Effect of 0.9% saline solution and phosphate buffer saline at different temperatures and incubation times on the morphology of goat preantral follicles

The present work investigated the efficiency of 0.9% saline solution and Phosphate Buffered Saline (PBS) in the preservation of goat preantral follicles in situ at different temperatures and incubation times. The ovarian pair of each animal was divided into 19 fragments. One ovarian fragment was taken randomly and fixed (control). The other 18 fragments were randomly distributed in tubes containing 0.9% saline solution or PBS at 4, 20 or 39 ºC for 4, 12 or 24 h. A total of 5,921 preantral follicles were examined. The quality of preantral follicles was evaluated by classical histology. The storage of ovarian fragments in 0.9% saline solution or PBS at 4 ºC did not reduce significantly the percentage of morphologically normal follicles when compared with the control, except after preservation in 0.9% saline solution for 24 h. The storage of ovarian fragments at 20 or 39°C reduced the percentage of normal preantral follicles when compared to the control, except after preservation in PBS at 20°C for 4 h. In conclusion, this study showed for the first time that goat preantral follicles can be stored in situ successfully at 4 ºC in 0.9% saline solution for 12 h and in PBS for 24 h, and at 20 ºC in PBS for 4 h.O presente trabalho investigou a eficiência da solução salina 0,9% e tampão fosfato salina (PBS) na conservação de folículos pré-antrais caprinos in situ a diferentes temperaturas e tempos de incubação. O par ovariano de cada animal foi dividido em 19 fragmentos. Um fragmento foi escolhido aleatoriamente e fixado (controle). Os outros 18 fragmentos foram distribuídos aleatoriamente em tubos contendo solução salina 0,9% ou PBS a 4, 20 ou 39 °C por 4, 12 ou 24 h. Um total de 5.921 folículos pré-antrais foram analisados. A qualidade dos folículos pré-antrais foi avaliada através de histologia clássica. A incubação de fragmentos ovarianos em solução salina 0,9% ou PBS a 4 ºC não reduziu significativamente a percentagem de folículos morfologicamente normais quando comparados com o controle, exceto após a conservação em solução salina 0,9% por 24 h. A incubação de fragmentos ovarianos a 20 ou 39°C reduziu a percentagem de folículos pré-antrais normais quando comparados com o controle, exceto após conservação em PBS a 20°C por 4 h. Em conclusão, este estudo mostrou pela primeira vez que folículos pré-antrais caprinos podem ser conservados in situ com sucesso a 4 ºC em solução salina 0,9% por 12 h e em PBS por 24 h, e a 20 ºC em PBS por 4 h

Cryopreservation of caprine ovarian tissue using glycerol and ethylene glycol

Cryopreservation of ovarian tissue may be a potential alternative for the conservation of genetically superior animals, including high milk- and meat-producing goat breeds. However, until now, no information was available concerning the cryopreservation of preantral follicles (PF) enclosed in caprine ovarian tissue. The objective of the present study was to evaluate the structural and ultrastructural characteristics of caprine PF after exposure to and cryopreservation of ovarian tissue in 1.5 and 3 M glycerol (GLY) and ethylene glycol (EG). At the slaughterhouse, each ovarian pair from five adult mixed breed goats was divided into nine fragments and randomly distributed into treatment groups. One fragment was immediately fixed for histological examination and ultrastructural analysis, after slaughter (control). Four of the ovarian fragments were equilibrated at 20 °C for 20 min in 1.8 ml of MEM containing 1.5 or 3 M GLY or EG for a toxicity test and the final four fragments were slowly frozen using these cryoprotectants at the concentrations above. After toxicity testing and freezing/thawing, the ovarian fragments were fixed for histological examination. Histological analysis showed that after toxicity testing and cryopreservation of the ovarian tissue in GLY or EG at both concentrations, the percentage of normal PF was significantly lower than controls. Ultrastructural analysis of PF frozen in 1.5 and 3 M GLY, as well as 3 M EG demonstrated that these follicles remained morphologically normal. In conclusion, we demonstrated cryopreservation of caprine PF in ovarian tissue

Conservação de folículos pré-antrais caprinos em solução salina ou à base de água de coco

The present study investigated the efficiency of saline solution and coconut water solution in the preservation of goat preantral follicles enclosed in ovarian tissue, at different temperatures and for different incubation periods. At the slaughterhouse, the ovarian pair was divided into 19 fragments; one ovarian fragment was immediately fixed for histology (control-time zero). The other 18 ovarian fragments were preserved in both solutions at 4ºC, 20ºC or 39ºC for 4 h, 12 h or 24 h. The histological analysis showed that the storage of ovarian fragments in both solutions at 4ºC for up to 24 h kept the percentage of normal preantral follicles similar to the control values. In contrast, preservation at 20°C or 39ºC, in either solution, reduced significantly the percentage of normal preantral follicles compared to the control values, except in saline solution at 20ºC for 4 h or in coconut water solution at 20ºC for 4 h and 12 h. In conclusion, this study shows that both solutions can be used with the same efficiency to preserve goat preantral follicles at 4°C, irrespective of the incubation time. However, to preserve goat preantral follicles at higher temperatures, coconut water solution is recommended.O presente estudo investigou a eficiência da solução salina e solução à base de água de coco na preservação de folículos pré-antrais inclusos em tecido ovariano, em diferentes temperaturas e diferentes tempos de incubação. No abatedouro, o par ovariano foi dividido em 19 fragmentos; um fragmento ovariano foi imediatamente fixado para histologia clássica (controle-tempo zero). Os outros 18 fragmentos ovarianos foram conservados em ambas as soluções a 4ºC, 20ºC ou 39ºC por 4 h, 12 h ou 24 h. A análise histológica mostrou que a conservação de fragmentos ovarianos em ambas as soluções a 4ºC por até 24 h mantém a percentagem de folículos pré-antrais normais similar aos valores do controle. Ao contrário, a conservação a 20°C ou 39ºC, em ambas as soluções, reduziu significativamente a percentagem de folículos pré-antrais normais comparado aos valores do controle, exceto em solução salina a 20ºC por 4 h ou em solução à base de água de coco a 20ºC por 4 h e 12 h. Em conclusão, esse estudo mostrou que ambas as soluções podem ser usadas com igual eficiência para conservar folículos pré-antrais caprinos a 4°C, independente do tempo de incubação. No entanto, para conservar folículos pré-antrais caprinos a altas temperaturas, a solução à base de água de coco é recomendada

Morphological and ultrastructural analysis of sheep primordial follicles preserved in 0.9% saline solution and TCM 199

The objective was to determine the morphological and ultrastructural features of sheep primordial follicles preserved in either 0.9% saline solution or TCM 199 at different temperatures. Soon after death, the ovarian pair of each ewe (n=5) was divided into 25 fragments. One fragment was immediately fixed for morphological evaluation (control). The other 24 fragments were randomly distributed in tubes containing 2 ml of 0.9% saline solution or TCM 199 and maintained at 4, 20 or 39 °C for 2, 4, 12, or 24 h. Based on histological assessment, storage of ovarian fragments in 0.9% saline solution at 20 °C for up to 24 h and in both solutions at 39 °C for 4, 12 or 24 h increased (P<0.01) the percentage of degenerate primordial follicles compared with controls. In contrast, preservation at 4 °C in both solutions, kept the percentage of morphologically normal primordial follicles similar to control values. Although histological integrity of primordial follicles was maintained in fragments stored at 20 °C for up to 24 h in TCM 199, these results were not confirmed by ultrastructural analysis. Based on transmission electron microscopy, only primordial follicles stored at 4 °C for up to 24 h, at 20 °C for up to 12 h and at 39 °C for up to 2 h in both solutions were ultrastructurally normal. In conclusion, sheep primordial follicles were successfully preserved at 4 °C for up to 24 h, at 20 °C for up to 12 h and at 39 °C for 2 h in 0.9% saline solution or TCM 199

Degeneration rate of preantral follicles in the ovaries of goats

The degeneration rate of ovarian preantral follicles in goats, and the distribution in the follicular classes (primordial, primary or secondary) was assessed. Ovaries from adult goats were collected at a local slaughterhouse. To evaluate the morphology of the caprine preantral follicles in situ, one fragment from each ovary was fixed individually in Carnoy for 12 h, sectioned serially at a thickness of 7 μm and stained with Periodic Acid Shiff-hematoxylin. Preantral follicles were then classified according to the stage of development. Preantral follicles were classified individually either as morphologically normal; as Type 1 degenerated follicles (only the oocyte was degenerated); or as Type 2 degenerated follicles (when degeneration occurred at both oocyte and granulosa cells). The total examined was 235 primordial, 195 primary and 101 secondary follicles. The distribution of degenerated follicles as primordial, primary and secondary follicles was 8.5, 14.3 and 16.8%, respectively. When Types 1 and 2 degenerated follicles were pooled, secondary follicles were significantly more degenerated than primordial and primary follicles. When degeneration Types 1 and 2 was compared in each follicular class, a higher (P<0.05) percentage of Type 1 degeneration was observed in primordial and primary follicles. Conversely, secondary follicles were significantly more affected by Type 2 degeneration. When the follicular classes were taken together, a significantly higher percentage of Type 1 degenerated preantral follicles was observed when compared with Type 2 degenerated follicles (P<0.05). In conclusion, a low percentage of degenerated preantral follicles was observed and secondary follicles were more affected by degeneration than primordial follicles. Thus, primordial follicles constitute a large and potentially valuable source of oocytes for reproductive programs after in vitro growth and maturation

Histological and ultrastructural analysis of cryopreserved sheep preantral follicles

The aim of this study was to verify the histological and ultrastructural characteristics of sheep preantral follicles after exposure of ovarian tissue to cryopreservation in glycerol (GLY), ethylene glycol (EG), propanediol (PROH) or dimethyl sulfoxide (DMSO) in order to determine the optimum method to store sheep ovarian tissue for later experimental or clinical use. Each ovarian pair from five mixed-breed ewes was divided into 17 fragments. One (control) fragment was immediately fixed for routine histological and ultrastructural studies and the remaining (test) fragments were randomly distributed in cryotubes, equilibrated at 20 °C/20 min in 1.8 mL of minimal essential medium (MEM) containing 1.5 or 3 M GLY, EG, PROH or DMSO and then either fixed for morphological studies to determine their possible toxic effect or frozen/thawed and then fixed to test the effect of cryopreservation on preantral follicles. Histological analysis showed that, compared to control fragments, all cryoprotectants at both concentrations significantly reduced the percentage of normal preantral follicles in ovarian fragments prior to or after cryopreservation. PROH 3.0 M appeared to exert a more toxic effect (P < 0.05) than the other cryoprotectants in noncryopreserved tissues. After freezing/thawing, the highest (P < 0.05) percentages of lightmicroscopical normal preantral follicles were observed in ovarian fragments cryopreserved in EG (1.5 and 3 M) or DMSO (1.5 M). However, transmission electronic microscopical (TEM) examination showed that only the DMSO-cryopreserved preantral follicles had normal ultrastructure. The data suggest that sheep preantral follicles should be cryopreserved with 1.5 M DMSO for later clinical or experimental application

Effectiveness and long-term retention of anti-tumour necrosis factor treatment in juvenile and adult patients with juvenile idiopathic arthritis: data from Reuma.pt

Methods. We prospectively collected patient and disease characteristics from patients with JIA who started biological therapy. Adverse events were collected during the follow-up period. Predictors of response at 1 year and drug retention rates were assessed at 4 years of treatment for the first biologic agent.Results. A total of 812 JIA patients [65% females, mean age at JIA onset 6.9 years (s.d. 4.7)], 227 received biologic therapy; 205 patients (90.3%) were treated with an anti-TNF as the first biologic. All the parameters used to evaluate disease activity, namely number of active joints, ESR and Childhood HAQ/HAQ, decreased significantly at 6 months and 1 year of treatment. The mean reduction in Juvenile Disease Activity Score 10 (JADAS10) after 1 year of treatment was 10.4 (s.d. 7.4). According to the definition of improvement using the JADAS10 score, 83.3% respond to biologic therapy after 1 year. Fourteen patients discontinued biologic therapies due to adverse events. Retention rates were 92.9% at 1 year, 85.5% at 2 years, 78.4% at 3 years and 68.1% at 4 years of treatment. Among all JIA subtypes, only concomitant therapy with corticosteroids was found to be univariately associated with withdrawal of biologic treatment (P = 0.016).Conclusion. Biologic therapies seem effective and safe in patients with JIA. In addition, the retention rates for the first biologic agent are high throughout 4 years

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017.

The Global Burden of Diseases, Injuries and Risk Factors 2017 includes a comprehensive assessment of incidence, prevalence, and years lived with disability (YLDs) for 354 causes in 195 countries and territories from 1990 to 2017. Previous GBD studies have shown how the decline of mortality rates from 1990 to 2016 has led to an increase in life expectancy, an ageing global population, and an expansion of the non-fatal burden of disease and injury. These studies have also shown how a substantial portion of the world's population experiences non-fatal health loss with considerable heterogeneity among different causes, locations, ages, and sexes. Ongoing objectives of the GBD study include increasing the level of estimation detail, improving analytical strategies, and increasing the amount of high-quality data. METHODS: We estimated incidence and prevalence for 354 diseases and injuries and 3484 sequelae. We used an updated and extensive body of literature studies, survey data, surveillance data, inpatient admission records, outpatient visit records, and health insurance claims, and additionally used results from cause of death models to inform estimates using a total of 68 781 data sources. Newly available clinical data from India, Iran, Japan, Jordan, Nepal, China, Brazil, Norway, and Italy were incorporated, as well as updated claims data from the USA and new claims data from Taiwan (province of China) and Singapore. We used DisMod-MR 2.1, a Bayesian meta-regression tool, as the main method of estimation, ensuring consistency between rates of incidence, prevalence, remission, and cause of death for each condition. YLDs were estimated as the product of a prevalence estimate and a disability weight for health states of each mutually exclusive sequela, adjusted for comorbidity. We updated the Socio-demographic Index (SDI), a summary development indicator of income per capita, years of schooling, and total fertility rate. Additionally, we calculated differences between male and female YLDs to identify divergent trends across sexes. GBD 2017 complies with the Guidelines for Accurate and Transparent Health Estimates Reporting

Measuring progress from 1990 to 2017 and projecting attainment to 2030 of the health-related Sustainable Development Goals for 195 countries and territories: a systematic analysis for the Global Burden of Disease Study 2017

Background: Efforts to establish the 2015 baseline and monitor early implementation of the UN Sustainable Development Goals (SDGs) highlight both great potential for and threats to improving health by 2030. To fully deliver on the SDG aim of “leaving no one behind”, it is increasingly important to examine the health-related SDGs beyond national-level estimates. As part of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 (GBD 2017), we measured progress on 41 of 52 health-related SDG indicators and estimated the health-related SDG index for 195 countries and territories for the period 1990–2017, projected indicators to 2030, and analysed global attainment. Methods: We measured progress on 41 health-related SDG indicators from 1990 to 2017, an increase of four indicators since GBD 2016 (new indicators were health worker density, sexual violence by non-intimate partners, population census status, and prevalence of physical and sexual violence [reported separately]). We also improved the measurement of several previously reported indicators. We constructed national-level estimates and, for a subset of health-related SDGs, examined indicator-level differences by sex and Socio-demographic Index (SDI) quintile. We also did subnational assessments of performance for selected countries. To construct the health-related SDG index, we transformed the value for each indicator on a scale of 0–100, with 0 as the 2\ub75th percentile and 100 as the 97\ub75th percentile of 1000 draws calculated from 1990 to 2030, and took the geometric mean of the scaled indicators by target. To generate projections through 2030, we used a forecasting framework that drew estimates from the broader GBD study and used weighted averages of indicator-specific and country-specific annualised rates of change from 1990 to 2017 to inform future estimates. We assessed attainment of indicators with defined targets in two ways: first, using mean values projected for 2030, and then using the probability of attainment in 2030 calculated from 1000 draws. We also did a global attainment analysis of the feasibility of attaining SDG targets on the basis of past trends. Using 2015 global averages of indicators with defined SDG targets, we calculated the global annualised rates of change required from 2015 to 2030 to meet these targets, and then identified in what percentiles the required global annualised rates of change fell in the distribution of country-level rates of change from 1990 to 2015. We took the mean of these global percentile values across indicators and applied the past rate of change at this mean global percentile to all health-related SDG indicators, irrespective of target definition, to estimate the equivalent 2030 global average value and percentage change from 2015 to 2030 for each indicator. Findings: The global median health-related SDG index in 2017 was 59\ub74 (IQR 35\ub74–67\ub73), ranging from a low of 11\ub76 (95% uncertainty interval 9\ub76–14\ub70) to a high of 84\ub79 (83\ub71–86\ub77). SDG index values in countries assessed at the subnational level varied substantially, particularly in China and India, although scores in Japan and the UK were more homogeneous. Indicators also varied by SDI quintile and sex, with males having worse outcomes than females for non-communicable disease (NCD) mortality, alcohol use, and smoking, among others. Most countries were projected to have a higher health-related SDG index in 2030 than in 2017, while country-level probabilities of attainment by 2030 varied widely by indicator. Under-5 mortality, neonatal mortality, maternal mortality ratio, and malaria indicators had the most countries with at least 95% probability of target attainment. Other indicators, including NCD mortality and suicide mortality, had no countries projected to meet corresponding SDG targets on the basis of projected mean values for 2030 but showed some probability of attainment by 2030. For some indicators, including child malnutrition, several infectious diseases, and most violence measures, the annualised rates of change required to meet SDG targets far exceeded the pace of progress achieved by any country in the recent past. We found that applying the mean global annualised rate of change to indicators without defined targets would equate to about 19% and 22% reductions in global smoking and alcohol consumption, respectively; a 47% decline in adolescent birth rates; and a more than 85% increase in health worker density per 1000 population by 2030. Interpretation: The GBD study offers a unique, robust platform for monitoring the health-related SDGs across demographic and geographic dimensions. Our findings underscore the importance of increased collection and analysis of disaggregated data and highlight where more deliberate design or targeting of interventions could accelerate progress in attaining the SDGs. Current projections show that many health-related SDG indicators, NCDs, NCD-related risks, and violence-related indicators will require a concerted shift away from what might have driven past gains—curative interventions in the case of NCDs—towards multisectoral, prevention-oriented policy action and investments to achieve SDG aims. Notably, several targets, if they are to be met by 2030, demand a pace of progress that no country has achieved in the recent past. The future is fundamentally uncertain, and no model can fully predict what breakthroughs or events might alter the course of the SDGs. What is clear is that our actions—or inaction—today will ultimately dictate how close the world, collectively, can get to leaving no one behind by 2030