A Systematic Review of Genetics and Reproductive Health Outcomes: Asian Perspective.

In the last four decades, advances in assisted reproductive technology (ART) have offered hope to individuals with fertility problems to conceive. However, a closer examination of the clinical outcomes of ART shows a stark contrast in Asian women compared to Caucasians, with majority of studies reporting lower reproductive success among Asian women. We performed a systematic review to elucidate the genes associated with ART clinical outcomes, with a focus on Asian ethnicities. We completed a database search to identify all studies associated with reproductive outcomes in women of different ethnic backgrounds. Following PRISMA, 128 studies were analyzed. Pathway analysis of gene sets was done using Cytoscapev3.4.0. We observed that age at menarche (AAM) was correlated with the timing of the first pregnancy, with Hawaiians having the lowest age (22.2 years) and Japanese the highest age (25.0 years). LIN28 mutations were associated with AAM and prevalent in both Chinese and American populations. FMR1 was most associated with ovarian reserve. Network analysis highlighted a close association between FMR1, FSHR, ESR1, BMP15, and INHA, through biological functions affecting menstrual cycle and hypothalamic-pituitary axis and therefore ovarian follicle development. Leveraging these findings, we propose the development of a personalized, ethnic-specific biomarker panel which would enhance patient stratification to address every woman's unique reproductive potential.

Effect of Surgical Mask use on Peak Physical Performance During Exercise Treadmill Testing-A Real World, Crossover Study.

Background: Mask wearing is an essential strategy to combat the spread of SARS-CoV-2. Some individuals may wear masks during physical activity to reduce disease transmission. This study aimed to investigate the real-world effect of wearing a surgical face mask on physiological parameters at peak exercise in healthy individuals. Methods: In this crossover design study, participants underwent maximal treadmill electrocardiogram exercise tests using the Bruce protocol on two separate occasions, once with a standard 3-ply surgical face mask and once without. Heart rate, oxygen saturation, blood pressure, rate pressure product, metabolic equivalents (METS) and total exercise time were measured. Subjective rate of perceived exertion was also assessed using the modified Borg Scale. Results: 50 adults (mean age = 31.7 ± 6.5 years; 27 males) completed both treadmill tests. Mask wearing resulted in a significant reduction in peak METS by 1.5 units, maximum speed by 0.5 km/h, exercise time by 68.4 s with a significantly lower peak heart rate by 4.4 bpm, and lower percentage of age-predicted maximum heart rate by 2.5% (p < 0.001 for all parameters). During each corresponding stage of the Bruce protocol, the average modified Borg score was found to be significantly higher in subjects exercising with mask after adjusting for age, gender and body mass index (p < 0.03). Conclusion: In a cohort of healthy individuals, wearing of a surgical face mask during maximal treadmill exercise lead to reduced physical performance and increased rate of perceived exertion. Individuals exercising with surgical masks need to be mindful of these limitations while undergoing physical training in order to differentiate these physiological responses from symptoms of early respiratory illness.