Vitrification of Germinal Vesicle Stage Oocytes

In order to cryopreserve germinal vesicle (GV) stage oocytes, we first need to develop a novel container for keeping large quantities of GV oocytes, because of collecting them as cumulus oocytes complexes (COCs) that have bigger size and larger volume than oocytes themselves, and second modify a protocol for optimizing vitrification of them. In this mini-review, we describe our recent progress for attaining these objectives. When 65 bovine COCs having GV oocytes could be placed on a sheet of nylon mesh, and plunged directly into liquid nitrogen for vitrification, the recovery rate was significantly higher compared with that in 15 ones on the electron microscope (EM) grid as a control, followed by obtaining the resultant cleavage and developmental rates after in vitro fertilization and culture (IVFC) without significant difference. Using bovine and murine oocytes, we found that a step-wise manner to expose them with the vitrification solution increased rates of in vitro maturation, subsequent development to blastocysts and hatching/hatched blastocysts after IVFC. Our results show that nylon mesh is an alternative material for cryopreserving large quantities of bovine GV oocytes, and that a step-wise exposure to cryoprotectants may have befit for decreasing disadvantage during vitrification

The efficacy of incretin therapy in patients with type 2 diabetes undergoing hemodialysis

BACKGROUND: Although incretin therapy is clinically available in patients with type 2 diabetes undergoing hemodialysis, no study has yet examined whether incretin therapy is capable of maintaining glycemic control in this group of patients when switched from insulin therapy. In this study, we examined the efficacy of incretin therapy in patients with insulin-treated type 2 diabetes undergoing hemodialysis. METHODS: Ten type 2 diabetic patients undergoing hemodialysis received daily 0.3 mg liraglutide, 50 mg vildagliptin, and 6.25 mg alogliptin switched from insulin therapy on both the day of hemodialysis and the non-hemodialysis day. Blood glucose level was monitored by continuous glucose monitoring. After blood glucose control by insulin, patients were treated with three types of incretin therapy in a randomized crossover manner, with continuous glucose monitoring performed for each treatment. RESULTS: During treatment with incretin therapies, severe hyperglycemia and ketosis were not observed in any patients. Maximum blood glucose and mean blood glucose on the day of hemodialysis were significantly lower after treatment with liraglutide compared with treatment with alogliptin (p < 0.05), but not with vildagliptin. The standard deviation value, a marker of glucose fluctuation, on the non-hemodialysis day was significantly lower after treatment with liraglutide compared with treatment with insulin and alogliptin (p < 0.05), but not with vildagliptin. Furthermore, the duration of hyperglycemia was significantly shorter after treatment with liraglutide on both the hemodialysis and non-hemodialysis days compared with treatment with alogliptin (p < 0.05), but not with vildagliptin. CONCLUSIONS: The data presented here suggest that patients with type 2 diabetes undergoing hemodialysis and insulin therapy could be treated with incretin therapy in some cases

ライフスタイルと自覚的疲労が身体組成へ及ぼす影響

本研究では7週間×2回の長期臨床実習(実習I・II)を控えた健康な男子学生18名(年齢21.6±0.6歳)を対象とし、ライフスタイルと自覚的疲労が身体組成に及ぼす影響を調べ、肥満予防への効果について検討することを目的とした。身体組成値はBoCA x1(Body Composition Analyzer)を用いて体脂肪率、腹部脂肪レベル、皮下脂肪断面積、内臓脂肪断面積、基礎代謝量/体重を測定し、自覚的疲労度の調査に自覚症しらべ(日本産業衛生学会)を実施した。実習I・II各々の前後をパターン1 .2. として、実習期間中のライフスタイル調査結果より分類した2群において身体組成値の変化量と自覚的疲労との関連を検討した。ライフスタイルの違いによる各身体組成値の変化量に有意な差は認められなかったが、パターン1. の身体組成値では朝食摂取群で有意な減少がみられた。また、自覚的疲労ではパターン1. の睡眠の質不良群で有意に高い値を示した。以上より、若年健常者においても、日常的な朝食摂取と十分な休養がもたらす身体への効果は肥満予防の一助となることが示唆された

COVID-19 symptoms at hospital admission vary with age and sex: results from the ISARIC prospective multinational observational study

Background: The ISARIC prospective multinational observational study is the largest cohort of hospitalized patients with COVID-19. We present relationships of age, sex, and nationality to presenting symptoms. Methods: International, prospective observational study of 60 109 hospitalized symptomatic patients with laboratory-confirmed COVID-19 recruited from 43 countries between 30 January and 3 August 2020. Logistic regression was performed to evaluate relationships of age and sex to published COVID-19 case definitions and the most commonly reported symptoms. Results: ‘Typical’ symptoms of fever (69%), cough (68%) and shortness of breath (66%) were the most commonly reported. 92% of patients experienced at least one of these. Prevalence of typical symptoms was greatest in 30- to 60-year-olds (respectively 80, 79, 69%; at least one 95%). They were reported less frequently in children (≤ 18 years: 69, 48, 23; 85%), older adults (≥ 70 years: 61, 62, 65; 90%), and women (66, 66, 64; 90%; vs. men 71, 70, 67; 93%, each P &lt; 0.001). The most common atypical presentations under 60 years of age were nausea and vomiting and abdominal pain, and over 60 years was confusion. Regression models showed significant differences in symptoms with sex, age and country. Interpretation: This international collaboration has allowed us to report reliable symptom data from the largest cohort of patients admitted to hospital with COVID-19. Adults over 60 and children admitted to hospital with COVID-19 are less likely to present with typical symptoms. Nausea and vomiting are common atypical presentations under 30 years. Confusion is a frequent atypical presentation of COVID-19 in adults over 60 years. Women are less likely to experience typical symptoms than men

Forest reference emission level and carbon sequestration in Cambodia

Adoption of the Paris Agreement suggests the urgent need for developing countries to establish a forest reference emission level (FREL) if they wish to seek financial support to reduce carbon emissions from deforestation and forest degradation. Analysis of past trends of deforestation is important for establishing a FREL, but so far only a handful of studies exist on such analysis at the commune level. We used the available data of forest cover in 2002 and 2006 and forest inventory data to analyze forest cover and carbon stock changes according to seven forest types at commune level in Cambodia. Carbon stocks were estimated in four carbon pools, namely aboveground, belowground, litter and deadwood pools. This analysis formed the basis for determining the FREL at national and provincial levels in Cambodia. We found that carbon emissions due to deforestation were 82.2 TgCO2 yr−1, but carbon sinks (removals) due to increase of forest cover were 72.3 TgCO2 yr−1, representing the net emission loss of 9.9 TgCO2 yr−1 between 2002 and 2006. Taking the trend of deforestation between 2002 and 2006 as a baseline, FREL for a 30-year timeframe was estimated for six time intervals. FRELs at national level were estimated to be 26.8 to 69.2 TgCO2 yr−1 or up to 36% of the total greenhouse gas emissions in Cambodia. Our study provides a first look at how to set subnational and national FRELs for Cambodia using a retrospective approach. Such a framework could form a useful basis for Cambodia to adopt the national and subnational FRELs, for which effective policies can be developed to address the drivers of deforestation and forest degradation

Reduced diffusing capacity for carbon monoxide predicts borderline pulmonary arterial pressure in patients with systemic sclerosis

Early intervention in pulmonary arterial hypertension associated with systemic sclerosis (SSc) may improve its prognosis. We aimed to establish an algorithm to detect mean pulmonary artery pressure (mPAP) > 20 mmHg using non-invasive examinations in SSc patients by modifying the DETECT algorithm. This study included SSc patients who underwent right heart catheterization (RHC) in our hospital during 2010-2018. Following variables were assessed for performance to predict mPAP >= 25 mmHg or > 20 mmHg; anti-centromere or U1-RNP antibody, plasma BNP level, serum urate level, right axis deviation, forced vital capacity (FVC)/diffusing capacity for carbon monoxide (DLCO) ratio, and tricuspid regurgitation velocity. Of 58 patients enrolled in this study, 24 had mPAP of >= 25 mmHg and 9 had mPAP of 21-24 mmHg. Among variables tested, only FVC/DLCO elevated similarly in patients with mPAP of >= 25 mmHg (median 2.5) and those with mPAP of 21-24 mmHg (median 2.5) compared to those with mPAP of 20 mmHg, each variable was weighted according to its odds ratio and the total weighted score was calculated. The total weighted score exhibited a good predictive performance for mPAP of > 20 mmHg with its sensitivity of 87.5% and specificity of 92%. Among conventional risk factors for PAH, decreased DLCO may predict mPAP > 20 mmHg with priority in SSc patients. Weighting DLCO may improve the performance of screening algorithm for early SSc-PAH