An overview of Personalized Medicine landscape and policies in the European Union.

BACKGROUND: The spread of Personalized Medicine (PM) over the last decade defined a revolution in healthcare systems. PM is among the priorities of the European Commission's research agenda, which funded the IC2PerMed international project aiming to integrate China into the International Consortium of PM (ICPerMed). In the context of this project, we mapped the existing policies related to PM in the European Union (EU) and at the EU Member States (EU-MS) level. METHODS: PubMed, Google Scholar, Google, Microsoft and national and international institutions' official repositories were searched in order to identify documents on PM-related policies, programmes and action plans at the EU and EU-MS level, published up to December 2020. RESULTS: We identified 28 policies in the EU aimed at improving public health promoting and fostering PM implementation, through some actions including the standardization of good medical practice, use of big data and digital innovation, data sharing and cross-border interoperability, healthcare sustainability, disease prevention and patients'/citizens' engagement. We identified 23 policies at EU-MS level which, notwithstanding national differences, have a common focus, such as patient-tailored treatment and targeted prevention, education of healthcare workers, research and innovation, big data harmonization and healthcare system sustainability. CONCLUSIONS: The definition of an integrated regulatory framework is essential to turn PM into an opportunity for citizens and patients with the involvement of all the stakeholders. This work can provide a valuable tool for decision-makers to define common approaches, priorities for research, development and increase international collaboration, which could overcome the fragmented European scenario and align the future direction on PM.

Spatiotemporal distribution of a non-haematophagous bat community and rabies virus circulation: a proposal for urban rabies surveillance in Brazil.

In Brazil, rabies surveillance is based on monitoring domestic and wild animals, although the most prevalent lineage of the rabies virus (RABV) currently diagnosed in Brazil is associated with bats, particularly non-haematophagous bats. Disease control is based on the mass vaccination of dogs and cats. We used data collected by the passive surveillance system of the city of Campinas from 2011 to 2015, to describe the temporal and geographic distributions of the bat specimens and RABV and discuss the current rabies surveillance with the advent of the declaration of canine and feline rabies-free areas in Brazil. We described the species, locations and health statuses of the collected bat specimens. Moreover, all samples were submitted for RABV diagnosis. Then, we performed a time series decomposition for each bat family. Additionally, we determined the spatiotemporal relative risk for RABV infection using the ratio of the kernel-smoothed estimates of spatiotemporal densities of RABV-positive and RABV-negative bats. From the 2537 bat specimens, the most numerous family was Molossidae (72%), followed by Vespertilionidae (14%) and Phyllostomidae (13%). The bat families behaved differently in terms of seasonal and spatial patterns. The distribution of bats varied geographically in the urban environment, with Molossidae and Phyllostomidae being observed downtown and Vespertilionidae being observed in peripheral zones. Concurrently, a significant relative risk of RABV infection was observed downtown for Vespertilionidae and in peripheral zones for Molossidae. No RABV-positive sample clusters were observed. As a result of the official declaration of RABV-free areas in southern Brazil, mass dog and cat vaccinations are expected to halt in the near future. This stoppage would make most dog and cat populations susceptible to other RABV lineages, such as those maintained by non-haematophagous bats. In this scenario, all information available on bats and RABV distribution in urban areas is essential. Currently, few studies have been conducted. Some local health authorities, such as that in Campinas, are spontaneously basing their surveillance efforts on bat rabies, which is the alternative in reality scenario of increased susceptibility to bat-associated RABV that is developing in Brazil.

Heart Rate and Perceived Experience Differ Markedly for Children in Same- versus Mixed-Gender Soccer Played as Small- and Large-Sided Games.

This study examines heart rate (HR) and perceived experience during same- versus mixed-gender soccer played as small- (SSG) and large-sided (LSG) games. HR, rating of perceived exertion (RPE), and fun scores were determined in 134 pupils (50 girls, 84 boys) randomly assigned to same- and mixed-genders formats playing 2x15-min of SSG (2v2, 4v4) and LSG (12v12) in a random order (~50 m2/player). HR was lower (p≤0.03) for girls when playing together with boys than when playing alone (71±10 versus 77±7%HRmax), while being similar for boys playing mixed- or same-gender games (74±7 versus 77±4%HRmax). Boys perceived less fun when playing together with girls than when playing alone (4.4±2.3 versus 6.3±2.3, p<0.001). Irrespective of gender, higher (p<0.001) HRmean, %time>80%HRmax, and RPE were observed during 2v2 (78±9%HRmax, 43±33%, 5.5±2.5) and 4v4 (76±9%HRmax, 39±32%, 5.5±2.7) than during 12v12 (70±10%HRmax, 23±27%, 3.8±2.9). Cardiovascular strain was lower for girls when playing together with boys than when playing alone in LSG. SSG were more intense than LSG when girls played mixed-gender games and when boys played mixed- and same-gender games. When boys played mixed-gender games, SSG were considered more fun than LSG. Physical education teachers and coaches should consider gender and game format differences when using soccer.

Acute and Residual Soccer Match-Related Fatigue: A Systematic Review and Meta-analysis.

BACKGROUND: Understanding soccer players' match-related fatigue and recovery profiles likely helps with developing conditioning programs that increase team performance and reduce injuries and illnesses. In order to improve match recovery (the return-to-play process and ergogenic interventions) it is also pivotal to determine if match simulation protocols and actual match-play lead to similar responses. OBJECTIVES: (1) To thoroughly describe the development of fatigue during actual soccer match play and its recovery time course in terms of physiological, neuromuscular, technical, biochemical and perceptual responses, and (2) to determine similarities of recovery responses between actual competition (11 vs. 11) and match simulations. METHODS: A first screening phase consisted of a systematic search on PubMed (MEDLINE) and SportDiscus databases until March 2016. Inclusion criteria were: longitudinal study with soccer players; match or validated protocol; duration > 45 min; and published in English. RESULTS: A total of 77 eligible studies (n = 1105) were used to compute 1196 effect sizes (ES). Half-time assessments revealed small to large alterations in immunological parameters (e.g. leukocytes, ES = 1.9), a moderate decrement in insulin concentration (ES = - 0.9) and a small to moderate impairment in lower-limb muscle function (ES = - 0.5 to - 0.7) and physical performance measures (e.g. linear sprint, ES = - 0.3 to - 1.0). All the systematically analyzed fatigue-related markers were substantially altered at post-match. Hamstrings force production capacity (ES = - 0.7), physical performance (2-4%, ES = 0.3-0.5), creatine kinase (CK, ES = 0.4), well-being (ES = 0.2-0.4) and delayed onset muscle soreness (DOMS, ES = 0.6-1.3) remained substantially impaired at G + 72 h. Compared to simulation protocols, 11 vs. 11 match format (CK, ES = 1.8) induced a greater magnitude of change in muscle damage (i.e. CK, ES = 1.8 vs. 0.7), inflammatory (IL-6, ES = 2.6 vs. 1.1) and immunological markers and DOMS (ES = 1.5 vs. 0.7) than simulation protocols at post-assessments. Neuromuscular performances at post-match did not differ between protocols. CONCLUSION: While some parameters are fully recovered (e.g. hormonal and technical), our systematic review shows that a period of 72 h post-match play is not long enough to completely restore homeostatic balance (e.g. muscle damage, physical and well-being status). The extent of the recovery period post-soccer game cannot consist of a 'one size fits all approach'. Additionally, the 'real match' (11 vs. 11 format) likely induces greater magnitudes of perceptual (DOMS) and biochemical alterations (e.g. muscle damage), while neuromuscular alterations were essentially similar. Overall, coaches must adjust the structure and content of the training sessions during the 72-h post-match intervention to effectively manage the training load within this time-frame.

Anthropometric and physiological characteristics of Melanesian futsal players: a first approach to talent identification in Oceania.

This study assessed the anthropometric and physiological characteristics of elite Melanesian futsal players in order to determine the best performance predictors. Physiological parameters of performance were measured in 14 Melanesian (MEL-G, 24.4±4.4 yrs) and 8 Caucasian (NMEL-G, 22.9±4.9) elite futsal players, using tests of jump-and-reach (CMJ), agility (T-Test), repeated sprint ability (RSA), RSA with change-of-direction (RSA-COD), sprints with 5 m, 10 m, 15 m, and 30 m lap times, and aerobic fitness with the 30-15 intermittent fitness test (30-15 IFT). The anthropometric data revealed significantly lower height for MEL-G compared with NMEL-G: 1.73±0.05 and 1.80±0.08 m, respectively; P = 0.05. The CMJ was significantly higher for MEL-G than NMEL-G: 50.4±5.9 and 45.2±4.3 cm, respectively; P = 0.05. T-Test times were significantly lower for MEL-G than NMEL-G: 10.47±0.58 and 11.01±0.64 seconds, respectively; P = 0.05. MEL-G height was significantly related to CMJ (r = 0.706, P = 0.01), CMJpeakP (r = 0.709, P = 0.01) and T-Test (r = 0.589, P = 0.02). No significant between-group differences were observed for sprint tests or 30-15 IFT, including heart rate and estimated VO2max. Between groups, the percentage decrement (%Dec) in RSA-COD was significantly lower in MEL-G than NMEL-G (P = 0.05), although no significant difference was noted between RSA and RSA-COD. Within groups, no significant difference was observed between %Dec in RSA or RSA-COD; P = 0.697. This study presents specific anthropometric (significantly lower height) and physiological (significantly greater agility) reference values in Melanesians, which, taken together, might help coaches and physical fitness trainers to optimize elite futsal training and talent identification in Oceania.

External Responsiveness of the Yo-Yo IR Test Level 1 in High-level Male Soccer Players.

The aim of this study was to assess the external responsiveness, construct validity and internal responsiveness of the Yo-Yo Intermittent Recovery test level 1 and its sub-maximal version in semi-professional players. Tests and friendly matches were performed during the preseason and regular season. The distance covered above 15 km·h(-1) was considered as an indicator of the physical match performance. Construct validity and external responsiveness were examined by correlations between test and physical match performance (preseason and regular season) and training-induced changes. Internal responsiveness was determined as Cohen's effect size, standardized response mean and signal-to-noise ratio. The physical match performance increased after training (34.8%). The Yo-Yo Intermittent Recovery test level 1 improved after training (40.2%), showed longitudinal (r=0.69) and construct validity (r=0.73 and 0.59, preseason and regular season) and had higher internal responsiveness compared to its sub-maximal version. The heart rate at the 6(th) minute in the sub-maximal version did not show longitudinal (r=-0.38) and construct validity (r=0.01 and -0.06, preseason and regular season) and did not significantly change after training (-0.3%). The rate of perceived exertion decreased in the sub-maximal version (- 29.8%). In conclusion, the Yo-Yo Intermittent Recovery test level 1 is valid and responsive, while the validity of its sub-maximal version is questionable.

Aerobic fitness and performance in elite female futsal players.

Despite its growing popularity, few studies have investigated specific physiological demands for elite female futsal. The aim of this study was to determine aerobic fitness in elite female futsal players using laboratory and field testing. Fourteen female futsal players from the Venezuelan National team (age =21.2±4.0 years; body mass =58.6±5.6 kg; height =161±5.0 cm) performed a progressive maximal treadmill test under laboratory conditions. Players also performed a progressive intermittent futsal-specific field test for endurance, the Futsal Intermittent Endurance Test (FIET), until volitional fatigue. Outcome variables were exercise heart rate (HR), VO2, post-exercise blood lactate concentrations ([La]b) and running speeds (km · h-1). During the treadmill test, VO2max, maximal aerobic speed (MAS), HR and peak [La]b were 45.3±5.6 ml · kg-1 · min-1, 12.5±1.77 km · h-1, 197±8 beats · min-1 and 11.3±1.4 mmol · l-1, respectively. The FIET total distance, peak running velocity, peak HR and [La]b were 1125.0±121.0 m, 15.2±0.5 km · h-1, 199±8 beats · min-1 and 12.5±2.2 mmol · l-1, respectively. The FIET distance and peak speed were strongly associated (r= 0.85-87, p < 0.0001) with VO2max and MAS, respectively. Peak HR and [La]b were not significantly different between tests. Elite female futsal players possess moderate aerobic fitness. Furthermore, the FIET can be considered as a valid field test to determine aerobic fitness in elite level female futsal players.

Evaluation of PCR in the diagnosis of canine leishmaniasis in two different epidemiological regions: Campinas (SP) and Teresina (PI), Brazil.

SUMMARY Using the polymerase chain reaction (PCR) test for diagnosis of canine leishmaniasis has greater sensitivity and specificity than culture and visualization of the parasite. This study compares PCR for the diagnosis of the genus and species of Leishmania with serological techniques used for the control of canine visceral leishmaniasis (CVL) in Brazil, considering two regions. We analysed peripheral blood samples collected from 195 dogs in the Campinas (SP) and Teresina (PI) regions. ELISA was performed as a serological method and PCR was performed using specific primers for the genus Leishmania spp. and the species Leishmania chagasi. In Campinas, a greater sensitivity of PCR (88.24%) (P = 0.0455) compared to Teresina (14.71%) (P < 0.0001) was observed, and an agreement was observed for Cohen's kappa index (0.9096). Both PCR and ELISA showed discordance for sensitivity (Campinas 100%, Teresina 21.74%), specificity (Campinas 30.77%, Teresina 100%), positive predictive value (Campinas 68.97%, Teresina 100%), negative predictive value (Campinas 100%, Teresina 37.94%) and Cohen's kappa index (0.1238). This study confirms the importance of PCR in analysis of the canine reservoir, and as an effective method for the detection of active and recent infection.

Effect of the number of sprint repetitions on the variation of blood lactate concentration in repeated sprint sessions.

The aim of the present study was to examine the effect of number of sprint repetitions on the variation of blood lactate concentration (blood [La]) during different repeated-sprint sessions in order to find the appropriate number of sprint repetitions that properly simulates the physiological demands of team sport competitions. Twenty male team-sport players (age, 22.2 ± 2.9 years) performed several repeated-sprint sessions (RSS) consisting of 1, 2, 3, 4, 5, 9, or 10 repetitions of 30 m shuttle sprints (2 × 15 m) with 30 s recovery in between. The blood [La] was obtained after 3 min of recovery at the end of each RSS. The present study showed that for RSS of 3 sprints (RSS3) there was a high increase (p<0.001) in blood [La], which reached approximately fivefold resting values (9.4±1.7 mmol · l(-1)) and then remained unchanged for the RSS of 4 and 5 sprints (9.6±1.4 and 10.5±1.9 mmol · l(-1), p=0.96 and 0.26, respectively). After RSS9 and RSS10 blood [La] further significantly increased to 12.6 and 12.7 mmol · l(-1), p<0.001, respectively. No significant difference was found between RSS3, RSS4 and RSS5 for the percentage of sprint speed decrement (Sdec) (1.5±1.2; 2.0±1.1 and 2.6±1.4%, respectively). There was also no significant difference between RSS9 and RSS10 for Sdec (3.9±1.3% and 4.5±1.4%, respectively). In conclusion, the repeated-sprint protocol composed of 5 shuttle sprint repetitions is more representative of the blood lactate demands of the team sports game intensity.

Stretch and sprint training reduces stretch-induced sprint performance deficits in 13- to 15-year-old youth.

The recently reported static stretching impairments found in adults have not been studied in youth. Furthermore, stretch-training effects on sprint performance are equivocal, hence the purpose of this study was to examine the effect of stretch and sprint training on the acute effects of static stretching in 13-15 year olds. A total of 48 students were randomly divided into a sprint only and a stretch and sprint training groups who performed static stretching at the beginning and middle of the speed training sessions (6 weeks). Flexibility tests and 30-m sprints were performed before and after training. Sprint performance was evaluated with and without prior stretching. A main effect indicated that prior static stretching impairs sprint times at 10 (P = 0.01) and 30 m (P = 0.0005). Both groups improved times over 10 (0.7%; P = 0.04) and 30-m (1.5%; P = 0.0007) sprint distance after training. Stretch and sprint trained participants were more resistant to stretch-induced sprint deficits with 3.2% (P < 0.0001), 3.6% (P = 0.0002) and 1.3% (P < 0.0001) faster times at 5, 10, and 30 m, respectively, than the sprint only group. In conclusion, a stretch and sprint training program in 13-15 year olds diminished the detrimental effects of static stretching compared to a sprint only training program.

Validity of a repeated-sprint test for football.

Three studies involving 108 football players were conducted to examine the reliability of a repeated-shuttle-sprint ability (RSSA) test and its ability to differentiate between players of various competitive levels and playing positions. Study 1: Short-term reliability was determined in 22 professional players completing the RSSA test (6 x 40-m sprints with 20 s of recovery between sprints) on two separate occasions. Study 2: Long-term reliability (seasonal changes) was examined in 31 professional players completing the RSSA test four times (during the preseason period, at the start, middle and end of the competitive season). Study 3: 108 players were divided and compared according to competitive level or playing position. Standard error of measurement values expressed as coefficient of variation for RSSA mean time and best time were 0.8 and 1.3 % (short-term reliability) and 0.9 and 1.2 % (long-term reliability), respectively. The smallest worthwhile changes were 0.5 % for both mean and best time. Professional players showed better RSSA performance than amateur players, and defenders displayed the lowest RSSA performance. In conclusion, the RSSA test showed adequate construct validity but only RSSA mean time showed sufficient reliability to detect large training-induced changes but not small important differences.

Sprint vs. interval training in football.

The aim of this study was to compare the effects of high-intensity aerobic interval and repeated-sprint ability (RSA) training on aerobic and anaerobic physiological variables in male football players. Forty-two participants were randomly assigned to either the interval training group (ITG, 4 x 4 min running at 90 - 95 % of HRmax; n = 21) or repeated-sprint training group (RSG, 3 x 6 maximal shuttle sprints of 40 m; n = 21). The following outcomes were measured at baseline and after 7 weeks of training: maximum oxygen uptake, respiratory compensation point, football-specific endurance (Yo-Yo Intermittent Recovery Test, YYIRT), 10-m sprint time, jump height and power, and RSA. Significant group x time interaction was found for YYIRT (p = 0.003) with RSG showing greater improvement (from 1917 +/- 439 to 2455 +/- 488 m) than ITG (from 1846 +/- 329 to 2077 +/- 300 m). Similarly, a significant interaction was found in RSA mean time (p = 0.006) with only the RSG group showing an improvement after training (from 7.53 +/- 0.21 to 7.37 +/- 0.17 s). No other group x time interactions were found. Significant pre-post changes were found for absolute and relative maximum oxygen uptake and respiratory compensation point (p < 0.05). These findings suggest that the RSA training protocol used in this study can be an effective training strategy for inducing aerobic and football-specific training adaptations.

Effect of plyometric training on sand versus grass on muscle soreness and jumping and sprinting ability in soccer players.

OBJECTIVE: The lower impact on the musculoskeletal system induced by plyometric exercise on sand compared to a firm surface might be useful to reduce the stress of intensified training periods or during rehabilitation from injury. The aim of this study was to compare the effects of plyometric training on sand versus a grass surface on muscle soreness, vertical jump height and sprinting ability. DESIGN: Parallel two-group, randomised, longitudinal (pretest-post-test) study. METHODS: After random allocation, 18 soccer players completed 4 weeks of plyometric training on grass (grass group) and 19 players on sand (sand group). Before and after plyometric training, 10 m and 20 m sprint time, squat jump (SJ), countermovement jump (CMJ), and eccentric utilization ratio (CMJ/SJ) were determined. Muscle soreness was measured using a Likert scale. RESULTS: No training surface x time interactions were found for sprint time (p>0.87), whereas a trend was found for SJ (p = 0.08), with both groups showing similar improvements (p<0.001). On the other hand, the grass group improved their CMJ (p = 0.033) and CMJ/SJ (p = 0.005) significantly (p<0.001) more than players in the sand group. In contrast, players in the sand group experienced less muscle soreness than those in the grass group (p<0.001). CONCLUSIONS: Plyometric training on sand improved both jumping and sprinting ability and induced less muscle soreness. A grass surface seems to be superior in enhancing CMJ performance while the sand surface showed a greater improvement in SJ. Therefore, plyometric training on different surfaces may be associated with different training-induced effects on some neuromuscular factors related to the efficiency of the stretch-shortening cycle.

Variation in top level soccer match performance.

This study examined the influence of the opposing team, seasonal variations and the influence of first half activity on match performance in top-level soccer players. Physical performance measures were collected using the ProZone match analysis system from 20 professional soccer players from the same team and their opponents (n = 188) during a season. Match activities (standing, walking, jogging, running, high-speed running and sprinting), distances (total distance [TD], high-intensity running [HIR] and very high-intensity running [VHIR]) and other measures including involvement with the ball and peak running speed were collected. The influence of opponent team, the level of opposition, first half physical activities on second half activities, and playing position were analysed. The main finding was that TD (r = 0.62, p < 0.05), HIR (r = 0.51, p < 0.05), and VHIR (r = 0.65, p < 0.05) of the reference team was influenced by the activity profile of the opponent teams. The TD and HIR was higher against Best opponent teams compared to Worst opponent teams (p < 0.05), and the TD, HIR and VHIR travelled in the first half significantly influenced the distances covered in the second half. TD, HIR and VHIR were greater at the end of the season. These results may be used to interpret meaningful changes in match performance in top level soccer.

Physiological and performance effects of generic versus specific aerobic training in soccer players.

The aim of this study was to compare the effects of specific (small-sided games) vs. generic (running) aerobic interval training on physical fitness and objective measures of match performance in soccer. Forty junior players were randomly assigned to either generic (n=20) or specific (n=20) interval training consisting of 4 bouts of 4 min at 90-95 % of maximum heart rate with 3 min active rest periods, completed twice a week. The following outcomes were measured at baseline (Pre), after 4 weeks of pre-season training (Mid), and after a further 8 weeks of training during the regular season (Post): maximum oxygen uptake, lactate threshold (Tlac), running economy at Tlac, a soccer-specific endurance test (Ekblom's circuit), and indices of physical performance during soccer matches (total distance and time spent standing, walking, and at low- and high-intensity running speed). Training load, as quantified by heart rate and rating of perceived exertion, was recorded during all training sessions and was similar between groups. There were significant improvements in aerobic fitness and match performance in both groups of soccer players, especially in response to the first 4 weeks of pre-season training. However, no significant differences between specific and generic aerobic interval training were found in any of the measured variables including soccer specific tests. The results of this study showed that both small-sided games and running are equally effective modes of aerobic interval training in junior soccer players.

The effect of match standard and referee experience on the objective and subjective match workload of English Premier League referees.

The aim of the present study was to examine the effect of match standard and referee experience on the objective and subjective workload of referees during English Premier League and Football League soccer matches. We also examined the relationship between heart rate (HR) and ratings of perceived exertion (RPE) for assessing match intensity in soccer referees. Heart rate responses were recorded using short-range telemetry and RPE scores were collected using a 10-point scale. Analysis revealed a significant relationship between mean match HR and match RPE scores (r=0.485, p<0.05, n=18). There were significant differences in match HR (Premier League 83.6+/-2.6% maximal HR (HRmax) versus Football League 81.5+/-2.2%HRmax, p<0.05) and match RPE scores (Premier League 7.8+/-0.8 versus Football League 6.9+/-0.8, p<0.05) between standards of competition. Referee experience had no effect on match HR and RPE responses to Premier League and Football League matches. The results of the present study demonstrate the validity of using HR and RPE as a measure of global match intensity in soccer referees. Referee experience had no effect on the referees' objective and subjective match workload assessments, whereas match intensity was correlated to competition standard. These findings have implications for fitness preparation and evaluation in soccer referees. When progressing to a higher level of competition, referees should ensure that appropriate levels of fitness are developed in order to enable them to cope with an increase in physical match demands.

Strong correlation of maximal squat strength with sprint performance and vertical jump height in elite soccer players.

BACKGROUND: A high level of strength is inherent in elite soccer play, but the relation between maximal strength and sprint and jumping performance has not been studied thoroughly. OBJECTIVE: To determine whether maximal strength correlates with sprint and vertical jump height in elite male soccer players. METHODS: Seventeen international male soccer players (mean (SD) age 25.8 (2.9) years, height 177.3 (4.1) cm, weight 76.5 (7.6) kg, and maximal oxygen uptake 65.7 (4.3) ml/kg/min) were tested for maximal strength in half squats and sprinting ability (0-30 m and 10 m shuttle run sprint) and vertical jumping height. RESULT: There was a strong correlation between maximal strength in half squats and sprint performance and jumping height. CONCLUSIONS: Maximal strength in half squats determines sprint performance and jumping height in high level soccer players. High squat strength did not imply reduced maximal oxygen consumption. Elite soccer players should focus on maximal strength training, with emphasis on maximal mobilisation of concentric movements, which may improve their sprinting and jumping performance.

Prenatal diagnosis after ART success: the role of early combined screening tests in counselling pregnant patients.

First-trimester Down syndrome screening may cause a higher false positive rate in pregnant patients who have undergone ART (assisted reproductive technologies). The aim of this paper is to contribute to this analysis with the second largest series of combined biophysical and biochemical tests in the first trimester of pregnancy after ART. One hundred and forty-two singleton successful ART pregnancies were selected for this study: 50 pregnancies induced by using in-vitro fertilization (IVF), and 92 using intracytoplasmic sperm injection (ICSI). Each patient was matched with three naturally conceived pregnancies based on maternal age and gestational age. Free beta-HCG and PAPP-A were measured on dried blood spots and converted to MoMs. Nuchal translucency (NT) was measured by certified operators. Mean maternal age was 33 +/- 4. NT, free beta-HCG and PAPP-A values of the control cases were not significantly different from local standards evaluated on 3043 cases. NT between ART pregnancies and matched controls was not significantly different. PAPP-A was reduced but not significantly lower in ART pregnancies. Free beta-HCG was the only analyte that resulted in significantly higher values in ART pregnancies (1.12 MoM) versus controls (0.99 MoM). No significant differences were found for biochemical values observed between ICSI and IVF patients. The screen positive rates observed in ART and control pregnancies were 5.5 per cent and 4.6 per cent respectively. NT measurements were not affected by ART pregnancies. Our results (non-significant lower values of PAPP-A and significantly higher free beta-HCG values) were consistent with other reported series. The increase in the screen positive rate determined by these biological variations was not greater than 0.9 per cent. This higher false positive rate has a negligible impact on counselling ART patients. The algorithm used to calculate the relative risk after the combined tests should not be changed until the detection rate of trisomies in ART pregnancies is not fully disclosed by larger series.

The effect of post-ovulatory artificial insemination on sow reproductive performance.

In order to increase reproductive performance, sows are usually inseminated several times during oestrus. In practice, this results in a significant number of sows receiving one or more post-ovulatory inseminations. This study was carried out to determine the percentage of sows that receive one or more post-ovulatory inseminations and the effect of such treatment on reproductive performance. The results were analysed from a total of 1298 sows on two farms. It was observed that more than 70% of the sows received at least one post-ovulatory insemination and approximately 20% received two or more. There was no observed effect on the rate of return to oestrus, farrowing rate or litter size (p > 0.05).