Enucleated egg donation: why is it important to understand the attitudes of women on donating enucleated eggs?

Enucleated egg donation is increasingly used for mitochondrial replacement therapy and in assisted conception to improve the success rate for women with recurrent IVF failure. With the possibility of a future increase in demand for enucleated egg donation, it is important to understand the attitudes of the general public and egg donors towards it. This Viewpoint elaborates on the general public's and donors' perspectives on important aspects of enucleated egg donation that need to be explored, and points towards the areas that need to be researched in the future.

Analysing the behavioural, psychological, and demographic determinants of financial decision making of household investors.

Adding to the behavioural science domain, the principal idea behind the study is to investigate the impact of an array of behavioural, psychological, and demographic factors on financial decision making. The study utilizes a structured questionnaire to collect the opinions of 634 investors using a blend of random and snowball sampling techniques. The partial least squares structural equation modelling has been used to test hypotheses. PLS Predict has been applied to estimate the out-of-sample predictive power of the proposed model. Finally, the multi-group analysis has been applied to assess the differences across gender. Our findings attest the relevance of digital financial literacy, financial capability, financial autonomy, and impulsivity on financial decision making. Additionally, financial capability partially mediates the nexus between digital financial literacy and financial decision making. Also, Impulsivity negatively moderates the relationship between financial capability and financial decision making. The overall results of this comprehensive and unique study portray the influence that various psychological, behavioural, and demographic factors have on financial decision making, favouring the design of a feasible and lucrative financial portfolio to ensure financial well-being of households in the long run.

Immunohistochemical expression of cyclooxygenase-2 in oral lichen planus and normal oral mucosa.

BACKGROUND: Oral lichen planus (OLP) is a chronic inflammatory disease for which the pathogenesis is complex and not fully understood; autoimmunity has been suggested as a causative factor. World health organization (WHO) has classified OLP as a potentially malignant lesion. Cyclooxygenase-2 (COX-2) is an inducible key enzyme that generates prostanoids which play a critical role in inflammation, immunopathology; also considered as a malignant potential marker. AIMS: The present study was conducted to analyze and compare epithelial COX-2 expression in OLP clinical subtypes and normal oral mucosa to evaluate its role in the pathophysiology of the disease process. METHODS: This retrospective immunohistochemistry (IHC) study was performed on tissue sections of 30 OLP and 10 normal oral mucosae for COX-2 expression. STATISTICAL ANALYSIS USED: Descriptive and comparative statistical methods were done using 'one-way Analysis of Variance (ANOVA), 't' and Chi-square tests. RESULTS: All the OLP showed epithelial COX-2 expression; strong expression was noted in 80% of the OLP while normal oral mucosa sections showed no expression. Cox-2 expression was significantly higher in erosive lichen planus compared to reticular lichen planus. CONCLUSIONS: Strong expression of COX-2 in OLP suggested its important role in pathogenesis. Although COX-2 has been connected to malignant development and autoimmunity, as the malignant development in OLP is quite rare, this study suggests that increased levels of COX-2 seen here may support an autoimmune cause of the disease process.

Clinical Effects of the Self-administered Subcutaneous Complement Inhibitor Zilucoplan in Patients With Moderate to Severe Generalized Myasthenia Gravis: Results of a Phase 2 Randomized, Double-Blind, Placebo-Controlled, Multicenter Clinical Trial.

Importance: Many patients with generalized myasthenia gravis (gMG) have substantial clinical disability, persistent disease burden, and adverse effects attributable to chronic immunosuppression. Therefore, there is a significant need for targeted, well-tolerated therapies with the potential to improve disease control and enhance quality of life. Objective: To evaluate the clinical effects of zilucoplan, a subcutaneously (SC) self-administered macrocyclic peptide inhibitor of complement component 5, in a broad population of patients with moderate to severe gMG. Design, Setting, and Participants: This randomized, double-blind, placebo-controlled phase 2 clinical trial at 25 study sites across North America recruited participants between December 2017 and August 2018. Fifty-seven patients were screened, of whom 12 did not meet inclusion criteria and 1 was lost to follow-up after randomization but before receiving study drug, resulting in a total of 44 acetylcholine receptor autoantibody (AChR-Ab)-positive patients with gMG with baseline Quantitative Myasthenia Gravis (QMG) scores of at least 12, regardless of treatment history. Interventions: Patients were randomized 1:1:1 to a daily SC self-injection of placebo, 0.1-mg/kg zilucoplan, or 0.3-mg/kg zilucoplan for 12 weeks. Main Outcomes and Measures: The primary and key secondary end points were the change from baseline to week 12 in QMG and MG Activities of Daily Living scores, respectively. Significance testing was prespecified at a 1-sided α of .10. Safety and tolerability were also assessed. Results: The study of 44 patients was well balanced across the 3 treatment arms with respect to key demographic and disease-specific variables. The mean age of patients across all 3 treatment groups ranged from 45.5 to 54.6 years and most patients were white (average proportions across 3 treatment groups: 78.6%-86.7%). Clinically meaningful and statistically significant improvements in primary and key secondary efficacy end points were observed. Zilucoplan at a dose of 0.3 mg/kg SC daily resulted in a mean reduction from baseline of 6.0 points in the QMG score (placebo-corrected change, -2.8; P = .05) and 3.4 points in the MG Activities of Daily Living score (placebo-corrected change, -2.3; P = .04). Clinically meaningful and statistically significant improvements were also observed in other secondary end points, the MG Composite and MG Quality-of-Life scores. Outcomes for the 0.1-mg/kg SC daily dose were also statistically significant but slower in onset and less pronounced than with the 0.3-mg/kg dose. Rescue therapy (intravenous immunoglobulin or plasma exchange) was required in 3 of 15, 1 of 15, and 0 of 14 participants in the placebo, 0.1-mg/kg zilucoplan, and 0.3-mg/kg zilucoplan arms, respectively. Zilucoplan was observed to have a favorable safety and tolerability profile. Conclusions and Relevance: Zilucoplan yielded rapid, meaningful, and sustained improvements over 12 weeks in a broad population of patients with moderate to severe AChR-Ab-positive gMG. Near-complete complement inhibition appeared superior to submaximal inhibition. The observed safety and tolerability profile of zilucoplan was favorable. Trial Registration: ClinicalTrials.gov Identifier: NCT03315130.

Prediction of miscarriage in women with viable intrauterine pregnancy-A systematic review and diagnostic accuracy meta-analysis.

Both ultrasound and biochemical markers either alone or in combination have been described in the literature for the prediction of miscarriage. We performed this systematic review and meta-analysis to determine the best combination of biochemical, ultrasound and demographic markers to predict miscarriage in women with viable intrauterine pregnancy. The electronic database search included Medline (1946-June 2017), Embase (1980-June 2017), CINAHL (1981-June 2017) and Cochrane library. Key MESH and Boolean terms were used for the search. Data extraction and collection was performed based on the eligibility criteria by two authors independently. Quality assessment of the individual studies was done using QUADAS 2 (Quality Assessment for Diagnostic Accuracy Studies-2: A Revised Tool) and statistical analysis performed using the Cochrane systematic review manager 5.3 and STATA vs.13.0. Due to the diversity of the combinations used for prediction in the included papers it was not possible to perform a meta-analysis on combination markers. Therefore, we proceeded to perform a meta-analysis on ultrasound markers alone to determine the best marker that can help to improve the diagnostic accuracy of predicting miscarriage in women with viable intrauterine pregnancy. The systematic review identified 18 eligible studies for the quantitative meta-analysis with a total of 5584 women. Among the ultrasound scan markers, fetal bradycardia (n=10 studies, n=1762 women) on hierarchical summary receiver operating characteristic showed sensitivity of 68.41%, specificity of 97.84%, positive likelihood ratio of 31.73 (indicating a large effect on increasing the probability of predicting miscarriage) and negative likelihood ratio of 0.32. In studies for women with threatened miscarriage (n=5 studies, n=771 women) fetal bradycardia showed further increase in sensitivity (84.18%) for miscarriage prediction. Although there is gestational age dependent variation in the fetal heart rate, a plot of fetal heart rate cut off level versus log diagnostic odds ratio showed that at ≤110 beat per minutes the diagnostic power to predict miscarriage is higher. Other markers of intra uterine hematoma, crown rump length and yolk sac had significantly decreased predictive value. Therefore in women with threatened miscarriage and presence of fetal bradycardia on ultrasound scan, there is a role for offering repeat ultrasound scan in a week to ten days interval.

Sex determination efficacy of Papanicolaou and acriflavine Schiff stains in buccal smears.

BACKGROUND: Barr body is formed from random inactivation and condensation of one of the two female chromosomes in virtually all the somatic cells of female mammals. Buccal smears have been reported to be potential sources of Barr bodies. AIM: This study was done to assess the efficacy of acriflavine (AF) Schiff and Papanicolaou (PAP) stains in sex determination by identifying Barr bodies in buccal smears of both sexes. MATERIALS AND METHODS: Two samples of buccal smears, collected from thirty males and thirty females in the age group of 16-60 years were used to demonstrate Barr bodies using AF Schiff and PAP stains, respectively. Hundred cells were examined for Barr body positive nucleus, and its mean percentage was calculated and statistically analyzed. RESULTS: In females, AF Schiff stained positive cells ranged from 16% to 53% and PAP stained positive cells ranged from 9% to 38%. In males, 0-9% AF positive Barr bodies and 0-5% PAP stained Barr bodies were identified. CONCLUSION: Sex determination using buccal smear is a simple and reliable method. AF Schiff stain is better both qualitatively and quantitatively when compared to PAP stain, thus aids in more accurate sex determination.

Role of serum biomarkers in the prediction of outcome in women with threatened miscarriage: a systematic review and diagnostic accuracy meta-analysis.

BACKGROUND: Threatened miscarriage affects one in five women and is associated with significant emotional distress. The uncertainty around the prognosis of threatened miscarriage makes it equally challenging to the healthcare professionals. Various biochemical markers have been investigated in the past to predict the outcome of threatened miscarriage; however, the results have been conflicting. Therefore, we have conducted a systematic review and meta-analysis to determine the diagnostic accuracy of biochemical markers in predicting the outcome in women presenting with threatened miscarriage. METHODS: This is a systematic review and meta-analysis of prospective studies that investigated biochemical markers to determine outcomes for women with threatened miscarriage at 5-23 weeks gestational age. Electronic databases were searched up to June 2015 and study quality assessment was performed using QUADAS-2 (Quality Assessment for Diagnostic Accuracy Studies-2: A Revised Tool) for evaluating the diagnostic accuracy studies. Statistical analysis was performed using the Cochrane systematic review software. RESULTS: A total of 19 studies were included in the qualitative data synthesis of which 15 (including 1263 women) were eligible for the meta-analysis. The review highlights the role of biochemical markers serum progesterone, hCG, pregnancy associated plasma protein A, estradiol and cancer antigen 125 (CA 125) in the prediction of outcome in women with threatened miscarriage. Interestingly, serum CA 125 appears to be the most promising marker (n = 648 women in seven studies), whereas serum progesterone and hCG are less useful once fetal viability is established. The summary receiver operating characteristics for CA 125 showed a sensitivity of 90% (95% confidence interval (CI) 83-94%), specificity of 88% (95% CI 79-93%), positive likelihood ratio of 7.86 (95% CI 4.23-14.60) and negative likelihood ratio of 0.10 (95% CI 0.06-0.20). The inverse of negative likelihood ratio was 9.31 (95% CI 5-17.1) indicating that a negative test is likely to identify those who are likely to continue with the pregnancy. Serum estradiol was the next best marker with a sensitivity of 45% (95% CI 6-90%), a specificity of 87% (95% CI 81-92%), a positive likelihood ratio of 3.72 (95% CI 1.01-13.71) and a negative likelihood ratio of 0.62 (95% CI 0.20-1.84). CONCLUSIONS: In women with threatened miscarriage, serum CA 125 has high predictive value in identifying pregnancies that are 'likely to continue', whereas the most commonly used biomarkers of serum hCG and progesterone are not useful in predicting outcome of a pregnancy with a viable fetus. Other markers such as inhibin A and a combination of markers need to be investigated to hopefully improve the prediction of outcome in women with threatened miscarriage.

The effects of subtle misinformation in news headlines.

Information presented in news articles can be misleading without being blatantly false. Experiment 1 examined the effects of misleading headlines that emphasize secondary content rather than the article's primary gist. We investigated how headlines affect readers' processing of factual news articles and opinion pieces, using both direct memory measures and more indirect reasoning measures. Experiment 2 examined an even more subtle type of misdirection. We presented articles featuring a facial image of one of the protagonists, and examined whether the headline and opening paragraph of an article affected the impressions formed of that face even when the person referred to in the headline was not the person portrayed. We demonstrate that misleading headlines affect readers' memory, their inferential reasoning and behavioral intentions, as well as the impressions people form of faces. On a theoretical level, we argue that these effects arise not only because headlines constrain further information processing, biasing readers toward a specific interpretation, but also because readers struggle to update their memory in order to correct initial misconceptions. Practical implications for news consumers and media literacy are discussed. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

An insight into internal resorption.

Internal resorption, a rare phenomenon, has been a quandary from the standpoints of both its diagnosis and treatment. It is usually asymptomatic and discovered by chance on routine radiographic examinations or by a classic clinical sign, "pink spot" in the crown. This paper emphasizes the etiology and pathophysiologic mechanisms involved in internal root resorption. Prognosis is good for smaller lesions; however, for those with extensive resorption associated with perforation the tooth structure is greatly weakened and the prognosis remains poor.

Aberrant ß-catenin expression in the histologic differentiation of oral squamous cell carcinoma and verrucous carcinoma: an immunohistochemical study.

ß-Catenin acts as a structural protein at cell-cell adherens junctions and as a transcription activator mediating Wnt signal transduction. Altered ß-catenin expression has been associated with loss of cell differentiation and acquisition of an invasive phenotype. In the present study, ß-catenin expression was compared immunohistochemically between oral squamous cell carcinoma (30 cases) and verrucous carcinoma (30 cases), and correlated with different histological grades of oral squamous cell carcinoma. Positivity for ß-catenin was seen in 17 cases (56.6%) of oral squamous cell carcinoma and 25 cases (83.3%) of verrucous carcinoma, and was significantly correlated with the grade of oral squamous cell carcinoma, whereas no significant correlation of ß-catenin expression was observed between oral squamous cell carcinoma and verrucous carcinoma. In oral squamous cell carcinoma, the number of ß-catenin-positive cases and the intensity of expression decreased as cancers became more poorly differentiated. Decreased membranous localization and intense cytoplasmic staining were observed in poorly differentiated squamous cell carcinoma. In verrucous carcinoma, ß-catenin was demonstrable mainly in the membrane. Down-regulation of ß-catenin was significantly correlated with lack of differentiation in oral squamous cell carcinoma. Reduced membranous expression and predominant cytoplasmic localization were prominent among higher-grade tumors, suggesting stabilization of ß-catenin and its role as a signaling molecule. Predominant membranous expression in verrucous carcinoma was similar to that observed in well differentiated squamous cell carcinoma, thus corroborating its role in cell adhesion in these subgroups.

Children having children: Outcome of extreme teenage pregnancies (13-15 years).

A case-control study was conducted to compare obstetric and fetal outcomes of teenage mothers 0.05) at similar gestations (39+/-4 weeks vs. 39+/-2 weeks vs. 39+/-3 weeks, p >0.05).

Application of a rule-based model to estimate mercury exchange for three background biomes in the continental United States.

Ecosystems that have low mercury (Hg) concentrations (i.e., not enriched or impacted by geologic or anthropogenic processes) cover most of the terrestrial surface area of the earth yet their role as a net source or sink for atmospheric Hg is uncertain. Here we use empirical data to develop a rule-based model implemented within a geographic information system framework to estimate the spatial and temporal patterns of Hg flux for semiarid deserts, grasslands, and deciduous forests representing 45% of the continental United States. This exercise provides an indication of whether these ecosystems are a net source or sink for atmospheric Hg as well as a basis for recommendation of data to collect in future field sampling campaigns. Results indicated that soil alone was a small net source of atmospheric Hg and that emitted Hg could be accounted for based on Hg input by wet deposition. When foliar assimilation and wet deposition are added to the area estimate of soil Hg flux these biomes are a sink for atmospheric Hg.

An association of purple urine bag syndrome with intussusception.

We report a case of an elderly lady with a long-term suprapubic catheter who developed purple discoloration of urine around the same time as she developed intussusception. Purple urine bag syndrome is a benign condition known to be associated with intestinal stasis. However, this association with intussusception should be kept in mind before the patient is reassured.

Cytokine-related genes identified from the RIKEN full-length mouse cDNA data set.

To identify novel cytokine-related genes, we searched the set of 60,770 annotated RIKEN mouse cDNA clones (FANTOM2 clones), using keywords such as cytokine itself or cytokine names (such as interferon, interleukin, epidermal growth factor, fibroblast growth factor, and transforming growth factor). This search produced 108 known cytokines and cytokine-related products such as cytokine receptors, cytokine-associated genes, or their products (enhancers, accessory proteins, cytokine-induced genes). We found 15 clusters of FANTOM2 clones that are candidates for novel cytokine-related genes. These encoded products with strong sequence similarity to guanylate-binding protein (GBP-5), interleukin-1 receptor-associated kinase 2 (IRAK-2), interleukin 20 receptor alpha isoform 3, a member of the interferon-inducible proteins of the Ifi 200 cluster, four members of the membrane-associated family 1-8 of interferon-inducible proteins, one p27-like protein, and a hypothetical protein containing a Toll/Interleukin receptor domain. All four clones representing novel candidates of gene products from the family contain a novel highly conserved cross-species domain. Clones similar to growth factor-related products included transforming growth factor beta-inducible early growth response protein 2 (TIEG-2), TGFbeta-induced factor 2, integrin beta-like 1, latent TGF-binding protein 4S, and FGF receptor 4B. We performed a detailed sequence analysis of the candidate novel genes to elucidate their likely functional properties.