Bona fide diminished ovarian reserve or profound ovarian suppression by long-term oral contraceptive use?

Combined oral contraceptives (COCs) are widely used by reproductive-aged women. Current data suggest that long-term use of COCs can suppress ovarian reserve markers, including anti-mullerian hormone and antral follicle count, which may negatively impact ovarian response and oocyte yield in patients undergoing planned oocyte cryopreservation to preserve future reproductive potential. Discontinuation of COCs can improve ovarian stimulation outcomes, though the ideal duration of cessation is unknown.

Gender-affirming care education in pharmacy: a scoping review protocol of practices in Canada and the USA.

Introduction: Gender-affirming care refers to a range of social, psychological, medical and/or surgical interventions provided to affirm one's gender. Pharmacists play a key role in gender-affirming care and are involved with choosing optimal treatments, monitoring progress/side-effects and providing education. However, it is currently unknown what gender-affirming care education is provided to pharmacy students and pharmacists according to information available in published literature.

Behind the scenes of EQA - characteristics, capabilities, benefits and assets of external quality assessment (EQA).

External quality assessment (EQA) cycles are the smallest complete units within EQA programs that laboratories can use to obtain external assessments of their performance. In each cycle, several samples are distributed to the laboratories registered for participation, and ideally, EQA programs not only cover the examination procedures but also the pre- and post-examination procedures. The properties and concentration range of measurands in individual samples are selected with regard to the intended challenge for the participants so that each sample fulfils its purpose.

Behind the scenes of EQA - characteristics, capabilities, benefits and assets of external quality assessment (EQA).

Providers of external quality assessment (EQA) programs evaluate data or information obtained and reported by participant laboratories using their routine procedures to examine properties or measurands in samples provided for this purpose. EQA samples must offer participants an equal chance to obtain accurate results, while being designed to provide results in clinically relevant ranges. It is the responsibility of the EQA provider to meet the necessary requirements for homogeneity, stability and some other properties of the EQA items in order to offer participants a fair, reliable and technically interesting EQA experience.

Inner Helmholtz layer control through co-solvent strategies for high-performance copper hexacyanoferrate//zinc battery.

Copper hexacyanoferrate (CuHCF) demonstrates high working voltage, convenient synthesis methods, and economic benefits. However, capacity decay of CuHCF//Zn full cells is usually observed in aqueous electrolytes due to the dissolution of Cu and Fe, as indicated by the irreversible insertion of Zn ions and the consequent formation of ZnCuHCF. To address these challenges, a cathode-oriented electrolyte engineering design employing a methyl acetate (MA) co-solvent with zinc triflate (Zn(OTf)) salt electrolyte is implemented.

Herbal nanoemulsions in cosmetic science: A comprehensive review of design, preparation, formulation, and characterization.

The rapid development of delivery systems for cosmetics has revealed two critical challenges in the field: enhancing the solubility of active ingredients and ensuring the stability of natural materials used in cosmetics. Nanoemulsion technology has emerged as an indispensable solution for addressing these challenges, not only enhancing the stability of cosmetics but also improving the solubility of pharmaceuticals and active ingredients with poor solubility. Nanoemulsion formulations have reinforced stability and amended the bioavailability of hydrophobic drugs.

Dual-Modality Flow Phantom for Ultrasound and Optical Flow Measurements.

As ultrasound-compatible flow phantoms are devised for performance testing and calibration, there is a practical need to obtain independent flow measurements for validation using a gold-standard technique such as particle image velocimetry (PIV). In this paper, we present the design of a new dual-modality flow phantom that allows ultrasound and PIV measurements to be simultaneously performed. Our phantom's tissue mimicking material is based on a novel hydrogel formula that uses propylene glycol to lower the freezing temperature of an ultrasound-compatible poly(vinyl) alcohol cryogel and, in turn, maintain the solution's optical transparency after thermocycling.

Relaxation-optimized correlation spectroscopy ROCSY for assigning H or C spin systems in large proteins.

Solution NMR studies of large systems are hampered by rapid signal decay. We hereby introduce ROCSY (relaxation-optimized total correlation spectroscopy), which maximizes transfer efficiency across J-coupling-connected spin networks by minimizing the amount of time magnetization spends in the transverse plane. Hard pulses are substituted into the Clean-CITY TOCSY pulse element first developed by Ernst and co-workers, allowing for longer delays in which magnetization is aligned along the z-axis.

Making sense of praxis within an evolving clinical context: A grounded theory of nursing student learning transfer.

Background: Nursing students are tasked with connecting theoretical knowledge with clinical practice to ensure patient safety and provide quality care. However, there is a distinct lack of research on nursing student learning transfer. More exploration and research are necessary to understand how nursing students apply their learning in complex and evolving clinical situations.

Towards transcervical ultrasound-guided transoral robotic surgery.

Background: In the context of transoral robotic surgery (TORS) for oropharyngeal squamous carcinoma (OPSCC), preoperative imaging and intraoperative visualization plays a pivotal role in optimizing resection margins. Prior work has demonstrated the ability of transoral ultrasound (US) in identifying OPSCC margins and vascular structures. This study evaluates the effectiveness of transcervical ultrasound (TUS), as well as other preoperative imaging modalities, in evaluating OPSCC volumes and compares this to post TORS pathological OPSCC volumes.

Thalamic deep brain stimulation for central poststroke pain syndrome: an international multicenter study.

Objective: The effectiveness and optimal stimulation site of deep brain stimulation (DBS) for central poststroke pain (CPSP) remain elusive. The objective of this retrospective international multicenter study was to assess clinical as well as neuroimaging-based predictors of long-term outcomes after DBS for CPSP.

Methods: The authors analyzed patient-based clinical and neuroimaging data of previously published and unpublished cohorts from 6 international DBS centers.

Curvature Dependence of Gravitational-Wave Tests of General Relativity.

High-energy extensions to general relativity modify the Einstein-Hilbert action with higher-order curvature corrections and theory-specific coupling constants. The order of these corrections imprints a universal curvature dependence on observations while the coupling constant controls the deviation strength. In this Letter, we leverage the theory-independent expectation that modifications to the action of a given order in spacetime curvature (Riemann tensor and contractions) lead to observational deviations that scale with the system length scale to a corresponding power.

Disentangling Sources of Momentum Fluctuations in Xe+Xe and Pb+Pb Collisions with the ATLAS Detector.

High-energy nuclear collisions create a quark-gluon plasma, whose initial condition and subsequent expansion vary from event to event, impacting the distribution of the eventwise average transverse momentum [P([p_{T}])]. Disentangling the contributions from fluctuations in the nuclear overlap size (geometrical component) and other sources at a fixed size (intrinsic component) remains a challenge. This problem is addressed by measuring the mean, variance, and skewness of P([p_{T}]) in ^{208}Pb+^{208}Pb and ^{129}Xe+^{129}Xe collisions at sqrt[s_{NN}]=5.

Metallic Bonding in Close-Packed Structures: Structural Frustration from a Hidden Gauge Symmetry.

Based on its simple valence electron configuration, we may expect lithium to have straightforward physical properties that are easily explained. However, solid lithium, when cooled below 77 K, develops a complex structure that has been debated for decades. A close parallel is found in sodium below 36 K where the crystal structure still remains unresolved.

The gap between surgeon goal and achieved sagittal alignment in adult cervical spine deformity surgery.

Objective: Malalignment following cervical spine deformity (CSD) surgery can negatively impact outcomes and increase complications. Despite the growing ability to plan alignment, it remains unclear whether preoperative goals are achieved with surgery. The objective of this study was to assess how good surgeons are at achieving their preoperative goal alignment following CSD surgery.

Optimizing Virtual Follow-Up Care: Realist Evaluation of Experiences and Perspectives of Patients With Breast and Prostate Cancer.

Background: Virtual follow-up (VFU) has the potential to enhance cancer survivorship care. However, a greater understanding is needed of how VFU can be optimized.

Objective: This study aims to examine how, for whom, and in what contexts VFU works for cancer survivorship care.

The moral web of accessibility to medical assistance in dying: Reflections from the Canadian context.

In this paper, we reflect on factors that seem to have influenced the accessibility of medical assistance in dying (MAID) in the Canadian context. Since legalization in 2016, the uptake of MAID has increased rapidly to equal or exceed rates in other countries. In that MAID implementation involves numerous ethical/moral complexities, we consider four factors that appear to have influenced this growth.

Oxylipin Profiling of Airway Structural Cells Is Unique and Modified by Relevant Stimuli.

Oxylipins, diverse lipid mediators derived from fatty acids, play key roles in respiratory physiology, but the contribution of lung structural cells to this diverse profile is not well understood. This study aimed to characterize the oxylipin profiles of airway smooth muscle (ASM), lung fibroblasts (HLF), and epithelial (HBE) cells and define how they shift when they are exposed to stimuli related to contractility, fibrosis, and inflammation. Using HPLC-MS/MS, 162 oxylipins were measured in baseline media from cultured human ASM, HLF, and HBE cells as well as after stimulation with modulators of contractility and central regulators of fibrosis/inflammation.

Risk Factors for Proliferative Vitreoretinopathy in a Large Clinical Database.

Purpose: Proliferative vitreoretinopathy (PVR) is the leading cause of surgical failure following rhegmatogenous retinal detachment (RRD). In this study, we aimed to explore ocular and systemic risk factors for PVR due to RRD in a large patient database.

Methods: Patients who have a diagnosis of RRD and PVR, and who have been seen in the last seven years prior to analysis (January 2015-February 2023) were identified in the Vestrum Health database.

The American Clinical Neurophysiology Society Guideline on Indications for Continuous Electroencephalography Monitoring in Neonates.

Purpose: Continuous EEG (cEEG) monitoring is increasingly used in the management of neonates with seizures. There remains debate on what clinically relevant information can be gained from cEEG in neonates with suspected seizures, at high risk for seizures, or with definite seizures, as well as the use of cEEG for prognosis in a variety of conditions. In this guideline, we address these questions using American Clinical Neurophysiology Society structured methodology for clinical guideline development.

Renal Tubule-Specific Angiotensinogen Deletion Attenuates SGLT2 Expression and Ameliorates Diabetic Kidney Disease in Murine Models of Type 1 Diabetes.

The role of the intrarenal renin-angiotensin system (iRAS) in diabetic kidney disease (DKD) progression remains unclear. In this study, we generated mice with renal tubule-specific deletion of angiotensinogen (Agt; RT-Agt-/-) in both Akita and streptozotocin (STZ)-induced mouse model of diabetes. Both Akita RT-Agt-/- and STZ-RT-Agt-/- mice exhibited significant attenuation of glomerular hyperfiltration, urinary albumin/creatinine ratio, glomerulomegaly and tubular injury.