Activity

Assisted reproductive technologies (ART) may be supplemented with in vitro gametogenesis (IVG). Although IVG is still experimental the question arises whether IVG offers any moral advantages compared to implemented methods. The aim of the paper is to present the landscape of ethical arguments in favour or against IVG. ART-related ethical issues in relation to reproductive autonomy, health risks for the woman and foetus, the welfare of the future child, the adverse effects of advanced motherhood, gender equality, and justice are similar for IVG, oocyte cryopreservation, and oocyte donation. IVG may have the following advantages (I) the psychological and physical burden of stimulation and puncture of the oocyte could be avoided; (II) women do not necessarily have to cope with motherhood at young age; (III) ethical doubts associated with oocyte donation would be eliminated; (IV) by using IVG in combination with preimplantation diagnostics, it is more likely to find suitable oocytes or embryos to increase the probability of pregnancy; (V) women would have the opportunity to decide how many oocytes should be generated and how often an attempt should be made to achieve pregnancy. Simultaneously, however, the advent of IVG may lead to new moral disadvantages pressure on women to give birth at an advanced age or pressure on women to follow ‘male’ career structures. Additionally, the reimbursement of costs related to IVG is an open question, especially if equal opportunities regarding motherhood are linked to demands for equal access to ART. An early discussion about the ethical, legal, and social consequences for IVG is necessary.

An inverse relationship between hospital volume and adverse patient outcomes has been established for many conditions, but has not yet been examined in ovarian hyperstimulation syndrome (OHSS). Given the rarity of severe OHSS, but potential for high morbidity, this study aimed to elucidate the effect of hospital volume on inpatient OHSS-related complications.

This is a retrospective observational study querying the National Inpatient Sample, 1/2001-12/2011. Study population was 11,878 patients with OHSS treated at 735 hospitals. Annualized hospital OHSS treatment volume was grouped as low-volume (1 case/year), mid-volume (>1 but<3.5 cases/year), and high-volume (≥3.5 cases/year). Main outcome measure was major complication rates stratified by hospital treatment volume, assessed by multinomial regression and binary logistic regression models.

A total of 2,415 (20.3%) patients were treated at low-volume centers, 5,023 (42.3%) at mid-volume centers, and 4,440 (37.4%) at high-volume centers. Patients treated at high-volume centers were more likely to be older and less comorbid with higher incomes and lower body mass index (P<0.05). High-volume hospitals were more likely to be urban-teaching centers with large bed capacity (P<0.001). Overall, 1,624 (13.7%) patients experienced a major complication during hospitalization. Patients treated at high-volume hospitals had lower rates of major complications (high 11.0%, mid 15.2%, low 15.6%, P<0.001). On multivariable analysis, treatment at high-volume hospitals was independently associated with a nearly 20% lower rate of major complications (odds ratio 0.82, 95% confidence interval 0.70-0.97, P=0.021).

Our study suggests that higher hospital treatment volume for OHSS may be associated with improved outcomes.

Our study suggests that higher hospital treatment volume for OHSS may be associated with improved outcomes.

Catheter/cannula-bloodstream infection (CBI) has been proposed as a marker of the quality of care provided to patients receiving parenteral nutrition (PN). However, surveillance criteria for CBI are variable, inconsistent, and sometimes confusing and impractical. Surveillance criteria were developed to simply and accurately demonstrate the presence or absence of CBI. The aim of this study was to establish a simple and valid surveillance tool, with consideration of changes in vital signs, to identify CBI in patients receiving PN.

Adult (≥18 y) inpatients prescribed PN at a single large teaching hospital were recruited between October 11, 2017 and November 16, 2018. Common clinical and laboratory criteria, including blood culture, associated with 100 consecutive PN episodes associated with suspected CBI were examined for potential predictive markers of CBI. Using binary logistic regression, criteria were incorporated into an instrument that was validated against a reference classification of CBI established comparisons of the care received by hospitalized patients given PN.

A CBI tool shows promise as a surveillance instrument for benchmarking and interinstitutional comparisons of the care received by hospitalized patients given PN.

Factors associated with stroke mortality are understudied in sub-Saharan Africa but have implications for designing interventions that improve stroke outcomes. We investigated predictors of in-hospital and 90-day post-discharge stroke mortality in Lusaka, Zambia.

Data from consecutive adults admitted with stroke at University Teaching Hospital in Lusaka, Zambia between October 2018 and March 2019 were retrospectively reviewed for clinical in-hospital outcomes. Cilengitide Integrin inhibitor Vital status at 90-days post-discharge was determined through phone calls. Factors associated with stroke mortality were included in multivariable logistic regression models utilizing multiple imputation analysis to determine independent predictors of in-hospital and 90-days post-discharge mortality.

In-hospital mortality was 24%, and 90-day post-discharge mortality was 22% among those who survived hospitalization. Hemorrhagic and unknown strokes, ICU care, seizures, and aspiration pneumonia were significantly associated with in-hospital mortality both acute stroke care and post-stroke systems of care to improve stroke outcomes in Zambia.

Data on utilization of outpatient departments (OPD) within a country is one strategic approach to gain nationwide and regional insights into the frequency of and types of health facilities where patients seek healthcare. In particular, such data could be used to develop quality improvement interventions in sub-Saharan Africa where the burden of stroke is high but outcomes are relatively poor.

To evaluate the characteristics of out-patient clinic visits by stroke survivors in Ghana by geo-ecological region (state) and by type of health facilities.

We conducted a retrospective analysis of prospectively collected data from 2019 to 2021 via the District Health Information System (DHIMS2) platform of the Ghana Health Service. Rates of stroke OPD encounters were expressed as number of visits by stroke survivors divided by number of OPD visits in a healthcare facility per 100,000 visits.

Across, 9309 health facilities, there were 23,074 stroke OPD encounters in 2019, 19,485 in 2020 and 20,333 in 2021. Rates ructural capacity at the lower cadres of healthcare delivery to optimally address stroke care delivery in these settings.Parabens are chemicals widely used as preservatives in different types of industrial products. In recent years, the concern about the safety of these compounds has increased due to their endocrine disrupting activity. For this reason, their use is highly regulated and even some of them have already been banned. Thus, methods for the sensitive and selective detection of these compounds are required to control their presence in food, cosmetic, and pharmaceutical products. This paper presents an HPLC method with electrochemical detection using disposable screen-printed electrodes (SPE) for simultaneous determination of 6 different parabens in personal care products. Electrochemical behaviour of parabens was studied on SPE with different carbon-based materials as working electrode carbon, ordered mesoporous carbon and graphene. From these studies, pH, detection potential, and the most adequate SPE were chosen. Due to the wide range of textures and viscosities (e.g., liquid, solid, and semi-solid) of personal care products, adequate sample pretreatments are required before chromatographic measurement. Here, a fast ultrasound-assisted extraction method was applied to simultaneously extract 6 parabens (methyl-, ethyl-, isopropyl-, propyl-, butyl-and benzyl-paraben) from different complex-matrix cosmetic products. Instrumental limits of detection between 20 and 115 μg L-1 were obtained applying +1.0 V (vs. Ag) as detection potential on carbon-based SPE. The total analysis time, including sample extraction and HPLC run, was shorter than 35 min. The proposed method is more versatile and faster than the current available methods and has been successfully applied to determine parabens in commercial samples such as shampoos, body creams, facial tonics, and toothpastes.A cerium metal organic framework-loaded silver nanocluster (MOFCeAgNC) is synthesized by a facile stirring procedure with trimesic acid, cerium nitrate, silver nitrate and NaBH4, which exhibites strong catalytic activity in the indicated reaction of HAuCl4-sodium lactate (SL). MOFCeAgNC can sensitively detect dopamine (DA) by surface-enhanced Raman scattering (SERS) and resonance Rayleigh scattering (RRS) techniques with a detection concentration range of 0.01-0.25 nmol/L and a detection limit of 0.008 nmol/L. Based on the specific binding of aptamer (Apt)-DA and the catalytic amplification strategy of MOFCeAgNC on HAuCl4-SL, a sensitive and convenient DA platform for dual-mode detection of SERS and RRS is constructed. In addition, the platform is successfully applied to detect DA in human serum with satisfactory recoveries (95.7-102%).We designed a SERS-based method to detect β-lactoglobulin (β-Lg), a major allergen of milk, utilizing aptamers to specifically anchor β-Lg. The Au-Ag nanourchins with excellent Raman enhancement effects were prepared and modified with a β-Lg aptamer as the capture substrate. By taking advantage of the hybridization of aptamer and Raman reporter molecule (6-Carboxyl-X-Rhodamine ROX)-labeled complementary DNA (cDNA), when ROX is close to Au-Ag nanourchins, the SERS signal is enhanced. In the presence of β-Lg, aptamer binding to β-Lg induces the dissociation of ROX-cDNA from Au-Ag nanourchins, thereby decreasing the SERS signal. Under optimal conditions, the present bioassay provides a wide detection range of 10 ng/mL to 1000 ng/mL with a detection limit of 0.07 ng/mL. In addition, the established SERS sensor can selectively and accurately identify β-Lg with recovery rates of 93.25-107.0% in milk samples. It provides great potential as a sensitive and reliable detection method against the growing threat of allergens.U, Sr, Pb, Nd, and Hf isotope ratios can provide basic and important information of nuclear materials. We established a simple and efficient column chemistry method using nano-NaBiO3, as both oxidizer and adsorbent, to completely separate Ce from rare earth elements (REEs). This new method exhibited a high decontamination (Ce/Nd less then 10-5) ability and was easy to conducted, thereby providing clear advantages compared to traditional liquid-liquid and solid phase micro-extraction techniques. Additionally, a rapid four-column separation procedure, based on Sr, TUR, Ln resins and nano-NaBiO3, was developed to isolate U, Sr, Pb, Nd, and Hf in ore samples. The entire procedure could be completed in 4-5 hrs. The robustness of the proposed method was demonstrated by analyzing the 235U/238U, 87Sr/86Sr, 206Pb/204Pb, 207Pb/204Pb, 208Pb/204Pb, 142Nd/144Nd, 143Nd/144Nd, and 176Hf/177Hf isotopic ratios of two certified reference materials (CRMs). The analytical results obtained using this method showed good agreement with previously published data.