BACKGROUND Pregnancy- related deaths in the U.S. are increasing. Medical, social, economic and cultural issues have all been implicated in this trend, but little data exist to differentiate the relative contributions of these various factors. OBJECTIVE To examine trends in U.S. pregnancy-related mortality by place of death and maternal race and age. We hypothesized that such an analysis may allow some distinction between deaths related to medical performance and those more closely related to social, cultural or environmental issues. STUDY DESIGN We conducted a retrospective, cross-sectional study for the years 2003 to 2016 using Multiple Cause-of-Death Mortality Data provided by the Centers for Disease Control and Natality Data provided by National Vital Statistics System of the National Center for Health Statistics. Temporal trends analyses for the place of death, race/ethnicity and age at the time of death were performed using joinpoint regression over the study period. RESULTS Approximately 1/3 of pregnancontribution of events occurring outside a medical facility to the overall morality ratio. Current trends in pregnancy-related mortality in the U.S. are, in part, driven by social, cultural and financial issues beyond the direct control of the medical community. BACKGROUND Black women experience poorer survival compared to white women across all endometrial cancer stages and histologies. The incidence of endometrial cancer is 30% lower in black women compared to white women, yet mortality is 80% higher in black women. Differences in adherence to evidence-based guidelines have been proposed to be major contributors to this disparity. OBJECTIVES We examined whether adherence to evidence-based treatment recommendations for endometrial cancer could mitigate survival disparities between black and white women. STUDY DESIGN The National Cancer Database was used to identify women with endometrial cancer treated from 2004-2016. We established five evidence-based quality metrics based on review of primary literature and accepted guidelines surgical treatment within 6 weeks of diagnosis (Q1), use of minimally invasive surgery (stage I-IIIC) (Q2), pelvic nodal assessment (high risk tumors) (Q3), adjuvant radiation (high intermediate risk) (Q4), systemic chemotherapy (stage III-I; 95% CI, 1.26-1.59) compared to similar white women. Among women with stage III tumors, perfect adherence to the relative quality metrics was seen in 56.6% of white and 44.1% of black women. Perfectly adherent black women with stage III disease had improved outcomes, but remained at increased risk of 30-day (aRR=1.86; 95% CI, 1.01-3.44) and 5-year mortality (aHR=1.35; 95% CI, 1.22-1.50) compared to white women. CONCLUSIONS Black women are less likely than white women with endometrial cancer to receive evidence-based care. However, receipt of evidence-based care mitigates but does not eliminate racial disparities in outcomes and black women remain at greater risk of death from endometrial cancer. This work studies the effect of vitrification of in vitro matured (IVM) prepubertal goat oocytes on 1) oocyte damage assessed by reactive oxygen species (ROS) level and apoptosis and 2) embryo development after Intracytoplasmic sperm injection (ICSI) and Parthenogenic Activation (PA). Oocytes were IVM in supplemented TCM-199 for 22-24 h. Control group oocytes matured during 24 h were directly used for the analysis after IVM. Vitrified/warmed IVM-oocytes were vitrified after 22 h of IVM in 15% ethylene glycol (EG), 15% dimethyl sulfoxide (Me2SO) and 0.5 M sucrose and after subjected to warming procedure. Oocyte ROS level was measured by staining denuded IVM-oocytes with 10 μM 2'7' dichlorodihydrofluorescein diacetate. Apoptosis was analyzed by Annexin V (AV) Apoptosis Detection kit and Propidium iodide (PI) signal and oocytes were classified as Live (AV- PI-), early apoptotic (AV+ PI-), dead non-apoptotic (AV- PI+) and necrotic (AV+ PI+). Developmental competence of vitrified/warmed oocytes was assessed by PA (5 min in 5 μM Ionomycin plus 4 h in 2 mM 6-Dimethylaminopurine), and by ICSI fertilization. Presumptive zygotes were in vitro cultured for 8 days in commercial media BO-IVC. Vitrified/warmed oocytes showed higher ROS levels (P  less then  0.0001), lower live oocytes (44 vs. 66%; P 0.0025) and higher dead non-apoptotic oocytes (33 vs. 13% P 0.023) compared to control. No differences were found on normal zygote formation (2 PN) (32 vs. https://www.selleckchem.com/products/pf-04691502.html 25%) or blastocyst development (0 vs. 4%) after ICSI fertilization. However, after PA, significant differences were found in cleavage rate (59 vs.78%; P  less then  0.0343) and blastocyst formation (1 vs. 25%; P  less then  0.0001). In conclusion, vitrification reduced oocyte competence by increasing dead oocytes and ROS levels. Chemotherapy induces inevitable adverse effects, while complementary and alternative medicine employs many chemical substances. Herb pairs normally contain two herbal medicines, and they have satisfactory effects on cancer therapy. Zuojinwan, a well-known herb pair, is composed of Coptidis Rhizoma and Euodiae Fructus. Berberine and evodiamine are considered the most important compounds in the Zuojinwan herb pair. Previous reports have shown that combined use of evodiamine and berberine displays synergistic anticancer activities in various types of cancers, but this combination has not been tested in colorectal cancer. Hence, this study aimed to explore the combined effects of evodiamine and berberine on colorectal cancer cell lines and cardiomyocytes. We found that the combination of berberine and evodiamine showed synergistic anticancer activity in P-glycoprotein (P-gp)-positive colorectal cancer cells through attenuating the overexpression of P-gp mRNA independent of cell cycle arrest and cell apoptosis. However, berberine did not increase the cytotoxicity of evodiamine in normal human colon mucosal epithelial cells. Furthermore, berberine attenuated evodiamine-induced cardiotoxicity by regulating extrinsic apoptosis via nuclear factor erythroid-2-related factor 2 (Nrf2)-dependent and reactive oxygen species-independent pathways. Therefore, we suggest that the combination of berberine and evodiamine displays high anticancer activity while reducing the side effects in specific cell lines. V.