Abstract
Study question
What are the uses and real-life experiences of patients currently treated in France in medically-assisted reproduction (MAR) centers?
Summary answer
One in four patients is in ...a situation of significant pain in relation to MAR; half are not optimistic about the outcome of their treatment.
What is known already
Internationally, work on the quality of life and impact of treatments has been completed in the field of endometriosis (Culley et al. 2017). In the field of MAR in France, one study underlines an important level of general well-being, with nearly 4 people out of 5 who say they are rather content (Coudrière et al. 2020). A better understanding of this result is however still lacking, especially in respect to whether patients actually believe in the success of their treatments, or how dependent satisfaction is on variables, like age, secondary infertility or the number of years engaged in fertility treatments.
Study design, size, duration
We conducted an online self-administered questionnaire by means of a two-step process: a first survey dedicated to patients’ uses was carried out from January 15, 2020 to February 26, 2000; the following and complementary survey about real-life experience was conducted from March 3, 2020 to April 10, 2020. The initial sample included 1503 people before selecting relevant participants.
Participants/materials, setting, methods
The final sample of 967 patients targets patients that were enrolled in a French procreative medical center at the time of the study. Were excluded from the sample: ex-patients, patients who have not started treatment or are not followed in France, solo and homosexual care patient trajectories. The questionnaire was composed of 178 questions. In the questionnaire dealing with MAR uses, six fields were examined; in the case of real-life experience, eight themes were questioned.
Main results and the role of chance
The study shows that one in four patients suffers significantly in relation to MAR care; nearly half are pessimistic about treatment outcome and 65% claim that MAR prevents full enjoyment of everyday life. Further findings include: MAR is globally satisfying regarding the quality of care provided by practitioners and staff (80%), general administration of patients (77 to 87%), first encounters with staff and center (78 to 91%), quality of dialogue (81%), physical state of the premises (82 to 97%), continuum with professional activity (73%). Where centers/practitioners need to pay attention: one out of two patients wanted more means of communication; time management was an issue; 41% state that infertility prevents entrepreneurial outreach and general success; treatments strongly disrupt work for 83% and reduce performances for 79%; work rights, while known, were not respected in ¼ cases. Discoveries made: young women are not very positive, men are not well-identified in such medical trajectories, women’s body image is completely transformed for 95%, 85.5% of women are depressed by seeing a pregnant woman, and 15% do not think about wanting a child daily.
Limitations, reasons for caution
This research, carried out online, was distributed mainly through a grassroot organization, potentially biasing representativeness. Also, the study finished at the start of the first French confinement. Previous studies show that the general context does not impact results, but this limitation cannot be ignored (Fisher, Bayhem, 2019).
Wider implications of the findings: These findings underline the need for a comprehensive conception of MAR, including more than medical support. It highlights anew the need to better take men into account in future research as well as people in their twenties as knowledge of these categories of people is still lacking.
Trial registration number
Not applicable
Systems of correlated particles appear in many fields of modern science and represent some of the most intractable computational problems in nature. The computational challenge in these systems ...arises when interactions become comparable to other energy scales, which makes the state of each particle depend on all other particles
. The lack of general solutions for the three-body problem and acceptable theory for strongly correlated electrons shows that our understanding of correlated systems fades when the particle number or the interaction strength increases. One of the hallmarks of interacting systems is the formation of multiparticle bound states
. Here we develop a high-fidelity parameterizable fSim gate and implement the periodic quantum circuit of the spin-½ XXZ model in a ring of 24 superconducting qubits. We study the propagation of these excitations and observe their bound nature for up to five photons. We devise a phase-sensitive method for constructing the few-body spectrum of the bound states and extract their pseudo-charge by introducing a synthetic flux. By introducing interactions between the ring and additional qubits, we observe an unexpected resilience of the bound states to integrability breaking. This finding goes against the idea that bound states in non-integrable systems are unstable when their energies overlap with the continuum spectrum. Our work provides experimental evidence for bound states of interacting photons and discovers their stability beyond the integrability limit.
Inherent symmetry of a quantum system may protect its otherwise fragile states. Leveraging such protection requires testing its robustness against uncontrolled environmental interactions. Using 47 ...superconducting qubits, we implement the one-dimensional kicked Ising model, which exhibits nonlocal Majorana edge modes (MEMs) with
ℤ
2
parity symmetry. We find that any multiqubit Pauli operator overlapping with the MEMs exhibits a uniform late-time decay rate comparable to single-qubit relaxation rates, irrespective of its size or composition. This characteristic allows us to accurately reconstruct the exponentially localized spatial profiles of the MEMs. Furthermore, the MEMs are found to be resilient against certain symmetry-breaking noise owing to a prethermalization mechanism. Our work elucidates the complex interplay between noise and symmetry-protected edge modes in a solid-state environment.
Tough edges
The dynamics of quantum many-body systems can be profoundly affected by their interaction with the environment. This includes systems that have topological protection from certain kinds of perturbations due to symmetry. Mi
et al
. studied the interplay between symmetry and noise using a chain of 47 superconducting qubits. They implemented a periodically driven transverse Ising spin model, and found that the system’s edge modes were surprisingly resilient to some types of symmetry-breaking noise. —JS
A 47-qubit chain was used to study the interplay of noise and symmetry in an open quantum system.
Enterococcus species are associated with an increased morbidity in intraabdominal infections (IAI). However, their impact on mortality remains uncertain. Moreover, the influence on outcome of the ...appropriate or inappropriate status of initial antimicrobial therapy (IAT) is subjected to debate, except in septic shock. The aim of our study was to evaluate whether an IAT that did not cover Enterococcus spp. was associated with 30-day mortality in ICU patients presenting with IAI growing with Enterococcus spp.
Retrospective analysis of French database OutcomeRea from 1997 to 2016. We included all patients with IAI with a peritoneal sample growing with Enterococcus. Primary endpoint was 30-day mortality.
Of the 1017 patients with IAI, 76 (8%) patients were included. Thirty-day mortality in patients with inadequate IAT against Enterococcus was higher (7/18 (39%) vs 10/58 (17%), p = 0.05); however, the incidence of postoperative complications was similar. Presence of Enterococcus spp. other than E. faecalis alone was associated with a significantly higher mortality, even greater when IAT was inadequate. Main risk factors for having an Enterococcus other than E. faecalis alone were as follows: SAPS score on day 0, ICU-acquired IAI, and antimicrobial therapy within 3 months prior to IAI especially with third-generation cephalosporins. Univariate analysis found a higher hazard ratio of death with an Enterococcus other than E. faecalis alone that had an inadequate IAT (HR = 4.4 1.3-15.3, p = 0.019) versus an adequate IAT (HR = 3.1 1.0-10.0, p = 0.053). However, after adjusting for confounders (i.e., SAPS II and septic shock at IAI diagnosis, ICU-acquired peritonitis, and adequacy of IAT for other germs), the impact of the adequacy of IAT was no longer significant in multivariate analysis. Septic shock at diagnosis and ICU-acquired IAI were prognostic factors.
An IAT which does not cover Enterococcus is associated with an increased 30-day mortality in ICU patients presenting with an IAI growing with Enterococcus, especially when it is not an E. faecalis alone. It seems reasonable to use an IAT active against Enterococcus in severe postoperative ICU-acquired IAI, especially when a third-generation cephalosporin has been used within 3 months.
High-level synthesis (HLS) allows hardware to be directly produced from behavioral description in C/C++, thus accelerating the design process. Loop pipelining is a key transformation of HLS, as it ...improves the throughput of the design at the price of a small hardware overhead. However, for small loops, its use often results in a poor hardware utilization due to the pipeline latency overhead. Overlapping the iterations of the whole loop nest instead of only overlapping the innermost loop is a way to overcome this difficulty, but currently available techniques are restricted to perfectly nested loops with constant bounds, involving uniform dependences only. Using the polyhedral model, we extend the applicability of the nested loop pipelining transformation by proposing a new legality check and a new loop correction technique, called polyhedral bubble insertion. This method was implemented in a source-to-source compiler targeting HLS, and results on benchmark kernels show that polyhedral bubble insertion is effective in practice on a much larger class of loop nests.
A total of 101 staphylococcal strains were ribotyped using EcoRI and HindIII as restriction enzymes and plasmid pBA2 as the rDNA probe. Isolates from 10 newly described staphylococcal taxa were among ...those examined. All the ribotypes were added to our database, Staph DB, which now contains the sizes of the bands of 135 EcoRI and 120 HindIII ribotypes from 408 strains belonging to 42 staphylococcal taxa. The relatedness of ribotypes was evaluated by using the Dice coefficient. The ribotypes, and thus the strains, were clustered by the unweighted pair group method with averages (UPGMA). Separation into clusters correlated well with the delineation of the staphylococcal species but not with that of the different subspecies. No discrimination was possible between Staphylococcus vitulinus and Staphylococcus pulvereri. Ecovar-specific groups were evident within Staphylococcus intermedius and Staphylococcus hyicus. The data increase the usefulness of rRNA gene restriction site polymorphism analysis for staphylococcal taxonomy.
The objective of this paper is to analyze the behaviour of a backscattered signalaccording to soil moisture depth over bare soils. Analysis based on experimental verticalmoisture profiles and ...ASAR/ENVISAT measurements has been carried out. A modifiedIEM model with three permittivity layers (0-1cm, 1-2cm, 2-5cm) has been developed andused in this study. Results show a small effect of moisture profile on the backscatteredsignal (less than 0.5dB). However, measurements and simulations have provided a moredetailed insight into the behaviour of the radar signal and have shown that it was importantto consistently use the same protocol when performing ground truth measurements of soilmoisture.
•A synergism on ruminal digestion is observed when alfalfa is mixed with axonopus.•The condensed tannins of sainfoin allow to reduce ruminal protein degradability.•The condensed tannins of sainfoin ...allow to mitigate methane production.•The condensed tannins content in peanut is not enough to have the same effects.
Associative effects between plants included in some mixtures with tropical and temperate species, which are able to grow in a wide range of temperature, deserve to be better investigated. The aim of this work was to assess the in vitro rumen fermentation characteristics when a tropical (peanut, Arachis pintoi) or temperate legume (sainfoin, Onobrychis viciifolia) with condensed tannins (CT), or a temperate legume without CT (alfalfa, Medicago sativa), were mixed with a tropical (axonopus, Axonopus catharinenses) or a temperate grass (tall fescue, Festuca arundinacea). Different proportions of each legume were mixed with each grass (in%, on dry matter (DM) basis, 0:100, 25:75, 50:50 75:25 and 100:0), and were tested using an in vitro rumen fermentation assay. The crude protein content in both tropical and temperate grasses ranged from 100 to 120g/kg DM, but the aNDF content was much higher in the tropical (617g/kg DM) than in the temperate grass (464g/kg DM). The ADF (+214g/kg DM) and lignin (+46.2g/kg DM) content was much higher in the alfalfa when compared with the average of two other legumes. Positive quadratic effects were detected on in vitro DM disappearance (IVDMD), total gas production, and volatile fatty acids production, when alfalfa was mixed with axonopus, but similar response was not observed when alfalfa was mixed with tall fescue. The IVDMD and total gas production linearly increased when the proportion of peanut or sainfoin increased in the mixtures containing axonopus, but did not change when these legumes were mixed with tall fescue. The ammonia production increased when the proportion of legume increased in all mixtures. Reductions on ammonia and methane (CH4) productions were observed in mixtures containing sainfoin without the presence of polyethylene glycol (PEG) compared to fermentation done with PEG, but this response was not observed in the mixtures containing peanut. We conclude that complementarities in terms of energy and protein content can create favourable conditions leading to positive associative effects on rumen digestive parameters when legume species were mixed with axonopus, but not when they are mixed with tall fescue, probably due to different fibre content of grasses. The CT of sainfoin allow to reduce ruminal protein degradability and mitigate CH4 emissions per kg of DM, while the CT content of peanut is not enough to have the same effects.
•Bioactive legumes and grass produce associative effects on volatile fatty acids.•Bioactive legumes increase protein protection during in vitro rumen fermentation.•Bioactive legumes in grass silage ...did not change dry matter disappearance.•Inclusion of bioactive legumes in grass silage did not affect methane production.
In this study, we tested the effects of the inclusion in silages of bioactive legumes containing condensed tannins (CT) or polyphenol oxidase (PPO), ensiled alone or in mixture with one grass species, on in vitro rumen fermentations. Six mini-silos were prepared in triplicate as follows: pure sainfoin (SF), pure red clover (RC), pure timothy (T, control without bioactive compounds); binary mixtures T–SF and T–RC (in g/kg on a DM basis, 500:500); ternary mixture T–SF–RC (in g/kg on a DM basis, 500:250:250). Samples from each mini-silo were incubated under anaerobic conditions in culture bottles containing buffered rumen fluid from sheep. Rumen fermentation parameters, namely DM disappearance, volatile fatty acids (VFA), ammonia (NH3), gas production and methane (CH4) were determined. The presence of RC in mixtures with T or T–SF results in fermentation similar to pure T and a positive associative effect between T and RC on total VFA production was observed (P=0.029). The NH3: total N ratio was similar among the treatments, but lower values for NH3: insoluble N ratio in silages containing SF or RC (P<0.05, except for T–SF) indicates that the bioactive compounds can limit silage protein degradation in the rumen. The CH4 production per g of DM only tended to differ among treatments (P=0.096), being slightly lower for pure SF than for pure T and RC, probably due to differences in the fermentation pathways towards less acetate and butyrate productions. Overall, the benefits of including RC in forage mixtures previously observed on silage quality are also present on ruminal digestion efficiency.
The pathway of carbon phloem loading was examined in leaf tissues of the forage grass Lolium perenne. The effect of defoliation (leaf blade removal) on sucrose transport capacity was assessed in leaf ...sheaths as the major carbon source for regrowth. The pathway of carbon transport was assessed via a combination of electron microscopy, plasmolysis experiments and plasma membrane vesicles (PMVs) purified by aqueous two-phase partitioning from the microsomal fraction. Results support an apoplastic phloem loading mechanism. Imposition of an artificial proton-motive force to PMVs from leaf sheaths energized an active, transient and saturable uptake of sucrose (Suc). The affinity of Suc carriers for Suc was 580 microM in leaf sheaths of undefoliated plants. Defoliation induced a decrease of. Ksub(m) followed by an increase of Vsub(max). A transporter was isolated from stubble (including leaf sheaths) cDNA libraries and functionally expressed in yeast. The level of L. perenne SUcrose Transporter 1 (LpSUT1) expression increased in leaf sheaths in response to defoliation. Taken together, the results indicate that Suc transport capacity increased in leaf sheaths of L. perenne in response to leaf blade removal. This increase might imply de novo synthesis of Suc transporters, including LpSUT1, and may represent one of the mechanisms contributing to rapid refoliation.
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