To investigate the association between oocyte number and the rates of ovarian hyperstimulation syndrome (OHSS) and live birth (LB) in fresh autologous in vitro fertilization (IVF) cycles.
...Retrospective cohort study.
An academic reproductive medicine practice.
We analyzed data from 256,381 IVF cycles using the 2008-2010 Society for Assisted Reproductive Technology national registry. Patients were divided into five groups based on retrieved oocyte number.
Rates of OHSS and LB were calculated for each group. A generalized estimating equation (GEE) was used to assess differences in OHSS and LB between groups. Receiver operating characteristic (ROC) curves were used to evaluate oocyte number as a predictor of OHSS and LB.
None.
The LB rate increased up to 15 oocytes, then plateaued (0-5: 17%, 6-10: 31.7%; 11-15: 39.3%; 16-20: 42.7%; 21-25: 43.8%; and >25 oocytes: 41.8%). However, the rate of OHSS became much more clinically significant after 15 oocytes (0-5: 0.09%; 6-10: 0.37%; 11-15: 0.93%; 16-20: 1.67%; 21-25: 3.03%; and >25 oocytes: 6.34%). These trends remained after adjustment with the use of GEE. ROC curves revealed that although oocyte number is not useful in the prediction of LB, 15 retrieved oocytes is the number that best predicts OHSS risk.
Retrieval of >15 oocytes significantly increases OHSS risk without improving LB rate in fresh autologous IVF cycles. In general, less aggressive stimulation protocols should be considered, especially in high-responders, to optimize outcomes.
To examine the effect of body mass index (BMI) on IVF outcomes in fresh autologous cycles.
Retrospective cohort study.
Not applicable.
A total of 239,127 fresh IVF cycles from the 2008-2010 Society ...for Assisted Reproductive Technology registry were stratified into cohorts based on World Health Organization BMI guidelines. Cycles reporting normal BMI (18.5-24.9 kg/m(2)) were used as the reference group (REF). Subanalyses were performed on cycles reporting purely polycystic ovary syndrome (PCOS)-related infertility and those with purely male-factor infertility (34,137 and 89,354 cycles, respectively).
None.
Implantation rate, clinical pregnancy rate, pregnancy loss rate, and live birth rate.
Success rates and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for all pregnancy outcomes were most favorable in cohorts with low and normal BMIs and progressively worsened as BMI increased. Obesity also had a negative impact on IVF outcomes in cycles performed for PCOS and male-factor infertility, although it did not always reach statistical significance.
Success rates in fresh autologous cycles, including those done for specifically PCOS or male-factor infertility, are highest in those with low and normal BMIs. Furthermore, there is a progressive and statistically significant worsening of outcomes in groups with higher BMIs. More research is needed to determine the causes and extent of the influence of BMI on IVF success rates in other patient populations.
Whether FinTech causes the fragility of financial institutions is a controversial issue. Using a panel sample of listed banks from 84 countries, we exploit the introduction of FinTech regulatory ...sandboxes as an exogenous shock and examine the heterogeneous effect of FinTech on the fragility of financial institutions. We find that (i) a shock to FinTech innovations has no net effect on the fragility of financial institutions when we ignore market characteristics, (ii) promoting FinTech decreases (increases) the fragility of financial institutions in emerging (developed) financial markets, and (iii) FinTech affects the fragility of financial institutions through the channel of profitability.
•When market characteristics are ignored, FinTech has no net effect on stability.•FinTech enhances (undermines) stability in emerging (developed) financial markets.•FinTech affects stability through the channel of profitability.
To help enhancing affordability and availability in the U.S. individual health insurance markets, we evaluate whether expanding interstate markets is associated with efficiency improvement, and the ...potentials of “Medicaid for All” and “Medicare for All”. This research aims to provide insights and evidence for data-driven decision making in reforming individual health insurance markets and optimizing individual health insurance operations. We employ traditional, non-oriented slack-based, order-α partial frontier, bootstrapped bias-corrected, and modified context-dependent data envelopment analysis (DEA) models, as well as generalized linear, Tobit, and residual inclusion regression models. We find that higher competition or expansion is not associated with higher consumer efficiency or societal efficiency. Our results also indicate that, in minimizing premiums or expenses given enrollment and utilization of medical services, individual health plans are less efficient than Medicaid managed care plans, but more efficient than Medicare Advantage plans. Our findings imply that, for individual plans, expanding interstate markets is not accompanied with lower premiums or expenses without the sacrifice of medical services. This research suggests that it should be advisable to structure individual health insurance markets following the Medicaid managed care model but not the Medicare Advantage model. To “Medicaid-ize” individual markets, we propose to structure the individual coverage in two layers: a conditionally subsidized Medicaid managed care program with mandatory essential benefits, and an unsubsidized “Medicaid Supplement” program for optional additional coverages.
To examine the effect of recipient body mass index (BMI) on IVF outcomes in fresh donor oocyte cycles.
Retrospective cohort study.
Not applicable.
A total of 22,317 donor oocyte cycles from the ...2008-2010 Society for Assisted Reproductive Technology Clinic Outcome Reporting System registry were stratified into cohorts based on World Health Organization BMI guidelines. Cycles reporting normal recipient BMI (18.5-24.9) were used as the reference group.
None.
Implantation rate, clinical pregnancy rate (PR), pregnancy loss rate, live birth rate.
Success rates and adjusted odds ratios with 95% confidence intervals for all pregnancy outcomes were most favorable in cohorts of recipients with low and normal BMI, but progressively worsened as BMI increased.
Success rates in recipient cycles are highest in those with low and normal BMI. Furthermore, there is a progressive and statistically significant worsening of outcomes in groups with higher BMI with respect to clinical pregnancy and live birth rate.
Embedded value is commonly used by life insurers to measure the realistic valuation of their consolidated shareholders’ interest. Previous studies use market price as a yardstick for measuring the ...value relevance of embedded value. This study challenges that view by examining the market price to embedded value gap. We explain it by testing the intellectual capital hypothesis and the investor sentiment hypothesis. While the intellectual capital hypothesis asserts that the difference between market price and embedded value is due to the omission of intellectual capital in the calculation of embedded value, the investor sentiment hypothesis asserts that the market price to embedded value gap is driven by the bias of investor sentiment on market price. Drawing on a sample of European public life insurers, we find that insurers with market prices higher than their embedded values have lower future stock returns. Using the Heckman two-stage regression to control for life insurers’ endogenous decision to disclose embedded values, we also find that the market price to embedded value (PEV) ratio is not related to future financial performance, but is negatively associated with our crisis sentiment index in the short term. In addition, the PEV ratio is positively associated with analysts’ overestimation of long-term earnings. Such results support the investor sentiment hypothesis instead of the intellectual capital hypothesis. Our findings provide a better understanding of the gap between embedded value and market price.
To use a large and recent national registry to provide an updated report on the effect of recipient age on the outcome of donor oocyte in vitro fertilization (IVF) cycles.
Retrospective cohort study.
...United States national registry for assisted reproductive technology.
Recipients of donor oocyte treatment cycles between 2008 and 2010, with cycles segregated into five age cohorts: ≤34, 35 to 39, 40 to 44, 45 to 49, and ≥50 years.
None.
Implantation, clinical pregnancy, live-birth, and miscarriage rates.
In donor oocyte IVF cycles, all age cohorts ≤39 years had similar rates of implantation, clinical pregnancy, and live birth when compared with the 40- to 44-year-old reference group. Patients in the two oldest age groups (45 to 49, ≥50 years) experienced statistically significantly lower rates of implantation, clinical pregnancy, and live birth compared with the reference group. Additionally, all outcomes in the ≥50-year-old group were statistically significantly worse than the 45- to 49-year-old group, demonstrating progressive decline with advancing age.
Recent national registry data suggest that donor oocyte recipients have stable rates of pregnancy outcomes before age 45, after which there is a small but steady and significant decline.
To use a national registry to examine the role of oocyte donation on pregnancy outcomes in singleton pregnancies.
Retrospective cohort.
Not applicable.
Women undergoing autologous cycles and donor ...oocyte recipients in the United States from 2008-2010.
None.
Preterm delivery, birth weight <2,500 g, small for gestational age birthweight, perinatal death.
The rates of preterm delivery and low birthweight for all members of this cohort were higher than the US national average. Pregnancies resulting from oocyte donation were significantly more likely to end before 34 weeks' and 37 weeks' gestation (adjusted odds ratio OR = 1.30, 95% confidence interval CI = 1.03-1.64 for 34 weeks' gestation, adjusted OR = 1.28, 95% CI = 1.12-1.46 for 37 weeks' gestation), and to result in infants weighing <2,500 g (adjusted OR = 1.21, 95% CI = 1.02-1.44). However, once gestational age at delivery is accounted for, these infants are actually at decreased risk of having a small for gestational age birthweight (adjusted OR = 0.72, 95% CI = 0.58-0.89) and of perinatal death (adjusted OR = 0.29, 95% CI = 0.09-0.94).
Data from a national cohort indicate that donor oocyte recipients are more likely to deliver preterm when compared with autologous patients. The effect of donor oocyte donation on birthweight is likely a function of an increased rate of preterm delivery among this population.
Feline injection‐site sarcomas (FISSs) are highly invasive malignant mesenchymal neoplasms that arise from injection sites in cats. Although the tumorigenesis of FISSs is still uncertain, there is a ...consensus that FISS is associated with chronic inflammation caused by irritation of injection‐related trauma and foreign chemical substances. Chronic inflammation can provide a proper microenvironment for tumour development, which has been known as one of the risk factors of tumorigenesis in many tumours. To investigate the tumorigenesis of FISS and screen for its potential therapeutic targets, cyclooxygenase‐2 (COX‐2), an inflammation‐enhancing enzyme, was selected as a target for this study. In vitro experiments using FISS‐ and normal tissue‐derived primary cells and robenacoxib, a highly selective COX‐2 inhibitor, were performed. The results demonstrated that expression of COX‐2 could be detected in formalin‐fixed and paraffin‐embedded FISS tissues and FISS‐derived primary cells. Cell viability, migration and colony formation of FISS‐derived primary cells were inhibited, and cell apoptosis was enhanced by robenacoxib in a dose‐dependent manner. However, susceptibility to robenacoxib varied in different lines of FISS primary cells and was not completely correlated with COX‐2 expression. Our results suggest that COX‐2 inhibitors could be potential adjuvant therapeutics against FISSs.
This paper examines the informativeness of embedded value reporting to stock price by investigating the cross‐sectional variations in life insurers’ price to embedded value ratios. By conducting ...variance decomposition analysis on a dataset provided by Morgan Stanley, we find that 15 percent (40 percent) of the difference between embedded value and stock price can be explained by growth opportunities and future stock returns in the short (long) run. One‐third and two‐thirds of the unexplained variation are attributed to firm‐ and country‐specific factors, respectively. The above findings provide investors with a better understanding of the value relevance of embedded value reporting.
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