Potential use of preimplantation genetic testing for aneuploidy (PGT-A) is increasing. Patients who have excess embryos cryopreserved at the blastocyst stage may desire PGT-A but there is little data ...available on options for these patients. We compared the efficacy and safety of the timing on the cryopreservation and trophectoderm(TE) biopsy for preimplantation genetic testing for aneuploidy (PGT-A) program associated with the better outcomes after frozen blastocyst transfer. Retrospective analysis of patients who underwent PGT-A cycles from January 2016 to December 2019 was carried out. 2684 blastocysts from cycles were subjected to TE biopsy for performing array comparative genomic hybridization test and Next-generation sequencing. All cycles were divided into two according to the timing of biopsy: biopsy-first (n = 211 cases/ 232 transfers) versus freeze all-first (n = 327 cases/ 415 transfers). In the biopsy-first group, embryos were cultured to expanded blastocyst and proceed to TE biopsy on day 5 or day 6 followed by cryopreservation. In the freeze all-first, blastocysts were vitrified and warmed before biopsy. Rates of clinical pregnancy (52.3% vs. 38.7%, P = 0.09) and ongoing pregnancy (44.3% vs. 34.5%, P = 0.07) in biopsy-first were significantly higher than those in freeze all-first. Biopsy-first showed comparable miscarriage rate with freeze all-first (15.2% (33/217) vs.11.1% (10/90), respectively). Rate ratio (RR) for clinical pregnancy was lower in freeze all-first group (adjusted RR = 0.78, 95% confidence interval: 0.65, 0.93). The RRs for miscarriage and live birth was also lower but it did not reach statistical significance. Our result supported performing TE biopsy of blastocyst for PGT-A before vitrification and warming. This finding would contribute to more evidence-based decision in PGT-A cycles.
Background Arterial cannulation in elderly patients is difficult because of age-related morphological changes. Applying dynamic needle tip positioning (DNTP) that guides the catheter to position ...inside the vessel sufficiently may aid in successful cannulation. Methods This prospective study enrolled patients aged over 70 years, who were scheduled for elective surgery under general anaesthesia with arterial cannulation. The patients were randomly assigned to the DNTP (group D, n = 76) or the conventional short-axis view(group C, n = 75) group. The arterial depth, diameter, and arterial conditions(calcification, segmental stenosis, and tortuosity) were evaluated using ultrasound, before puncture. We recorded the first attempt success, cannulation time, the number of attempts, and cannulation-related complications. Results A total of 151 patients were enrolled in this study. The first attempt success rate in group D was significantly higher than that in group C (89% versus 72%; P = 0.0168). The median cannulation time per last attempt in group D versus group C was 25 versus 30 sec(P = 0.0001), and the overall cannulation time was 25 versus 35 sec(P = 0.0001), respectively. Arterial cannulation per last attempt and overall cannulation time were shorter in group D. The number of attempts was higher in group C (P = 0.0038). The occurrence rate of hematoma was significantly lower in group D (16% versus 47%, relative risk = 3.0, P = 0.0001). Conclusions The DNTP method may improve the first attempt success rate of arterial cannulation and reduce complications in elderly patients over 70 years of age.
Abstract
Protecting replication fork integrity during DNA replication is essential for maintaining genome stability. Here, we report that SDE2, a PCNA-associated protein, plays a key role in ...maintaining active replication and counteracting replication stress by regulating the replication fork protection complex (FPC). SDE2 directly interacts with the FPC component TIMELESS (TIM) and enhances its stability, thereby aiding TIM localization to replication forks and the coordination of replisome progression. Like TIM deficiency, knockdown of SDE2 leads to impaired fork progression and stalled fork recovery, along with a failure to activate CHK1 phosphorylation. Moreover, loss of SDE2 or TIM results in an excessive MRE11-dependent degradation of reversed forks. Together, our study uncovers an essential role for SDE2 in maintaining genomic integrity by stabilizing the FPC and describes a new role for TIM in protecting stalled replication forks. We propose that TIM-mediated fork protection may represent a way to cooperate with BRCA-dependent fork stabilization.
Background: The purpose of this study was to develop a mobile head mounted display (HMD)-based virtual reality (VR) nursing education program (VRP), and to evaluate the effects on knowledge, learning ...attitude, satisfaction with self-practice, and learning motivation in nursing students. Methods: This was a quasi-experimental study using a nonequivalent control group pretest-posttest design to evaluate the effects of HMD-based VRP on nursing students. A Chemoport insertion surgery nursing scenario was developed with HMD-based VRP. The experimental group consisting of 30 nursing students underwent pre-debriefing, followed by VRP using HMD and debriefing. The control group, consisting of 30 nursing students, underwent pre-debriefing, followed by self-learning using handouts about Chemoport insertion surgery procedures for 30 min, and debriefing. Results: The experimental group that underwent HMD-based VRP showed significantly improved post-intervention knowledge on operating nursing (p = 0.001), learning attitude (p = 0.002), and satisfaction (p = 0.017) compared to the control group. Sub-domains of motivation, attention (p < 0.05), and relevance (p < 0.05) were significantly different between the two groups, post-intervention. Conclusions: HMD-based VRP of Chemoport insertion surgery is expected to contribute to knowledge, learning attitude, satisfaction, attention, and relevance in nursing students.
The harmful effects of alcohol consumption by adolescents have been increasingly emphasized. Thus, it is necessary to identify individual and environmental factors that encourage drinking. This study ...investigated factors associated with the sustainable use of alcohol (SUA) in adolescents who consume alcohol, and the possibility of future drinking (PFD) in non-drinking adolescents. Data from "The Adolescents Awareness Survey of Alcohol Encouraging Environment" by the Ministry of Health and Welfare and the Korea Health Promotion Institute (2017) were used. The survey was completed by 1,038 participant, selected through a proportional allocation extraction method, who were aged 13-18 years and lived in five cities with a population of over 1 million. The factors associated with SUA included gender (beta = 0.634, p = 0.004), grade (8.sup.th beta = 1.591, p<0.001, 9.sup.th beta = 1.674, p<0.001, 10.sup.th beta = 1.497, p = 0.001, 11.sup.th beta = 1.041, p = 0.004, 12.sup.th beta = 2.610, p<0.001), drinking alone (beta = -2.147, p = 0.002), liquor commercial (beta = 1.644, p<0.001), ease of alcohol purchase (beta = 1.541, p = 0.025), parent's recommendation for drinking (beta = 1.084, p<0.001), not knowing the mother's education level (beta = -0.685, p = 0.045), positive expectancy of drinking (beta = 0.141, p<0.001), number of pubs (beta = 0.303, p = 0.002), internet game cafes (beta = 0.456, p = 0.019), and karaokes (beta = -0.098, p = 0.023) in the community. The factors associated with the PFD in non-drinkers were grade (8.sup.th beta = 0.531, p = 0.024, 10.sup.th beta = 0.717, p = 0.035, 12.sup.th beta = 1.882, p = 0.001), liquor commercial (beta = -1.355, p<0.001), parent's recommendation for drinking (beta = 0.783, p = 0.020), positive expectancy of drinking (beta = 0.139, p<0.001), and relationship with the father (beta = 0.072, p = 0.033). Multidimensional interventions, including those by individuals, parents, peers, and local communities, are needed to prevent SUA and the PFD in adolescents.
Autophagy is responsible for the bulk degradation of cytosolic constituents and plays an essential role in the intestinal epithelium by controlling beneficial host-bacterial relationships. Atg5 and ...Atg7 are thought to be critical for autophagy. However, Atg5- or Atg7-deficient cells still form autophagosomes and autolysosomes, and are capable of removing proteins or bacteria. Here, we report that human TRIM31 (tripartite motif), an intestine-specific protein localized in mitochondria, is essential for promoting lipopolysaccharide-induced Atg5/Atg7-independent autophagy. TRIM31 directly interacts with phosphatidylethanolamine in a palmitoylation-dependent manner, leading to induction of autolysosome formation. Depletion of endogenous TRIM31 significantly increases the number of intestinal epithelial cells containing invasive bacteria. Crohn's disease patients display TRIM31 downregulation. Human cytomegalovirus-infected intestinal cells show a decrease in TRIM31 expression as well as a significant increase in bacterial load, reversible by the introduction of wild-type TRIM31. We provide insight into an alternative autophagy pathway that protects against intestinal pathogenic bacterial infection.
Human cytomegalovirus (HCMV) has evolved sophisticated immune evasion mechanisms that target both the innate and adaptive immune responses. However, how HCMV encoded proteins are involved in this ...immune escape is not clear. Here, we show that HCMV glycoprotein US9 inhibits the IFN-β response by targeting the mitochondrial antiviral-signaling protein (MAVS) and stimulator of interferon genes (STING)-mediated signaling pathways. US9 accumulation in mitochondria attenuates the mitochondrial membrane potential, leading to promotion of MAVS leakage from the mitochondria. Furthermore, US9 disrupts STING oligomerization and STING-TBK1 association through competitive interaction. Intriguingly, US9 blocks interferon regulatory factor 3 (IRF3) nuclear translocation and its cytoplasmic domain is essential for inhibiting IRF3 activation. Mutant HCMV lacking US7-16 is impaired in antagonism of MAVS/STING-mediated IFN-β expression, an effect that is reversible by the introduction of US9. Our findings indicate that HCMV US9 is an antagonist of IFN signaling to persistently evade host innate antiviral responses.
Background: Outside activities have decreased due to the spread of the COVID-19 since 2019; therefore, the need for education using information and communication technology (ICT) for older adults ...with mild cognitive impairment (MCI) has increased. This study systematically evaluated the effects of cognitive enhancement interventions using ICT on older adults with MCI. Methods: Six electronic databases (CINAHL, Cochrane CENTRAL, EMBASE, PubMed, RISS, and KISS) were searched for relevant articles published from 25 January to 10 February, 2021. Results: As a result of the systematic literature review, 12 research papers were finally selected as the literature for quality evaluation, and 11 final papers were selected, excluding one in the quality evaluation. From the synthesis in this study, it was found that cognitive intervention using ICT showed a statistically significant positive effect on cognitive function when compared with various control groups (SMD = 0.4547; p < 0.001; 95% CI: 0.1980–0.7113). Conclusions: Through this study, cognitive intervention using ICT showed a small effect size for older adults with mild cognitive impairment, and statistically significant results were found.
Background: Mild cognitive impairment (MCI) is a stage preceding dementia, and early intervention is critical. This study investigated whether multi-domain cognitive training programs, especially ...robot-assisted training, conducted 12 times, twice a week for 6 weeks can improve cognitive function and depression decline in community-dwelling older adults with mild cognitive impairment (MCI). Methods: A randomized controlled trial was conducted with 135 volunteers without cognitive impairment aged 60 years old or older. Participants were first randomized into two groups. One group consisted of 90 participants who would receive cognitive training and 45 who would not receive any training (NI). The cognitive training group was randomly divided into two groups, 45 who received traditional cognitive training (TCT) and 45 who received robot-assisted cognitive training (RACT). The training for both groups consisted of a daily 60 min session, twice a week for six weeks. Results: RACT participants had significantly greater post-intervention improvement in cognitive function (t = 4.707, p < 0.001), memory (t = −2.282, p = 0.007), executive function (t = 4.610, p < 0.001), and depression (t = −3.307, p = 0.004). TCT participants had greater post-intervention improvement in memory (t = −6.671, p < 0.001) and executive function (t = 5.393, p < 0.001). Conclusions: A 6-week robot-assisted, multi-domain cognitive training program can improve the efficiency of global cognitive function and depression during cognitive tasks in older adults with MCI, which is associated with improvements in memory and executive function.
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