Preservation Services Research Articles

Podocalyxin is a key negative regulator of human endometrial epithelial receptivity for embryo implantation.

How is endometrial epithelial receptivity, particularly adhesiveness, regulated at the luminal epithelial surface for embryo implantation in the human? Podocalyxin (PCX), a transmembrane protein, was identified as a key negative regulator of endometrial epithelial receptivity; specific downregulation of PCX in the luminal epithelium in the mid-secretory phase, likely mediated by progesterone, may act as a critical step in converting endometrial surface from a non-receptive to an implantation-permitting state. The human endometrium must undergo major molecular and cellular changes to transform from a non-receptive to a receptive state to accommodate embryo implantation. However, the fundamental mechanisms governing receptivity, particularly at the luminal surface where the embryo first interacts with, are not well understood. A widely held view is that upregulation of adhesion-promoting molecules is important, but the details are not well characterized. This study first aimed to identify novel adhesion-related membrane proteins with potential roles in receptivity in primary human endometrial epithelial cells (HEECs). Further experiments were then conducted to determine candidates' in vivo expression pattern in the human endometrium across the menstrual cycle, regulation by progesterone using cell culture, and functional importance in receptivity using in vitro human embryo attachment and invasion models. Primary HEECs (n = 9) were isolated from the proliferative phase endometrial tissue, combined into three pools, subjected to plasma membrane protein enrichment by ultracentrifugation followed by proteomics analysis, which led to the discovery of PCX as a novel candidate of interest. Immunohistochemical analysis determined the in vivo expression pattern and cellular localization of PCX in the human endometrium across the menstrual cycle (n = 23). To investigate whether PCX is regulated by progesterone, the master driver of endometrial differentiation, primary HEECs were treated in culture with estradiol and progesterone and analyzed by RT-PCR (n = 5) and western blot (n = 4). To demonstrate that PCX acts as a negative regulator of receptivity, PCX was overexpressed in Ishikawa cells (a receptive line) and the impact on receptivity was determined using in vitro attachment (n = 3-5) and invasion models (n = 4-6), in which an Ishikawa monolayer mimicked the endometrial surface and primary human trophoblast spheroids mimicked embryos. Mann-Whitney U-test and ANOVA analyses established statistical significance at *P ≤ 0.05 and **P ≤ 0.01. PCX was expressed on the apical surface of all epithelial and endothelial cells in the non-receptive endometrium, but selectively downregulated in the luminal epithelium from the mid-secretory phase coinciding with the establishment of receptivity. Progesterone was confirmed to be able to suppress PCX in primary HEECs, suggesting this hormone likely mediates the downregulation of luminal PCX in vivo for receptivity. Overexpression of PCX in Ishikawa monolayer inhibited not only the attachment but also the penetration of human embryo surrogates, demonstrating that PCX acts as an important negative regulator of epithelial receptivity for implantation. Primary HEECs isolated from the human endometrial tissue contained a mixture of luminal and glandular epithelial cells, as further purification into subtypes was not possible due to the lack of specific markers. Future study would need to investigate how progesterone differentially regulates PCX in endometrial epithelial subtypes. In addition, this study used primary human trophoblast spheroids as human embryo mimics and Ishikawa as endometrial epithelial cells in functional models, future studies with human blastocysts and primary epithelial cells would further validate the findings. The findings of this study add important new knowledge to the understanding of human endometrial remodeling for receptivity. The identification of PCX as a negative regulator of epithelial receptivity and the knowledge that its specific downregulation in the luminal epithelium coincides with receptivity development may provide new avenues to assess endometrial receptivity and individualize endometrial preparation protocols in assisted reproductive technology (ART). The study also discovered PCX as progesterone target in HEECs, identifying a potentially useful functional biomarker to monitor progesterone action, such as in the optimization of progesterone type/dose/route of administration for luteal support. Study funding was obtained from ESHRE, Monash IVF and NHMRC. LR reports potential conflict of interests (received grants from Ferring Australia; personal fees from Monash IVF Group and Ferring Australia; and non-financial support from Merck Serono, MSD, and Guerbet outside the submitted work. LR is also a minority shareholder and the Group Medical Director for Monash IVF Group, a provider of fertility preservation services). The remaining authors have no potential conflict of interest to declare. NA.

IRENE audio preservation at the Northeast Document Conservation Center: Developing workflows and standards for preservation projects that use innovative technology

In 2014, the Northeast Document Conservation Center (NEDCC) began offering the IRENE audio preservation service to libraries, archives and museums. IRENE is an innovative optical scanning technology for digitising grooved audio carriers without using a stylus. Developed at the Lawrence Berkeley National Laboratory and the Library of Congress, IRENE uses cameras and microscopes to image the grooves at high resolution, and customised software that mimics the motion of the stylus through the grooves in the images to produce an audio file. The multi-step process offers the operator a critical degree of control for addressing the unique characteristics of ‘irregular’ (ie not produced in a controlled, professional environment) grooved recordings often found in archival collections, but also complicates the task of properly documenting the digital provenance of the files it produces. The rapid development of this technology presents the challenge of continually updating workflows and methods, at a rate faster than audio preservation standards and best practices can dictate. This paper provides a case study in developing preservation workflows and standards for projects that use innovative technology, by working from a foundation of established standards and providing transparent documentation of the ways in which IRENE deviates from those standards.

Digital preservation services at digital scholarship centers

As academic library support services for digital scholarship activities continue to expand and evolve, large volumes of digital outputs have been created by, and in collaboration with, library and information professionals who are affiliated with digital scholarship centers. Drawing on a literature review and a 2018 pilot study of digital preservation services in digital scholarship centers, we propose future directions for investigation of preservation services for digital scholarship and projects.

Use of fertility preservation services in male reproductive-aged cancer patients

While fertility preservation is a major concern among reproductive age cancer patients, little is known about access and use of fertility preserving services. We examined use of fertility preserving services among men with common solid tumors.A total of 3648 men age 18–40 including 2610 (71.6%) with testicular cancer, 939 (25.7%) with colorectal and 99 (2.7%) with prostate cancer were identified. Fertility preservation services were utilized in 9.3% of men overall including 4.1% who underwent fertility evaluation only and 7.8% who had a fertility preservation procedure. The rate of fertility preservation services rose from 6.6% (95%CI, 3.2–10.0) in 2008 to 12.4% (95%CI, 7.3–17.5) in 2017 (P = 0.04).Use of fertility preservation service was more common in patients with testicular (11.6%, aRR = 3.31; 95% CI 2.22–4.92) and prostate cancer (6.1%, aRR = 3.14; 95% CI 1.28–7.70) compared to those with colon cancer (3.4%). Younger men were more likely to utilize fertility preservation services. 11.5% of men age ≤ 35 years vs. 5.2% of men 36–40 used these services (P < 0.0001). Fertility preservation services were used in 10.8% of those who received chemotherapy (aRR = 1.81; 95% CI, 1.45–2.27) and in 8.1% of those who received radiation (aRR = 1.30 95% CI, 0.98–1.73). Medicaid patients were less likely to receive fertility preservation services than those with commercial insurance (0.7% vs. 10.1%; aRR = 11.58, 95%CI 2.10–63.69). These data indicate that while use of fertility preserving services is increasing, overall use of services is low among reproductive age males with cancer.

Reproductive desires in transgender and gender diverse adults: A cross-sectional study in Thailand

Objective: To explore the desires and barriers to fertility preservation among transgender women and gender diverse people assigned male at birth in Thailand. Material and methods: This study is a cross-sectional study in clinic-based setting. The data was obtained from a questionnaire. Three hundred and three participants visiting the Gender Care Clinic at Chiang Mai University Hospital and Mplus clinics between April 2019 and December 2019 were included. Of these, 199 were transgender women and 104 were gender diverse people assigned male at birth. Results: The overall parental desire was 30.4% which was similar across the 2 groups (p = 0.897). A genetically related child was preferred in 40.9% of transgender women and 50.5% of gender diverse group (p = 0.115). Factors impacting a parental desire were a good relationship with family (OR 2.905, 95%CI 1.315–6.420, p = 0.008), being in a stable relationship (OR 4.183, 95%CI 1.738–10.069, p < 0.001) and belief in a positive attitude of society toward LGBTQ parenting (OR 2.572, 95%CI 1.207–5.479, p = 0.014). Access to fertility preservation services was low. The majority of transgender women (75.3%) and gender diverse people (95.2%) never received a consultation regarding fertility. The utilization rate of fertility treatments was 5.3% in our study. Conclusion: Transgender women and gender diverse people assigned male at birth have parental desires for a genetically related child. However, access to reproductive information, consultation and services were very limited. Social support along with competent health services might increase access to reproductive services in transgender and gender diverse populations.

ARCHIVER - Data archiving and preservation for research environments

Over the last decades, several data preservation efforts have been undertaken by the HEP community, as experiments are not repeatable and consequently their data considered unique. ARCHIVER is a European Commission (EC) co-funded Horizon 2020 pre-commercial procurement project procuring R&amp;D combining multiple ICT technologies including data-intensive scalability, network, service interoperability and business models, in a hybrid cloud environment. The results will provide the European Open Science Cloud (EOSC) with archival and preservation services covering the full research lifecycle. The services are co-designed in partnership with four research organisations (CERN, DESY, EMBL-EBI and PIC/IFAE) deploying use cases from Astrophysics, HEP, Life Sciences and Photon-Neutron Sciences creating an innovation ecosystem for specialist data archiving and preservation companies willing to introduce new services capable of supporting the expanding needs of research. The HEP use cases being deployed include the CERN Opendata portal, preserving a second copy of the completed BaBar experiment and the CERN Digital Memory digitising CERN’s multimedia archive of the 20th century. In parallel, ARCHIVER has established an Early Adopter programme whereby additional use cases can be incorporated at each of the project phases thereby expanding services to multiple research domains and countries.

The Development, Implementation, and Evaluation of Innovative Strategies to Reduce Food Insecurity among Children in the United States

The Development, Implementation, and Evaluation of Innovative Strategies to Reduce Food Insecurity among Children in the United States

Personal, Familial, and Service-Related Predictors of Outcome in Intensive Family Preservation Services Treatment

The use of Intensive Family Preservation services (IFPS) has increased dramatically in recent years, with most states having such programs in place to assist families involved in the child welfare system. While IFPS programs are diverse in their scope, nature, and service provision, most are home-based and employ a highly trained social services professionals. The present study examined the familial, personal, and service characteristics associated with treatment completion and re-referral in IFPS at a community agency. Data were archival (n = 2301) and were provided to the researchers by the agency itself. The present study represents an analysis of treatment-as-usual data, in an effort to determine patterns in service provision and family re-referral. A variety of family factors, such as family structure and the presence of adults in the household, as well as hours and types of services completed, predicted IFPS completion and re-referral. Increased provider-family contact was influential in positive outcomes, including re-referral. These findings suggest that increased provider-family contact is likely to improve the outcomes for families served by IFPS.

The Cybernetics Thought Collective: Machine-Generated Data Using Computational Methods

This dataset comprises machine-generated data from the research records and personal archives of four founding members of the transdisciplinary field of cybernetics—W. Ross Ashby, Warren S. McCulloch, Heinz von Foerster, and Norbert Wiener. These archives (or, fonds) are held by the British Library, the American Philosophical Society, the University of Illinois at Urbana-Champaign, and MIT, respectively. The data were created for “The Cybernetics Thought Collective: A History of Science and Technology Portal Project” (2017–2019), a pilot project funded by the National Endowment for the Humanities (NEH). Using computational methods and tools—machine learning, named entity recognition, and natural language processing—on digitized archival records, the data were generated to enhance archival access in three distinct but interrelated ways: as archival metadata for the digitized records, as reusable data to facilitate digital scholarly analyses, and as the basis for a series of test visualizations. The data represent entities associated with cybernetic concepts and the main actors attached to the cybernetics movement and the exchange of its ideas. The dataset is stored along with the digitized records in the University of Illinois (U of I) Library’s multi-tiered repository, a replicated preservation service based on PREMIS (Preservation Metadata: Implementation Strategies). Reuse potential for this dataset includes historical/archival, linguistic, and artistic analyses of the data to examine connections between the cybernetic entities. <strong>Funding statement:</strong> “The Cybernetics Thought Collective: A History of Science and Technology Portal Project” (NEH PW-253912-17), was funded by the National Endowment for the Humanities’ Humanities Collections and Reference Resources program (US).

Equal opportunity for all? An analysis of race and ethnicity in fertility preservation in New York City.

PurposeTo compare the racial and ethnic make-up of patients who accessed medically indicated fertility preservation services (MIFP) against the overall racial diversity (including Hispanic origin) across women of reproductive age diagnosed with cancer in New York City (NYC).MethodsAll patients who completed at least one MIFP between January 2017 and December 2018 were reviewed. Race was self-reported. A calculation of the expected racial distribution across women of reproductive age with cancer in NYC was determined using the most recent NYC census data. Statistical analysis included chi-square goodness of fit and test for independence and Kruskal-Wallis H test, with p < 0.05 considered significant.ResultsA total of 107 patients who accessed MIFP were included. A total of 55 (51.4%) identified as White, 3 (2.8%) as Black, 13 (12.2%) as Asian, 6 (5.6%) as Hispanic, 3 (2.8%) as other, and 27 (25.2%) did not report. A total of 78.5% of patients had insurance. There was no significant difference in racial distribution by cancer type (p = 0.255). A subgroup analysis excluding the BRCA+ patients and races not reported by the census (n = 69) was then performed, showing a statistically significant difference between observed (O) and expected (E) cases of fertility preservation (FP) by race at our center—White 47O/32E, Black 3O/15E, Asian 13O/7E, and Hispanic 6O/15E (p < 0.001). A statistically significant difference in racial distribution by FP type was observed.ConclusionsThere is a difference in the observed vs expected racial distribution of patients accessing MIFP. Further studies are needed to identify modifiable factors to better ensure equal opportunity to all patients.

Utilization and knowledge of oncofertility services: A single institution experience

Objective: The aim of this study was to analyze fertility preservation referral patterns, utilization of fertility preservation services, and provider knowledge of fertility preservation for oncology patients at a large tertiary referral center.

A Novel Locus Predicts Spermatogenic Recovery among Childhood Cancer Survivors Exposed to Alkylating Agents.

Exposure to high doses of alkylating agents is associated with increased risk of impaired spermatogenesis among nonirradiated male survivors of childhood cancer, but there is substantial variation in this risk. Here we conducted a genetic study for impaired spermatogenesis utilizing whole-genome sequencing data from 167 nonirradiated male childhood cancer survivors of European ancestry from the St. Jude Lifetime Cohort treated with cyclophosphamide equivalent dose (CED) ≥4,000 mg/m2. Sperm concentration from semen analysis was assessed as the primary outcome. Common variants (MAF > 0.05) were adjusted for age at cancer diagnosis, CED, and top principal components. Rare/low-frequency variants (MAF ≤ 0.05) were evaluated jointly by various functional annotations and 4-kb sliding windows. A novel locus at 7q21.3 containing TAC1/ASNS was associated with decreased sperm concentration (rs7784118: P = 3.5 × 10-8). This association was replicated in two independent samples of SJLIFE survivors of European ancestry, including 34 nonirradiated male survivors treated with 0 < CED < 4,000 mg/m2 (P = 3.1 × 10-4) and 24 male survivors treated with CED ≥4,000 mg/m2 and radiotherapy <40 Gray (P = 0.012). No association was observed among survivors not exposed to alkylating agents included in the CED (P > 0.29). rs7784118 conferred 3.48- and 9.73-fold increases in risk for clinically defined oligospermia and azoospermia and improved prediction of normospermic, oligospermic, and azoospermic states by 13.7%, 5.3%, and 21.7%. rs7784118 was associated with decreased testosterone level, increased levels of follicle stimulating and luteinizing hormones, and 8.52-fold increased risk of Leydig cell failure. Additional research is warranted to determine how this SNP influences spermatogenesis and to assess its clinical utility in characterizing high-risk survivors and guiding intervention strategies. SIGNIFICANCE: The identified genetic markers harbor potential clinical utility in characterizing high-risk survivors and guiding intervention strategies including pretreatment patient counseling and use of fertility preservation services.

The Impact of a Limb Preservation Service on the Incidence of Major Amputations for All Indications at a Level I Trauma Center

Multidisciplinary limb preservation services (LPS) have improved the care of patients with limb-threatening vascular disease. However, the impact of an LPS on major amputations for nonvascular etiologies is unknown. We sought to characterize the trends in major amputations performed at a level I trauma center following the institution of an LPS. A retrospective review of all patients undergoing amputation at a level I trauma center from January 2009 to December 2018 was performed. Patients were divided into 2 cohorts: those undergoing amputation pre-LPS (2009-2013) and post-LPS (2014-2018). Major amputations were defined as any amputation at or proximal to the below-knee level. Indications for amputation included chronic limb-threatening ischemia (CLTI), acute limb ischemia (ALI), trauma, infection, and revision amputations. During the study period, 609 major amputations were performed, 490 pre-LPS and 119 post-LPS, representing a 76% reduction. Reductions were seen for every indication, including trauma (95%), ALI (90%), chronic infection (83%), revision (79%), CLTI (68%), and acute infection (62%). Although previous work has validated the role of an LPS in advanced vascular disease, its value extends beyond vascular disease alone. The drastic reductions seen in the number of amputations performed for a variety of indications, including trauma and diabetic foot infections, further validate the use of a multidisciplinary LPS.

An insight into the dairy chain of a Protected Designation of Origin cheese: The case study of Asiago cheese

The Protected Designation of Origin (PDO) label of the European Union safeguards and guarantees top-quality traditional agri-food products that must be manufactured in a specific region according to traditional production methods. Production specifications of PDO cheeses are often focused on the cheese-making process and lack information on the dairy farming system that is upstream of the chain. This case study aimed to analyze and cluster the dairy farms that supply milk to the chain of Asiago, an internationally known PDO cheese of northeastern Italy. A large survey involving all of the cheese factories of the Asiago PDO chain was made in 2017. Each cheese factory submitted a questionnaire to its supplying dairy farmers concerning (1) farm facilities and herd management and (2) feeding program of lactating cows. Results from 517 farms were processed; there were 67 ± 27% (mean ± standard deviation) respondents per cheese factory. Four clusters of dairy farms were identified by hierarchical clustering analysis. Cluster 1 (8% of the surveyed farms) and cluster 2 (22%) are small in size and low in yield, representing the traditional milk production system; farms are mainly located on mountains or hills and have autochthonous dual-purpose breeds mostly housed in tiestall barns. By rearing cattle of endangered breeds and feeding cows primarily with forages produced on-farm together with the use of pasture, these clusters, and especially cluster 1, have shown to provide essential ecosystem services for landscape and biodiversity preservation in the alpine areas. Clusters 3 and 4 (34 and 36% of the surveyed farms, respectively) gather medium-scale farms mainly located in the lowland that operate according to modern management and housing systems and rear high-producing dairy cows. These cows are mainly fed total mixed rations based on corn silage, but the dietary forage:concentrate ratio is kept relatively high, as farmers are more interested in producing high-quality milk for cheese-making than pushing for yield. Regardless of the cluster allocation, a considerable cow longevity, which is a recognized "iceberg indicator" of cattle well-being, was highlighted. This study showed that different farming systems may lay behind a single PDO cheese. The knowledge of their characteristics is important to reinforce the PDO production specifications as well as to distinguish and protect niche products that come from specific groups of farms that provide essential ecosystem services.

The Possibility for Stateless Dynastic Wealth and the Case of China

Part I of this paper explains how wealth managers have modified the trust to create the possibility for stateless dynastic wealth. By this I mean wealth that is held by a family through a trust that is established in a haven state to eliminate the power of other states to regulate and oversee transmission and management of wealth and to make it very difficult for courts in another state to levy against wealth on behalf of private creditors. These structures also permit legal tax avoidance if income and wealth is not attributed to family members. And they facilitate tax evasion by not reporting foreign income and wealth. I use the relatively novel structure of a perpetual purpose trust to illustrate. Part II is a case study of China. It draws on multiple sources of information to estimate the potential demand for wealth preservation services in China and the current extent of the use of such services. I selected China as a case study in part because it was in the remit of the conference for which this paper was written, which was sponsored by the Chinese Journal of Comparative Law. This was a happy coincidence. Several factors make China an interesting case study. Private wealth has grown exponentially in China in the last fifty years, creating large potential demand for wealth preservation services. But China has been slow in developing internal legal structures like family trusts that would enable wealth holders in China to preserve wealth using Chinese law and Chinese entities. This creates an incentive to move wealth outside of China in addition to the usual incentives canvassed in Part I. Political risk adds to the incentive to move wealth outside of China. But it seems that relatively little wealth has moved outside of China compared to other wealthy states. Some of this lack of uptake of wealth management services may be attributed to unfamiliarity with such services. I speculate that a significant part can be attributed to restrictions imposed by China on the movement of capital. These restrictions increase the cost of moving capital out of China. This would imply is that there is not strong intrinsic demand for the more exotic services wealth managers can provide, such as the structure described in Part I. This is consistent with the experience in the U.S. where a change in tax law in 1986 is thought to explain an increase in demand for perpetual trusts. If this speculation is correct, then China would expect there to be a significant increase in capital export if it liberalized capital accounts and increased taxes on wealth. And, if the U.S. adopted significant wealth taxes such as have been proposed by some progressive Democrats, then we should expect wealthy individuals to respond by increasing use of structures such as the structure described in Part I.

Local Differential Privacy for Deep Learning

The Internet of Things (IoT) is transforming major industries, including but not limited to healthcare, agriculture, finance, energy, and transportation. IoT platforms are continually improving with innovations, such as the amalgamation of software-defined networks (SDNs) and network function virtualization (NFV) in the edge-cloud interplay. Deep learning (DL) is becoming popular due to its remarkable accuracy when trained with a massive amount of data such as generated by IoT. However, DL algorithms tend to leak privacy when trained on highly sensitive crowd-sourced data such as medical data. The existing privacy-preserving DL algorithms rely on the traditional server-centric approaches requiring high processing powers. We propose a new local differentially private (LDP) algorithm named LATENT that redesigns the training process. LATENT enables a data owner to add a randomization layer before data leave the data owners' devices and reach a potentially untrusted machine learning service. This feature is achieved by splitting the architecture of a convolutional neural network (CNN) into three layers: 1) convolutional module (CNM); 2) randomization module; and 3) fully connected module. Hence, the randomization module can operate as an NFV privacy preservation service in an SDN-controlled NFV, making LATENT more practical for IoT-driven cloud-based environments compared to existing approaches. The randomization module employs a newly proposed LDP protocol named utility enhancing randomization, which allows LATENT to maintain high utility compared to existing LDP protocols. Our experimental evaluation of LATENT on convolutional deep neural networks demonstrates excellent accuracy (e.g., 91%-96%) with high model quality even under low privacy budgets (e.g., ε = 0.5).

Assessment of Public Awareness of the Forestry Sector: Biodiversity, Certification and Ecosystem Services in Velingrad Municipality

The purpose of this study was to survey the current public awareness in Velingrad Municipality in terms of biodiversity preservation, certification and ecosystem services in the regional forestry sector. The answers to the questions related to the biodiversity and ecosystem services showed good aware- ness and a very positive attitude of respondents regarding the need for conservation and sustainable use of biodiversity as well as the improvement of ecosystem services. According to the conducted surveys, the awareness concerning the certification and standards in the local forestry sector as well as the regional NATURA 2000 protected sites was still weak or lacking.

Environmental incomes: Refined standard and extended accounts applied to cork oak open woodlands in Andalusia, Spain

Abstract In this research, our objectives are twofold: firstly to conceptualize and compare the ecosystem services and environmental incomes of individual activities at producer, basic and social prices using the extended accounts (Agroforestry Accounting System) and the refined standard accounts (a slightly refined standard System of National Accounts), and secondly, to apply both methodologies at a scale of 4,095 land-cover tiles predominately occupied by cork oak open woodlands (COW), which cover 248,015 ha in Andalusia, Spain. This analysis considers spatial-explicit characteristics of COW across Andalusia. The 15 COW economic activities valued in 2010 include: timber, cork, firewood, nuts, grazing, conservation forestry, residential services, private amenity, fire services, water supply, mushroom, carbon, free access recreation, landscape conservation services and threatened wild biodiversity preservation services. In this research, the ecosystem service is defined as an economic indicator that provides information on the contribution of nature to product consumption by humans in the period, but with an uncertain meaning of ecological sustainability. We show that environmental income is the maximum economic value in the period of sustainable ecosystem service with both ecological and economic significance only if the future sustainable biophysical silvicultural management scenarios are accounted for. To measure environmental incomes, we model the future sustainable silviculture while considering all the management practices required to maintain cork oak woodlands in perpetuity. We use farm-level data to estimate voluntary opportunity costs incurred by land and livestock owners associated with hunting and livestock activities of the farmer as well as their subsequent scaling up to COW land-cover tiles in order to estimate environmental incomes at social prices for each individual activity. In this study, we measure the ecosystem services and incomes of the COW private amenity and public landscape activities at social prices, that is, their basic prices less own compensated and auto-consumed non-commercial intermediate consumption of services used by the private amenity and public landscape activities. The ecosystem services and environmental incomes of cork oak open woodlands measured by the extended accounts at basic prices in 2010 were 1.1 and 1.2 times higher, respectively, than those estimated at social prices. The ecosystem services and environmental incomes measured at basic prices by the refined standard accounts were 0.3 and 0.2 times, respectively, those estimated by the extended accounts at social prices.

Awareness of fertility preservation among Chinese medical students.

The fertility preservation (FP) services offered in Hong Kong are underutilised. There have been no previous studies on Chinese medical students to investigate the underlying reasons for this underutilisation in terms of awareness, knowledge, and attitudes towards FP and age-related fertility. This was a cross-sectional survey among Chinese medical students in Hong Kong. The majority of participants (77.8%) were not familiar with any clinics or specialists who provide FP services. The vast majority (88.1%) underestimated female infertility at age 45 years, and 89.8% overestimated the age of male fertility decline. The students' FP knowledge was mainly acquired from electronic media (58.4%) and medical school (57.6%). Medical students showed overwhelming support towards FP for medical reasons (97.9%) but had mixed responses about FP for elective reasons related to career development in women (58.8%). Of the participants, 80.2% agreed that the government should subsidise FP services for patients with medical reasons. This study highlights the limited awareness and knowledge of FP among Chinese medical students. There is a strong worldwide need to increase education about and exposure to FP in the medical curriculum and improve medical students' knowledge.

Availability of Fertility Preservation Information on the Websites of U.S. News and World Report Top-Ranked Pediatric Cancer Programs.

Purpose: To evaluate the availability of fertility preservation (FP) services and educational resources on the websites of top-ranked U.S. pediatric cancer programs. Methods: Cross-sectional survey of information and resources related to FP on websites from top-ranked pediatric cancer programs according to the 2018-2019 U.S.-News & World Report (USNWR) ranking. Factors that predicted the website availability of FP information or a fertility team were analyzed, as was availability in Spanish and for specific groups by sex and puberty status. As a surrogate marker of comprehensive oncological services, the availability of resources for psychological support was compared to FP. Results: A fertility team was referenced on the website of 36% of programs, but only 32% provided FP educational resources for patients. Among them, 100%, 93.8%, 93.8%, and 68.8% provided specific information for postpubertal females, prepubertal females, postpubertal males, and prepubertal males, respectively. The majority (93.8%) did not provide information in Spanish. The ranking on USNWR (p < 0.05) and patient volume (p < 0.05) positively correlated with the availability of FP information and fertility team on the program's website. Information regarding psychological support was provided more often than information regarding FP (96% vs. 32%, p < 0.05). Conclusion: The majority of the top-ranked pediatric cancer programs in the United States do not list FP resources or a fertility team on their website. The lack of resources is particularly concerning for the Spanish-speaking population, as well as for prepubertal males. This may be potentially hindering access to FP and contributing to health care disparities.