Outcomes of oocyte cryopreservation: an analysis based on age and treatment indications.

Study Question: How do age at oocyte cryopreservation (OC) and treatment indication affect the outcomes of OC cycles, particularly cumulative live birth rates (CLBR) per warm cycle?

Summary Answer: Age at OC significantly influenced CLBRs per warm cycle, with younger patients achieving higher success, while differences between treatment indications were not statistically significant.

What Is Known Already: OC is a well-established fertility preservation method, with success rates largely influenced by the woman's age at the time of freezing. However, limited data exist on how various medical and non-medical (elective) indications affect outcomes.

[Heat adaptation in healthcare: from awareness to action].

Due to climate change, heatwaves are becoming more frequent and intense in the Netherlands, posing disproportionate health risks to vulnerable groups such as older adults, psychiatric patients, and individuals with chronic illnesses. In this opinion article, the authors advocate for a proactive approach to heat adaptation within healthcare. General practitioners and hospital-based specialists can help reduce heat-related stress and mortality through relatively simple interventions, including medication reviews for at-risk patients, early detection of dehydration, and the implementation of personalized heat plans in collaboration with community care providers and pharmacists.

Global tracking of marine megafauna space use reveals how to achieve conservation targets.

The recent Kunming-Montreal Global Biodiversity Framework (GBF) sets ambitious goals but no clear pathway for how zero loss of important biodiversity areas and halting human-induced extinction of threatened species will be achieved. We assembled a multi-taxa tracking dataset (11 million geopositions from 15,845 tracked individuals across 121 species) to provide a global assessment of space use of highly mobile marine megafauna, showing that 63% of the area that they cover is used 80% of the time as important migratory corridors or residence areas. The GBF 30% threshold (Target 3) will be insufficient for marine megafauna's effective conservation, leaving important areas exposed to major anthropogenic threats.

A Hybrid Artificial Neural Network Approach for Modeling the Behavior of Polyethylene Terephthalate (PET) Under Conditions Applicable to Stretch Blow Molding.

Stretch blow molding (SBM) is widely utilized in industrial applications, yet the deformation characteristics of materials during this process are intricate and challenging to precisely articulate. To accurately forecast the stress-strain response of polyethylene terephthalate (PET) in SBM, a hybrid Artificial Neural Network (ANN)-based constitutive model has been developed. The model has been created by combining a physical-based function for capturing the small-strain behavior in parallel with an ANN-based model for capturing the temperature-dependent large-strain nonlinear viscoelastic behavior.

Innovative balloon-inflatable venous cannula for enhanced cardiopulmonary bypass in minimally invasive cardiac surgery.

Objectives: Minimally invasive cardiac surgery (MICS) struggles with effective caval isolation and cannulation for cardiopulmonary bypass (CPB). We aimed to develop a novel MICS venous cannula, eliminating external manipulations. The goal of this study is to thoroughly evaluate both the safety and the efficacy of a newly developed venous cannula.

The Effect of Assisted Reproductive Technologies on Human Sex Ratios.

Background: Modern assisted reproductive technology (ART), including pre-implantation genetic testing for aneuploidy (PGT-A), has opened new avenues in understanding early embryonic events and has simultaneously raised questions about the impact of ART itself on sex ratios.

Aims: The primary aim was to investigate whether patient demographic characteristics, ovarian stimulation protocols or laboratory characteristics in ART influence sex ratios. The secondary aim was to relate the blastocyst sex ratio (BSR) to the corresponding secondary sex ratio (SSR) in our patient cohort.

Continuous Glucose Monitors and Programmed Shared Medical Appointments in Managing Type 2 Diabetes Mellitus Among First Nation Women in Australia: A Co-Designed Feasibility Study.

First Nations women in Australia diagnosed with type 2 diabetes, co-designed and attended a programmed shared medical appointment that included continuous glucose monitors and culturally responsive food appreciation activities over 8 weekly sessions to improve glycaemic control. The project was a single site, longitudinal change from baseline, mixed methods, feasibility study using HbA1c as the primary outcome measure. Secondary outcome measures included, weight, metabolic health-related blood panels, CGM, Blood Glucose Levels (BGL) time-in-range percentage, Patient Activation Measure (PAM) and Problem Areas In Diabetes (PAID) tools and client satisfaction survey and semi focussed interviews.

Home Blood Pressure Measurements Are Not Performed According to Guidelines and Standardized Education Is Urgently Needed.

Background: Patient education is needed to perform home blood pressure measurement (HBPM) according to blood pressure (BP) guidelines. It is not known how BP is measured at home and what education is provided, which was the aim of the study.

Methods: Mixed-methods study among Australian adults who perform HBPM (June to December 2023).

Novel Retractor-Camera System Facilitates Less Traumatic Minimally Invasive Procedures and Declutters the Operation Field.

Objective: To develop a novel endoscopic system that reduces trauma to the patient and declutters the surgical field for the surgeon in minimally invasive heart valve surgery.

Methods: We designed and developed a retractor-camera combination for minimally invasive heart surgery; the cable and camera were connected to the underbelly of the left atrial retractor blade to provide an illuminated, wide-angle view of the mitral valve. We conducted ex vivo, in vivo, and, ultimately, a first-in-man randomized, nonanonymized clinical trial on 20 patients who required minimally invasive mitral valve surgery.

A step closer to parenthood with non-obstructive azoospermia: Unveiling the impact of microdissection testicular sperm extraction in Australia's largest single-centre study.

Background: Non-obstructive azoospermia (NOA) diagnosis poses challenges for couples seeking parenthood. Microdissection testicular sperm extraction (MD-TESE) excels in retrieving testicular sperm cells for NOA cases. However, limited live birth data in Australian NOA patients hinders accurate counselling.

Systematic review of first-in-human and early phase clinical trials for surgically implantable biological mitral valve substitutes.

Background: The aim of this review was the creation of uniform protocols to carry out and disclose First-In-Human and preliminary clinical trials of biological mitral valve replacement. The need for consistent methodology in these early trials was highlighted by the observation of significant variability in the methods and protocols used across different research.

Methods: An extensive search through six major databases was carried out to retrieve First-In-Human (FIH) clinical studies evaluating surgically implanted bio-prostheses in the mitral position.

A Systematic Review of Individualized Heart Surgery with a Personalized Prosthesis.

Personalized surgery is not just a new trend but rather a patient-specific approach to therapy that makes it possible to adopt a targeted approach for a specific patient and closely mirrors the approach of personalized medicine. However, the application of tailored surgery in the context of cardiovascular replacement surgery has not been systematically reviewed. The ability to customize a device is highly dependent on the collection of radiological image data for precise prosthesis modeling.

A rare case of mosaic Klinefelter syndrome in a 45-year-old man leading to successful live birth through ejaculated spermatozoa: a case report and literature review.

Men diagnosed with Klinefelter syndrome (KS) commonly exhibit non-obstructive azoospermia or rarely having sperm in their ejaculate, rendering them traditionally considered sterile prior to the introduction of intracytoplasmic sperm injection (ICSI). The presence of mosaic KS may mask the classical phenotype, resulting in underdiagnosis throughout their lifetime. Surgical sperm retrieval through Microdissection Testicular Sperm Extraction (Micro-TESE) combined with ICSI has become the gold standard approach, maximizing reproductive outcomes in these individuals.

Re-imaging healthcare delivery in the era of COVID-19.

The COVID-19 pandemic has exposed the deficiencies of the current healthcare system in terms of a disconnect between primary and tertiary care and increasing subspecialisation, the focus on acute episodic care rather than on prevention in a time where chronic disease prevails and an inefficient use of healthcare resources. Herein, we present the case for an alternative model of healthcare delivery - shared medical appointments - which are efficient, effective and empowering and can be transitioned to the virtual environment successfully. We highlight the barriers to implementation and how these can be overcome.

Overweight and obesity management in musculo-skeletal primary care: a survey of Australian health practitioners exploring ‘the elephant in the room’.

Background: Overweight and obesity has a bi-directional association with the growing burden of musculoskeletal (MSk) dysfunction and pain. It seems inevitable that MSk practitioners will see increasing numbers of patients who are overweight and or obese and require this to be addressed as part of their management. Little evidence exists to describe the engagement of patients and their MSk practitioner in weight management as an adjunct or direct component of their intervention or therapy.

Shared Medical Appointments in Weight Management: A Culturally Responsive Process for Aboriginal Women. Translational Trial Results.

This paper presents a secondary analysis of data from a study of 216 people participating in a trial of program shared medical appointments (PSMA) in weight management. The focus of this paper is the Aboriginal women who participated in this translational research project and who were not reported on specifically in the primary analysis and publication. This paper, therefore, examines the use of PSMA as a culturally safe and responsive procedure to facilitate weight management.

Post-warming embryo morphology is associated with live birth: a cohort study of single vitrified-warmed blastocyst transfer cycles.

Purpose: This study aims to examine whether blastocyst morphology post-warming correlates with live birth.

Methods: In this cohort study, morphological characteristics post-warming were reviewed in all single vitrified-warmed blastocyst transfer cycles performed between November 2016 and May 2017. Immediately before transfer, the degree of blastocoel re-expansion was graded as A, fully expanded; B, partially expanded ≥ 50%; C, partially expanded < 50%; and D, collapsed.

Implementing recovery-oriented practice in older people’s mental health services: the NSW experience.

Personal recovery is central to Australian mental health standards, but promoting recovery-oriented practice remains a wicked problem (ie complex, with definitions and appropriate interventions impacted upon by context and values), with limited evidence regarding effective implementation. This case study re-examines a statewide initiative to enhance recovery-oriented practice in older people's mental health services in New South Wales from the perspective of complex adaptive systems. The initiative consisted of three key strategies: (1) statewide collaborative leadership and practice resources; (2) locally determined and led improvement projects; and (3) evaluating, disseminating and sustaining initiative outcomes.

The implementation of random survival forests in conflict management data: An examination of power sharing and third party mediation in post-conflict countries.

Time-to-event analysis is a common occurrence in political science. In recent years, there has been an increased usage of machine learning methods in quantitative political science research. This article advocates for the implementation of machine learning duration models to assist in a sound model selection process.

Adverse Childhood Experiences as "Upstream" Determinants of Lifestyle-Related Chronic Disease: A Scoping Perspective.

We have previously proposed a list of determinants (causes) of modern lifestyle-related chronic disorders, which provides a structure for the emerging discipline of lifestyle medicine. This consists of lifestyle factors with a common immune biomarker () that interact in a systems fashion linked with chronic disease outcomes. We considered this to be a work in progress and later added 3 psychosocial determinants into the causal mix: meaninglessness, alienation, and loss of culture and identity (MAL).

Worldwide relative smoking prevalence among people living with and without HIV.

Objective And Design: People living with HIV (PLH) suffer disproportionately from the chronic diseases exacerbated by smoking tobacco. We performed a systematic review and meta-analysis to establish the relative prevalence of smoking among PLH.

Methods: We included observational studies reporting current smoking rates among PLH and comparators without HIV.

How to be an Innovator in Cardiothoracic Surgery.

Cardiothoracic surgeons are uniquely and expertly positioned to be innovators. Innovation is an iterative process by which unmet needs are identified, a solution is invented, and the results are implemented. A team approach is required, with participation from a variety of experts including the surgeon-innovator.

Shared Medical Appointments and Mindfulness for Type 2 Diabetes-A Mixed-Methods Feasibility Study.

Introduction: Type 2 diabetes (T2DM) is a major health concern with significant personal and healthcare system costs. There is growing interest in using shared medical appointments (SMAs) for management of T2DM. We hypothesize that adding mindfulness to SMAs may be beneficial.

Virtual group consultations offer continuity of care globally during Covid-19.

Covid-19 has led to virtual care (mainly telephone consultations) becoming a default worldwide, despite well-documented shortcomings. Published evidence on virtual group consultations is limited, although interest and front-line experience have grown substantially since pandemic onset. Unpublished data are summarised showing feasibility of transitioning care to this model across different countries, care settings and conditions.

Identification and Characterization of a DmoB Flavin Oxidoreductase from a Putative Two-Component DMS -Monooxygenase.

The compound dimethyl sulfide (DMS) links terrestrial and oceanic sulfur with the atmosphere because of its volatility. Atmospheric DMS is responsible for cloud formation and radiation backscattering and has been implicated in climate control mitigation. The enzyme DMS -monooxygenase degrades DMS and has been classified as a two-component FMNH-dependent monooxygenase.