Fruit and Vegetable Intake, Food Security, Barriers to Healthy Eating, and Empowerment among Dietetic Interns and Physician Assistant Interns: A Cross-Sectional Pilot Study.

Students are required to complete supervised practice hours prior to becoming Registered Dietitians and Physician Assistants. Research suggests that environmental and social factors affect dietetic interns' diets during their internship, although these factors have not been studied among physician assistant interns. This cross-sectional study utilized an online survey to compare dietetic interns' (n = 81) and physician assistant interns' (n = 79) fruit and vegetable intake, food security, barriers to healthy eating, and empowerment for making healthy dietary choices during an internship. Differences were assessed via independent t-tests and chi-square distributions. The significance was set at p < 0.05. Dietetic interns had a higher vegetable intake (p = 0.002) while physician assistant interns had higher rates of food insecurity (p = 0.040). Dietetic interns reported a greater impact on their dietary choices due to mental fatigue (p = 0.006), while physician assistant interns' dietary choices were more heavily impacted by peer influence, interactions with patients, and interactions with preceptors (p < 0.05). There was not a group difference in overall empowerment (p = 0.157), although both groups rated empowerment for asking for help with food and nutrition challenges the lowest of the empowerment sub-items. Addressing interns' unique needs may support students' educational success and wellbeing once they are professionals, promote a diverse workforce, and ensure optimal care for patients.

In vitro fertilization and andrology laboratory in 2030: expert visions.

The aim of this article is to gather 9 thought leaders and their team members to present their ideas about the future of in vitro fertilization and the andrology laboratory. Although we have seen much progress and innovation in the laboratory over the years, there is still much to come, and this article looks at what these leaders think will be important in the future development of technology and processes in the laboratory.

Evolution of embryo selection for IVF from subjective morphology assessment to objective time-lapse algorithms improves chance of live birth.

RESEARCH QUESTION: Does using an objective time-lapse imaging algorithm (TLIA) after IVF relate to conventional morphological assessment of human blastocysts as a prognosticator for live birth? DESIGN: Prospective use of a TLIA to select embryos in multicentre IVF clinics all using the same strictly controlled laboratory protocols. Each blastocyst was given a ranking from A to D, with the highest rank preferred for fresh transfer. This ranking was retrospectively compared with a given morphological score, which was blinded to the TLIA rank; all embryos were cultured under the same conditions. RESULTS: Using multiple variable logistic regression models, TLIA embryo rank enabled greater discrimination between cycles with and without live births than the conventional morphology grade, even when considered in isolation, and when adjusting for covariates related to treatment and patient criteria. Of the 1810 cycles of single blastocyst transfer, 894 (49.4%) resulted in a live birth. A Vuong non-nested test including covariates showed strong evidence of the superiority of the embryo rank model compared with the transfer grade model (P = 0.0008 [raw], P = 0.0003 [Akaike information criterion - corrected]). From the receiver operating characteristic (ROC) curves across all possible thresholds the TLIA rank showed better true positive and true negative rates and had a higher area under the curve [AUC] of 67.43% compared with 61.74% for the blastocyst morphology grade. The same analysis but excluding covariates demonstrated an AUC of 62.86% versus 54.02%, respectively. CONCLUSION: Objective TLIA is superior for selecting embryos for their propensity to generate a live birth over a conventional, subjective blastocyst morphology scoring system.

Aneuploidy is a key causal factor of delays in blastulation: author response to 'A cautionary note against aneuploidy risk assessment using time-lapse imaging'.

In a previous paper, we had reported use of time-lapse monitoring to develop an aneuploidy risk classification model after identifying significant periblastulation delays in aneuploid embryos compared with euploid embryos. The model was validated subsequently in a second paper by retrospective assessment of transferred blastocysts that had also undergone time-lapse monitoring in which clinical pregnancy or live birth outcomes were established. A significant difference was seen for both outcome measures between embryos classified as low and medium risk by the model. Here we respond to the commentary entitled 'A cautionary note against embryo aneuploidy risk assessment using time-lapse imaging', which presented a case for our conclusions being unsound on the basis that maternal age, rather than aneuploidy, might be the cause of the developmental delays observed. We demonstrate that this is not the case and strengthen the argument that ploidy is a key factor influencing morphokinetics of blastulation. We also describe why the arguments made in the commentary based on comparisons between static standard observations and timings of the preimplantation embryo compared with those obtained from dynamic or time-lapse methodologies are inexact.

A community health worker home visitation project to prevent neonatal deaths in Kenya.

Neonatal deaths account for 43% of under-5 childhood deaths in Kenya. Most infants are born at home, and many of them die at home unaccounted for, often during the first week of life. Previous studies in which community health workers (CHWs) were trained to provide neonatal care reported reductions in neonatal mortality. These programmes required more resources than may be available in some resource-poor settings. We implemented a brief and inexpensive programme to train rural Kenyan CHWs to evaluate newborn infants for signs of severe illness during the first week of life and refer the ill infants to a health facility. During the first 12 months, 20 CHWs visited 702 infants, and all three visits were completed for 93% of the infants. There were five neonatal deaths, none after the first week of life. A brief low-cost training programme for CHW home visitation of newborns is feasible for rural Kenya and the larger African setting.