Safety issues in semen banks during the COVID-19 pandemic: data from a European survey.

PURPOSE: We performed a survey among European semen banks enquiring safety protocols during the COVID-19 pandemic. We report the experience from a center searching SARS-CoV-2 mRNA in semen of patients undergoing cryopreservation from May 2020 to January 2021. METHODS: A questionnaire was submitted to accredited semen banks of the European Academy of Andrology (EAA) and the Italian Society of Andrology and Sexual Medicine (SIAMS). A total of 22 centers answered to the survey. SARS-CoV-2 mRNA in semen was evaluated by RT-PCR in 111 subjects banking in the Semen Bank of Careggi University Hospital (Florence, Italy). RESULTS: No particularly drastic safety measures were adopted by the majority of the centers to prevent the risk of contamination or transmission of the virus. The most common strategy (77.3%) was the administration of an anamnestic questionnaire. About half of the centers request a negative nasopharyngeal swab (NPS) before cryopreservation. Few centers use a quarantine tank, in case of late response of NPS, and only 4 store in a dedicated tank in case of infection. SARS-CoV-2 mRNA was not found in 111 semen samples cryopreserved in the Florentine bank. CONCLUSIONS: European semen banks use different measures to handle semen samples for cryopreservation during COVID-19 pandemic. The request of NPS is advised to better manage couples undergoing ART and to protect the personnel operating in the bank/ART center. Finally, due to the areas of uncertainties of an almost unknown virus, it is absolutely recommended the use of safe devices for sample handling and storage.

Economic evaluation of the Very Early Rehabilitation in SpEech (VERSE) intervention.

INTRODUCTION: There is limited evidence on the costs and outcomes of patients with aphasia after stroke. The aim of this study was to estimate costs in patients with aphasia after stroke according to the aphasia therapies provided. METHODS: A three-arm, prospective, randomized, parallel group, open-label, blinded endpoint assessment trial conducted in Australia and New Zealand. Usual ward-based care (Usual Care) was compared to additional usual ward-based therapy (Usual Care Plus) and a prescribed and structured aphasia therapy program in addition to Usual Care (the VERSE intervention). Information about healthcare utilization and productivity were collected to estimate costs in Australian dollars for 2017-18. Multivariable regression models with bootstrapping were used to estimate differences in costs and outcomes (clinically meaningful change in aphasia severity measured by the WAB-R-AQ). RESULTS: Overall, 202/246 (82%) participants completed follow-up at 26 weeks. Median costs per person were $23,322 (Q1 5,367, Q3 52,669, n = 63) for Usual Care, $26,923 (Q1 7,303, Q3 76,174, n = 70) for Usual Care Plus and $31,143 (Q1 7,001. Q3 62,390, n = 69) for VERSE. No differences in costs and outcomes were detected between groups. Usual Care Plus was inferior (i.e. more costly and less effective) in 64% of iterations, and in 18% was less costly and less effective compared to Usual Care. VERSE was inferior in 65% of samples and less costly and less effective in 12% compared to Usual Care. CONCLUSION: There was limited evidence that additional intensively delivered aphasia therapy within the context of usual acute care provided was worthwhile in terms of costs for the outcomes gained.

Increased food intake stimulates GnRH-I, glycoprotein hormone alpha-subunit and follistatin mRNAs, and ovarian follicular numbers in laying broiler breeder hens.

The aim of this study, in 36 week-old laying broiler breeder hens, was to establish the effects on reproductive neuroendocrine gene expression of reinstating ad libitum food intake after moderate food restriction from 2 weeks of age. Seven days of ad libitum feeding increased the number of large pre-ovulatory ovarian follicles and gonadotropin releasing hormone-I (GnRH-I), glycoprotein hormone alpha-subunit and follistatin mRNAs. Plasma luteinizing hormone (LH) was also increased while plasma follicle-stimulating hormone (FSH) was reduced. There were no associated changes in gonadotropin inhibitory hormone (GnIH), LHbeta or FSHbeta mRNAs. The mechanism underlying the increased expression of alpha-subunit and follistatin mRNAs was investigated in vitro by incubating pituitary fragments with pulses of GnRH-I. This treatment increased alpha-subunit and follistatin mRNAs but did not affect gonadotropin beta-subunit mRNAs. It is concluded that lifting food restriction in laying hens increases GnRH-I gene transcription or mRNA stability which may be a consequence, or cause of increased GnRH-I release. This, in turn, increases glycoprotein hormone alpha-subunit and follistatin mRNAs, resulting in increased plasma LH and decreased plasma FSH, respectively.

Missing voices: Profile and extent of acquired communication disorders in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia using linked administrative records.

BACKGROUND: Limited data exist on the extent of specific functional sequelae, including acquired communication disorder, among Aboriginal stroke survivors, making planning of multidisciplinary services difficult. AIMS: To obtain estimates of the extent and profile of acquired communication disorder in Aboriginal and non-Aboriginal adult stroke survivors in Western Australia and investigate potential disparities in receiving in-hospital speech pathology services among survivors with acquired communication disorder. METHODS: Stroke cases surviving their first stroke episode during 2002-2011 were identified using Western Australia-wide person-based linked hospital and mortality data, and their five-year comorbidity profiles determined. The mid-year prevalence of stroke cases with acquired communication disorder was estimated for 2011. Regression methods were used to investigate determinants of receiving speech pathology services among acquired communication disorder cases. RESULTS: Of 14,757 stroke survivors aged 15-79 years admitted in 2002-2011, 33% had acquired communication disorder (22% aphasia/dysphasia) and 777 (5.3%) were Aboriginal. Aboriginal patients were more likely to be younger, live remotely, and have comorbidities. A diagnosis of aphasia was more common in Aboriginal than non-Aboriginal patients 15-44 years (p = 0.003). A minimum of 107 Aboriginal and 2324 non-Aboriginal stroke patients with acquired communication disorder lived in Western Australia in 2011. Aboriginal status was not associated with receiving in-hospital speech services among acquired communication disorder patients in unadjusted or adjusted models. CONCLUSIONS: The relative youth, geographical distribution, high comorbidity prevalence, and cultural needs of Aboriginal stroke patients with acquired communication disorder should inform appropriate service design for speech pathology and rehabilitation. Innovative models are required to address workforce issues, given low patient volumes.

Incidence and significance of cryptic chromosome aberrations detected by fluorescence in situ hybridization in acute myeloid leukemia with normal karyotype.

To better define the incidence and significance of cryptic chromosome lesions in acute myeloid leukemia (AML), fluorescence in situ hybridization (FISH) studies were performed in interphase cells and, when appropriate, in metaphase cells and in morphologically intact BM smears. Fifty-five adult de novo AML (group A) and 27 elderly AML or AML after myelodysplastic syndrome (AML-MDS) (group B) were tested using probes detecting the following anomalies: -5, -7, +8, deletions of 5q31, 7q31, 12p13/ETV6, 17p13/p53, 20q11. All the patients had a normal karyotype in more than 20 cells and tested negative for the common AML-associated fusion genes. No patient in group A was found to carry occult chromosome anomalies, whereas 8/27 patients in group B (P < 0.0001) showed 5q31 or 7q31 deletion (three cases each), a 17p13/p53deletion or trisomy 8 (one case each) in 33-60% interphase cells. Metaphase cells showed only one hybridization signal at 5q31 (three cases) and 7q31 (one case), whereas two normal signals at 7q31 and chromosome 8 centromeres were seen in two patients with 7q deletion and trisomy 8 in interphase cells. The majority of blast cells (76-94%) carried the chromosome anomaly in all cases; erythroid involvement in a minority of cells was seen in three patients. In group B, the presence of occult chromosome anomalies was associated with exposure to myelotoxic agents in the workplace (5/8 cases vs 3/19, P = 0.026) and with a lower complete remission rate (0/6 patients vs 7/12, P = 0.024). We arrived at the following conclusions: (1) cryptic chromosome deletions in the order of a few hundred kb magnitude may be found in a fraction of elderly AML or MDS-related AML and not in de novo adult AML with normal karyotype; (2) these chromosome lesions are usually represented by submicroscopic rearrangements; (3) they display a specific pattern of cell-lineage involvement arguing in favor of their role in the outgrowth of the leukemic blast cells; (4) they are associated with a history of exposure to myelotoxic agents in the workplace and, possibly, with resistance to induction treatment.

Gonadotrophin inhibitory hormone depresses gonadotrophin alpha and follicle-stimulating hormone beta subunit expression in the pituitary of the domestic chicken.

Studies performed in vitro suggest that a novel 12 amino acid RF amide peptide, isolated from the quail hypothalamus, is a gonadotrophin inhibitory hormone (GnIH). The aim of the present study was to investigate this hypothesis in the domestic chicken. Injections of GnIH into nest-deprived incubating hens failed to depress the concentration of plasma luteinizing hormone (LH). Addition of GnIH to short-term (120 min) cultures of diced pituitary glands from adult cockerels depressed follicle-stimulating hormone (FSH) and LH release and depressed common alpha and FSHbeta gonadotrophin subunit mRNAs, with no effect on LHbeta subunit mRNA. Hypothalamic GnIH mRNA was higher in incubating (out-of-lay) than in laying hens, but there was no significant difference in the amount of hypothalamic GnIH mRNA in out-of-lay and laying broiler breeder hens at the end of a laying year. It is concluded that avian GnIH may play a role in controlling gonadotrophin synthesis and associated constitutive release in the domestic chicken.

Lighting regimens and plasma LH and FSH in broiler breeders.

Egg production by meat-type fowl is markedly inferior to that from commercial laying hens, and so, to assess the degree to which photorefractoriness might be a contributing factor, male- and female-line broiler breeders were maintained on 8-, 11- or 16-h photoperiods. In addition, to determine the age-related rate of change in response to an increment in photoperiod, other birds were transferred from 8- to 16-h photoperiods at 67 or 124 d. Blood samples were taken from all groups, except those on constant 11-h photoperiods, in both genotypes at 67, 69, 124 and 126 d, and from all lighting groups in the female line at 58 weeks (end of trial), and the plasma was assayed for plasma luteinising hormone (LH) and follicle stimulating hormone (FSH) concentration to investigate possible correlations with rate of sexual maturity, total egg numbers and terminal rates of lay. Prepubertal LH was consistently higher for the female line than for the male line, and higher for 16-h birds than for 8-h birds. At 69 and 126 d, LH values were not significantly different from those 2 d earlier for 8-h birds, but significantly reduced for 16-h birds. There was an increase in LH following photostimulation at 67 d, but no significant change after the 124-d light increase. There were no significant differences in FSH between the two genetic lines, nor any effect of photostimulation at 67 or 124 d. There was a tendency for FSH in 8-h birds to be higher than for 16-h birds, and this difference became significant for male-line birds at 67 d. At 58 weeks, LH was higher for constant 11- and 16-h birds and for birds photostimulated at 67 d than for constant 8-h controls or birds transferred from 8 to 16h at 124 d. Neither baseline nor photoinduced prepubertal changes in plasma LH nor FSH were found to be of value for predicting age at sexual maturity or subsequent rates of egg production. At 58 weeks, LH was not generally correlated with sexual maturity, total eggs or terminal rates of lay, however, there was a negative correlation with age at first egg in birds photostimulated at 124 d. It must be concluded that plasma LH and FSH concentrations are of minimal value to the broiler breeder industry for predicting the degree of photorefractoriness, the age at sexual maturity, or subsequent egg production.

Changes in reproductive neuroendocrine mRNAs with decreasing ovarian function in ageing hens.

Egg production declines with advancing age in the domestic chicken and this is particularly pronounced in breeding stocks of meat type hens (broiler breeders). The objective of this study was to establish whether declining egg production with reproductive ageing in broiler breeders is correlated with plasma LH and FSH, and with mRNAs encoding hypothalamic gonadotrophin-releasing hormone-I (GnRH-I), gonadotrophin inhibitory hormone (GnIH), and gonadotrophin subunits. Comparisons were made between hens at the peak of egg laying (young: 30 weeks) and at the end of a laying year (old: 60 weeks). Old hens were subdivided into laying and out-of-lay groups. Plasma LH and FSH were lower in old than in young laying hens. Compared with old laying hens, old out-of-lay hens had significantly increased plasma FSH but not plasma LH. There were no differences in total hypothalamic GnRH-I and GnIH mRNAs between young and old hens. In old laying hens, the decrease in plasma LH was correlated with decreased gonadotrophin alpha-subunit but not LHbeta mRNAs. The decrease in plasma FSH was not associated with a change in FSHbeta mRNA. In old out-of-lay hens, the increase in plasma FSH was correlated with increased FSHbeta mRNA, while unchanged plasma LH was associated with increased LHbeta mRNA. A regression analysis of all plasma gonadotrophin and gonadotrophin subunit mRNA data collected from the study demonstrated that plasma LH is correlated with alpha-subunit but not LHbeta mRNAs, while plasma FSH is correlated with FSHbeta but not alpha-subunit mRNAs. It is concluded that the decrease in the rate of lay in ageing broiler breeders is not correlated with decreased GnRH-I mRNA nor with increased GnIH mRNA, but it is related to a decrease in alpha-subunit mRNA which may account for the associated reduction in plasma LH but not FSH.

Light intensity can influence plasma FSH and age at sexual maturity in domestic pullets.

1. Shaver White and ISA Brown pullets were reared to 140 d in cage groups of 8 on a 10-h photoperiod of incandescent light and maintained at an illuminance of 3 or 25 lux, or transferred from 3 to 25 lux or from 25 to 3 lux at 63 or 112 d of age. 2. Plasma follicle stimulating hormone (FSH) concentration at 63 and 112 d was higher in both breeds for pullets maintained at an illuminance of 25 lux compared with 3 lux. After 2-4 d, and relative to constant-illuminance controls, plasma FSH increased significantly for ISA Brown transferred from 3 to 25 lux at 63 d and for Shaver White transferred at 112 d. Irrespective of genotype, plasma FSH for pullets given a decrease in illuminance at 63 or 112 d showed a tendency for less change than did constant-illuminance controls. 3. There was no significant difference in sexual maturity for ISA Brown maintained on 3 or 25 lux, but Shaver White pullets exposed to constant 3 lux matured later than those maintained on 25 lux. Shaver White matured later following an increase from 3 to 25 lux at 63 and 112 d, and earlier subsequent to a decrease from 25 to 3 lux at 112 d. ISA Brown pullets were not significantly affected by a change in illuminance at 63 or 112 d, though their responses were in the same direction as Shaver White. 4. Changes in plasma FSH in the 2- to 4-d period following a change in illuminance at 63 or 112 d were not significantly correlated with sexual maturity.