Cruising through a pandemic: Or not?

The features of the cruise value offering that once appealed to the cruising market have changed as a result of COVID 19. This paper employs a choice experiment to reveal how COVID-19 has influenced consumer preferences for and trade-offs between specific aspects of the cruise experience across four different COVID-19 scenarios. Such insight is highly valuable for cruise organisations seeking to better understand the evaluative criteria by which their consumer segments are now making decisions. Theoretically, this study employs Protection Motivation Theory to determine how ones self-rated ability to protect themselves against the virus while cruising may in turn influence choice behaviour. Our research is the first to report actual choice behaviours of cruise consumers adopting a choice modelling method.

Viability and function of the cryopreserved whole rat ovary: comparison between slow-freezing and vitrification.

OBJECTIVE: To investigate four different protocols for cryopreservation of the whole rat ovary with intact vasculature to evaluate whether differences exist in post-thawing viability of the ovary after either vitrification or slow freezing. DESIGN: Experimental study. SETTING: Obstetrics and gynecology department. ANIMAL(S): Immature Sprague-Dawley female rats. INTERVENTION(S): Ovaries were isolated with the vascular tree intact up to the bifurcation of the abdominal aorta and were subsequently cannulated. The ovaries were flushed with increasing concentrations of the cryoprotectant dimethyl sulfoxide (DMSO) to either 1.5 or 7 M. The ovaries underwent cryopreservation by vitrification or passive slow freezing. MAIN OUTCOME MEASURE(S): After thawing, the ovaries were subjected to neutral red viability staining to assess the density of viable small follicles and for long-term (48 hours) incubation evaluation of steroid secretion, histology, and apoptosis assay. RESULT(S): The follicular viability was decreased in both vitrification groups and in the slow-freezing group with the high concentration of DMSO, as compared with fresh controls. Estradiol levels in the incubation medium followed the same pattern. Light microscopy revealed well-preserved morphology in all groups after 48 hours' incubation. Apoptosis was increased in both vitrified and cryopreserved ovaries. CONCLUSION(S): We have developed a new method that can be used in basic studies to improve cryopreservation protocols. Our initial findings suggest that a moderate concentration of the cryoprotectant DMSO is superior to a high DMSO concentration for both vitrification and slow freezing.

Negative pressure wound therapy - a descriptive study.

 To address a persistent lack of evidence regarding the clinical outcomes of negative pressure wound therapy (NPWT) and identify which patient groups are most likely to benefit from NPWT, a retrospective, descriptive study was conducted to describe outcomes of this treatment modality when used in clinical practice. Charts from a consecutive series of 87 patients (median age 68 years, range 16 - 92 years) who received NPWT during a period of 24 months were abstracted to a statistical software file. Patient demographics, history, and comorbidity variables as well as treatment outcomes were obtained from the computerized in- and outpatient record system. Treatment outcomes were grouped as successful (goal of care was met) or not successful (goal of care was not met). Successful treatment was noted for a total of 62 patients (71%) with a median treatment time of 17 days. The proportion of patients with a successful outcome was significantly higher in patients with infectious, postoperative, and traumatic wounds than in patients with wounds related to peripheral vascular disease or pressure ulcers (P = 0.001). Treatment complications were observed in 18 patients (21%); five were related to infection. Quality-of-life concerns were noted as a reason for stopping treatment in four patients and equipment problems were recorded for two patients receiving NPWT in the home. This study confirms previous re- search that NPWT may be an effective and safe treatment method for acute wounds but further studies are needed to evaluate treatment efficacy and effectiveness in patients with peripheral vascular disease or pressure-induced wounds. Results also suggest that research protocols should include patient quality-of-life outcomes.

Alterations of follicular microcirculation and apex structure during ovulation in the rat.

OBJECTIVE: We utilized methods for intravital microscopy and microcirculation measurements to study changes during ovulation. STUDY DESIGN: Immature gonadotrophin-primed rats were laparotomized and one ovary was examined for morphological alterations during a 3 h period (covering a period from 1h before to 27 h after hCG) through water-immersion lenses (maximum magnification 812×). Microcirculatory blood flow was assessed by measurements of blood cell velocity and laser Doppler flowmetry. RESULTS: Follicular hyperaemia was observed 30 min after hCG and then vasomotion was observed. A gradual decline of apical blood flow was seen, which later was associated with an avascular area over the top of the apex. Cells from the surface over the follicular apex were then detached from the exterior of the follicle and this phenomenon was initiated more than one hour prior to follicular rupture. The subsequent structural alterations varied with or without formation of a cone over the stigma. In ovulations with a stigma-cone, a translucent, irregular mass formed over the stigma. Prior to follicular rupture, granulosa cells and follicular fluid were extruded from the follicular cavity at a velocity of around 70 µm/s. Occasionally, intra-antral haemorrhage occurred prior to or during follicular rupture. CONCLUSION: Characteristic features of ovulation in the rat are microcirculatory vasomotion, gradual formation of apical avascular area, specific changes of the stigma, and extrusion of the oocyte-granulosa cell complex with or without haemorrhage.

The human postmenopausal ovary as a tool for evaluation of cryopreservation protocols towards whole ovary cryopreservation.

PURPOSE: Cryopreservation of a complete ovary may be a future method for fertility preservation in cancer patients. Difficulties exist in cryopreservation of the relatively large ovarian tissue mass. This study evaluates whether a human postmenopausal ovary can be used, as a complement to animal models, in studies of this research field. METHODS: Postmenopausal human ovaries (n = 10) were isolated and flushed through ovarian arteries with either the cryoprotectant dimethylsulphoxide or Ringer-Acetate, followed by slow freezing. After thawing, production of androgens during in vitro perfusion and morphology (light/electron microscopy) were assessed. RESULTS: The dimethylsulphoxide-cryopreserved ovaries showed larger secretion of androgens during perfusion than Ringer Acetate-cryopreserved ovaries. Light microscopy showed well preserved morphology in both groups. Electron microscopy revealed normal appearance of stroma and vessels in the dimethylsulphoxide group. CONCLUSIONS: The study demonstrates the potential to use the postmenopausal human ovary for further studies aiming at optimizing cryopreservation protocols, with special reference to ovarian vascularity and stroma.

Whole sheep ovary cryopreservation: evaluation of a slow freezing protocol with dimethylsulphoxide.

PURPOSE: To evaluate a slow freezing method for whole ovary cryopreservation by evaluating effects of added cryoprotectant. METHODS: Sheep ovaries were isolated during surgery, flushed with either Ringer-Acetate or dimethylsulphoxide and cryopreserved by slow freezing. After rapid thawing, viability was assessed by ovarian in vitro perfusion, cell culture, histology and fluorescent live-dead assay. RESULTS: Production of cyclic AMP and progesterone was slightly higher in the dimethylsulphoxide group. Cultured ovarian cells from dimethylsulphoxide-preserved ovaries secreted larger amounts of progesterone than cells from Ringer-Acetate preserved. Light microscopy of ovarian biopsies obtained after perfusion, revealed well-preserved tissue in the dimethysulphoxide group but not in the Ringer-Acetate group. The density of small follicles and ovarian cell viability were higher in dimethysulphoxide ovaries compared to Ringer-Acetate ovaries. CONCLUSIONS: Equilibrium with its protective effect can be achieved by slow freezing protocol, with an additional protective effect by the presence of dimethylsulphoxide.

First report on fertility after allogeneic uterus transplantation.

Uterus transplantation may become the first available treatment for uterine factor infertility, which is due to the absence or malfunction of the uterus. Here we describe for the first time pregnancy after allogeneic uterus transplantation, as a proof of concept of uterine function in a transplanted uterus in a standardized animal model (rat) under immunosuppression.

Viability and function of the cryopreserved whole ovary: in vitro studies in the sheep.

BACKGROUND: Cryopreservation of whole ovaries followed by vascular transplantation may improve long-term function in comparison to conventional cryopreservation of ovarian cortex and avascular transplantation. The aim of this study was to assess methods for the evaluation of viability and function of frozen-thawed whole ovaries. METHODS: Ewe ovaries were flushed with either cryoprotectant (propandiol: FROZEN-PROH) or Ringer Acetate (FROZEN-RA) followed by slow freezing. Some ovaries were assessed fresh after flushing with Ringer Acetate (FRESH-RA). Assessment was done by light microscopy, biochemical response (cyclic adenosine 3',5'-monophosphate (cAMP) and steroids) during in vitro perfusion with forskolin, viability assay and cell culture. RESULTS: Microscopy showed well-preserved morphology with the presence of small follicles in all groups before perfusion. Stromal oedema was seen after in vitro perfusion of FROZEN ovaries, and shrunken small follicles were seen only in FROZEN-RA at the end of perfusion. During in vitro perfusion, FRESH-RA ovaries responded with large increase in levels of cAMP after stimulation with forskolin. FROZEN-PROH and FROZEN-RA ovaries exhibited lower production of cAMP. Progesterone concentrations in cell cultures of dispersed ovarian cells were higher in FRESH-RA when compared with FROZEN groups. Addition of hCG to cell cultures resulted in higher progesterone levels in the FROZEN-PROH compared with FROZEN-RA. Cell viability assay showed overall viability of 60-75% with no significant difference between groups. CONCLUSION: In vitro perfusion may prove to be a suitable method to test viability and function of frozen-thawed whole ovaries contributing to the optimization of current cryopreservation protocols.

The presence of cytokines and growth factors in hydrosalpingeal fluid.

PURPOSE: To examine the presence of cytokines and growth factors in hydrosalpingeal fluid. METHODS: Eighteen hydrosalpingeal fluids were compared with 15 follicular fluids and serum samples regarding the presence of interleukin-8 (IL-8), IL-12, IL-1alpha, epidermal growth factor (EGF), granulocyte macrophage colony stimulating factor (GM-CSF), leukemia inhibitory factor (LIF), tumor necrosis factor-alpha (TNFalpha), interferon-gamma (IFNgamma), and transforming growth factor-beta2 (TGFbeta2). RESULTS: IL-8 and EGF were detected in all the hydrosalpinx samples. IL-8, IL-12, IL-1alpha, TNFalpha, TGFbeta2, GM-CSF, and LIF were detected to a significantly larger extent in hydrosalpingeal than follicular fluids (p < 0.01). The same cytokines, with the exception of IL-8, TGFbeta2, and LIF, were also more frequently present in comparison with serum. CONCLUSION: The abundant presence of cytokines in hydrosalpingeal fluid suggests an increased expression from the tubal epithelium. Whether high concentrations have a negative influence on embryo development and implantation needs further investigation.