This article represents a viewpoint on the POSEIDON criteria by a group of clinicians and embryologists. Its primary objective is to contextualize the Poseidon criteria and their metric of success ...for the relevant Frontiers Research Topic "POSEIDON's Stratification of Low Prognosis Patients in ART: The WHY, the WHAT, and the HOW". "Low prognosis" relates with reduced oocyte number, which can be associated with low or sometimes a normal ovarian reserve and is aggravated by advanced female age. These aspects will ultimately affect the number of embryos generated and consequently, the cumulative live birth rate. The novel system relies on female age, ovarian reserve markers, ovarian sensitivity to exogenous gonadotropin, and the number of oocytes retrieved, which will both identify the patients with low prognosis and stratify such patients into one of four groups of women with "expected" or "unexpected" impaired ovarian response to exogenous gonadotropin stimulation. Furthermore, the POSEIDON group introduced a new measure of clinical success in ART, namely, the ability to retrieve the number of oocytes needed to obtain at least one euploid blastocyst for transfer in each patient. Using the POSEIDON criteria, the clinician can firstly identify and classify patients who have low prognosis in ART, and secondly, aim at designing an individualized treatment plan to maximize the chances of achieving the POSEIDON measure of success in each of the four low prognosis groups. The novel POSEIDON classification system is anticipated to improve counseling and management of low prognosis patients undergoing ART, with an expected positive effect on reproductive success and a reduction in the time to live birth.
Purpose
To characterize nail and enthesis abnormalities using high frequency ultrasound (HFUS) in patients with psoriasis (PSO), psoriatic arthritis (PSA) with PSO, and PSA sine PSO.
Material and ...Methods
Patients with PSO, PSA with PSO, and PSA sine PSO were evaluated and compared in a cross-sectional single centre study. Nail and enthesis abnormalities were evaluated by HFUS using high frequency probes (27 MHz). After a descriptive assessment, Brown University Nail Enthesis Scale (BUNES) and Madrid Sonography Enthesitis Index (MASEI) were used to assess nail and enthesis, respectively.
Results
Fifty-nine patients were enrolled (19 PSO, 22 PSA with PSO, 18 PSA sine PSO). In patients with PSO and in those with PSA and PSO, HFUS evaluation identified the following nail alterations characterised by thickened matrix, inhomogeneous echogenicity of the nail bed, and increased blood flow by power Doppler. In 38.9% patients with PSA sine PSO, a subclinical nail involvement was described. No difference was observed comparing BUNES values in three groups. In PSA patients with PSO and in those with PSA sine PSO, HFUS assessment of entheses mainly showed a hypoechoic aspect and thickness of the tendon, focal cortical erosion, and ossification. A subclinical enthesis involvement in 47.4% patients with PSO was observed. No difference was reported comparing MASEI values in three groups.
Conclusion
Qualitative and quantitative abnormalities of nail and enthesis were demonstrated by HFUS in patients with PSO, PSA with PSO, and PSA sine PSO, suggesting a practical additional tool to be used in clinical settings. Furthermore, HFUS highlighted a subclinical nail involvement in patients with PSA sine PSO and enthesis subclinical alterations in patients with PSO.
It is well recognized that the human uterus and adjoining tissues of the female reproductive tract exist in a non-sterile state where dysbiosis can impact reproductive outcomes. The endometrial ...microbiota is a part of this greater milieu. To date, it has largely been studied using 16S rRNA or metagenomics-based methodologies. Despite the known advantages of sequencing analysis, several difficulties have been noted including sample contamination and standardization of DNA extraction or sequencing. The aim of this study was to use a culturomics-based method to analyze the endometrial microbiota and correlate the results with ongoing pregnancy rates.
A prospective cohort study was performed at the University of Naples from June 2022 to December 2022. Ninety-three patients undergoing an IVF cycle with single embryo transfer (ET) (fresh or frozen) were enrolled in the study. Following ET, the catheter tip was inserted into brain heart infusion (BHI) medium under sterile conditions for culture. After 24h and 48h of incubation the microorganisms in the colonies were identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS).
Overall, 68 (73,92%) patients resulted positive for one or more microbes and 25 patients (26,08%) had no microbial growth. Across all participants, the four most important phyla were
(87,76%),
(27,94%),
(10,29%) and
(8,82%).
species, in particular, was significantly correlated with ongoing pregnancy rate (p=0,05). On the other hand, Staphylococcus subspecies (spp.) (p<0,05) and Enterobacteriaceae (p<0,001) were found to have a negative impact on the implantation rate.
Detection of bacteria by culturomics from catheter tips used for embryo transfer has been shown to be a reliable method to detect pathogen growth. Endometrial microbiota testing in clinical practice could certainly offer a means to further improve diagnosis and treatment strategies in IVF patients.
The compatibility of sediments in terms of grain size, composition and colour among beaches and strategic sediment deposits (SSD) along Western Sardinia (Western Mediterranean Sea) were assessed to ...explore management strategy in the protection and adaptation to counteract the beach erosion and the effect of sea level rise along sandy shores. Twelve beaches, mainly conditioned by geological control, due to the presence of extensive rocky outcrops in the sea, enclosed in seven sedimentary cells (defined by the continuity of sediment transport pathways and by identification of boundaries where there are discontinuities), were characterised in terms of sediment composition and grain size. One hundred ninety-three beach sediments and one hundred sediments from SSDs were collected and analysed for sediment grain size, carbonate content and sediment colour. The beach sediments are composed by gravel to fine sands (D50: from 81 µm to 4986 µm) with siliciclastic and biogenic carbonate sediments mixed in different proportions (0–100% in CaCO3). The SSDs sediments are gravels to medium-fine sand (D50: from 96 µm to 1769 µm) composed by biogenic carbonate sands mixed with siliciclastic grains (0–100% in CaCO3). To be able to evaluate the compatibility between the beaches and SSDs, a multivariate statistical procedure was applied to grain size dataset. Our results show that 8 beaches have strategic deposits of compatible grain size and composition, whereas only 2 beaches have compatible strategic deposits of both grain size and colour. This may be related to the different sediment sources and depositional processes of sediment along the coastal cells and the continental shelf.
In this study, we aimed at describing the multivisceral involvement on adult-onset Still’s disease (AOSD) to retrieve imaging-based differences in patients with and without macrophage activation ...syndrome (MAS). From our historical cohort, patients were assessed among those who underwent a total body CT scan. Clinical and CT scan characteristics of AOSD patients with and without MAS were compared. Out of 39 AOSD patients evaluated, 14 were complicated by MAS. These patients showed higher values of ferritin and systemic score. AOSD patients with MAS presented a higher prevalence of lung disease, hepatomegaly, splenomegaly, abdominal effusions, and lymph node enlargement than others without this complication. In addition, the presence of these manifestations significantly correlated with the systemic score, furtherly reinforcing its prognostic value. Due to the specific design of our study, our findings could be burdened by a selection bias since assessing those patients underwent a total body CT scan. Thus, these data should be prudently generalised suggesting the need of further studies to fully elucidate this issue. Our findings showed a higher prevalence of multiorgan involvement in AOSD patients with MAS, suggesting imaging-based differences, although other studies are needed to fully assess this issue. Pulmonary disease, hepatomegaly, splenomegaly, lymph node enlargement, and abdominal effusions were associated with a more aggressive subset of AOSD.
Key Points
•The importance of an accurate assessment AOSD multivisceral involvement is suggested since it is associated with life-threatening complications.
•A higher prevalence of multiorgan involvement in AOSD patients with MAS could be recognised, than others without this complication, suggesting imaging-based differences.
•AOSD multivisceral involvement may correlate with the systemic score, furtherly reinforcing its prognostic value.
Recent evidence suggests that follicular development occurs in a wave-like model during the ovarian cycle, where up to three cohorts of follicles are recruited to complete folliculogenesis. This ...understanding overtakes the previous dogma stating that follicles grow only during the follicular phase of the menstrual cycle. Therefore, in in vitro fertilization (IVF), novel protocols regarding ovarian stimulation have been theorized based on the use of gonadotrophins to prompt the growth of antral follicles at any stage of the menstrual cycle. These unconventional protocols for ovarian stimulation aim at a more efficient management of poor-prognosis patients, otherwise exposed to conflicting outcomes after conventional approaches. DuoStim appears among these unconventional stimulation protocols as one of the most promising. It combines two consecutive stimulations in the follicular and luteal phases of the same ovarian cycle, aimed at increasing the number of oocytes retrieved and embryos produced in the short time-frame. This protocol has been suggested for the treatment of all conditions requiring a maximal and urgent exploitation of the ovarian reserve, such as oncological patients and poor responders at an advanced maternal age. At present, data from independent studies have outlined the consistency and reproducibility of this approach, which might also reduce the drop-out between consecutive failed IVF cycles in poor-prognosis patients. However, the protocol must be standardized, and more robust studies and cost-benefit analyses are needed to highlight the true clinical pros and cons deriving from DuoStim implementation in IVF.
This review provides a comprehensive overview of the existing research on the seminal microbiome and its association with male infertility, while also highlighting areas that warrant further ...investigation.
A narrative review was conducted, encompassing all relevant studies published between 1980-2023 on the male reproductive tract microbiome in humans. This review considered studies utilizing culture-based, polymerase chain reaction (PCR)-based, and next-generation sequencing (NGS)-based methodologies to analyze the microbiome. Data extraction encompassed sample types (semen or testicular tissue), study designs, participant characteristics, employed techniques, and critical findings.
We included 37 studies comprising 9,310 participants. Among these, 16 studies used culture-based methods, 16 utilized NGS, and five employed a combination of methods for microorganism identification. Notably, none of the studies assessed fungi or viruses. All NGS-based studies identified the presence of bacteria in all semen samples. Two notable characteristics of the seminal microbiome were observed: substantial variability in species composition among individuals and the formation of microbial communities with a dominant species. Studies examining the testicular microbiome revealed that the testicular compartment is not sterile. Interestingly, sexually active couples shared 56% of predominant genera, and among couples with positive cultures in both partners, 61% of them shared at least one genital pathogen. In couples with infertility of known causes, there was an overlap in bacterial composition between the seminal and vaginal microbiomes, featuring an increased prevalence of Staphylococcus and Streptococcus genera. Furthermore, the seminal microbiome had discernible effects on reproductive outcomes. However, bacteria in IVF culture media did not seem to impact pregnancy rates.
Existing literature underscores that various genera of bacteria colonize the male reproductive tract. These organisms do not exist independently; instead, they play a pivotal role in regulating functions and maintaining hemostasis. Future research should prioritize longitudinal and prospective studies and investigations into the influence of infertility causes and commonly prescribed medication to enhance our understanding of the seminal microbiota's role in reproductive health.
Geohazard features of the Northern Sardinia Conforti, Alessandro; Budillon, Francesca; De Falco, Giovanni ...
Journal of maps,
12/2024, Volume:
20, Issue:
1
Journal Article
Peer reviewed
Open access
The maps of the geohazard-related features of the North Sardinia continental margin produced by the Magic project (MArine Geohazard along Italian Coasts) are here presented. The maps were created on ...the base of morphobathymetric data obtained by with multibeam echo sounders. ThreCoNISMa, DSCG Università degli studi di Cagliari, Cittadella Universitaria Monserrato - S.P. Monserrato-Sestu, Monserrato (CA), Italye wide canyon systems, Castelsardo to the west, Lavezzi and Caprera to the east, originate from the continental shelf between the islands of Sardinia and Corsica and run toward the Sardinia Sea and the Tyrrhenian Sea, respectively. The canyons feature very wide and articulated heads, meandered sections of the main axis. The continental shelfhosts several coastal lithotomies, genetically related to late Quaternary sea-level oscillation and coastline migration. Furthermore, in the Bonifacio Strait, several bedform fields testify to the present-day activity of strong bottom currents. The main geohazard potential from the North Sardinia is related to the retreating of Castelsardo canyon heads, in offshore of Castelsardo and Asinara, which cuts the continental shelf reaching a few kilometers from the coast.
Mild stimulation (MS) consists in prescribing gonadotropin at the minimum amount alone or in combination with other compounds. This strategy has gained popularity in assisted reproduction for the ...reduced costs, better patient compliance, and reduced risk of hyperstimulation syndrome. Some investigators proposed MS even in women with low prognosis. The Poseidon group proposed new criteria to identify these patients categorizing them into 4 different groups, each one characterized by a specific segment of prognosis. The use of MS in women with low prognosis involves risks that cannot be overlooked. The most crucial concerns are the increased rate of cycle cancellation and the reduced number of eggs collected. Notably, the number of eggs collected still represents the most accurate predictor of live birth and cumulative live birth rate. Despite promising preliminary data, recent evidence has confirmed that MS does not improve gamete quality. Hence, considering that no robust strategy was identified so far to improve oocyte quality, the only reasonable strategy to improve the chance of live birth in women with low prognosis is to collect the necessary number of oocytes to maximize the probability to obtain at least 1 good-quality embryo. In this sense, conventional protocols offer better results when compared with the mild approach. Given the difficulty in collecting enough oocytes in a single round of stimulation, accumulation strategy could represent a valuable approach especially in women with advanced reproductive age and reduced ovarian reserve.
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