the highest concentration. Probit analysis resulted in 725.90 mg/L as the median lethal concentration (LC50). Chromatographic analysis revealed the presence of propanedioic acid, malic acid, contrunculin-A, glutamine, D-fructose, sorbopyranose, xylitol, galactonic acid, D-mannitol, and mannose. These compounds may contribute to the deformities observed in a concentration-dependent manner. Therefore, M. charantia fruit must be consumed with caution and within the recommended amount. [ABSTRACT FROM AUTHOR]

Momordica charantia or bitter melon (Cucurbitaceae) is a widely consumed edible fruit with strong antioxidant properties. Due to these properties, it has been commercialised by the natural product industries as a coadjutant in the treatment of various ailments attributable to the deleterious effects of oxidants. The present work aimed to evaluate the antioxidant activity of M. charantia fruit extracts made with different compositions of ethanol:water, and to identify the metabolites that are responsible for this activity. To this end, the fruit samples were extracted using six different concentrations of ethanol in water (0, 20, 40, 60, 80, and 100%). Gas chromatography-mass spectrometry (GC-MS) and multivariate data analysis (MVDA) were used to identify significant antioxidants. The 80% ethanol:water extract showed the most significant (p < 0.05) antioxidant activity when tested with the 1, 1-diphenyl-2-picrylhydrazyl (DPPH) and ferric reducing antioxidant power (FRAP) antioxidant assays. The multivariate data analysis revealed that the metabolites related to this antioxidant activity were gentiobiose, glucose, galactonic acid, palmitic acid, galactose, mannose, and fructose. [ABSTRACT FROM AUTHOR]

Given the increasing demand for high-quality food and protein, global food security remains a challenge, particularly in the face of global change. However, since agriculture, food and water security are inextricably linked, they need to be examined via an interdisciplinary lens. Sociohydrology was introduced from a post-positivist perspective to explore and describe the bidirectional feedbacks and dynamics between human and water systems. This review situates sociohydrology in the agricultural domain, highlighting its contributions in explaining the unintended consequences of water management interventions, addressing climate change impacts due to/on agriculture and incorporating human behaviour into the description of agricultural water systems. Sociohydrology has combined social and psychological insights with novel data sources and diverse multi-method approaches to model human behaviour. However, as agriculture and agriculturalists face global change, sociohydrology can better use concepts from resilience thinking more explicitly to identify gaps in terms of desirable properties in resilient agricultural water systems, potentially informing more holistic climate adaptation policy.

Clinacanthus nutans (Acanthaceae) is a local plant consumed as tisane in Indonesia and ‘ulam’ in Malaysia. This plant has been claimed for its ability to prevent many diseases including diabetes. However, the scientific proof on this claim is still lacking. Therefore, the present work study was designed to evaluate the antidiabetic potential and antioxidant capacity of C. nutans leaves extracts using in vitro bioassay tests. The 80% methanolic crude extract of this plant was further partitioned using different polarity solvents namely hexane, hexane:ethyl acetate (1:1, v/v), ethyl acetate, ethyl acetate:methanol (1:1, v/v), and methanol. All the sub-fractions were analysed for antioxidant effect via 2, 2-diphenyl-2-picrylhydrazil (DPPH) scavenging activity, ferric reducing power (FRAP) and xanthine oxidase (XO) assays followed by antidiabetic evaluation via α-glucosidase and dipeptidyl peptidase-IV (DPP-IV) inhibitory assays and glucose uptake experiment. The ethyl acetate fraction showed a good antioxidant potential while the hexane fraction exhibited high α-glucosidase and DPP-IV enzyme inhibition. The hexane fraction also improved glucose uptake in a dose-dependent manner. The present work thus provides an informative data on the potential of C. nutans to be developed as a functional food in preventing diabetes. [ABSTRACT FROM AUTHOR]

Understanding the historical evolution of science development for rethinking science in the Anthropocene is crucial for our future survival. This paper analyzed the knowledge development of the top 95 most researched river basins in the Web of Science database in the past 3 decades (1987–2017) using a network metric-based framework, comprising one scalar metric and three structural metrics: equality, efficiency, and resilience. We found that the highly researched river basins accounting about 30% of total publications, including the Yangtze River and the Great Lakes, demonstrated the “ageing” knowledge structures characterized by high inequality, low efficiency, and large redundancy with continuous expansion in scales. Dominations of knowledge interactions among Environmental Sciences, Water Resources, Marine Science and Freshwater Biology contributed to this knowledge structure. Transformations of both the composition and structure of the knowledge system is required to support global river basin management in the Anthropocene.

In a recent editorial in the journal Nature Sustainability, the editors raised the concern that journal submissions on water studies appear too similar. The gist of the editorial: “too many publications and not enough ideas.” In this response, we contest this notion, and point to the numerous new ideas that result from taking a broader view of the water science field. Drawing inspiration from a recently hosted conference geared at transcending traditional disciplinary silos and forging new paradigms for water research, we are, in fact, enthusiastic and optimistic about the ways scientists are investigating political, economic, historical, and cultural intersections toward more just and sustainable human-water relations and ways of knowing.

Sediment yield is affected by many factors, such as climate, geology, geomorphology, land use and human activities. Sediment signatures are the statistic indices or curves that are able to effectively describe the temporal and spatial characteristics of sediment transport and evaluate the ability of the streamflow to deliver the sediment. In this study, the sediment signatures of Upper Sangamon River Basin, which is an intensively managed watershed for agriculture development, are analyzed. Firstly, a semi-distributed model of sediment transport is built up based on the Tsinghua Representative Elementary Watershed (THREW) model, and it is applied to Upper Sangamon River Basin. The result of sediment simulation is analyzed by four sediment signatures, i.e. specific sediment yield, sediment delivery ratio, cumulative sediment curve and effective discharge. The sediment signatures are consistent with each other and accord with the fact of the agricultural production in Upper Sangamon River Basin.

Methods An online survey of London trainees via Health Education England (HEE) was carried out to understand trainee gynecological ultrasound skills and training. First to evaluate trainee perception of gynecological ultrasound training. Trainees and supervisors completed a usability score and feedback survey on the utility of ultrasound telementoring. [Extracted from the article]

Momordica charantia, also known as bitter melon or 'peria katak' in Malaysia, is a member of the family Cucurbitaceae. Bitter melon is an excellent source of vitamins and minerals that made it extensively nutritious. Moreover, the seed, fruit and leave of the plant contain bioactive compounds with a wide range of biological activities that have been used in traditional medicines in the treatment of several diseases, including inflammation, infections, obesity and diabetes. The aim of this study was to evaluate changes in urinary metabolite profile of the normal, streptozotocin-induced type 1 diabetes and M. charantia treated diabetic rats using proton nuclear magnetic resonance (1H-NMR) -based metabolomics profiling. Study had been carried out by inducing diabetes in the rats through injection of streptozotocin, which exhibited type 1 diabetes. M. charantia extract (100 and 200 mg/kg body weight) was administrated to the streptozotocin-induced diabetic rats for one week. Blood glucose level after administration was measured to examine hypoglycemic effect of the extract. The results obtained indicated that M. charantia was effective in lowering blood glucose level of the diabetic rats. The loading plot of Partial Least Square (PLS) component 1 showed that diabetic rats had increased levels of lactate and glucose in urine whereas normal and the extract treated diabetic rats had higher levels of succinate, creatine, creatinine, urea and phenylacetylglycine in urine. While the loading plot of PLS component 2 showed a higher levels of succinate, citrate, creatine, creatinine, sugars, and hippurate in urine of normal rat compared to the extract treated diabetic rat. Administration of M. charantia extract was found to be able to regulate the altered metabolic processes. Thus, it could be potentiallyJ used to treat the diabetic patients. [ABSTRACT FROM AUTHOR]

The emerging field of socio-hydrology is a special case of social-ecological systems research that focuses on coupled human-water systems, exploring how the hydrologic cycle and human cultural traits coevolve and how such coevolutions lead to phenomena of relevance to water security and sustainability. As such, most problems tackled by socio-hydrology involve some aspects of engineering design, such as large-scale water infrastructure, and self-organization in a broad context, such as cultural change at the population level and the hydrologic shift at the river basin or aquifer level. However, within the field of socio-hydrology, it has been difficult to find general theories that assist our understanding of the dynamics emerging from the interplay between design and self-organization, hindering generalization of phenomena between cases. We address this gap by developing insights on how the theoretical frameworks of robustness-fragility trade-off and cultural multilevel selection can inform our understanding in this regard. We apply the two theories to two cases in the Ganges Brahmaputra Delta in Bangladesh and the Kissimmee River Basin in Florida, illustrating how the two theories may provide general insights into causal mechanisms shaping the socio-hydrological phenomena observed in the two cases. Specifically, we use the two theories to address (1) the transference of system fragility across different domains due to design choices and (2) the multilevel social processes in the nested organizational hierarchy that lead to the formation or collapse of shared cultural traits. We show that these two theories, separately or taken together, can provide richer theoretical grounding for understanding socio-hydrological phenomena.

Food flows underpin the complex food supply chains that are prevalent in our increasingly globalized world. Recently, much effort has been devoted to evaluating the resources (e.g. water, carbon, nutrients) embodied in food trade. Now, research is needed to understand the scientific principles of the food commodity flows that underpin these virtual resource transfers. How do food flows vary with spatial scale? To address this question, we present an empirical analysis of food commodity flow networks across the full spectrum of spatial scales: global, national, and village. We discover properties of both scale invariance and scale dependence in food flow networks. The statistical distribution of node connectivity and mass flux are consistent across scales. Node connectivity follows a generalized exponential distribution, while node mass flux follows a Gamma distribution across scales. Similarly, the relationship between node connectivity and mass flux follows a power law across scales. However, the parameters of the distributions change with spatial scale. Mean node connectivity and mass flux increase with increasing scale. A core group of nodes exists at all scales, but node centrality increases as the spatial scale decreases, indicating that some households are more critical to village food exchanges than countries are to global trade. Remarkably, the structural network properties of food flows are consistent across spatial scales, indicating that a universal mechanism may underpin food exchange systems. In future research, this understanding can be used to develop theoretical models of food flow networks and to model food flows at resolutions for which empirical information is not available.

Assisted colonization—the deliberate translocation of species from unsuitable to suitable regions—is a controversial management tool that aims to prevent the extinction of populations that are unable to migrate in response to climate change or to survive in situ. The identification of suitable translocation sites is therefore a pressing issue. Correlative species distribution models, which are based on occurrence data, are of limited use for site selection for species with historically restricted distributions. In contrast, mechanistic species distribution models hold considerable promise in selecting translocation sites. Here we integrate ecoenergetic and hydrological models to assess the longer-term suitability of the current habitat of one of the world’s rarest chelonians, the Critically Endangered Western Swamp Tortoise (Psuedemydura umbrina). Our coupled model allows us to understand the interaction between thermal and hydric constraints on the foraging window of tortoises, based on hydrological projections of its current habitat. The process can then be repeated across a range of future climates to identify regions that would fall within the tortoise’s thermodynamic niche. The predictions indicate that climate change will result in reduced hydroperiods for the tortoises. However, under some climate change scenarios, habitat suitability may remain stable or even improve due to increases in the heat budget. We discuss how our predictions can be integrated with energy budget models that can capture the consequences of these biophysical constraints on growth, reproduction and body condition.

Introduction: 15.3% of pregnancies result in miscarriage, management options include expectant, medical, or surgical. However, each patient has a range of variables, which makes navigating the available literature challenging when supporting individual patient decision-making. This systematic review aims to investigate whether there are any specific predictors for miscarriage management outcome., Material and Methods: The following databases were searched, from the start of each database up to April 2023: PubMed, Medline, and Google Scholar. Inclusion criteria were studies interrogating defined predictors for expectant or medical management of miscarriage success. Exclusion criteria were poor quality, review articles, trial protocols, and congress abstracts. Data collection was carried as per PRISMA guidelines. Quality assessment for each study was assessed using the QUIPS proforma., Results: Relevant predictors include demographics, ultrasound features, presenting symptoms, and biochemical markers. Across the 24 studies there is heterogeneity in miscarriage definition, predictors reported, and management outcomes used. Associations with certain variables and miscarriage management outcomes are described. Ten studies assessed the impact of miscarriage type on expectant and/or medical management. The majority found that a diagnosis of incomplete miscarriage had a higher success rate following expectant or medical management compared to missed miscarriage or anembryonic pregnancy., Conclusions: We conclude that there is evidence supporting the possibility to offer personalized miscarriage management advice with case specific predictors. Further larger studies with consistent definitions of predictors, management, and outcomes are needed in order to better support women through the decision-making of miscarriage management., (© 2024 The Author(s). Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

In disease treatment, the utilisation of medicinal plants has witnessed a discernible rise, driven by concerns over the adverse effects associated with synthetic drugs available in the market. Analyses of the plant Christia vespertilionis (L.f.) Bakh. F., indigenous to Malaysia, has suggested its antidiabetic property linked to α-glucosidase inhibition, but metabolites responsible for antidiabetic are unexplored. The metabolomics approaches and molecular docking simulations were integrated to identify the putative α-glucosidase inhibitors and their enzyme interaction. In this study, the crude leaves extracted from this plant were extracted using solvents of varying polarity, followed by gas and liquid chromatography coupled with mass spectrometry metabolomics. The highest inhibition activity in a mixture of n-hexane and ethyl acetate (1:1, v/v)) was observed. Six putative metabolites corresponding to antidiabetic activity were identified: palmitic acid (2), linolenic acid (4), 7-tetradecenal (5), aloeemodin-8-monoglucoside (14), bruceine I (15), and sanjidin B (16). The mechanism of action of all the identified compounds is competitive, mainly involving hydrophobic and hydrogen bonding interactions with the protein residues. Compounds 14, 15, and 16 exhibited strong binding capabilities with both enzyme crystal structures compared to the positive control, quercetin. The metabolites extracted from C. vespertilionis leaves have demonstrated promising antidiabetic effects. These antidiabetic compounds can potentially commercialise new drug candidates in managing diabetes conditions., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

(1) Background: This study aims to establish the knowledge, attitudes and current behaviours towards female fertility preservation (FP) services amongst healthcare professionals (HCPs) in the UK. (2) Methods: An online survey was advertised publicly on the social media platform Instagram between 25 February 2021 and 11 March 2021. (3) Results: In total, 415 participants fulfilled the inclusion criteria and completed the survey. The majority of HCPs discussed FP techniques either never 39.5% (n = 164), once a year 20.7% (n = 86) or once a month 17.8% (n = 74). The majority rated their knowledge of each type of FP method as 'very poor' or 'poor' and strongly disagreed 14.2% (n = 59) or disagreed 42.2% (n = 175) with the statement they 'felt confident to counsel a patient on FP'. The majority either agreed 37.8% (n = 157) or strongly agreed 22.2% (n = 92) that it was their responsibility to discuss FP and 38.1% (n = 158) agreed or strongly agreed 19.5% (n = 81) they considered the desire for future fertility when planning treatment. The majority 87.2% (n = 362) had not experienced formal training on FP. (4) Conclusions: Discrepancies in knowledge remain regarding techniques of FP, referral pathways, awareness of facilities offering services and existing educational resources. Many HCPs recognise the importance of FP and their responsibility to initiate discussions. The knowledge that FP may not delay the treatment of cancer has also improved; however, training in FP is scarce.

Purpose of the Study: Fibrodysplasia ossificans progressiva (FOP) is a rare autosomal dominant condition that leads to significant disability and morbidity, characterised by the formation of heterotopic hard tissues within connective tissues. The condition has an incidence of approximately one per two million people worldwide. There is no known single effective treatment available for FOP. We report the world's first case of a healthy infant born following in vitro fertilisation (IVF) and preimplantation genetic testing for monogenic disorder (PGT-M) using Karyomapping for FOP., Case Presentation: A 30-year-old Caucasian female with FOP presented with her partner seeking IVF with PGT-M to achieve a healthy pregnancy with an embryo unaffected by FOP., Methods: The couple underwent IVF and PGT-M using Karyomapping as the testing method. A multi-disciplinary team approach was utilised in planning this case, considering the additional risks of oocyte retrieval, pregnancy and childbirth in women with FOP., Main Findings: The oocyte retrieval was covered with a 5-day course of prednisolone to reduce the risk of a localised inflammatory reaction, which could result in subsequent heterotopic ossification. This was subsequently weaned down with reducing doses every two days. The patient underwent uncomplicated oocyte retrieval, yielding 12 mature oocytes. Following intracytoplasmic sperm injection (ICSI), ten zygotes having two pro-nuclei were cultured, and six underwent trophoectoderm biopsy and vitrification 5-6 days after retrieval. PGT-M via Karyomapping revealed four out of six (66.7%) of blastocysts were not carriers of the maternal high-risk FOP allele. In total, the patient had three separate embryo transfers. Pregnancy was achieved following the third frozen embryo transfer, which went to 37 weeks' gestation, and delivered by Caesarean section. The baby was born in excellent condition and is unaffected by FOP., Conclusion: IVF/ICSI and PGT-M using Karyomapping was successfully implemented to identify embryos carrying the high-risk FOP allele resulting in a healthy livebirth., (© 2024. The Author(s).)

Intrauterine instillation (IU) of Human Chorionic Gonadotropin (hCG) before embryo transfer (ET) has been proposed to enhance implantation success rates. This is the first meta-analysis to evaluate the effect at the blastocyst-stage. A systematic literature search was performed using Medline, Embase, Cochrane Library and Google. Randomized clinical trials (RCTs) were included. The primary outcome combined live birth rate (LBR) and ongoing pregnancy rate (OPR). The secondary outcomes were clinical pregnancy rate (CPR), implantation rate (IR) and miscarriage rate (MR). 93 citations were identified, of which there were seven eligible RCTs. 2499 participants were included in the meta-analysis; 1331 were assigned to an experimental group and 1168 were assigned to the control group. The overall effect of IU hCG instillation on LBR and OPR was not significant: risk ratio (RR) 1.00 (95% CI, 0.90-1.12). Analysis of secondary outcomes found the effect of IU hCG instillation was not significant. Analysis of the data suggests that the studies conducted have too much heterogeneity to identify whether a specific cohort may have a significant benefit. The findings of this meta-analysis demonstrate that there is insufficient evidence at present to support the use of IU hCG instillation prior to blastocyst-stage ET., Competing Interests: Declaration of Competing Interest The authors declare there is no conflict of interests., (Copyright © 2023. Published by Elsevier Masson SAS.)

Introduction: Since the emergence of COVID-19, we have experienced potent variants and sub-variants of the virus with non-specific neurological manifestations. We observed a surge of the Omicron variant of COVID-19 patients with neurological manifestations where less cases of multisystem inflammatory syndrome in children (MIS-C) were reported. This article describes our experience of children with severe and rare neurological manifestations following COVID-19 infection., Methods: This is a retrospective observational case series of patients under 18 years old who fulfilled the WHO COVID-19 case definition and were referred to our paediatric neurology unit at Hospital Tunku Azizah Kuala Lumpur. Their demographic data, neurological symptoms, laboratory and supporting investigations, neuroimaging, treatment and outcomes were collected and analysed., Results: There were eleven patients with neurological manifestations who fulfilled the WHO COVID-19 case definition. Nine patients presented with seizures and/or encephalopathy, one patient with eye opsoclonus and another patient with persistent limbs myokymia. Based on the history, clinical, electrophysiological and radiological findings, two of them had febrile infection-related epilepsy syndrome, two had acute disseminated encephalomyelitis, two had acute necrotising encephalopathy of childhood, one each had hemiconvulsion-hemiplegia-epilepsy syndrome, acute encephalopathy with bilateral striatal necrosis, hemi-acute encephalopathy with biphasic seizures and reduced diffusion, infection-associated opsoclonus and myokymia., Conclusions: This case series highlighted a wide spectrum of neurological manifestations of COVID-19 infection. Early recognition and prompt investigations are important to provide appropriate interventions. It is essential that these investigations should take place in a timely fashion and COVID-19 quarantine period should not hinder the confirmation of various presenting clinical syndromes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Medical care for transgender people is multi-faceted and attention to individual reproductive aspirations and planning are an essential, yet often overlooked aspect of care. Given the impact of hormonal therapy and other gender affirmation procedures on reproductive function, extensive counselling and consideration of fertility preservation is recommended prior to their commencement. This review article explores the reproductive aspirations of transgender women and considers the current disparity between stated desires regarding utilisation of fertility preservation services. Current fertility preservation options and prospective treatments currently showing promise in the research arena are explored.

Introduction: This study aims to assess the motivations and treatment experiences of women undergoing social egg freezing and to understand the impact of the Covid-19 pandemic., Material and Methods: Between January 2011 to December 2021, 191 social egg freezing patients were recruited from the Lister Fertility Clinic, London UK. Participants completed a validated questionnaire investigating patients' perspectives of social egg freezing. A response rate of 46.6% was achieved., Results: In all, 93.9% of women expressed concern regarding age-related fertility decline which influenced their decision to undergo social egg freezing. The majority (89.5%) of women were not in a relationship at the time of social egg freezing and considered this a motivating factor. Also, 39.0% of participants had side effects related to treatment which affected work and social life. Participants were significantly more likely to experience side effects if they underwent multiple egg freezing cycles (χ 2 , p < 0.01) or if they cryopreserved oocytes during the COVID-19 pandemic (χ 2 , p < 0.05). Of the women, 64.0% wished to have cryopreserved oocytes at a younger age, a view significantly more likely if older than 37 years at first social egg freezing cycle (χ 2 , p < 0.001). Also, 82.3% of women reported their decision to undergo social egg freezing was not delayed due to concerns regarding COVID-19 exposure during treatment; 44.1% considered the pandemic made them more willing to undergo social egg freezing., Conclusions: Most participants did not regret their decision to undergo social egg freezing but the majority wished they had cryopreserved oocytes at a younger age. This highlights the importance of early education to optimize outcomes and patient choice. The egg freezing process can be stressful, women may have concerns around social egg freezing and unprecedented situations such as the COVID-19 pandemic may alter treatment experience., (© 2023 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG).)

This study aimed to characterize the metabolic composition of four types of commercially available chicken breeds [village chicken, colored broiler (Hubbard), broiler (Cobb), and spent layers (Dekalb)] by 1 H NMR coupling and discriminate them using multivariate analysis. Five chickens were collected for each chicken breed based on the marketing age from the respective commercial farms. The orthogonal partial least squares discriminant analysis (OPLS-DA) results showed an obvious separation of local village chickens from the other breeds based on the metabolites present in their serum and meat (pectoralis major). The cumulative values of Q 2 , R 2 X , and R 2 Y of the OPLS-DA model for chicken serum were 0.722, 0.877, and 0.841. For the pectoralis major muscle, the cumulative values of Q 2 , R 2 X , and R 2 Y of the OPLS-DA model were reported as 0.684, 0.781, and 0.786, respectively. The quality of both OPLS-DA models was accepted by the cumulative values of Q 2  ≥ 0.5 and R 2  ≥ 0.65. The 1 H NMR result with multivariate analysis has successfully distinguished local village chicken from the other three commercial chicken breeds based on serum and pectoralis major muscle. Nonetheless, colored broiler (Hubbard) was not distinguished from broiler (Cobb) and spent layers (Dekalb) in serum and pectoralis major, respectively. The OPLS-DA assessment in this study identified 19 and 15 potential metabolites for discriminating different chicken breeds in serum and pectoralis major muscle, respectively. Some of the prominent metabolites identified include amino acids (betaine, glycine, glutamine, guanidoacetate, phenylalanine, and valine), nucleotides (IMP and NAD+), organic acids (lactate, malate, and succinate), peptide (anserine), and sugar alcohol (myo-inositol)., Competing Interests: The authors declare that they do not have any conflict of interest., (© 2023 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Background: Geniospasm is a rare and generally benign movement disorder of the chin yet with potentially debilitating complications. Due to its rarity, previous literature was limited to only case reports or series with critical knowledge gap on its natural history, prognosis, and management. We aimed to establish the natural history, prognosis, and treatment for geniospasm., Methods: A systematic review on case reports or series was performed with literature search on PubMed and Google Scholar, from inception through December 2021. The quality of the reports was assessed with low-quality articles excluded for analyses other than demographics., Results: Forty-one articles were included for demographic analysis (n = 489) while forty articles for other analyses (n = 451). There was only slight male preponderance of this disease in our cohort (Male:Female = 1.2:1) with 98.6% having family history of geniospasm, 68.1% having onset below 1 year of age, 91.4% having emotional triggers of the symptoms, 25.7% having geniospasm in sleep, 100% involving mentalis muscles, 4.9% involving muscles adjacent to mentalis, 55.2% having regular paroxysms (≥1/week, but brief in 56.3% of the cases) and only 11.1% having complications. The paroxysms reduced with age, but complete remission only happened in 9.9%. Females (p = 0.010) and those without geniospasm in sleep (p = 0.048) were associated with good outcome of the disease. Geniospasm was usually refractory to treatment except for regular botulinum toxin injections., Conclusion: Generally, geniospasm improved with age but complete remission was rare. Considering our review limitations, our findings should be interpreted with caution. Future studies of higher evidence level are crucial., (Copyright © 2022 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)

Infertility affects more than 14% of couples, 30% being caused by male factor infertility. This meta-analysis includes 28 studies, selected according to PRISMA guidelines. Data were extracted from these studies to collate cycles separating paternal age at 30, 35, 40, 45 and 50 years (±1 year). Primary outcomes of interest were clinical pregnancy, live birth and miscarriage rates. Secondary outcomes were the number of fertilized eggs, cleavage-stage embryos and blastocysts, and embryo quality per cycle. Fixed-effects and random-effects models giving pooled odds ratios (OR) were used to assess the effect of paternal age. This meta-analysis included a total 32,484 cycles from 16 autologous oocyte studies and 12 donor oocyte studies. In autologous cycles, a statistically significant effect of paternal age <40 years was noted in clinical pregnancy (OR 1.65, 95% confidence interval [CI] 1.27-2.15), live birth (OR 2.10, 95% CI 1.25-3.51) and miscarriage (OR 0.74, 95% CI 0.57-0.94) rates. Paternal age <50 years significantly reduced miscarriage rate (OR 0.68, 95% CI 0.54-0.86), and increased blastocyst rate (OR 1.61, 95% CI 1.08-2.38) and number of cleavage-stage embryos (OR 1.67, 95% CI 1.02-2.75) in donor oocyte cycles, where maternal age is controlled. This is an important public and societal health message highlighting the need to also consider paternal age alongside maternal age when planning a family., (Copyright © 2022. Published by Elsevier Ltd.)

Objective: This study was undertaken to determine the hemoglobin A1c (HbA1c) and modified glucose-ketone index (mGKI) in children on different types of ketogenic diet (KD) for treatment of drug-resistant epilepsy, with attempts to evaluate their relationships with components of diet regime and other biomarkers., Methods: We conducted a cross-sectional study in children with drug resistant epilepsy aged between 6 months and 18 years, who were on various types of KD therapies without any change in regime for at least 3 months. Parental interview, review of medical records, and a single measurement for blood ketone, HbA1c, and plasma carnitine were performed. mGKI was the ratio of an average plasma glucose estimated from HbA1c to blood β-hydroxybutyrate level., Results: Thirty-four patients were recruited with a median blood ketone of 2.90 mmol·L -1 and median HbA1c of 4.55%. Those on classical KD (cKD) had higher blood ketone (p = .031) and lower HbA1c (p = .010) and mGKI (p = .021) than those receiving modified Atkins diet, although both shared similar percentages of calories from carbohydrate (p = .211). The cKD and medium-chain triglyceride (MCT) KD groups had similar HbA1c (p = .252) and mGKI (p = .510). Blood ketone (p = .045) and the percentage of calories from MCT (p = .037) were the two main independent variables, inversely correlating with HbA1c. Other than plasma acylcarnitine (p = .047), neither blood ketone (p = .188) nor HbA1c (p = .170) could predict seizure reduction reliably. Both plasma acylcarnitine ≥ 6 μmol·L -1 (p = .013) and mGKI ≤ 2.2 (p = .013) were significantly associated with good seizure control., Significance: HbA1c could potentially be useful for monitoring KD adherence or, indirectly, systemic ketosis in nondiabetic children on KD for drug-resistant epilepsy. Plasma acylcarnitine and mGKI could be important biomarkers in the management of KD therapy., (© 2022 International League Against Epilepsy.)