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Non-invasive cumulus cell analysis can be applied for oocyte ranking and is useful for countries with legal restrictions on embryo generation or freezing

by Tom Adriaenssens, Inge Van Vaerenbergh, Lisbet Van Landuyt, Greta Verheyen, Michaël De Brucker, Michel Camus, Peter Platteau, Michel De Vos, Maria Reis, Elien Van Hecke, André Rosenthal, Johan Smitz

Research question

Can a strategy for scoring oocyte quality, based on cumulus cell (CC) gene expression, prioritize oocytes with the highest implantation potential, while limiting the number of embryos to be processed in culture and the number of supernumerary embryos to be vitrified?

Design

An interventional, blinded, prospective cohort study was retrospectively analyzed. In the original study, patients underwent a fresh Day3 single embryo transfer with embryos ranked based on morphology and CC gene expression (Aurora Test). The additional ranking of the embryos with the Aurora Test resulted in significant higher clinical pregnancy and live birth rates. Now it is investigated if the Aurora Test ranking could be applied to select oocytes. The effect of an Aurora Test based restriction to 2 and 3 2PN or MII oocytes on clinical pregnancy and other outcomes, was analyzed in two subsets of patients with all 2PN (n = 83) or all MII oocytes (n = 45) ranked.

Results

Considering only the top three ranked 2PN oocytes, 95% of the patients would have received a fresh SET on Day3 resulting in 65% clinical pregnancies. This was not different from the pregnancy rate obtained in a strategy using all oocytes but significantly reduced the need for vitrification of supernumerary embryos by 3-fold. Considering only top-ranked MII oocytes gave similar results.

Conclusions

In countries with legal restrictions on freezing of embryos, gene expression of CC can be used for the selective processing of oocytes and would thus decrease the twin pregnancy rate and workload, especially for embryo morphology scoring and transfers as the handling and processing of lower competence oocytes is prevented, while improving the ART outcome.

The holistic nursing competence and transition shock of newly graduated nurses as the determinants of missed nursing care: The mediation analysis

Abstract

Aims and Objective

To investigate the determinants of missed nursing care and to analyse the mediating effect of holistic nursing competence on the relationship between transition shock and missed nursing care.

Background

Transition shock of newly graduated nurses is associated with missed nursing care. Previous studies have shown the determinants of missed nursing care among nurses, but little is known about the relationship between missed nursing care, transition shock and holistic nursing competence.

Design

Descriptive and correlational design.

Methods

The study was conducted among newly graduated nurses (n = 201) working in acute care hospitals for 1–12 months. The MISSCARE survey, Holistic Nursing Competence Scale and Nursing Transition Shock Scale were used for data collection, in addition to a sociodemographic question form. Data were analysed using Pearson correlation, multiple regression and mediation analyses. The study was reported following the STROBE checklist.

Results

The determinants of missed nursing care among newly graduated nurses were sex, unit type, rotating shift work, holding a certificate, holistic nursing competence and transition shock. All these variables explain 35% of the variance in missed nursing care. Holistic nursing competence directly mediated 51.7% of the relationship between transition shock and missed nursing care.

Conclusions

Holistic nursing competence may decrease missed nursing care by reducing the effects of transition shock on newly graduated nurses.

Relevance to Clinical Practice

The study highlighted that newly graduated nurses are an important population regarding missed nursing care. The determinants of missed care should be considered in the nursing care delivery to prevent missed care by newly graduated nurses. Based on the study findings, some recommendations were made for nurse managers and faculty for the orientation program and undergraduate nursing education.

A medium-chain fatty acid analogue prevents hepatosteatosis and decreases inflammatory lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis

by Bennet S. Cho, Scott C. Fligor, Gillian L. Fell, Jordan D. Secor, Savas T. Tsikis, Amy Pan, Lumeng J. Yu, Victoria H. Ko, Duy T. Dao, Lorenzo Anez-Bustillos, Thomas I. Hirsch, Jenny Lund, Arild C. Rustan, David A. Fraser, Kathleen M. Gura, Mark Puder

Background

Parenteral (intravenous) nutrition is lifesaving for patients with intestinal failure, but long-term use of parenteral nutrition often leads to liver disease. SEFA-6179 is a synthetic medium-chain fatty acid analogue designed to target multiple fatty acid receptors regulating metabolic and inflammatory pathways. We hypothesized that SEFA-6179 would prevent hepatosteatosis and lipotoxicity in a murine model of parenteral nutrition-induced hepatosteatosis.

Methods

Two in vivo experiments were conducted. In the first experiment, six-week-old male mice were provided an ad lib fat-free high carbohydrate diet (HCD) for 19 days with orogastric gavage of either fish oil, medium-chain triglycerides, or SEFA-6179 at a low (0.3mmol/kg) or high dose (0.6mmol/kg). In the second experiment, six-week-old mice were provided an ad lib fat-free high carbohydrate diet for 19 days with every other day tail vein injection of saline, soybean oil lipid emulsion, or fish oil lipid emulsion. Mice then received every other day orogastric gavage of medium-chain triglyceride vehicle or SEFA-6179 (0.6mmol/kg). Hepatosteatosis was assessed by a blinded pathologist using an established rodent steatosis score. Hepatic lipid metabolites were assessed using ultra-high-performance liquid chromatography-mass spectrometry. Effects of SEFA-6179 on fatty acid oxidation, lipogenesis, and fatty acid uptake in human liver cells were assessed in vitro.

Results

In the first experiment, mice receiving the HCD with either saline or medium-chain triglyceride treatment developed macrovesicular steatosis, while mice receiving fish oil or SEFA-6179 retained normal liver histology. In the second experiment, mice receiving a high carbohydrate diet with intravenous saline or soybean oil lipid emulsion, along with medium chain triglyceride vehicle treatment, developed macrovescular steatosis. Treatment with SEFA-6179 prevented steatosis. In each experiment, SEFA-6179 treatment decreased arachidonic acid metabolites as well as key molecules (diacylglycerol, ceramides) involved in lipotoxicity. SEFA-6179 increased both β- and complete fatty oxidation in human liver cells, while having no impact on lipogenesis or fatty acid uptake.

Conclusions

SEFA-6179 treatment prevented hepatosteatosis and decreased toxic lipid metabolites in a murine model of parenteral nutrition-induced hepatosteatosis. An increase in both β- and complete hepatic fatty acid oxidation may underlie the reduction in steatosis.

Investigation of the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions

Abstract

Aim

This study aimed to investigate the relationship between nurses' perception of toxic leadership and their organizational trust levels and turnover intentions.

Design

This cross-sectional study was conducted using an online survey of 168 nurses working in public and university hospitals.

Methods

Data were collected between April and November 2022 with the Toxic Leadership Scale, Organizational Trust Scale and Turnover Intention Scale. Descriptive statistics, correlations, and regression analyses were used to analyse these data.

Results

It was determined that almost half of the nurses (46.4%) were exposed to negative behaviours from their managers within the last year. Nurses' perception of toxic leadership, organizational trust level and turnover intention were moderate. It was found that nurses' perceptions of toxic leadership had a negative effect on organizational trust level (R 2 = .691; β = −0.832; p < .05) and a positive significant effect on turnover intention (R 2 = .267; β = 0.521; p < .05).

Conclusions

This study revealed that toxic leadership behaviours in health organizations should be struggled with to increase nurses' organizational trust and reduce their turnover. In this context, an organizational culture in which toxic behaviours are not tolerated should be established in health organizations.

Impact

What problem did the study address? In the literature, mostly positive leadership behaviours of nurse managers are emphasized and little is known about their negative behaviours such as toxic leadership.

What were the main findings? It was determined that nurses who perceived more toxic behaviour from their managers had less trust in their organizations and higher turnover intention.

On whom will the research have an impact? To provide a positive working environment and reduce turnover, it is necessary to create an organizational culture in which the toxic behaviours of nurse managers are not tolerated.

Patient or Public Contribution

No patient or public contribution.

Occupational fatigue and pandemics: Letter to the Editor

Journal of Clinical Nursing, Volume 32, Issue 23-24, Page 8155-8155, December 2023.
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