TAU researcher’s cutting-edge innovation pinpoints top candidates for assisted reproductive technology. More than 10percent of American women aged 15-44 struggle to conceive or maintain full-term pregnancies, according to the Centers for Disease Control and Prevention (CDC). Assisted reproductive technology (ART), through which eggs are fertilized with sperm in a lab and then returned to a woman’s uterus, is often the last resort for reproductively-challenged couples. But the physical, emotional, and financial toll they exact is high because the success rates of ART treatments are low – only 20-30percent, according to the CDC.
New microscopic technology from Tel Aviv University promises to be a game-changer in the field of reproductive assistance. A team of TAU scientists have devised a new method of microscopy allowing scientists to perform clinical sperm analysis without the use of staining, which can affect the viability of sperm samples.
Sperm cells are nearly transparent under standard microscopy methods. Their optical properties differ only slightly from those of their surroundings, resulting in a weak image contrast. Sperm cells cannot be stained, if fertilization is the goal, because the process might damage the resulting fetuses. The challenge is to pinpoint strong sperm candidates without staining, while still being able to characterize their viability.
The research was led by Dr. Natan Shaked, PhD, of the Department of Biomedical Engineering at TAU’s Faculty of Engineering and his masters student, Dr. Miki Hifler, MD. Sperm cells for the study were obtained from the Male Fertility Clinic at Chaim Sheba Medical Center in Israel.
There are two effective ART methods available today. The first is in vitro fertilization (IVF), in which a woman is treated with drugs that cause her ovaries to produce multiple eggs. These are placed in a Petri dish with a man’s sperm for fertilization for three to five days, then implanted in the woman’s uterus. The second is intracytoplasmic sperm injection (ICSI), in which a single sperm is injected into a mature egg and then transferred to a woman’s uterus. Dr. Shaked’s method is applicable to both methods, but is especially helpful in ICSI.
‘Until now, clinicians have chosen the best’ sperm according to their speed, but speed is not necessarily an indicator of DNA quality,’ Dr. Shaked says. ‘Some of the best sperm candidates are slow or even immobile because their tails have malfunctioned. If we can better determine the full structure and composition of the sperm, the success rate of ART treatments will be higher. Success means more births without congenital defects. In cases where sample staining is impossible – such as in vitro fertilization and ICSI – our device provides a promising new direction.’
His new device, a small ‘black box’ attached to an existing microscope, is smaller, cost-effective, and easier to align than conventional interferometric imaging methods. It is joined to new automated software that produces a thickness map of the sample and other physical parameters to evaluate the sperm’s viability in real time.
Dr. Shaked believes his new imaging process, which harnesses phase imaging methods to record the passage of light through a sample to assess its thickness, can quantify the quality of sperm used in ART, leading to more successful ART treatments.

American Friends of Tel Aviv University http://tinyurl.com/h5665oc

A drug that blocks neurotransmitters could reduce nausea and vomiting caused by chemotherapy, research co-authored by a Sanford Health physician and published in the New England Journal of Medicine finds.
Sanford oncologist and cancer researcher Steven Powell, M.D., was among a team of researchers who discovered that the drug olanzapine, which is FDA approved for use as an antipsychotic agent, significantly improved nausea prevention in patients who were receiving chemotherapy for cancer treatment. The drug blocks neurotransmitters involved with nausea and vomiting.

‘We’ve long known the nausea and vomiting that come along with chemotherapy are a major problem and affect the quality of life of our patients,’ said Powell. ‘The findings of this study, fortunately, provide physicians with a tool to better address the needs of those they are treating for cancer.’
Researchers noted that within the first day after treatment, 74 percent of study participants experienced no nausea or vomiting when their chemotherapy was paired with olanzapine. When a placebo was used instead of olanzapine, that figure dropped to 45 percent. This benefit continued for five days after chemotherapy treatment for many patients.

Sanford Health www.sanfordresearch.org/newsevents/news/NewsDetail25278.cfm?Id=0,1887

Pediatric researchers at UT Southwestern Medical Center have identified a key component of the pathogenesis of bronchopulmonary dysplasia (BPD), a devastating and sometimes fatal lung disease that affects premature infants. Their findings clarify what prompts the inflammatory response that results in BPD, which previously had been unclear.
The study determined how the NLRP3 inflammasome activates the protein Interleukin 1 beta, which in turn triggers inflammation and development of BPD.
In an animal model of BPD, researchers also tested two FDA-approved drugs that either block the effect of or decrease the production of Interleukin 1 beta and found that these treatments allowed more normal lung development.
Bronchopulmonary dysplasia, a common chronic lung disease in premature infants, develops as a result of the ventilation and oxygen necessary for these infants to survive. Infants born before 30 weeks gestation have immature lungs that lack surfactant, a substance comprised of phospholipids and proteins that is needed for lungs to properly function. This causes premature infants to develop respiratory distress syndrome, requiring the aid of mechanical ventilation. The infants’ exposure to elevated oxygen levels during ventilation activates the process of inflammation that leads to BPD.
‘The same ventilation that ultimately saves their lives, damages their lungs,’ said Dr. Rashmin Savani, Professor and Chief of Neonatal-Perinatal Medicine. ‘Our findings suggest that if we target premature infants born at less than 28 weeks gestation from three to 10 days after birth with this therapy, we might be able to drastically reduce or even eliminate the development of BPD.’ Dr. Savani also holds the William Buchanan Chair in Pediatrics.
Next steps include testing the therapeutic intervention strategies outlined in this study in larger animal models, potentially followed by a Phase 1 clinical trial.

UT Southwestern Medical Center http://tinyurl.com/j2yjrtz

‘OB Nest’: Just the name may bring warm feelings to parents and prospective parents. However, at Mayo Clinic, it’s much more than a name. It’s a new way that Mayo Clinic is providing prenatal care. And, families say they are thrilled with the process.
Current prenatal care for a pregnancy consists of 12-14 visits with an obstetrician. However, often these visits are just brief check-ins to make sure a pregnancy is progressing well. Previous research has looked at ways to give providers more time for high-risk patients, and save time and office visits for women with low-risk pregnancies. While these studies have shown that fewer visits are safe, patients reported less satisfaction overall.
Seeking to identify ways to improve patient experience and perceived value, Mayo Clinic researchers decided to test a new way of providing prenatal care, dubbed ‘OB Nest.’
With the changes to the care experience provided within OB Nest, the researchers found that not only did patient satisfaction improve, but also this improved satisfaction came with fewer office visits.
‘Traditionally, pregnancy is treated as a sickness,’ says Yvonne Butler Tobah, M.D., a Mayo Clinic obstetrician and lead author of this study. ‘We wanted our care to reflect the normal, life-bringing event that it is, and [we] looked for a way to transform prenatal care into a wellness, patient-oriented experience.’
The Department of Obstetrics and Gynecology, in collaboration with the Center for Innovation, worked with patients and staff to collect and prioritize ideas to improve the way pregnant women and their families experience prenatal care. Along with the department, the Care Experience Program, which is part of the Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, took this information and these ideas and designed evidence-based practice improvements for prenatal care.
OB Nest study participants – all of whom were experiencing low-risk pregnancies – entered the programme with a specific nurse identified as their lead contact. They received eight scheduled office visits (More were optional.) and home monitoring equipment for fetal heart rate and maternal blood pressure. In addition, they could take part in an online care community with other OB Nest participants and nurses from the OB Nest care team.
‘My schedule is very hectic,’ says Seri Carney, M.D., a mom who participated in the OB Nest study during pregnancy with her second child. ‘It was really nice to only have to go in for my appointments every other month. My husband and I didn’t have to worry as often about arranging our work schedules for the appointments.’
‘We could listen to the heartbeat whenever we wanted,’ says Dr. Carney. ‘Our daughter was 4 at the time, and doing it at home meant that she could get involved, too. That was really fun. It also felt like it made me more aware of the movements and heartbeat of my baby.’
In her third trimester, when Dr. Carney noticed her baby’s heartbeat was a little low, she was able to email her care team. They reacted right away and got Carney in for a stress test. All was fine, and within a few weeks, she and her family welcomed baby Luisa Jane.
The OB Nest research project is part of Mayo Clinic’s healthcare delivery research efforts, and aligns with the Institute for Healthcare Improvement Triple Aim.
‘This fulfills the holy grail of what patients expect today,’ says Abimbola Famuyide, M.B.B.S., chair of the Department of Obstetrics and Gynecology, and study principal investigator. ‘How can we continue to improve patient experience and clinical outcomes, while, at the same time, keep costs down?’
‘Improving the patient experience, in the case of OB Nest, includes empowering expectant women to truly engage in, and take control of, their care,’ says Dr. Famuyide. He and his team learned that having one nurse as the centre point for each woman’s care and concerns provided them the comfort of easy connection. Concurrently, fewer office visits saved healthcare provider resources, while reducing patient burden.
This practice transforming research is leading to permanent changes in the way women receive prenatal care across Mayo Clinic. It is part of the goal of the Mayo Model of Community Care, to deliver wellness-focused, high-value healthcare – improving access, convenience and patient satisfaction, while lowering costs.

Mayo Clinichttp://tinyurl.com/jsjgz2t