Abstract
STUDY QUESTION
Does each millimeter decrease in endometrial thickness lead to lower pregnancy and live birth rates in fresh and frozen IVF cycles?
SUMMARY ANSWER
Clinical pregnancy and live ...birth rates decline as the endometrial thickness decreases below 8 mm in fresh IVF-ET and below 7 mm in frozen-thaw embryo transfer (ET) cycles.
WHAT IS KNOWN ALREADY
Previous studies have been heterogenous and have shown conflicting results on the impact of endometrial thickness on IVF outcomes. Most studies do not include many patients with an endometrial thickness below 6 mm, and there are few studies of frozen-thaw ET cycles.
STUDY DESIGN, SIZE, DURATION
This study is a retrospective cohort analysis of all Canadian IVF fresh and frozen-thaw ET cycles from the CARTR-BORN database for autologous and donor fresh and frozen-thaw IVF-ET cycles from 1 January 2013 to 31 December 2015. A total of 24 363 fresh and 20 114 frozen-thaw IVF-ET cycles were reported during this timeframe.
PARTICIPANTS/MATERIALS, SETTING, METHODS
33 Canadians clinics participated in voluntary reporting of IVF and pregnancy outcomes to the CARTR-BORN database. The impact of endometrial thickness on pregnancy, live birth and pregnancy loss rates were analyzed for fresh IVF-ET and frozen-thaw cycles.
MAIN RESULTS AND THE ROLE OF CHANCE
In fresh IVF-ET cycles, clinical pregnancy and live birth rates decreased (P < 0.0001) and pregnancy loss rates increased (P = 0.01) with each millimeter decline in endometrial thickness below 8 mm. Live birth rates were 33.7, 25.5, 24.6 and 18.1% for endometrial thickness ≥8, 7-7.9, 6-6.9 and 5-5.9 mm, respectively. In frozen-thaw ET cycles, clinical pregnancy (P = 0.007) and live birth rates decreased (P = 0.002) with each millimeter decline in endometrial thickness below 7 mm, with no significant difference in pregnancy loss rates. Live birth rates were 28.4, 27.4, 23.7, 15 and 21.2% for endometrial thickness ≥8, 7-7.9, 6-6.9, 5-5.9 and 4-4.9 mm, respectively. The likelihood of achieving an endometrial thickness ≥8 mm decreased with age (89.7, 87.8 and 83.9% in women <35, 35-39 and ≥40, respectively) (P < 0.0001).
LIMITATIONS, REASONS FOR CAUTION
This study only included cycles which proceeded to ET, which may overestimate pregnancy outcomes. Approximately 8% of cycles could not be included in the analysis due to data irregularity related to data entry. Demographic data aside from age were unavailable but may be important as lower endometrial thickness may be associated with poor ovarian response.
WIDER IMPLICATIONS OF THE FINDINGS
Although pregnancy and live birth rates decrease with endometrial thickness, reasonable outcomes were obtained even with lower endometrial thickness measurements. These data provide valuable guidance for both physicians and patients when confronted with decisions related to a persistently thin endometrium.
STUDY FUNDING/COMPETING INTEREST(S)
This study was not funded. The authors do not have any conflicts of interests to declare.
TRIAL REGISTRATION NUMBER
N/A.
Academic and industrial research on nanofibres is an area of increasing global interest, as seen in the continuously multiplying number of research papers and patents and the broadening range of ...chemical, medical, electrical and environmental applications. This in turn expands the size of the market opportunity and is reflected in the significant rise of entrepreneurial activities and investments in the field. Electrospinning is probably the most researched top-down method to form nanofibres from a remarkable range of organic and inorganic materials. It is well known and discussed in many comprehensive studies, so why this review? As we read about yet another "novel" method producing multifunctional nanomaterials in grams or milligrams in the laboratory, there is hardly any research addressing how these methods can be safely, consistently and cost-effectively up-scaled. Despite two decades of governmental and private investment, the productivity of nanofibre forming methods is still struggling to meet the increasing demand. This hinders the further integration of nanofibres into practical large-scale applications and limits current uses to niche-markets. Looking into history, this large gap between supply and demand of synthetic fibres was seen and addressed in conventional textile production a century ago. The remarkable achievement was accomplished via extensive collaborative research between academia and industry, applying ingenious solutions and technological convergence from polymer chemistry, physical chemistry, materials science and engineering disciplines. Looking into the present, current advances in electrospinning and nanofibre production are showing similar interdisciplinary technological convergence, and knowledge of industrial textile processing is being combined with new developments in nanofibre forming methods. Moreover, many important parameters in electrospinning and nanofibre spinning methods overlap parameters extensively studied in industrial fibre processing. Thus, this review combines interdisciplinary knowledge from the academia and industry to facilitate technological convergence and offers insight for upscaling electrospinning and nanofibre production. It will examine advances in electrospinning within a framework of large-scale fibre production as well as alternative nanofibre forming methods, providing a comprehensive comparison of conventional and contemporary fibre forming technologies. This study intends to stimulate interest in addressing the issue of scale-up alongside novel developments and applications in nanofibre research.
Abstract Previous data demonstrate that traumatic brain injury (TBI) activates autophagy, and increases microtubule-associated protein 1 light chain 3 (LC3) immunostaining mainly in neurons. However, ...the role of autophagy in traumatic brain damage remains elusive. The aim of the present study was to investigate the autophagic mechanisms participating in traumatic brain injury. The autophagy inhibitors 3-methyladenine (3-MA) and bafliomycin A1 (BFA) were administered with a single i.c.v. injection before TBI. We first examined the protein levels of Beclin-1 and LC3 II, which have been found to promote autophagy previously. Immunoblotting analysis showed that 3-MA pretreatment reduced post-TBI Beclin-1 and LC3-II levels, and maintained p62/SQSTM1 (p62) levels. In addition, double immunolabeling showed that the increased punctate LC3-II dots colocalizing with Propidium Iodide (PI)-stained nuclei at 24 h after injury, were partially inhibited by 3-MA pretreatment. Furthermore, inhibition of autophagy could reduce TBI-induced cell injury assessed with i.p. injection of PI and lesion volume, and attenuate behavioral outcome evaluated by motor test and Morris water maze. The neuroprotective effects were associated with an inhibition on TBI-induced up-regulation of LC3, Beclin-1, cathepsin B, caspase-3 and the Beclin-1/Bcl-2 ratio. Taken together, these data imply that the autophagy pathway is involved in the pathophysiologic responses after TBI, and inhibition of this pathway may help attenuate traumatic damage and functional outcome deficits.
Triple-negative breast cancer (TNBC) is an aggressive subtype characterized by extensive intratumoral heterogeneity. To investigate the underlying biology, we conducted single-cell RNA-sequencing ...(scRNA-seq) of >1500 cells from six primary TNBC. Here, we show that intercellular heterogeneity of gene expression programs within each tumor is variable and largely correlates with clonality of inferred genomic copy number changes, suggesting that genotype drives the gene expression phenotype of individual subpopulations. Clustering of gene expression profiles identified distinct subgroups of malignant cells shared by multiple tumors, including a single subpopulation associated with multiple signatures of treatment resistance and metastasis, and characterized functionally by activation of glycosphingolipid metabolism and associated innate immunity pathways. A novel signature defining this subpopulation predicts long-term outcomes for TNBC patients in a large cohort. Collectively, this analysis reveals the functional heterogeneity and its association with genomic evolution in TNBC, and uncovers unanticipated biological principles dictating poor outcomes in this disease.
Wi-Fi-based localization using received signal strength (RSS) with pedestrian dead reckoning (PDR) algorithm is widely used to track pedestrians in indoor environments. However, the unsatisfactory ...deployment of Wi-Fi access points (APs) in buildings and the unstable performance of PDR are still key problems that lead to low localization accuracy. In this paper, we make contributions on proposing a hybrid Wi-Fi and Bluetooth Low Energy (BLE) indoor localization system (ILS) based on an efficient BLE deployment strategy and hierarchical topological fingerprinting (HTF). For the BLE deployment strategy, we deploy BLE beacons in places that do not have clear Wi-Fi signals for localization. This efficiently increases the localization accuracy. For HTF, we hierarchically localize targets based on a topological fingerprint (TF) map. First of all, we quickly localize the room in which the target is located by Dendogram-based support vector machine (DSVM). Then, the specific position of the target is estimated by fusing Wi-Fi and BLE signals with the TF map. The new BLE-based fingerprinting algorithm is used to localize targets in environments sparsely populated by BLE beacons. We conduct physical experiments in a real building. The experimental results demonstrate that the beacons deployed based on our proposed deployment strategy results in greater localization accuracy. Furthermore, the HTF approach performs better than the other commonly used localization methods.
Solvent–polymer interactions critically influence not only the viscoelasticity and the critical minimum solution concentration required for electrospinning but also the diameter, crystallinity, ...tensile strength, aspect ratio, and morphology of the electrospun fibers. Hence, a good understanding of the solvents and nonsolvents available and electrospinnable for a polymer of interest is important. The electrospinnability–solubility map uniquely presents the solubility and the electrospinnability of all solvents for a polymer in a single figure. Poly(ε-caprolactone) (PCL), an important polymer in biomedical applications, has been electrospun in a few conventional solvent systems, but a comprehensive mapping of its solvents for electrospinning has not been performed. Based on 49 common solvents of diverse solubility parameters and functional groups, the spinnability–solubility graph for electrospinning PCL solutions was mapped for the first time to enable a comprehensive understanding of the processability of all solvent choices for electrospinning PCL solutions. Furthermore, to date, many studies have demonstrated the importance of the dielectric constant (relative permittivity) of solvents in solution electrospinning, but few have systematically investigated its influence for a broad range of solvent systems. Based on the comprehensive PCL solvent map, this work studies the influence of dielectric constant of solvent systems on the electrospinning of PCL solutions. PCL (M n = 80 000 g/mol) fiber diameters <100 nm were achieved when the dielectric constant of a solvent system was ∼19 and above, below which fibers or relics of diameters from submicrometer to millimeter range were produced. A detailed investigation was carried out on solvent systems with a calculated range of dielectric constants by mixing acetic acid and formic acidtwo solvents with significantly different dielectric constants but the same functional group and comparable in other physical properties influential in electrospinning. With increasing dielectric constant, the required applied voltage to achieve stable jetting increased, the frequency of bead-on-string morphology decreased, and the interfiber spacing increased without affecting the total mass of fibers spun per unit time. In addition, the dissolution and electrospinnability of poor or nonsolvents of PCL were tested at temperatures 10 °C or higher than the ambient temperature. A unique and novel morphology of electrospun fibers within electrosprayed relics was generated for the first time when electrospinning PCL in 2-ethoxyethyl acetate, a nonsolvent at an ambient temperature of 20–22 °C and a partial solvent of PCL at an elevated temperature of above 30 °C.
We develop a simple, fast and economical surface treatment under ambient temperature to improve the hydrophilicity and osteoconductivity of polyetheretherketone (PEEK) for bone implant applications. ...A major challenge in bone implants is the drastic difference in stiffness between traditional implant materials (such as titanium and stainless steel) and human bone. PEEK is biocompatible with an elastic modulus closely matching that of human bone, making it a highly attractive alternative. However, its bio-inert and poorly hydrophilic surface presents a serious challenge for osseointegration. Sulfonation can improve hydrophilicity and introduce bioactive sulfonate groups, but PEEK sulfonation has traditionally been applied for fuel cells, employing elevated temperatures and long reaction times to re-cast PEEK into sulfonated films. Little research has systematically studied PEEK surface modification by short reaction time (seconds) and ambient-temperature sulfonation for biomedical applications. Here, we investigate three ambient-temperature sulfonation treatments under varying reaction times (5-90 s) and evaluate the hydrophilicity and morphology of 15 modified PEEK surfaces. We establish an optimal treatment using 30 s H
SO
followed by 20 s rinsing, and then 20 s immersion in NaOH followed by 20 s rinsing. This 30 s ambient-temperature sulfonation is found to be more effective than conventional plasma treatments and reduced PEEK water contact angle from 78° to 37°.
Endovascular repair (EVAR) of mycotic aortic aneurysm (MAA) has become an alternative treatment for high risk patients. The aim of this study was to evaluate long-term survival and outcomes.
...Retrospective analysis of 40 consecutive patients with MAAs undergoing EVAR and subsequent intravenous antibiotic treatment between September 2009 and April 2015. Follow-up was truncated on 30 April 2015. Uni- and multivariate logistic regression were used to assess risk factors of adverse outcomes. Cumulative survival was calculated using the Kaplan–Meier method.
Median age at repair was 73 years (range 48–88 years) and 31 (77%) were men. Eleven (27%) patients were infected with Salmonella, 12 (30%) with non-Salmonella species, and 17 (42%) had negative cultures. Anatomical locations included the aortic arch/thoracic area in 10 (25%), the paravisceral area in seven (17%), and the infrarenal area in 23 (57%). Ten (25%) patients presented with aneurysm rupture and underwent emergency repair. Median follow-up was 25 months (range 1–69 months). Cumulative 1 and 5 year survival rates were 71% and 53%, respectively. Persistent or recurrent infection occurred in 20% (n = 8). Patients with persistent infection were treated with long-term medical therapy, but all died (75%; n = 6) within 6 months of repair. No survival difference was found between patients with or without Salmonella infections. However, there was a trend toward better survival in culture negative patients.
EVAR of MAA is an acceptable alternative treatment of MAA. However, persistent infection after endovascular treatment does occur and is often fatal without surgical treatment.
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