The transfer of fresh embryos is generally preferred over the transfer of frozen embryos for in vitro fertilization (IVF), but some evidence suggests that frozen-embryo transfer may improve the ...live-birth rate and lower the rates of the ovarian hyperstimulation syndrome and pregnancy complications in women with the polycystic ovary syndrome.
In this multicenter trial, we randomly assigned 1508 infertile women with the polycystic ovary syndrome who were undergoing their first IVF cycle to undergo either fresh-embryo transfer or embryo cryopreservation followed by frozen-embryo transfer. After 3 days of embryo development, women underwent the transfer of up to two fresh or frozen embryos. The primary outcome was a live birth after the first embryo transfer.
Frozen-embryo transfer resulted in a higher frequency of live birth after the first transfer than did fresh-embryo transfer (49.3% vs. 42.0%), for a rate ratio of 1.17 (95% confidence interval CI, 1.05 to 1.31; P=0.004). Women who underwent frozen-embryo transfer also had a lower frequency of pregnancy loss (22.0% vs. 32.7%), for a rate ratio of 0.67 (95% CI, 0.54 to 0.83; P<0.001), and of the ovarian hyperstimulation syndrome (1.3% vs. 7.1%), for a rate ratio of 0.19 (95% CI, 0.10 to 0.37; P<0.001), but a higher frequency of preeclampsia (4.4% vs. 1.4%), for a rate ratio of 3.12 (95% CI, 1.26 to 7.73; P=0.009). There were no significant between-group differences in rates of other pregnancy and neonatal complications. There were five neonatal deaths in the frozen-embryo group and none in the fresh-embryo group (P=0.06).
Among infertile women with the polycystic ovary syndrome, frozen-embryo transfer was associated with a higher rate of live birth, a lower risk of the ovarian hyperstimulation syndrome, and a higher risk of preeclampsia after the first transfer than was fresh-embryo transfer. (Funded by the National Basic Research Program of China and others; ClinicalTrials.gov number, NCT01841528.).
Tumor-infiltrating inflammatory cells comprise a major part of the stromal microenvironment and support cancer progression by multiple mechanisms. High numbers of tumor myeloid cells correlate with ...poor prognosis in breast cancer and are coupled with the angiogenic switch and malignant progression. However, the specific roles and regulation of heterogeneous tumor myeloid populations are incompletely understood. CSF-1 is a major myeloid cell mitogen, and signaling through its receptor CSF-1R is also linked to poor outcomes. To characterize myeloid cell function in tumors, we combined confocal intravital microscopy with depletion of CSF-1R–dependent cells using a neutralizing CSF-1R antibody in the mouse mammary tumor virus long-terminal region-driven polyoma middle T antigen breast cancer model. The depleted cells shared markers of tumor-associated macrophages and dendritic cells (M-DCs), matching the phenotype of tumor dendritic cells that take up antigens and interact with T cells. We defined functional subgroups within the M-DC population by imaging endocytic and matrix metalloproteinase activity. Anti–CSF-1R treatment altered stromal dynamics and impaired both survival of M-DCs and accumulation of new M-DCs, but did not deplete Gr-1 ⁺ neutrophils or block doxorubicin-induced myeloid cell recruitment, and had a minimal effect on lung myeloid cells. Nevertheless, prolonged treatment led to delayed tumor growth, reduced vascularity, and decreased lung metastasis. Because the myeloid infiltrate in metastatic lungs differed significantly from that in mammary tumors, the reduction in metastasis may result from the impact on primary tumors. The combination of functional analysis by intravital imaging with cellular characterization has refined our understanding of the effects of experimental targeted therapies on the tumor microenvironment.
Significance Tumor-infiltrating myeloid cells fail to support antitumor immunity, and instead contribute to increased malignancy and poor prognosis in breast cancer. We used intravital microscopy in a model of breast cancer to provide unique insight into cellular composition and real-time dynamics of the stromal microenvironment. We characterized the effects of targeted therapy against CSF-1R, an important myeloid cell mitogen receptor. We demonstrate that by blocking accumulation and compromising survival, anti–CSF-1R treatment depletes a cell population sharing characteristics of tumor-associated macrophages and dendritic cells, which further comprises subgroups with different endocytic and matrix metalloproteinase activities. However, the resulting relatively modest delay in tumor growth and metastasis suggests that other cells, such as neutrophils or fibroblasts, may maintain the tumor trophic microenvironment.
Co-optimizing information quality and energy efficiency are an important but challenging problem in sensor networks, because of the interdependency that exists between them. For example, increasing ...sensor sampling rate will improve information quality but cost energy consumption, due to more traffic needed to be transmitted. To address this co-optimization issue, this paper first presents a novel quality/energy efficient metric, which models the relationship of sensing, processing, and transmitting with quality and energy. Then, based on the metrics, a quality-energy adapting system is developed to exploit base station scheduling priority and techniques such as batch processing and adaptive sampling to optimize both energy efficiency and overall quality. Our results have demonstrated the usefulness of this model and its feasibility for base station to runtime co-optimize both quality and energy under changing environment and network conditions.
The aim of this observational study was to test whether ABO blood type was a prognostic factor for pancreatic ductal adenocarcinoma (PDAC) patients and whether other risk factors could influence ...pancreatic cancer patients' survival. This study included 610 patients who were diagnosed as pancreatic cancer and had undergone radical surgery. Patients' characteristics included age, gender, tumor stage, tumor grade, adenosquamous carcinoma (ASC) status, preoperative serum carbohydrate antigen 19-9 (CA19-9) levels, preoperative serum carcinoembryonic antigen (CEA) levels, ABO blood type, smoking status, and drinking status were analyzed in this study. Cox proportional hazards regression model and Kaplan-Meier method were used to evaluate the role of prognostic factors. For pancreatic cancer patients undergoing radical surgery, the overall survival was worse for ASC patients than PDAC patients (Log-rank = 11.315, P < .001). Compared with ASC patients (Log-rank < 0.001, P = .996), PDAC patients can benefit from chemotherapy (Log-rank = 17.665, P < .001). For PDAC patients, O blood type had better overall survival than non-O blood type (Log-rank = 4.153, P = .042). Moreover, the group with higher serum levels of CA19-9 had poor prognosis compared to another group with low serum CA19-9 (Log-rank = 4.122, P = .042). Higher CEA levels indicated poor prognosis (Log-rank = 13.618, P < .001). In conclusion, ASC status was associated with overall survival of pancreatic cancer patients and cannot benefit from postoperative chemotherapy. Non-O blood type was a prognostic factor for PDAC patients.
Mycoplasma species (spp.)
are predominantly found in the human oropharynx, and extracavity infections are rare. Conventional culture limitations hinder
Mycoplasma spp.
recovery, potentially causing ...overlooked infections. Molecular techniques reveal their roles in various infections.
Mycoplasma pneumoniae
causes pneumonia, while
Mycoplasma salivarium (M. salivarium)
in empyema is scarcely reported. We present a case of a 61-year-old man who suffered from tonsillitis, deep neck infection, necrotizing mediastinitis, and bilateral pleural infections. Mixed pathogens, mainly
M. salivarium
, were implicated.
Scalable packet classification is a key requirement to support scalable network applications such as firewalls, intrusion detection, and differentiated services. With the ever increasing line‐rate in ...core networks, it becomes a great challenge to design a scalable packet classification solution using hand‐tuned heuristic approaches. The authors present a scalable learning‐based packet classification engine by building an efficient data structure for different rulesets with many fields. This method consists of the decomposition of fields into subsets and building separate decision trees on those subsets using a deep reinforcement learning procedure. To decompose given fields of a ruleset, the authors consider different grouping metrics such as standard deviation of individual fields and introduce a novel metric called diversity index (DI). The authors examine different decomposition schemes and construct decision trees for each scheme using deep reinforcement learning and compare the results. The results show that the SD decomposition metrics results in 11.5% faster than DI metrics, 25% faster than random 2 and 40% faster than random 1. Furthermore, the authors’ learning‐based selection method can be applied to varying rulesets due to its ruleset independence.
Secondary hyperparathyroidism (SHPT) is a frequently encountered problem in patients with end-stage renal disease (ESRD) prior to renal transplantation (RTP), and the successful management of SPHP ...currently is challenging. In this study, we aimed to investigate the effectiveness of radiofrequency ablation (RFA) for SHPT as a bridge to RTP and to evaluate post-transplantation outcomes.
Patients with SHPT receiving RFA treatment were retrospectively reviewed, and those underwent RTP after ablation were enrolled. Serum parathyroid hormone (PTH), calcium, and phosphate levels were collected before ablation and at follow-up periods. The primary endpoints are PTH values at time of transplantation and at the final follow-up. The secondary endpoints were RFA-related complications, serum calcium and phosphate concentrations, and allograft function.
Eleven patients with 43 enlarged parathyroid glands were treated with 16 RFA sessions and enrolled in the study. Complete ablation was achieved in all glands with transient hoarseness and hypocalcemia occurring in two and five of the treatments, respectively. At time of transplantation, serum PTH levels (246.7 ± 182.6 pg/mL) were significantly lower than that before RFA (1666.55 ± 874.48 pg/mL, p < 0.001) and were all within guideline-oriented range. The median follow-up period was 57.2 months. At last visit, all patients were alive, with normal PTH values and functioning grafts.
Ultrasound-guided RFA is effective for destroying hyperplastic parathyroid tissues in SHPT patients, whose PTH values fall within the guideline-oriented range both pre-and post-transplantation. Percutaneous RFA acts as an effective bridge to RTP and might provide a new management paradigm designed to improve post-transplant outcomes.
•A simple and effective method is proposed for synthesizing high-quality quantitative phase images from multi-angle interferograms.•The proposed system can eliminate the zero-order term of ...holographic data, and increase the phase image reconstruction bandwidth by compounding multi-angle holograms.•The proposed method can effectively remove the negative phase repetition and noise in each interferogram.•Compared with the conventional off-axis single-shot digital holographic microscope, synthetic quantitative phase imaging has a lower noise level and can observe a more detailed internal cell structure.
We propose a simple common-path off-axis interferometric system to perform high-quality quantitative phase imaging based on a rotatable birefringent prism that is placed at the output port of a conventional transmission or reflection microscope. The proposed system effectively eliminates the zero-order term of holographic data and increases the phase image reconstruction bandwidth by compounding multi-angle holograms, thereby obtaining high-quality quantitative phase images without zero-order artifacts. In addition, the proposed multi-angle phase image compounding method can eliminate the repetitive object phases caused by self-reference interferometry, thereby alleviating the problem of field-of-view reduction. Furthermore, we realize high-quality quantitative phase imaging based on multi-angle phase images without sacrificing the imaging frame rate. The concept is demonstrated by performing high-quality quantitative phase imaging of polystyrene microspheres and a freshwater alga, Pinnularia. Experimental results show that the noise level of the quantitative phase images synthesized using the proposed rotatable common-path digital holographic microscopy system is lower than that of conventional single-shot digital holographic microscope reconstruction quantitative images, and a more detailed cell internal structure can be observed.
Kinesin superfamily of proteins (KIFs) has been broadly reported to play an indispensable role in the biological process. Recently, emerging evidence reveals its oncogenic role in various cancers. ...However, the prognostic, oncological, and immunological values of KIFs have not been comprehensively explored in pancreatic ductal adenocarcinoma (PDAC) patients. We aimed to illustrate the relationship between KIFs and pancreatic ductal adenocarcinoma by using bioinformatical analysis.
We use GEPIA, Oncomine datasets, cBioPortal, LOGpc, TIMER, and STRING bioinformatics tools and web servers to investigate the aberrant expression, prognostic values, and oncogenic role of KIFs. The two-gene prognostic model and the correlation between KIFs and KRAS and TP53 mutation were performed using an R-based computational framework.
Our results demonstrated that KIFC1/2C/4A/11/14/15/18A/18B/20B/23 (we name it prognosis-related KIFs) were upregulated and associated with unfavorable clinical outcome in pancreatic cancer patients. KIF21B overexpression is associated with better clinical outcome. The KIFC1/2C/4A/11/14/15/18A/18B/20B/23 profiles were significantly increased compared to grade 1 and grade 2/3. Besides, KIFC1/2C/4A/11/14/15/18A/18B/20B/23 was significantly associated with the mutation status of KRAS and TP53.Notably, most prognosis-related KIFs have strong correlations with tumor growth and myeloid-derived suppressor cells infiltration (MDSCs). A prognostic signature based on KIF20B and KIF21B showed a reliable predictive performance. Receiver operating characteristic (ROC) curve was employed to assess the predictive power of two-gene signature. Consequently, the gene set enrichment analysis (GSEA) showed that KIF20B and KIF21B's overexpression was associated with the immunological and oncogenic pathway activation in pancreatic cancer. Finally, real-time quantitative PCR (RT-qPCR) was utilized to investigate the expression pattern of KIF20B and KIF21B in pancreatic cancer cell lines and normal pancreatic cell.
Knowledge of the expression level of the KIFs may provide novel therapeutic molecular targets and potential prognostic biomarkers to pancreatic cancer patients.
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