Abstract STUDY QUESTION What are the data and trends on ART and IUI cycle numbers and their outcomes, and on fertility preservation (FP) interventions, reported in 2018 as compared to previous years? SUMMARY ANSWER The 22nd ESHRE report shows a continued increase in reported numbers of ART treatment cycles and children born in Europe, a decrease in transfers with more than one embryo with a further reduction of twin delivery rates (DRs) as compared to 2017, higher DRs per transfer after fresh IVF or ICSI cycles (without considering freeze-all cycles) than after frozen embryo transfer (FET) with higher pregnancy rates (PRs) after FET and the number of reported IUI cycles decreased while their PR and DR remained stable. WHAT IS KNOWN ALREADY ART aggregated data generated by national registries, clinics or professional societies have been gathered and analysed by the European IVF-monitoring Consortium (EIM) since 1997 and reported in 21 manuscripts published in Human Reproduction and Human Reproduction Open. STUDY DESIGN, SIZE, DURATION Data on medically assisted reproduction (MAR) from European countries are collected by EIM for ESHRE on a yearly basis. The data on treatment cycles performed between 1 January and 31 December 2018 were provided by either national registries or registries based on initiatives of medical associations and scientific organizations or committed persons of 39 countries. PARTICIPANTS/MATERIALS, SETTING, METHODS Overall, 1422 clinics offering ART services in 39 countries reported a total of more than 1 million (1 007 598) treatment cycles for the first time, including 162 837 with IVF, 400 375 with ICSI, 309 475 with FET, 48 294 with preimplantation genetic testing, 80 641 with egg donation (ED), 532 with IVM of oocytes and 5444 cycles with frozen oocyte replacement (FOR). A total of 1271 institutions reported data on IUI cycles using either husband/partner’s semen (IUI-H; n = 148 143) or donor semen (IUI-D; n = 50 609) in 31 countries and 25 countries, respectively. Sixteen countries reported 20 994 interventions in pre- and post-pubertal patients for FP including oocyte, ovarian tissue, semen and testicular tissue banking. MAIN RESULTS AND THE ROLE OF CHANCE In 21 countries (21 in 2017) in which all ART clinics reported to the registry, 410 190 treatment cycles were registered for a total population of ∼ 300 million inhabitants, allowing a best estimate of a mean of 1433 cycles performed per million inhabitants (range: 641–3549). Among the 39 reporting countries, for IVF, the clinical PR per aspiration slightly decreased while the PR per transfer remained similar compared to 2017 (25.5% and 34.1% in 2018 versus 26.8% and 34.3% in 2017). In ICSI, the corresponding rates showed similar evolutions in 2018 compared to 2017 (22.5% and 32.1% in 2018 versus 24.0% and 33.5% in 2017). When freeze-all cycles were not considered for the calculations, the clinical PRs per aspiration were 28.8% (29.4% in 2017) and 27.3% (27.3% in 2017) for IVF and ICSI, respectively. After FET with embryos originating from own eggs, the PR per thawing was 33.4% (versus 30.2% in 2017), and with embryos originating from donated eggs 41.8% (41.1% in 2017). After ED, the PR per fresh embryo transfer was 49.6% (49.2% in 2017) and per FOR 44.9% (43.3% in 2017). In IVF and ICSI together, the trend towards the transfer of fewer embryos continues with the transfer of 1, 2, 3 and ≥4 embryos in 50.7%, 45.1%, 3.9% and 0.3% of all treatments, respectively (corresponding to 46.0%, 49.2%. 4.5% and 0.3% in 2017). This resulted in a reduced proportion of twin DRs of 12.4% (14.2% in 2017) and similar triplet DR of 0.2%. Treatments with FET in 2018 resulted in twin and triplet DRs of 9.4% and 0.1%, respectively (versus 11.2% and 0.2%, respectively in 2017). After IUI, the DRs remained similar at 8.8% after IUI-H (8.7% in 2017) and at 12.6% after IUI-D (12.4% in 2017). Twin and triplet DRs after IUI-H were 8.4% and 0.3%, respectively (in 2017: 8.1% and 0.3%), and 6.4% and 0.2% after IUI-D (in 2017: 6.9% and 0.2%). Among 20 994 FP interventions in 16 countries (18 888 in 13 countries in 2017), cryopreservation of ejaculated sperm (n = 10 503, versus 11 112 in 2017) and of oocytes (n = 9123 versus 6588 in 2017) were the most frequently reported. LIMITATIONS, REASONS FOR CAUTION The results should be interpreted with caution as data collection systems and completeness of reporting vary among European countries. Some countries were unable to deliver data about the number of initiated cycles and/or deliveries. WIDER IMPLICATIONS OF THE FINDINGS The 22nd ESHRE data collection on ART, IUI and FP interventions shows a continuous increase of reported treatment numbers and MAR-derived livebirths in Europe. Although it is the largest data collection on MAR in Europe, further efforts towards optimization of both the collection and reporting, with the aim of improving surveillance and vigilance in the field of reproductive medicine, are awaited. STUDY FUNDING/COMPETING INTEREST(S) The study has received no external funding and all costs are covered by ESHRE. There are no competing interests.

Additive manufacturing (AM) or "3D-printing" is a ground-breaking technology that enables the production of complex 3D parts. Its rapid growth calls for immediate toxicological investigations of possible human exposures in order to estimate occupational health risks. Several laser-based powder bed fusion AM techniques are available of which many use metal powder in the micrometer range as feedstock. Large energy input from the laser on metal powders generates several by-products, like spatter and condensate particles. Due to often altered physicochemical properties and composition, spatter and condensate particles can result in different toxicological responses compared to the original powder particles. The toxicity of such particles has, however, not yet been investigated. The aim of the present study was to investigate the toxicity of condensate/spatter particles formed and collected upon selective laser melting (SLM) printing of metal alloy powders, including a nickel-chromium-based superalloy (IN939), a nickel-based alloy (Hastelloy X, HX), a high-strength maraging steel (18Ni300), a stainless steel (316 L), and a titanium alloy (Ti6Al4V). Toxicological endpoints investigated included cytotoxicity, generation of reactive oxygen species (ROS), genotoxicity (comet and micronucleus formation), and inflammatory response (cytokine/chemokine profiling) following exposure of human bronchial epithelial cells (HBEC) or monocytes/macrophages (THP-1). The results showed no or minor cytotoxicity in the doses tested (10-100 μg/mL). Furthermore, no ROS generation or formation of micronucleus was observed in the HBEC cells. However, an increase in DNA strand breaks (detected by comet assay) was noted in cells exposed to HX, IN939, and Ti6Al4V, whereas no evident release of pro-inflammatory cytokine was observed from macrophages. Particle and surface characterization showed agglomeration in solution and different surface oxide compositions compared to the nominal bulk content. The extent of released nickel was small and related to the nickel content of the surface oxides, which was largely different from the bulk content. This may explain the limited toxicity found despite the high Ni bulk content of several powders. Taken together, this study suggests relatively low acute toxicity of condensates/spatter particles formed during SLM-printing using IN939, HX, 18Ni300, 316 L, and Ti6Al4V as original metal powders.

Introduction: The novel coronavirus (COVID-19) causes severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which rapidly became a worldwide pandemic. During the pandemic, accurate utilization of medical resources is required while maintaining the safety and well-being of patients and medical staff. This study assessed the safety profile of performing emergency surgical procedures for COVID-19 negative patients confirmed by reverse transcription-polymerase chain reaction (RT-PCR) preoperatively while positive patients were transferred to be managed at a designated COVID-19 hospital. Methods: This retrospective descriptive study included COVID-19 negative patients who underwent urologic and general surgery procedures for 3 months from March to May 2020. Demographic characteristics, operative and postoperative hospital course, and postoperative COVID-19 status were evaluated. Results: During the 3 months, 865 preoperatively COVID-19 negative patients were evaluated. All patients had uneventful postoperative courses except 2 patients who developed SARS-COV-2 infection postoperatively and were managed conservatively at an isolation facility. The first patient developed bronchospasms and fever upon intubation for laparoscopic appendectomy, with RT-PCR yielding a positive result, while the second developed symptomatic COVID-19 infection 18 days after emergency ureteroscopy. Conclusion: Routine screening for COVID-19 using RT-PCR before emergency surgeries provide an acceptable safety profile and cost-effectiveness. COVID-19 negative patients can be managed safely with standard precautions, while positive patients should be managed at designated hospitals.

West Nile Virus Neuroinvasive Disease (WNV NID) requires prolonged intensive care treatment, resulting in high mortality and early disability. Long-term results are lacking. We have conducted an observational retrospective study with a prospective follow-up of WNV NID patients treated at the Intensive Care Unit (ICU), University Hospital for Infectious Diseases, Zagreb, Croatia, 2013–2018. Short-term outcomes were vital status, length of stay (LOS), modified Rankin Scale (mRS), and disposition at discharge. Long-term outcomes were vital status and mRS at follow-up. Twenty-three patients were identified, 78.3% males, median age 72 (range 33–84) years. Two patients (8.7%) died in the ICU, with no lethal outcomes after ICU discharge. The median ICU LOS was 19 days (range 5–73), and the median hospital LOS was 34 days (range 7–97). At discharge, 15 (65.2%) patients had moderate to severe/mRS 3–5, 6 (26.0%) had slight disability/mRS 2–1, no patients were symptom-free/mRS 0. Ten (47.6%) survivors were discharged to rehabilitation facilities. The median time to follow-up was nine months (range 6–69). At follow-up, seven patients died (30.5%), five (21.7%) had moderate to severe/mRS 3–5, one (4.3%) had slight disability/mRS 2–1, six (26.1%) had no symptoms/mRS 0, and four (17.4%) were lost to follow-up. Briefly, ten (43.5%) survivors improved their functional status, one (4.3%) was unaltered, and one (4.3%) aggravated. In patients with severe WNV NID, intensive treatment in the acute phase followed by inpatient rehabilitation resulted in significant recovery of functional status after several months.

Tissue ischemia means insufficient blood flow to a certain area of the body. Interruption of the arterial blood supply leads to an imbalance between metabolic supply and demand and the development of tissue hypoxia. Tissue hypoxia induces metabolic changes that result in inflammation, increased production of reactive oxygen species, and cell death. If adequate blood flow is established in the ischemic tissue, there will be an increase in cellular damage, which is referred to as ischemic-reperfusion injury. Ischemia and ischemia-reperfusion injury are at the root of numerous diseases widely present in modern society, such as myocardial infarction, cerebral insult, acute kidney injury. For now, there is no way to directly affect cellular hypoxia, but the clinical treatment of hypoxic conditions is aimed at modulating global hypoxemia and increasing the amount of oxygen dissolved in the blood. Hyperbaric oxygenation (HBO) is a treatment during which the patient breathes 100% oxygen under a pressure of at least 1.4 atmospheres. Although the use of hyperbaric therapy was recorded as early as the 17th century, today this treatment is approved for a few indications.

Cadmium (Cd) is an extremely toxic metal that is widespread in nature. Due to its favorable properties, it was widely used in the industry for the production of alkaline batteries, accumulators, pigments, and colored alloys. However, it has been shown that exposure to low concentrations of cadmium leads to damage to many organs and organ systems, and the use of this metal in industry is reduced, and it is replaced by other, less harmful materials. Today, fossil fuel combustion and cigarette consumption are important sources of cadmium exposure. Numerous studies have examined the toxic effects of cadmium and they highlight the kidneys, liver, gonads as the organs that suffer the most damage. The kidneys, as the main place of cadmium storage in the body, are mostly exposed to its toxic effects. In the proximal tubular cells of the kidney, exposure to cadmium disrupts transport processes. Although ionized cadmium (Cd 2+) is thought to be largely responsible for the damage that occurs, the role of the cadmium and metallothionein complex (Cd-MT) cannot be ignored. Peritubular exposure to ionized cadmium indirectly leads to a decrease in the activity of the Na + /L-alanine cotransporter and a decrease in the rate of slow repolarization of the luminal membrane, while the Cd-MT complex leads to both direct and indirect inhibition of this transporter. Also, the Cd-MT complex inhibits Na + /Glucosa cotransporter activity. Exposure to cadmium also leads to a decrease in the endocytic uptake of low molecular weight proteins, which is accompanied by microalbuminuria.

Information and communication technologies (ICT) such as smart devices, the Internet of Things and wireless sensor networks are gradually being introduced into the health system for early diagnosis and management of certain diseases. The state of the art of the use of these technologies in mental health identified 37 articles published in indexed high impact journals in the period 2003-2021. The snowball sampling method was used to select these papers. From this literature review, it appears that several of these technologies are used to support the early detection of mental disorders. Various systems based on wearable sensor networks, the Internet of Things and pervasive and ubiquitous computing have been designed and implemented in this sense. However, most of the applications are designed for academic purposes. 29% of the papers deal with the use of mobile technology in the detection of mental illness, while 67% have studied other technologies such as wearable sensor networks. 4% of the papers concern the use of web platforms in the detection and assessment of mental health disorders.

In this paper, the influence of the method of production, on the content of vitamin C in the leaf and root of parsley was investigated. The research was conducted during two growing seasons: 2013 and 2014. Three varieties of parsley were used in the research. The experiment included three type of fertilization.: mineral, organic and organomineral. The application of different fertilizers affected the content of vitamin C in the parsley. In both years the research the highest content of vitamin C were recorded with the application of organomineral, then with the application of organic fertilizers. Parsley leaf has a higher content of vitamin C compared to the root.