Duration of cryostorage is not associated with rates of thaw survival, fertilization, blastulation and ploidy, or pregnancy outcomes of vitrified human oocytes.

Purpose: This study is to evaluate duration of oocyte cryostorage and association with thaw survival, fertilization, blastulation, ploidy rates, and pregnancy outcomes in patients seeking fertility preservation.

Methods: Retrospective cohort study to evaluate clinical outcomes in patients who underwent fertility preservation from 2011 to 2023 via oocyte vitrification for non-oncologic indications. Primary outcome was thaw survival rate.

A multi-center evaluation of a novel IVF cryostorage device in an active clinical setting.

The objective of this study was to evaluate the function, and usability of a novel automated software-guided cryostorage system in an active IVF laboratory setting. The investigational device (ID) was installed at 3 IVF laboratories (sites: α, β, and γ). A total of 15 embryologists were trained to use the ID.

Effect of various contraceptives on oocyte yield and maturation in patients undergoing planned oocyte cryopreservation.

Research Question: Do the various forms of hormonal and non-hormonal contraceptives have any association with ovarian stimulation outcomes, such as oocyte yield and maturation, in patients undergoing planned oocyte cryopreservation (POC)?

Design: This retrospective cohort study included all patients who underwent POC cycles between 2011 and 2023. The use of types of contraception before a POC cycle was recorded. The study evaluated the median number of cumulus-oocyte complexes obtained after vaginal oocyte retrieval and the proportion of metaphase II oocytes that underwent vitrification among all the cohorts.

Rescue in vitro maturation using ovarian support cells of human oocytes from conventional stimulation cycles yields oocytes with improved nuclear maturation and transcriptomic resemblance to in vivo matured oocytes.

Purpose: Determine if the gene expression profiles of ovarian support cells (OSCs) and cumulus-free oocytes are bidirectionally influenced by co-culture during in vitro maturation (IVM).

Methods: Fertility patients aged 25 to 45 years old undergoing conventional ovarian stimulation donated denuded immature oocytes for research. Oocytes were randomly allocated to either OSC-IVM culture (intervention) or Media-IVM culture (control) for 24-28 h.

Effect of postthaw change in embryo score on single euploid embryo transfer success rates.

Objective: To assess whether the change in embryo morphology from precryopreservation to postthaw is associated with the embryo transfer success rates in single euploid embryo transfer cycles.

Design: Retrospective cohort study.

Setting: Academic affiliated fertility clinic.

National Institutes of Health pathways to prevention workshop: Improving rural health through telehealth-guided provider-to-provider communication.

Introduction: Rural communities often face chronic challenges of high rates of serious health conditions coupled with inadequate access to health care services-challenges exacerbated by the COVID-19 pandemic. One strategy with the potential to mitigate these problems is the increased use of telehealth technology. A feature of telehealth applications-collaboration between health care providers for consultation and other purposes-referred to herein as Rural Provider-to-Provider Telehealth (RPPT), introduces important expertise that may not exist locally in rural communities.

Clinical implementation of algorithm-based embryo selection is associated with improved pregnancy outcomes in single vitrified warmed euploid embryo transfers.

Purpose: To assess whether utilization of a mathematical ranking algorithm for assistance with embryo selection improves clinical outcomes compared with traditional embryo selection via morphologic grading in single vitrified warmed euploid embryo transfers (euploid SETs).

Methods: A retrospective cohort study in a single, academic center from September 2016 to February 2020 was performed. A total of 4320 euploid SETs met inclusion criteria and were included in the study.

What is the reproductive potential of day 7 euploid embryos?

Study Question: What is the rate of euploidy and the reproductive potential of embryos biopsied after 6 days of development?

Summary Answer: Embryos biopsied after 6 days of development have higher rates of aneuploidy; however, day 7 euploid embryos selected at transfer can achieve acceptable pregnancy rates and live birth (LB) outcomes.

What Is Known Already: Recent publications have shown promising treatment results after euploid day 7 embryo transfers (ETs), albeit these studies were limited by small sample sizes. Whereas the current clinical standard has been to discard embryos that do not reach expansion by day 6 of development, the lack of robust data surrounding the clinical utility of day 7 embryos warrants further evaluation.

Widening Disparities In Infant Mortality And Life Expectancy Between Appalachia And The Rest Of The United States, 1990-2013.

Appalachia-a region that stretches from Mississippi to New York-has historically been recognized as a socially and economically disadvantaged part of the United States, and growing evidence suggests that health disparities between it and the rest of the country are widening. We compared infant mortality and life expectancy disparities in Appalachia to those outside the region during the period 1990-2013. We found that infant mortality disparities widened for both whites and blacks, with infant mortality 16 percent higher in Appalachia in 2009-13, and the region's deficit in life expectancy increased from 0.

Hatching status before embryo transfer is not correlated with implantation rate in chromosomally screened blastocysts.

Study Question: Do the reproductive outcomes from the transfer of fully hatched (FH) blastocysts differ from those of not fully hatched (NFH) blastocysts?

Summary Answer: Biochemical pregnancy rate (BPR), implantation rate (IR), live birth rate (LBR) and early pregnancy loss (EPL) rate are similar in FH and NFH single euploid blastocyst embryo transfers.

What Is Known Already: The use of extended culture and PGS often leads to transfer of an embryo that is well developed and frequently FH from the zona pellucida. Without the protection of the zona, an FH embryo could be vulnerable to trauma during the transfer procedure.

Optimizing human oocyte cryopreservation for fertility preservation patients: should we mature then freeze or freeze then mature?

Objective: To evaluate the maturation and post-thaw survival rates of immature oocytes to determine whether in vitro maturation (IVM) should be attempted prior to or after cryopreservation.

Design: Nonrandomized observational study.

Setting: Private academic and clinical reproductive center.

Commercially available enhanced in vitro maturation medium does not improve maturation of germinal vesicle and metaphase I oocytes in standard in vitro fertilization cases.

Improvements in in vitro maturation techniques have focused on culture optimization to increase oocyte maturation rates. Specialized culture media, now commercially available, did not perform significantly better than standard IVF culture media for maturation of immature oocytes in our normal IVF cases.

The relationship between the financial status of sole community independent pharmacies and their broader involvement with other rural providers.

Purpose: To document sole community pharmacists' involvement with other local health care organizations, these pharmacies' current financial status, and to determine whether financial position was associated with the provision of pharmacy services to other local health care providers.

Methods: We conducted semistructured interviews with pharmacist-owners of 401 sole community pharmacies randomly selected using data from the National Council for Prescription Drug Programs, Inc. Bivariate and multivariate analyses of responses were conducted to examine associations between pharmacy characteristics, financial position, and involvement with other local health care providers.

A rural-urban comparison of allied health professionals' average hourly wage.

Nationwide, demand for allied health services is projected to grow significantly in the next several decades, and there is evidence that allied health shortages already exist in many states. Given the longstanding history of health professional shortages in rural areas, the existing and impending shortages in allied health professions may be particularly acute in these areas. To assess whether rural areas are potentially at a recruiting disadvantage because of relative wages, this report uses data from the Bureau of Labor Statistics to describe the extent to which rural-urban differentials exist in wages for eight allied health professions, focusing on professions that are both likely to be found in rural communities and have adequate data to support hourly wage estimates.

Rural and urban differences in children's Medicaid and CHIP participation.

Efforts to increase enrollment in Medicaid and the Children's Health Insurance Program (CHIP) among uninsured children would benefit from an understanding of how program participation varies in rural and urban areas. Using Current Population Survey data from the period 2006-2007, rural participation rates were slightly higher than urban rates in the nation overall. There was no rural-urban difference when comparisons were based on within-state variation, independent of adjustment for individual characteristics.

What does the clinical doctorate in physical therapy mean for rural communities?

Background And Purpose: The transition to the Doctor of Physical Therapy (DPT) as the entry-level degree for physical therapists in the United States is nearly complete. Little is known about how the transition has affected the characteristics of the physical therapy workforce or the provision of physical therapy services. Effects may be particularly acute in rural communities with persistent health-care provider shortages.

Designated medical directors for emergency medical services: recruitment and roles.

Context: Emergency medical services (EMS) agencies rely on medical oversight to support Emergency Medical Technicians (EMTs) in the provision of prehospital care. Most states require EMS agencies to have a designated medical director (DMD), who typically is responsible for the many activities of medical oversight.

Purpose: To assess rural-urban differences in obtaining a DMD and in their responsibilities.

Developing financial benchmarks for critical access hospitals.

This study developed and applied benchmarks for five indicators included in the CAH Financial Indicators Report, an annual, hospital-specific report distributed to all critical access hospitals (CAHs). An online survey of Chief Executive Officers and Chief Financial Officers was used to establish benchmarks. Indicator values for 2004, 2005, and 2006 were calculated for 421 CAHs and hospital performance was compared to the benchmarks.

Recruitment and retention in rural and urban EMS: results from a national survey of local EMS directors.

Maintaining an adequate staff is a challenge for rural emergency medical services (EMS) providers. This national survey of local EMS directors finds that rural EMS are more likely to be freestanding, that is, not affiliated with other public services, to employ only emergency medical technician-basics (EMT-Bs), and to be all volunteer. Rural EMS directors are more likely than urban ones to report that they are not currently fully staffed.

Continuing effects of Medicare Part D on rural independent pharmacies who are the sole retail provider in their community.

Background: The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 established funding to allow Medicare beneficiaries to enroll in plans providing outpatient prescription drug coverage beginning in January 2006. The Medicare Part D program has changed the means by which beneficiaries purchase prescription drugs, impacting the business operations of pharmacies.

Objectives: To describe the experiences of rural independently owned pharmacies that are the sole retail pharmacy in their community 1 year after implementation of Medicare Part D, in order to learn if the initial financial and administrative problems associated with the implementation of the program in 2006 resolved over time.

Rural hospitals: are you missing out on drug savings?

The 340B Drug Pricing Program requires drug manufacturers to offer outpatient drugs at a reduced price to certain safety net organizations that provide healthcare services to vulnerable populations. In a survey, participants reported pharmacy savings ranging from $600 to $158,000 per month, with a mean savings of $19,700 and a median savings of $10,000. The biggest challenge in administering the program is maintaining separate records for inpatient and outpatient drugs, according to participants.

The occupational mix adjustment to the Medicare hospital wage index: why the rural impact is less than expected.

Context: Rural hospitals are heavily dependent on Medicare for their long-term financial solvency. A recent change to Medicare prospective payment system reimbursement--the occupational mix adjustment (OMA) to the wage index--has attracted a great deal of attention in rural policy circles.

Purpose: This paper explores variation in the OMA across and within urban and rural markets.

Bridging health research and policy: effective dissemination strategies.

Unlabelled: INVESTIGATED: This study presents findings from a series of focus groups, composed of stakeholders both on Capitol Hill and among national stakeholder organizations, used to identify strategies health services researchers can use for the effective dissemination and expanded use of health services research in health policy.

Methods: Focus groups were created to assess the usefulness of rural health research products and approaches for disseminating information, and in each focus group, respondents were asked for their evaluation of several types of dissemination products and approaches, as well as participants' utilization of research findings.

Conclusions: The focus groups identify strategies that include tailoring products to policymakers' needs, making Research products accessible, expanding working relationships with end users, and investing in greater capacity for dissemination.