The primary purpose of this time-lapse data analysis was to identify the association between the nucleation status of a Day 2 preimplantation embryo and live births following in vitro fertilization ...(IVF). The retrospective data analysis was based on 2769 transferred embryos from 1966 treatment cycles and utilised only Known Implantation Data (KID) for live births. Nucleation errors (NE) such as micronucleation, binucleation, multinucleation and minor error groups, were annotated in the time-lapse images which were taken every 15 minutes for a minimum of 44 hours post insemination. Further, factors that may impact NE and the relationship of early morphological attributes and morphokinetic variables with NE occurrence were explored. The frequency of NE among the transferred embryos was 23.8%. The reversibility of NE evidenced by their presence at the two-cell stage, but absence at the four-cell stage was 89.6%. Embryos exhibiting nucleation errors at the two-cell stage had significantly lower live birth rates compared to embryos with no nucleation errors, constituting a significant predictor. A Generalized Additive Mixed Model was used to control for confounders and for controlling clustering effects from dual embryo transfers. Increased incidences of NE were observed with increasing age, with delayed occurrence of cell divisions and in oocytes inseminated with surgically retrieved spermatozoa. NE assessment and their impact on live birth provides valuable markers for early preimplantation embryo selection. In addition, the high incidence of reversibility of NE and their possible impact on live birth suggest that incorporating two-cell nuclear status annotations in embryo selection, alongside morphology and morphokinetics, is of value.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
STUDY QUESTION
Can the approach to, and terminology for, time-lapse monitoring of preimplantation embryo development be uniformly defined in order to improve the utilization and impact of this novel ...technology?
SUMMARY ANSWER
The adoption of the proposed guidelines for defining annotation practice and universal nomenclature would help unify time-lapse monitoring practice, allow validation of published embryo selection algorithms and facilitate progress in this field.
WHAT IS KNOWN ALREADY
An increasing quantity of publications and communications relating to time-lapse imaging of in vitro embryo development have demonstrated the added clinical value of morphokinetic data for embryo selection. Several articles have identified similar embryo selection or de-selection variables but have termed them differently. An evidence-based consensus document exists for static embryo grading and selection but, to date, no such reference document is available for time-lapse methodology or dynamic embryo grading and selection.
STUDY DESIGN, SIZE AND DURATION
A series of meetings were held between September 2011 and May 2014 involving time-lapse users from seven different European centres. The group reached consensus on commonly identified and novel time-lapse variables.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Definitions, calculated variables and additional annotations for the dynamic monitoring of human preimplantation development were all documented.
MAIN RESULTS AND THE ROLE OF CHANCE
Guidelines are proposed for a standard methodology and terminology for the of use time-lapse monitoring of preimplantation embryo development.
LIMITATIONS, REASONS FOR CAUTION
The time-lapse variables considered by this group may not be exhaustive. This is a relatively new clinical technology and it is likely that new variables will be introduced in time, requiring revised guidelines. A different group of users from those participating in this process may have yielded subtly different terms or definitions for some of the morphokinetic variables discussed. Due to the technical processes involved in time-lapse monitoring, and acquisition of images at varied intervals through limited focal planes, this technology does not currently allow continuous monitoring such that the entire process of preimplantation embryo development may be visualized.
WIDER IMPLICATIONS
This is the first time that a group of experienced time-lapse users has systematically evaluated current evidence and theoretical aspects of morphokinetic monitoring to propose guidelines for a standard methodology and terminology of its use and study, and its clinical application in IVF. The adoption of a more uniform approach to the terminology and definitions of morphokinetic variables within this developing field of clinical embryology would allow practitioners to benefit from improved interpretation of data and the sharing of best practice and experience, which could impact positively and more swiftly on patient treatment outcome.
STUDY FUNDING/COMPETING INTEREST(S)
There was no specific funding for the preparation of these proposed guidelines. Meetings were held opportunistically during scientific conferences and using online communication tools.
H.N.C. is a scientific consultant for ESCO, supplier of Miri TL. I.E.A. is a minor shareholder in Unisense Fertilitech, supplier of the EmbryoScope. Full disclosures of all participants are presented herein. The remaining authors have no conflict of interest.
The purpose of this retrospective time-lapse data analysis from transferred preimplantation human embryos was to identify early morphokinetic cleavage variables that are related to implantation and ...live birth following in vitro fertilization (IVF). All embryos were monitored from fertilization check until embryo transfer for a minimum of 44 hours. The study was designed to assess the association between day 2 embryo morphokinetic variables with implantation and live birth based on Known Implantation Data (KID). The kinetic variables were subjected to quartile-based analysis. The predictive ability for implantation and live birth was studied using receiver operator characteristic (ROC) curves. Three morphokinetic variables, time to 2-cells (t2), duration of second cell cycle (cc2) below one threshold and cc2 above another threshold had the highest predictive value with regards to implantation and live birth following IVF treatment. The predictive pre-transfer information has little divergence between fetal heartbeat and live birth data and therefore, at least for early morphokinetic variables up to the four-cell stage (t4), conclusions and models based on fetal heartbeat data can be expected to be valid for live birth datasets as well. The three above mentioned variables (t2, cc2 below one threshold and cc2 above another threshold) may supplement morphological evaluation in embryo selection and thereby improve the outcome of in vitro fertilization treatments.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
A middle school science teacher and a college teacher educator collaborate to explain how the Student Learning Objective (SLO) was embedded into the student teaching internship. After review of the ...SLO literature, details about the process and benefits of partnering with a mentor teacher in order to learn about the SLO implementation cycle are shared. Implications for future practice are offered.
Abstract The goal of embryo selection models is to select embryos with the highest reproductive potential, whilst minimizing the rejection of viable embryos. Ultimately, any embryo selection model ...must be tested on clinical outcome. We therefore retrospectively tested a published blastocyst prediction model on a large combined set of transferred embryos with known clinical outcome. The model was somewhat effective in that we found a relative increase of 30% for implantation in the model-selected group of embryos. There was, however, a concomitant large rejection of embryos from our test cohort, which actually resulted in pregnancy. This hypothetical experiment highlights the limitations of predicting blastulation only. Crucially, it illustrates that both sensitivity and specificity are important parameters when developing embryo selection models for prospective clinical use.
Controlled ovarian stimulation may lead to a large cohort of follicles and high estradiol levels, both of which increase the risk of ovarian hyperstimulation syndrome (OHSS). There may be a reduction ...in pregnancy rates in this milieu. Addition of letrozole in our pilot study showed a trend towards reducing the number of small and intermediate sized follicles. Estradiol levels were also lower than those expected for the follicle number. The aim of this study is to look for any statistically or clinically significant difference on adding letrozole to the controlled ovarian stimulation protocol.
Forty two consecutive intracytoplasmic sperm injection (ICSI) cycles where letrozole was used were compared with 40 in patients with polycystic ovarian syndrome (PCOS) in whom letrozole was not given.
A fall in the estradiol levels for the expected number of follicles was seen. There were no cases of moderate or severe OHSS in the letrozole group. There was a reduction in the cleavage rates in the letrozole group. There were no differences in the clinical pregnancy rates or miscarriage rates.
Stresses reductions and/or raising the load-carrying capacity for a mechanical structure are always great dilemmas for researchers. In this article, a novel method is proposed, and its efficiency is ...examined for achieving these goals on functionally graded rotating nonuniform thickness discs. The originality of this method relies on comprising a geometrically well-defined area, into the whole structure, with certain homogeneous properties including density, thermal expansion coefficient, and elasticity matrix. This area acts as a reducer of the maximum values of various stress components. The solution of the magnetoelastic/magneto-thermoelastic problem is accomplished using the finite element method. The disc is subjected to partial uniform outer pressure, whereas, upon applying thermal loads; the thermal boundary conditions are considered symmetric. The proposed method is found to be beneficial as the obtained results demonstrated the ability to reduce the maximum stresses with different percentages depending on the location, angular width, and properties of the predefined area. This is reflected by an attainable decrease in the maximum compressive tangential stress and the von Mises stress by approximately 20.7% and 12.5%, respectively, under certain conditions.
Crop yield prediction is critical for investigating the yield gap and potential adaptations to environmental and management factors in arid regions. Crop models (CMs) are powerful tools for ...predicting yield and water use, but they still have some limitations and uncertainties; therefore, combining them with machine learning algorithms (MLs) could improve predictions and reduce uncertainty. To that end, the DSSAT-CERES-maize model was calibrated in one location and validated in others across Egypt with varying agro-climatic zones. Following that, the dynamic model (CERES-Maize) was used for long-term simulation (1990–2020) of maize grain yield (GY) and evapotranspiration (ET) under a wide range of management and environmental factors. Detailed outputs from three growing seasons of field experiments in Egypt, as well as CERES-maize outputs, were used to train and test six machine learning algorithms (linear regression, ridge regression, lasso regression, K-nearest neighbors, random forest, and XGBoost), resulting in more than 1.5 million simulated yield and evapotranspiration scenarios. Seven warming years (i.e., 1991, 1998, 2002, 2005, 2010, 2013, and 2020) were chosen from a 31-year dataset to test MLs, while the remaining 23 years were used to train the models. The Ensemble model (super learner) and XGBoost outperform other models in predicting GY and ET for maize, as evidenced by R2 values greater than 0.82 and RRMSE less than 9%. The broad range of management practices, when averaged across all locations and 31 years of simulation, not only reduced the hazard impact of environmental factors but also increased GY and reduced ET. Moving beyond prediction and interpreting the outputs from Lasso and XGBoost, and using global and local SHAP values, we found that the most important features for predicting GY and ET are maximum temperatures, minimum temperature, available water content, soil organic carbon, irrigation, cultivars, soil texture, solar radiation, and planting date. Determining the most important features is critical for assisting farmers and agronomists in prioritizing such features over other factors in order to increase yield and resource efficiency values. The combination of CMs and ML algorithms is a powerful tool for predicting yield and water use in arid regions, which are particularly vulnerable to climate change and water scarcity.
Berberine is endowed with anti-oxidant, anti-inflammatory and anti-fibrotic effects. This study explored the role of adenosine A2a receptor (A2aR) activation and SDF-1/CXCR4 signaling suppression in ...the protective effects of berberine in bleomycin-induced pulmonary fibrosis in mice.
Pulmonary fibrosis was generated in mice by injecting bleomycin (40 U/kg, i.p.) on days 0, 3, 7, 10 and 14. Mice were treated with berberine (5 mg/kg, i.p.) from day 15 to day 28.
Severe lung fibrosis and increased collagen content were observed in the bleomycin-challenged mice. Pulmonary A2aR downregulation was documented in bleomycin-induced pulmonary fibrosis animals and was accompanied by enhanced expression of SDF-1/CXCR4. Moreover, TGF-β1elevation and pSmad2/3 overexpression were reported in parallel with enhanced epithelial mesenchymal transition (EMT) markers expression, vimentin and α-SMA. Besides, bleomycin significantly elevated the inflammatory and pro-fibrogenic mediator NF-κB p65, TNF-α and IL-6. Furthermore, bleomycin administration induced oxidative stress as depicted by decreased Nrf2, SOD, GSH and catalase levels. Interestingly, berberine administration markedly ameliorated the fibrotic changes in lungs by modulating the purinergic system through the inhibition of A2aR downregulation, mitigating EMT and effectively suppressing inflammation and oxidative stress. Strikingly, A2aR blockade by SCH 58261, impeded the pulmonary protective effect of berberine.
These findings indicated that berberine could attenuate the pathological processes of bleomycin-induced pulmonary fibrosis at least partially via upregulating A2aR and mitigating the SDF-1/CXCR4 related pathway, suggesting A2aR as a potential therapeutic target for the management of pulmonary fibrosis.
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