Proteomic Profiling Identifies Candidate Diagnostic Biomarkers of Hydrosalpinx in Endometrial Fluid: A Pilot Study.

Hydrosalpinx is a fluid occlusion and distension of the fallopian tubes, often resulting from pelvic inflammatory disease, which reduces the success of artificial reproductive technologies (ARTs) by 50%. Tubal factors account for approximately 25% of infertility cases, but their underlying molecular mechanisms and functional impact on other reproductive tissues remain poorly understood. This proteomic profiling study applied sequential window acquisition of all theoretical fragment ion spectra mass spectrometry (SWATH-MS) to study hydrosalpinx cyst fluid and pre- and post-salpingectomy endometrial fluid. Among the 967 proteins identified, we found 19 and 17 candidate biomarkers for hydrosalpinx in pre- and post-salpingectomy endometrial fluid, respectively. Salpingectomy significantly affected 76 endometrial proteins, providing insights into the enhanced immune response and inflammation present prior to intervention, and enhanced coagulation cascades and wound healing processes occurring one month after intervention. These findings confirmed that salpingectomy reverses the hydrosalpinx-related functional impairments in the endometrium and set a foundation for further biomarker validation and the development of less-invasive diagnostic strategies for hydrosalpinx.

Semen processing using magnetic-activated cell sorting before ICSI is deemed safe for obstetric and perinatal outcomes: a retrospective multicentre study.

RESEARCH QUESTION: Is magnetic-activated cell sorting (MACS) a safe semen sample processing technique for newborns and mothers when used for semen processing prior to intracytoplasmic sperm injection (ICSI) cycles? DESIGN: This retrospective multicentre cohort study involved patients undergoing ICSI cycles with either donor or autologous oocytes from January 2008 to February 2020. They were divided into two groups: those who underwent standard semen preparation (reference group) and those who had an added MACS procedure (MACS group). A total of 25,356 deliveries were assessed in the case of cycles using donor oocytes, and 19,703 deliveries from cycles using autologous oocytes. Of these, 20,439 and 15,917, respectively, were singleton deliveries. Obstetric and perinatal outcomes were retrospectively assessed. All means, rates and incidences were computed per live newborn in each study group. RESULTS: There were no significant differences between the main obstetric and perinatal morbidities affecting the mothers' and newborns' well-being between groups using either donated or autologous oocytes. There was a significant increase in the incidence of gestational anaemia in both subpopulations (donor oocytes P = 0.01; autologous oocytes P < 0.001). However, this incidence was within the estimated prevalence for gestational anaemia in the general population. There was a statistically significant decrease in preterm (P = 0.02) and very preterm (P = 0.01) birth rates in the MACS group in cycles using donor oocytes. CONCLUSIONS: The use of MACS during semen preparation before ICSI using either donor or autologous oocytes appears to be safe for the mothers' and newborns' well-being during pregnancy and birth. Nevertheless, a close follow-up of these parameters in the future is advised, especially concerning anaemia, in order to detect even smaller effect sizes.

Fasciolosis prevalence, risk factors and economic losses due to bovine liver condemnation in abattoirs in Mexico.

This study investigated the prevalence of bovine liver condemnation due to Fasciola hepatica in abattoirs and its influence on livestock productivity. It also explored risk factors such as season, breed, age and sex in the states of Puebla and Veracruz, Mexico. A total of 5281 cattle livers were inspected in two abattoirs. The overall prevalence of the parasite in cattle throughout 2020 was 24.9% (1313 out of 5281). The highest prevalence was found in Veracruz (28.5%; tropical climate), followed by Puebla (18.4%; temperate climate). The prevalence of fluke infection during the wet season was 19.0% and 25.8% in the states of Puebla and Veracruz, respectively; during the dry season, this was 18.0% and 30.2% respectively. The annual loss caused by condemnation of the liver for both abattoirs was estimated to be US$7502. Using multivariate logistic regression analysis, two models were constructed for potential association with the prevalence of condemned livers, using season, breed, age and sex as risk factors. The results indicate that season, age and sex were significantly associated with an increased risk of parasitic infection. Cattle age was the variable most strongly associated with F. hepatica infection, with the highest prevalence in cattle over three years of age as compared to younger animals, both in the states of Veracruz with a tropical climate (OR 6.443; 95% CI: 4.487-9.251) and in Puebla with a temperate climate (OR 2.854; 95% CI: 1.531-5.321). The results indicate that different factors were significantly associated with the prevalence of condemned livers, and it highlights the importance of continuous monitoring programmes for F. hepatica infection and preventing economic losses in cattle production.

Physical activity and sperm quality: influence in sperm donors.

PURPOSE: To ascertain whether physical activity (PA) is associated with better sperm quality in sperm donors. METHODS: A prospective case-control study was designed in an IVF center setting. A total of 207 sperm donation candidates from a relatively small geographical area were included in the study with no intervention. Donor candidates were subjected to conventional sperm analysis according to WHO criteria. Moreover, they answered a standardized questionnaire regarding their last week PA (IPAQ), with PA expressed in metabolic equivalents (METs)-min/week. Donors were classified into 4 groups: low, moderate, high and very high PA. Specific sports were included in the questionnaire. Semen samples from 43 accepted donors were used in artificial insemination by donor (AID) and IVF. The fertilization rates (FR) and pregnancy rates (PR) were studied. RESULTS: Semen volume, sperm concentration, progressive spermatozoa, non-progressive spermatozoa, total motile progressive spermatozoa and sperm morphology were similar in the four PA groups. No correlation between various semen parameters studied and METs was found. Running or cycling > 1 h/week did not influence sperm parameters. The AID PR was similar in the different PA groups. However, in IVF the mean donor FR was significantly higher in the high PA group and in the very high PA group. CONCLUSIONS: No detrimental effect was associated with PA, or even very high PA, regarding conventional sperm parameters. Moreover, a better FR was associated with high and very high PA in IVF cycles, which merits more studies.

Cumulative live birth rates in donor oocyte ICSI cycles are not improved by magnetic-activated cell sorting sperm selection.

RESEARCH QUESTION: Does magnetic-activated cell sorting (MACS) for sperm selection increase cumulative live birth rates (CLBR) or improve clinical parameters of reproductive success in couples undergoing intracytoplasmic sperm injection (ICSI) with donor oocytes? DESIGN: Retrospective multicentre observational study including data compiled from unselected couples who underwent ICSI cycles with donated oocytes in 15 Spanish IVIRMA fertility clinics (January 2008 to February 2020). Patients were divided into reference (standard semen processing, n = 40,157) and MACS (additional sperm selection step by MACS, n = 1,240) groups. CLBR were plotted on Kaplan-Meier curves and compared using the Mantel-Cox test. Proportions were compared with a generalized estimating equation model, and results were adjusted to clinically relevant variables. RESULTS: The MACS group showed a 27.1% CLBR after one embryo was transferred and 81.6% after four; the reference group had CLBR of 19.6% and 78.5%, respectively. CLBR in the MACS group was 4.2% after five oocytes were used and 75.5% after 15; for the reference group, CLBR were 7.8% and 78.3%, respectively. Kaplan-Meier curves showed statistically significant differences in CLBR per number of embryos transferred and per number of donated metaphase II oocytes between the two groups (both P < 0.0001), but not for CLBR per embryo transfer. No significant differences between groups were found for classical clinical outcomes such as pregnancy and live birth rates per embryo transfer. CONCLUSIONS: Although MACS sperm selection slightly increased the CLBR per embryo transferred compared with the reference group, this change was not clinically meaningful. MACS should not be recommended indiscriminately to all infertile patients undergoing ICSI with donated oocytes as a sperm processing add-on.

May Measurement Month 2017-2019: an analysis of blood pressure screening results from Guatemala.

In 2018, the Ministry of Public Health and Social Assistance of Guatemala published the last update of the prevalence of noncommunicable diseases (NCDs), and as in other low-income countries, the prevalence of NCD morbidity and mortality had risen. The prevalence of hypertension in Guatemala has been reported in a range from 18.7 to 22.7% which could be underestimated, because the country does not have an adequate statistical surveillance system. May Measurement Month (MMM) 2017, 2018, and 2019 in Guatemala was an opportunistic survey, which followed the methodology previously published. Blood pressure (BP) measurements were carried out in various locations, mainly hospitals and clinics (48.9%) or pharmacies (34.2%) in Guatemala City. In all patients, three BP measurements were taken after 5 min of rest and sitting in the correct recommended position. The mean of the second and third BP measurements was used for the analyses. Multiple imputation was used to impute the missing readings, based on the global MMM data. After multiple imputation, of all 3265 participants, 43.4% had hypertension. Of all participants with hypertension, 74.7% were aware of their diagnosis, 69.2% were on antihypertensive medication, and 63.1% had controlled BP (<140/90 mmHg). Of all those with hypertension, 43.6% had controlled BP. MMM is the largest hypertension survey ever carried out globally. The MMM results from Guatemala reported here provide complementary and strong data on the impact of hypertension in the country and help to make hypertension visible as a priority health problem, which requires urgent solutions.

Prevalence of Fatty Liver among Children under Multiple Machine Learning Models.

OBJECTIVES: To analyze the possible factors causing fatty liver in children based on ultrasound data of children in south Texas, and to establish machine learning models of fatty liver in children to provide ideas for the prevention and treatment of fatty liver in children. METHODS: The binary classification model of fatty liver problem in obese children in Texas was established under the multiple model. First, we selected important features using the CatBoost algorithm. Second, the best parameters of the algorithm were selected on the training set and the validation set by using the grid search method, and all six models were tested on the test set. The six models then were compared by area under the curve value, precision, accuracy, recall rate, and F1 score in a model evaluation. Then, two algorithms, logic regression and CatBoost, were selected to establish prediction models of fatty liver disease in children. RESULTS: We selected body mass index, height, liver size, kidney volume, glomerular filtration rate, and liver diameter as the features used in the machine learning model. The prediction models we chose showed that children with higher body mass index at the same age tended to have a greater probability of fatty liver. CONCLUSIONS: Based on the analysis of the results of the two prediction models established by logistic regression and CatBoost, we determined that the mean probability of fatty liver in severely obese children was between 74.47% and 92.22%, 73.45% and 85.41% in obese children, and slightly higher in boys than in girls, with a mean difference of 3.00% to 3.95%.

Vaccination with cathepsin L mimotopes of Fasciola hepatica in goats reduces worm burden, morphometric measurements, and reproductive structures.

Fasciolosis is a worldwide emergent zoonotic disease that significantly constrains the productivity of livestock. We conducted an experimental trial with four groups of five goats each, vaccinated with 1 × 1013 phage particles of cathepsin L1 (CLI: DPWWLKQ), CL1 (SGTFLFS), and CL2 (PPIRNGK) mimotopes combined with Quil A adjuvant. Animals received a booster four weeks later. The control group received phosphate-buffered saline. All animals were infected with 200 Fasciola hepatica metacercariae at week six and euthanised 16 weeks later. The percentage of significant worm reduction in CL1 (DPWWLKQ), CL1 (SGTFLFS), and CL2 (PPIRNGK) compared to the control group were 55.40%, 70.42% (P < 0.05), and 32.39%, respectively. Vaccinated animals showed a significant reduction in faecal egg production and egg viability. A significant reduction in the total biomass of parasites recovered was observed in the CL1 (DPWWLKQ) and CL1 (SGTFLFS) groups. In goats vaccinated with CL2 (PPIRNGK), fluke length and width were smaller than those in the control group. Furthermore, animals receiving CL mimotopes showed a significant reduction in the total area of reproductive structures. Goats immunised with phage-displayed mimotopes produced significantly high titres of specific IgG1 and IgG2 isotypes, indicating a mixed Th1/Th2 response. The liver fluke burdens in goats vaccinated with CL1 (DPWWLKQ) and CL1 (SGTFLFS) were significantly correlated with IgG and IgG1 levels.

Cervical pregnancy in assisted reproduction: an analysis of risk factors in 91,067 ongoing pregnancies.

RESEARCH QUESTION: What is the frequency of cervical pregnancy in women undergoing assisted reproductive technologies (ART) and what are the risk factors? DESIGN: Case-control study of women undergoing assisted reproductive technology (ART) at 25 private assisted reproduction clinics run by the same group in Spain. Two control groups (tubal ectopic pregnancies and intrauterine pregnancies) were established. The main outcome measure was frequency of cervical pregnancy. Demographic, clinical factors and IVF parameters were assessed for their influence on cervical pregnancy risk. RESULTS: Thirty-two clinical pregnancies were achieved out of 91,067 ongoing pregnancies, yielding a rate of 3.5/10,000. Cervical pregnancies represented 2.02% of all ectopic pregnancies (32/1582). The main risk factors two or more previous pregnancies (OR 2.68; CI 1.18 to 6.07); two or more previous miscarriages (OR 4.21; CI1.7 to 10.43), one or more previous curettages (OR 3.99, CI 1.67 to 9.56), two or more previous curettages (OR 4.71; CI 1.19 to 18.66) and smoking (OR 2.82 CI 1.14 to 6.94). History of caesarean sections and tubal pregnancy was not associated with an elevated cervical pregnancy risk. Infertility conditions and endometrial thickness were similar across the three groups. The proportion of women from whom fewer than 10 oocytes were retrieved was higher in the clinical pregnancy group than in the IUP group. CONCLUSIONS: In ART, the main risk factors for cervical ectopic pregnancy are a history of at least two pregnancies, miscarriages, at least one curettage and smoking. IVF parameters do not seem to influence the development of clinical pregnancies. Cervical pregnancies are less common in ART than previously reported, attributable to improvements in ART; a publication bias in early IVF reports cannot be ruled out.

Effects of Political Instability in Venezuela on Malaria Resurgence at Ecuador-Peru Border, 2018.

Mass migration from Venezuela has increased malaria resurgence risk across South America. During 2018, migrants from Venezuela constituted 96% of imported malaria cases along the Ecuador-Peru border. Plasmodium vivax predominated (96%). Autochthonous malaria cases emerged in areas previously malaria-free. Heightened malaria control and a response to this humanitarian crisis are imperative.

A Bayesian random partition model for sequential refinement and coagulation.

We analyze time-course protein activation data to track the changes in protein expression over time after exposure to drugs such as protein inhibitors. Protein expression is expected to change over time in response to the intervention in different ways due to biological pathways. We therefore allow for clusters of proteins with different treatment effects, and allow these clusters to change over time. As the effect of the drug wears off, protein expression may revert back to the level before treatment. In addition, different drugs, doses, and cell lines may have different effects in altering the protein expression. To model and understand this process we develop random partitions that define a refinement and coagulation of protein clusters over time. We demonstrate the approach using a time-course reverse phase protein array (RPPA) dataset consisting of protein expression measurements under different drugs, dose levels, and cell lines. The proposed model can be applied in general to time-course data where clustering of the experimental units is expected to change over time in a sequence of refinement and coagulation.

Lipidomic profiling of endometrial fluid in women with ovarian endometriosis†.

The proteomic content of the endometrial fluid (EF) from patients with endometriosis has been investigated, but the lipidomic profile has not been analyzed yet in detail.This study is a comparative untargeted lipidomic analysis of human EF obtained from 35 patients (12 endometriosis and 23 controls). Global differential lipidomic profile was analyzed in both groups by ultrahigh performance liquid chromatography coupled to mass spectrometry. A total of 123 out of the 457 metabolites identified in the EF were found to be significantly differentially expressed between ovarian endometriosis (OE) versus controls. Univariate statistical analysis showed reduced levels of saturated diacylglycerols and saturated triacylglycerols in endometriosis patients. A predictive model was generated using the 123 differentially expressed metabolites. Using this model, we were able to correctly classify 86% of the samples. This study identified the lipidomic profile in the EF associated with OE, suggesting that EF analysis could be considered as a minimally invasive approach for the diagnosis of endometriosis. In conclusion, the lipidomic profile of the EF is different between samples from patients with OE and controls.

Successful malaria elimination in the Ecuador-Peru border region: epidemiology and lessons learned.

BACKGROUND: In recent years, malaria (Plasmodium vivax and Plasmodium falciparum) has been successfully controlled in the Ecuador-Peru coastal border region. The aim of this study was to document this control effort and to identify the best practices and lessons learned that are applicable to malaria control and to other vector-borne diseases. A proximal outcome evaluation was conducted of the robust elimination programme in El Oro Province, Ecuador, and the Tumbes Region, Peru. Data collection efforts included a series of workshops with local public health experts who played central roles in the elimination effort, review of epidemiological records from Ministries of Health, and a review of national policy documents. Key programmatic and external factors are identified that determined the success of this eradication effort. CASE DESCRIPTION: From the mid 1980s until the early 2000s, the region experienced a surge in malaria transmission, which experts attributed to a combination of ineffective anti-malarial treatment, social-ecological factors (e.g., El Niño, increasing rice farming, construction of a reservoir), and political factors (e.g., reduction in resources and changes in management). In response to the malaria crisis, local public health practitioners from El Oro and Tumbes joined together in the mid-1990s to forge an unofficial binational collaboration for malaria control. Over the next 20 years, they effectively eradicated malaria in the region, by strengthening surveillance and treatment strategies, sharing of resources, operational research to inform policy, and novel interventions. DISCUSSION AND EVALUATION: The binational collaboration at the operational level was the fundamental component of the successful malaria elimination programme. This unique relationship created a trusting, open environment that allowed for flexibility, rapid response, innovation and resilience in times of crisis, and ultimately a sustainable control programme. Strong community involvement, an extensive microscopy network and ongoing epidemiologic investigations at the local level were also identified as crucial programmatic strategies. CONCLUSION: The results of this study provide key principles of a successful malaria elimination programme that can inform the next generation of public health professionals in the region, and serve as a guide to ongoing and future control efforts of other emerging vector borne diseases globally.

Bayesian inference for longitudinal data with non-parametric treatment effects.

We consider inference for longitudinal data based on mixed-effects models with a non-parametric Bayesian prior on the treatment effect. The proposed non-parametric Bayesian prior is a random partition model with a regression on patient-specific covariates. The main feature and motivation for the proposed model is the use of covariates with a mix of different data formats and possibly high-order interactions in the regression. The regression is not explicitly parameterized. It is implied by the random clustering of subjects. The motivating application is a study of the effect of an anticancer drug on a patient's blood pressure. The study involves blood pressure measurements taken periodically over several 24-h periods for 54 patients. The 24-h periods for each patient include a pretreatment period and several occasions after the start of therapy.

On species sampling sequences induced by residual allocation models.

We discuss fully Bayesian inference in a class of species sampling models that are induced by residual allocation (sometimes called stick-breaking) priors on almost surely discrete random measures. This class provides a generalization of the well-known Ewens sampling formula that allows for additional flexibility while retaining computational tractability. In particular, the procedure is used to derive the exchangeable predictive probability functions associated with the generalized Dirichlet process of Hjort (2000) and the probit stick-breaking prior of Chung and Dunson (2009) and Rodriguez and Dunson (2011). The procedure is illustrated with applications to genetics and nonparametric mixture modeling.

Cathepsin L1 mimotopes with adjuvant Quil A induces a Th1/Th2 immune response and confers significant protection against Fasciola hepatica infection in goats.

Thirty goats were randomly allocated in five groups of six animals each, for immunization with 1 × 10(14) phage particles of clones 11, 13, and 13 with Quil A adjuvant and wild-type M13KE phage at the beginning and 4 weeks later. The control group received phosphate-buffered saline. All groups were challenged with 200 metacercariae at week 6 and slaughtered 14 weeks later. The mean worm burdens after challenge were reduced by 46.91% and 79.53% in goats vaccinated with clones 13 and 13 with Quil A (P < 0.05), respectively; no effect was observed in animals immunized with clone 11 and M13KE phage. Animals receiving clones 11, 13, and 13 with Quil A showed a significant reduction in eggs output. Vaccinated animals produced parasite-specific total IgG antibody which were boosted after challenge with metacercariae of F. hepatica. Furthermore, levels of anti-phage total IgG increased rapidly within 2 weeks of the first vaccination and were always significantly higher in all vaccinated goats than in the infected control group. The fluke burden of goats immunized with clones 13 and 13 with Quil A was significantly correlated with IgG2 and total IgG. Goats vaccinated with phage clones produced significantly high titres of IgG1 and IgG2 antibodies indicating a mixed Th1/Th2 response. These data indicate that cathepsin L1 mimotopes has a potential as a vaccine candidate against Fasciola hepatica, whose efficacy will be evaluated in other host species, including those of veterinary importance.

Integrating SOMs and a Bayesian classifier for segmenting diseased plants in uncontrolled environments.

This work presents a methodology that integrates a nonsupervised learning approach (self-organizing map (SOM)) and a supervised one (a Bayesian classifier) for segmenting diseased plants that grow in uncontrolled environments such as greenhouses, wherein the lack of control of illumination and presence of background bring about serious drawbacks. During the training phase two SOMs are used: one that creates color groups of images, which are classified into two groups using K-means and labeled as vegetation and nonvegetation by using rules, and a second SOM that corrects classification errors made by the first SOM. Two color histograms are generated from the two color classes and used to estimate the conditional probabilities of the Bayesian classifier. During the testing phase an input image is segmented by the Bayesian classifier and then it is converted into a binary image, wherein contours are extracted and analyzed to recover diseased areas that were incorrectly classified as nonvegetation. The experimental results using the proposed methodology showed better performance than two of the most used color index methods.

Safety of Plasma Rich in Growth Factors (PRGF) as additive to healthy human sperm samples: a pilot study.

OBJECTIVE: The aim of our study was to assess if the addition of PRGF to healthy human sperm affects its motility and vitality. METHODS: This was a prospective study, with 44 sperm donors on whom sperm analysis was performed. Nine mL of blood was collected and PRGF was obtained using PRGF-Endoret® technology. The influence of different dilutions of PRGF (5%, 10%, 20%, 40%) applied to 15 sperm donors was compared, and sperm motility was assessed after 30 minutes. In the second part of the study, 29 sperm donors were studied to analyze the influence of 20% dilution of PRGF at 15, 30 and 45 minutes in fresh and thawed sperm samples. Motility was assessed after the addition of PRGF and after analysis each aliquot was frozen. After thawing, concentration and motility were assessed at the same time periods. RESULTS: There were no differences in sperm motility in fresh samples between dilutions of PRGF when assessed 30 minutes after administration, nor between them, nor when compared to the control group immediately prior to treatment. No trend was observed between motility and PRGF dilution in linear regression analysis. There were no significant differences in thawed samples. CONCLUSIONS: The administration of 20% PRGF dilution had no effect on sperm motility compared to samples without PRGF. In addition, there was no change in sperm vitality when comparing samples with and without PRGF. More studies focusing on subnormal sperm samples, analyzing different PRGF concentrations and increasing the number of study variables are needed.

Latin-American guidelines of recommendations at discharge from an acute coronary syndrome.

The diagnostic criteria, treatments at the time of admission, and drugs used in patients with acute coronary syndrome are well defined in countless guidelines. However, there is uncertainty about the measures to recommend during patient discharge planning. This document brings together the most recent evidence and the standardized and optimal treatment for patients at the time of discharge from hospitalization for an acute coronary syndrome, for comprehensive and safe care in the patient's transition between care from the acute event to the outpatient care, with the aim of optimizing the recovery of viable myocardium, guaranteeing the most appropriate secondary prevention, reducing the risk of a new coronary event and mortality, as well as the adequate reintegration of patients into daily life.

Los criterios diagnósticos, los tratamientos en el momento de la admisión y los fármacos utilizados en pacientes con síndrome coronario agudo están bien definidos en innumerables guías. Sin embargo, existe incertidumbre acerca de las medidas para recomendar durante la planificación del egreso de los pacientes. Este documento reúne las evidencias más recientes y el tratamiento estandarizado y óptimo para los pacientes al momento del egreso de una hospitalización por un síndrome coronario agudo, para un cuidado integral y seguro en la transición del paciente entre la atención del evento agudo y el cuidado ambulatorio, con el objetivo de optimizar la recuperación de miocardio viable, garantizar la prevención secundaria más adecuada, reducir el riesgo de un nuevo evento coronario y la mortalidad, así como la adecuada reinserción de los pacientes en la vida cotidiana.