A synopsis of global frontiers in fertility preservation.

Since 2007, the Oncofertility Consortium Annual Conference has brought together a diverse network of individuals from a wide range of backgrounds and professional levels to disseminate emerging basic and clinical research findings in fertility preservation. This network also developed enduring educational materials to accelerate the pace and quality of field-wide scientific communication. Between 2007 and 2019, the Oncofertility Consortium Annual Conference was held as an in-person event in Chicago, IL. The conference attracted approximately 250 attendees each year representing 20 countries around the world. In 2020, however, the COVID-19 pandemic disrupted this paradigm and precluded an in-person meeting. Nevertheless, there remained an undeniable demand for the oncofertility community to convene. To maintain the momentum of the field, the Oncofertility Consortium hosted a day-long virtual meeting on March 5, 2021, with the theme of "Oncofertility Around the Globe" to highlight the diversity of clinical care and translational research that is ongoing around the world in this discipline. This virtual meeting was hosted using the vFairs ® conference platform and allowed over 700 people to participate, many of whom were first-time conference attendees. The agenda featured concurrent sessions from presenters in six continents which provided attendees a complete overview of the field and furthered our mission to create a global community of oncofertility practice. This paper provides a synopsis of talks delivered at this event and highlights the new advances and frontiers in the fields of oncofertility and fertility preservation around the globe from clinical practice and patient-centered efforts to translational research.

Learning from facial expressions in individuals with Williams syndrome.

BACKGROUND: Despite high levels of social engagement, the social competence of individuals with Williams syndrome (WS) is frequently compromised. This descriptive study explores the ability of young people with WS to learn from facial expressions when provided as a source of feedback for their actions. METHOD: Using a novel task, the ability to interpret facial expressions and adapt behaviour after receiving feedback in the form of happy or angry faces was assessed in 12 participants with WS aged between 10 and 28 years and with a mean nonverbal mental age of 6.5 years, and in typically developing (TD) children aged between 4 and 7 years. RESULTS: Individuals with WS were able to use facial expressions as feedback in a manner commensurate with their mental age, only when other cognitive demands were low. Their performance profile differed from that of the TD children matched for mental age and from the performance profile of 4 year olds. CONCLUSIONS: Possible explanations for the unique performance profile observed in the participants with WS are discussed. The results highlight the need to examine social competencies in the context of the cognitive demands characteristic of social environments.

Implanted renal replacement for end-stage renal disease.

The nearly 400000 American patients on dialysis suffer high cardiovascular and infectious mortality, but there is now evidence that this morbid phenotype can be rescued by intensive dialytic therapy. Self-care dialysis at home is limited by patient fears about skill and safety. An implanted artificial kidney would provide the benefits of intensive therapy while avoiding the focal points of patient concern. Hollow fiber polymer membranes and dialytic waste removal are lifesaving innovations but are difficult to adapt to implantable therapies. Biomimetic membranes and living cells can replicate the native kidney's strategy for waste removal. Three key technology developments are necessary for implementation of an implantable artificial kidney: high efficiency ultrafiltration membranes, control of blood-materials interactions such as thrombosis and fouling, and stable differentiated function of renal proximal tubule cells in an engineered construct. There has been significant progress in demonstrating proof-of-concept experiments in each key technology area.

Influence of leaf trichomes on predatory mite (Typhlodromus pyri) abundance in grape varieties.

Non-glandular leaf trichomes positively influence the abundance of many phytoseiid mites. We characterized the influence of grape leaf trichomes (domatia, hairs, and bristles) on Typhlodromus pyri Scheuten abundance over two years in a common garden planting of many grape varieties and 2 years of sampling in a commercial vineyard. In general, a lack of trichomes was associated with much lower predator numbers and in the case of Dechaunac, a cultivar with almost no trichomes, very few T. pyri were found. Phytoseiid abundance was best predicted by a model where domatia and hair had an additive effect (r (2) = 0.815). Over two years of sampling at a commercial vineyard there were T. pyri present on all of the 5 cultivars except Dechaunac. At the same time, European red mite prey were present on Dechaunac alone. These results suggest that on grape cultivars lacking leaf trichomes, T. pyri likely will not attain sufficient densities to provide biological control of European red mite, despite presence of the mite food source. The relationship between leaf trichomes and phytoseiid abundance that is observed at the scale of single vines in a garden planting appears to also be manifest at the scale of a commercial vineyard. Because persistence of predatory mites in or nearby the habitats of prey mites is important for effective mite biological control, leaf trichomes, through their influence on phytoseiid persistence, may be critical for successful mite biological control in some systems.

Interpretations of a teratogen warning symbol.

BACKGROUND: Warning symbols are used on teratogenic medications to communicate the message that women should (1) not take that medication if they may already be pregnant, and (2) not get pregnant while taking that medication. Communications research indicates that people interpret symbols or pictures in different ways. Other studies have shown that patients do not always receive education materials that are part of prescription protocol. Researchers at the Centers for Disease Control and Prevention (CDC) tested the interpretation of the teratogen warning symbol and its ability to convey the correct information without accompanying education. METHODS: A teratogen warning symbol currently printed on some medication packaging uses graphics and text warning the user not to get pregnant. Researchers interviewed women of childbearing age about their interpretation of the warning symbol and its meaning. Ninety-seven women were interviewed in a variety of locations, including public health clinics, literacy and job training offices, health clubs, and malls. RESULTS: Only 21% of women interpreted correctly without prompting that they should either not take the medication if they are pregnant or not get pregnant while taking the medication. Twenty-seven percent of women first thought the symbol meant the package contained birth control medication, and 24% said it simply indicated the package contained drugs or medicine. An additional 7% said they did not know what the symbol was supposed to mean; 39% of respondents offered circumstances in which prescription medications might be shared. CONCLUSIONS: Misinterpretation of warning symbols can result in serious consequences. This research should serve as an urgent call for mandating education for all patients receiving drugs with teratogenic properties, and careful pretesting and modification of warning symbols before they are used on medications with teratogenic effects. Published 2001 Wiley-Liss, Inc.

Efficacy of a single occipitomental radiograph to screen for midfacial fractures.

PURPOSE: This study evaluated the use of a single 30 degrees occipitomental radiograph as an effective screening procedure for midface fractures. PATIENTS AND METHODS: The emergency room 30 degrees occipitomental films of 105 consecutive patients with suspected midface fractures were examined independently by 2 oral and maxillofacial surgeons (OMFS). They were asked to identify whether a midfacial fracture existed in each case. They also identified those cases in which they believed a computed tomography (CT) scan was indicated for definitive diagnosis of midfacial fractures. These findings and recommendations were then compared with the actual diagnosis and imaging studies for these patients to determine the efficacy of a single occipitomental film, supplemented by CT scans when indicated, in identifying midface fractures. RESULTS: Of the 105 occipitomental films, one oral and maxillofacial surgeon recommended CT scans for 13 of the 105 patients, and the second recommended CT scans for 26 patients. Seventeen patients actually had had CT scanning performed, and a midface fracture was identified in 12 cases. Of these 12 patients, 8 were treated by surgical intervention. One OMFS identified 11 of the 12 fractures that were subsequently identified in the emergency room, including all of the 8 that required surgical treatment, whereas the second OMFS identified all 12 of the fractures seen in the emergency room. CONCLUSION: A single 30 degrees occipitomental radiograph, augmented with CT scans when indicated, can accurately identify all midface fracture requiring treatment. The current practice of obtaining a series of plain radiographs may be unnecessary.

Genetic technologies. Bioengineered food--safety and labeling.

The safety and labeling of genetically engineered foods are two areas that have elicited considerable public concern and debate. This Policy Forum provides a legal analysis of these issues in the context of two bills that have been recently proposed in The U.S. Congress, the Genetically Engineered Food Safety Act and the Genetically Engineered Food Right to Know Act. Most transgenic components of foods currently on the market are plant-incorporated protectants or their inert ingredients. Therefore, they have been evaluated for safety by the Environmental Protection Agency (as well as the Food and Drug Administration), and their disclosure in labeling should not be required. If plant-incorporated protectants are considered safer than chemical pesticides, and chemical pesticides do not have to be disclosed in labels, then bioengineered foods should not be subject to stricter regulation, nor should they be required to be labeled. The two bills are inconsistent, in many respects, with well-established principles of food regulation.

Soft tissue surgery in the oral and maxillofacial region.

The practice of dentistry is most often perceived as the treatment of the hard tissues of the oral region, specifically the teeth and jaws. However, there are many disorders and conditions involving surgical treatment of the soft tissues that extend to the adjacent and associated structures of the oral and maxillofacial surgery region.

The effect of dust lead control on blood lead in toddlers: a randomized trial.

BACKGROUND: Contaminated household dust is believed to be a major source of exposure for most children with elevated blood lead levels. To determine if a vigorous dust clean-up effort would reduce this exposure we conducted a randomized controlled field trial. METHODS: We randomized 113 urban children between the ages of 6 and 36 months: 56 children to a lead dust intervention composed of maternal education and biweekly assistance with household cleaning and 57 children to a control group. Household cleaning was done by two trained lay workers who focused their efforts on wet mopping of floors, damp-sponging of walls and horizontal surfaces, and vacuuming with a high-efficiency particle accumulating vacuum. Household dust lead levels, child blood lead levels, and maternal knowledge of lead poisoning and sources of exposure were measured before and after the intervention. RESULTS: Ninety-nine children were successfully followed for 12 +/- 3 months: 46 children in the lead group and 53 children in the control group. Age and blood lead were similar in the two groups at baseline and averaged 20 months and 12.0 micrograms/dL, respectively. Blood lead fell 17% in the intervention group and did not change among controls. Household dust and dust lead measures also fell significantly in the intervention group. Children in homes cleaned 20 or more times throughout the year had an average blood lead reduction of 34%. CONCLUSIONS: Regular home cleaning, accompanied by maternal education, is a safe and partially effective intervention that should be recommended for the large majority of lead-exposed children for whom, unfortunately, removal to lead-safe housing is not an option.

Transfer from long to short photoperiods affects production efficiency of day-neutral rice.

The day-neutral, semidwarf rice (Oryza sativa L.) cultivar Ai-Nan-Tsao was grown in a greenhouse under summer conditions using high-pressure sodium lamps to extend the natural photoperiod. After allowing 2 weeks for germination, stand establishment, and thinning to a consistent planting density of 212 plants/m2, stands were maintained under continuous lighting for 35 or 49 days before shifting to 8- or 12-h photoperiods until harvest 76 days after planting. Non-shifted control treatments consisting of 8-, 12-, or 24-h photoperiods also were maintained throughout production. Tiller number increased as duration of exposure to continuous light increased before shifting to shorter photoperiods. However, shoot harvest index and yield efficiency rate were lower for all plants receiving continuous light than for those under the 8- or 12-h photoperiods. Stands receiving 12-h photoperiods throughout production had the highest grain yield per plant and equaled the 8-h-photoperiod control plants for the lowest tiller number per plant. As long as stands were exposed to continuous light, tiller formation continued. Shifting to shorter photoperiods late in the cropping cycle resulted in newly formed tillers that were either sterile or unable to mature grain before harvest. Late-forming tillers also suppressed yield of grain in early-forming tillers, presumably by competing for photosynthate or for remobilized assimilate during senescence. Stands receiving 12-h photoperiods throughout production not only produced the highest grain yield at harvest but had the highest shoot harvest index, which is important for resource-recovery strategies in advanced life-support systems proposed for space.

Childhood lead screening knowledge and practice. Results of a New Jersey physician survey.

CONTEXT: As the nation moves toward targeted childhood lead screening, CDC continues to recommend universal screening in states with no childhood lead poisoning prevalence data. OBJECTIVE: The study was conducted, prior to the new universal screening state law, to determine physician screening practices and their consistency with key CDC recommendations as a basis for future education activities. DESIGN/SETTING/PARTICIPANTS: A statewide cross-sectional self-administered multiple choice survey of 541 randomly selected New Jersey pediatricians and family practitioners. OUTCOME MEASURES: Risk assessment, screening and case management practices and their consistency with CDC recommendations. RESULTS: We obtained 333 usable responses (69.4%). Most respondents reported confirming blood lead level, initiating case management, and identifying medical emergencies at blood lead levels lower than recommended by CDC. More than half reported not assessing the risk of the majority of their patients. At least one third were not screening infants, children between 1 and 2 years, or children between 2 and 6 years of age. Physicians who assessed risk tended to screen high-risk children in all age groups. Only 42% of pediatricians and 24% of family practitioners said they screened the majority of the children in their practice by age 2 years. About 60% of all respondents reported not providing lead exposure education to half their patients. CONCLUSIONS: Passing a universal screening law, as New Jersey has done, is one way to obtain baseline childhood lead poisoning prevalence data. Private practice-targeted physician education led by preventive medicine specialists may also be helpful.

Deep venous thrombosis with pulmonary embolus after selective embolization of an internal iliac artery aneurysm.

A 69-year-old man with an isolated right internal iliac artery aneurysm measuring 5.6 cm in diameter was treated with percutaneous embolization inducing thrombosis of the aneurysm. Four months later, he was seen with thrombosis of the right common iliac vein and pulmonary embolus. He subsequently underwent ligation of the aneurysm and repair of the right common iliac artery. Computed tomographic and operative findings suggested that the iliac vein thrombosis was the result of direct compression by the aneurysm itself, as well as perianeurysmal inflammation that encased the right common iliac vein. This report summarizes this case and presents a new potential long-term complication after successful selective embolization of an internal iliac artery aneurysm.

A comparative study of saphenous vein, internal jugular vein, and knitted Dacron patches for carotid artery endarterectomy.

To determine whether the choice of material used for patch closure following carotid artery endarterectomy (CAE) affected the immediate operative results, the early follow-up results, or the incidence of early restenosis, a retrospective study of 275 consecutive carotid endarterectomies by two vascular surgeons was performed. Among 275 primary CAEs performed between July 1991 and August 1993, 159 (57.8%) were closed with saphenous vein (SV), 25 (9.1%) with double-thickness internal jugular vein (JV), and 91 (33.1%) with knitted Dacron (KD). Primary closure was not used in any of the arteries in this series. The overall perioperative mortality rate was 1.1% and the rate of major and minor morbidity was 4.4% There were four (1.5%) perioperative strokes: two (1.3%) in the SV group, one (4.0%) in the JV group, and one (1.1%) in the KD group. Two-hundred fifty-eight (93.8%) of the 275 endarterectomies were followed postoperatively for 2 to 35 months (mean 14.4). Two-hundred nineteen (79.6%) were evaluated using duplex scans during follow-up with a mean interval of 13.7 months. Of the arteries studied, four (3.6%) in the SV group, none in the JV group, and six (8.4%) in the KD group demonstrated restenosis of > 50% at the time of follow-up (NS). In addition, one (0.9%) artery in the SV group, one (5.6%) in the JV group, and none in the KD group demonstrated complete occlusion. Retrospective analysis of the data showed no statistically significant differences in perioperative morbidity, mortality, or early postoperative restenosis whether the artery was closed with saphenous vein, jugular vein, or knitted Dacron patches. Longer follow-up is needed to determine whether rates of late restenosis and aneurysmal dilation will differ between synthetic and autologous patches.

Retroperitoneal caval filter as a source of abdominal pain.

A patient with a Mobin-Uddin vena caval filter placed 10 years earlier was referred with abdominal pain, nausea, anorexia and weight loss. Diagnostic studies confirmed that the filter was in an extracaval position in the retroperitoneum, with the filter struts impinging on the right kidney, duodenum and colon. Following surgical removal of the filter the patient is now symptom-free with good appetite and weight gain.

Adult onset of inflammatory linear verrucous epidermal nevus in a mother and her daughter.

Inflammatory linear verrucous epidermal nevus (ILVEN) is a rather uncommon dermatosis that typically has an early age of onset, is unilateral, localized, pruritic and relatively refractory to treatment. Atypical presentations of ILVEN have also been described and include late onset in life, widespread involvement and response to treatment. We report the adult onset of an extremely pruritic systemized eruption in both mother and her daughter that clinically and histologically was most compatible with ILVEN. The eruptions were also partially responsive to therapy.