Human embryos from overweight and obese women display phenotypic and metabolic abnormalities

STUDY QUESTION Is the developmental timing and metabolic regulation disrupted in embryos from overweight or obese women? SUMMARY ANSWER Oocytes from overweight or obese women are smaller than those from women of healthy weight, yet post-fertilization they reach the morula stage faster and, as blastocysts, show reduced glucose consumption and elevated endogenous triglyceride levels. WHAT IS KNOWN ALREADY Female overweight and obesity is associated with infertility. Moreover, being overweight or obese around conception may have significant consequences for the unborn child, since there are widely acknowledged links between events occurring during early development and the incidence of a number of adult disorders. STUDY DESIGN, SIZE, DURATION We have performed a retrospective, observational analysis of oocyte size and the subsequent developmental kinetics of 218 oocytes from 29 consecutive women attending for ICSI treatment and have related time to reach key developmental stages to maternal bodyweight. In addition, we have measured non-invasively the metabolic activity of 150 IVF/ICSI embryos from a further 29 consecutive women who donated their surplus embryos to research, and have related the data retrospectively to their body mass index (BMI). PARTICIPANTS/MATERIALS, SETTING, METHODS In a clinical IVF setting, we compared oocyte morphology and developmental kinetics of supernumerary embryos collected from overweight and obese women, with a BMI in excess of 25 kg/m2 to those from women of healthy weight. A Primovision Time-Lapse system was used to measure developmental kinetics and the non-invasive COnsumption/RElese of glucose, pyruvate, amino acids and lactate were measured on spent droplets of culture medium. Total triglyceride levels within individual embryos were also determined. MAIN RESULTS AND THE ROLE OF CHANCE Human oocytes from women presenting for fertility treatment with a BMI exceeding 25 kg/m2 are smaller (R2 = −0.45; P = 0.001) and therefore less likely to complete development post-fertilization (P < 0.001). Those embryos that do develop reach the morula stage faster than embryos from women of a BMI < 25 kg/m2

Chern classes and extraspecial groups

The mod-p cohomology ring of the extraspecial p-group of exponent p is studied for odd p. We investigate the subquotient ch(G) generated by Chern classes modulo the nilradical. The subring of ch(G) generated by Chern classes of one-dimensional representations was studied by Tezuka and Yagita. The subring generated by the Chern classes of the faithful irreducible representations is a polynomial algebra. We study the interplay between these two families of generators, and obtain some relations between them

Ultrasound and phakometry measurements of the primate eye Technical report, Aug. 1965

Ultrasonic testing and phakometry measurements of primate ey

Modelling the Inflammatory Bowel Disease Specialist Nurse Workforce standards by determination of optimum caseloads in the United Kingdom.

Background and Aims Crohn’s disease and ulcerative colitis are the most common forms of inflammatory bowel disease affecting 1 in 250 of the population in the UK. It is accepted that access to a specialist nurse service improves patient experience and outcome. National Standards for inflammatory bowel disease care (2013) defined the number of nurse specialists required at 1.5 full time equivalent per 250,000 population. The aim of this study was to determine if these standards were being met and to publish a new, robust validated standard optimising the UK nursing workforce model. Methods Existing national data and specific workload and service data was collected from 164 IBD specialist nurses who completed a questionnaire designed to collect information on activity and complexity of work both done and undone. Results Data was received from all of the UK. Thirty-six percent of respondents were specialist nurses in the field for 3 years or less. A higher caseload than the recommended level was reported by 63% of respondents. Unpaid overtime was regularly carried out by 84%of respondents. The IBD specialist nurse was involved in all areas of the patient pathway. Areas of work left undone were psychological interventions, prescribing medicines and physical assessments. Conclusions Compared to other specialties IBD specialist nurses are less experienced. It is recommended that the current standard be increased to 2.5 full time equivalent specialist nurses per 250,000. patients to mitigate for the increasing complexity of the role, care and the “rookie” factor. Keywords: Inflammatory Bowel Disease, Specialist Nurse, Workforce Modellin

Metabolic profile of in vitro derived human embryos is not affected by the mode of fertilization

The pattern of metabolism by early embryos in vitro has been linked to a range of phenotypes, including viability. However, the extent to which metabolic function of embryos is modified by specific methods used during ART has yet to be fully described. This study has sought to determine if the mode of fertilization used to create embryos affects subsequent embryo metabolism of substrates. A metabolic profile, including consumption of key substrates and the endogenous triglyceride content of individual IVF and ICSI supernumerary embryos, was assessed and compared. Embryo development and quality was also recorded. All embryos were donated at a single clinical IVF centre, on day 5, from 36 patients aged 18-38 years, The data revealed that consumption of glucose and pyruvate, and production of lactate, did not differ between embryos created by IVF or ICSI. Similarly, the mode of insemination did not impact on the triglyceride content of embryos. However, ICSI-derived embryos displayed a more active turnover of amino acids (p=0.023), compared to IVF embryos. The specific amino acids produced in higher quantities from ICSI compared to IVF embryos were aspartate (p=0.016), asparagine (p=0.04), histidine (p=0.021), and threonine (p=0.009) while leucine consumption was significantly lower (p=0.04). However, importantly neither individual nor collective differences in amino acid metabolism were apparent for sibling oocytes subjected to either mode of fertilisation. Embryo morphology (the number of top grade embryos) and development (proportion reaching the blastocyst stage) were comparable in patients undergoing IVF and ICSI. In conclusion, the microinjection of spermatozoa into oocytes does not appear to have an impact on subsequent metabolism and viability. Observed differences in amino acid metabolism may be attributed to male factor infertility of the patients rather than the ICSI procedure per se

Determining acute nurse staffing, a hermeneutic review of an evolving science.

Abstract Background Calculating nurse staffing in the acute hospital has become a key issue but solutions appear distant. Community, mental health and areas such as learning disability nursing have attracted less attention and remain intractable. This review aims to examine current approaches to the issue across many disciplines. Design The approach taken is iterative and in the form of a hermeneutic review. 769 pieces of evidence were reviewed from across disciplines such as nursing, medicine, engineering, statistics, population science, computer science and mathematics where hospital nurse staffing was the subject of the study. Results A number of themes emerged. The first iteration showed the predominance of unit base approaches (e.g. nurse numbers, ratios, activity and workload) the second was the development of methodologies. Subsequent iterations examined issues such as demand, safety, nurse education, turnover, patient outcomes, patient or staff satisfaction, workload and activity. The majority of studies examined (n=767) demonstrated some association between staffing (units or type/skill) and various factors such as staff or patient satisfaction, working conditions, safety parameters, outcomes complexity of work achieved, work left undone or other factors. Many potential areas such as operational safety research were not utilised. Conclusion Although the relationship between staffing in acute care and factors such as units, safety or workload is complex, the evidence suggests an interdependent relationship which should only be dismissed with caution. The nature of these relationships should be further examined in order to determine nurse staffing. The body of knowledge appears substantial and complex yet appears to have little impact on policy