bluuebunny/crossref_metadata_2025 huggingface dataset:
Virtual Learning Communication Behaviors In Natural Birth Support Communities
Authors: Widyaningrum Alifiah Ghaniyyu , Sjafri Hubeis Aida Vitayala , Sarwoprasodjo Sarwititi , Matindas Krishnarini
Published: January 2024

Cesarean delivery rates are rising globally, presenting a growing concern, particularly in countries like Indonesia. Amidst this trend, the Cerita VBAC (Vaginal Birth After Caesar)  on Telegram emerges as a crucial platform for pregnant women seeking insights and preparations for expected deliveries following Cesarean sections. This study, grounded in the constructivism paradigm, delves into the experiences of active speakers within the Cerita VBAC Community, aiming to understand the dynamics and impact of this virtual support network. Employing narrative ethnography methods, this research focuses on four prominent contributors within the Cerita VBAC Community. The constructivist paradigm guides the exploration of their experiences, emphasizing the role of narrative ethnography in unravelling the intricacies of this unique social context. Data analysis involves a manual modification process complemented by NVIVO 12 Plus, a comprehensive data processing application. The findings highlight that the learning delivery mechanism through Telegram aligns with Kolb's Experiential Learning model. Community members actively share concrete experiences, engage in reflective processes, formulate abstract concepts, and participate in experiential learning. Telegram serves as an information exchange medium and creates a positive and supportive environment, empowering pregnant women to navigate labor challenges.
Free cGAS
Authors: Baek Amy E.
Published: January 2024

The DNA double-strand break sensor MRE11 is necessary to liberate cGAS and enable its activation by dsDNA.
Population pharmacokinetics and humanized dosage regimens matching the peak, area, trough, and range of amikacin plasma concentrations in immune-competent murine bloodstream and lung infection models
Authors: Jiao Yuanyuan , Yan Jun , Sutaria Dhruvitkumar S. , Lu Peggy , Vicchiarelli Michael , Reyna Zeferino , Ruiz-Delgado Juan , Burk Elizabeth , Moon Eugene , Shah Nirav R. , Spellberg Brad , Bonomo Robert A. , Drusano George L. , Louie Arnold , Luna Brian M. , Bulitta Jürgen B.
Published: January 2024

Amikacin is an FDA-approved aminoglycoside antibiotic that is commonly used. However, validated dosage regimens that achieve clinically relevant exposure profiles in mice are lacking. We aimed to design and validate humanized dosage regimens for amikacin in immune-competent murine bloodstream and lung infection models of
Acinetobacter baumannii
. Plasma and lung epithelial lining fluid (ELF) concentrations after single subcutaneous doses of 1.37, 13.7, and 137 mg/kg of body weight were simultaneously modeled via population pharmacokinetics. Then, humanized amikacin dosage regimens in mice were designed and prospectively validated to match the peak, area, trough, and range of plasma concentration profiles in critically ill patients (clinical dose: 25–30 mg/kg of body weight). The pharmacokinetics of amikacin were linear, with a clearance of 9.93 mL/h in both infection models after a single dose. However, the volume of distribution differed between models, resulting in an elimination half-life of 48 min for the bloodstream and 36 min for the lung model. The drug exposure in ELF was 72.7% compared to that in plasma. After multiple q6h dosing, clearance decreased by ~80% from the first (7.35 mL/h) to the last two dosing intervals (~1.50 mL/h) in the bloodstream model. Likewise, clearance decreased by 41% from 7.44 to 4.39 mL/h in the lung model. The humanized dosage regimens were 117 mg/kg of body weight/day in mice [administered in four fractions 6 h apart (q6h): 61.9%, 18.6%, 11.3%, and 8.21% of total dose] for the bloodstream and 96.7 mg/kg of body weight/day (given q6h as 65.1%, 16.9%, 10.5%, and 7.41%) for the lung model. These validated humanized dosage regimens and population pharmacokinetic models support translational studies with clinically relevant amikacin exposure profiles.
Functional characterization of the
dbu
locus for D-branched-chain amino acid catabolism in
Pseudomonas putida
Authors: Fulton Ronnie L. , Downs Diana M.
Published: January 2024

Pseudomonas putida
is a metabolically robust soil bacterium that employs a diverse set of pathways to utilize a wide range of nutrients. The versatility of this microorganism contributes to both its environmental ubiquity and its rising popularity as a bioengineering chassis. In
P. putida
, the newly named
dbu
locus encodes a transcriptional regulator (DbuR), D-amino acid oxidase (DbuA), Rid2 protein (DbuB), and a putative transporter (DbuC). Current annotation implicates this locus in the utilization of D-arginine. However, data obtained in this study showed that genes in the
dbu
locus are not required for D-arginine utilization, but, rather, this locus is involved in the catabolism of multiple D-branched-chain amino acids (D-BCAA). The oxidase DbuA was required for catabolism of each D-BCAA and D-phenylalanine, while the requirements for DbuC and DbuB were less stringent. The functional characterization of the
dbu
locus contributes to our understanding of the metabolic network of
P. putida
and proposes divergence in function between proteins annotated as D-arginine oxidases across the
Pseudomonas
genus.

IMPORTANCE

Pseudomonas putida
is a non-pathogenic bacterium that is broadly utilized as a host for bioengineering and bioremediation efforts. The popularity of
P. putida
as a chassis for such efforts is attributable to its physiological versatility and ability to metabolize a wide variety of compounds. Pathways for L-amino acid metabolism in this microbe have been rather well studied, primarily because of their relevance to efforts in foundational physiology research, as well as the commercial production of economically pertinent compounds. However, comparatively little is known about the metabolism of D-amino acids despite evidence showing the ability of
P. putida
to metabolize these enantiomers. In this work, we characterize the D-BCAA catabolic pathway of
P. putida
and its integration with the essential L-BCAA biosynthetic pathway. This work expands our understanding of the metabolic network of
Pseudomonas putida
, which has potential applications in efforts to model and engineer the metabolic network of this organism.
Deciphering the interaction of bacteria inoculants with the recipient endophytic community in grapevine micropropagated plants
Authors: Vergani Lorenzo , Patania Joa , Riva Valentina , Nerva Luca , Nuzzo Floriana , Gambino Giorgio , Borin Sara , Mapelli Francesca
Published: January 2024

Engineering the plant microbiome with beneficial endophytic bacteria can improve the growth, health, and productivity of the holobiont. Here, we administered two beneficial bacterial strains,
Kosakonia
VR04 sp. and
Rhizobium
GR12 sp., to micropropagated grapevine cuttings obtained via somatic embryogenesis. While both strains colonized the plant endosphere, only
Rhizobium
GR12 sp. increased root biomass under nutritional-deficit conditions, as supported by the plant growth promotion traits detected in its genome. Phylogenetic and co-occurrence analyses revealed that the plant native bacterial community, originally dominated by Streptococcaceae and Micrococcaceae, dramatically changed depending on the inoculation treatments, as invading strains differently affected the relative abundance and the interactions of pre-existing taxa. After 30 days of plantlets’ growth,
Pantoea
became a predominant taxon, and considering untreated plantlets as references,
Rhizobium
sp. GR12 showed a minor impact on the endophytic bacterial community. On the other hand,
Kosakonia
sp. VR04 caused a major change in community composition, suggesting an opportunistic colonization pattern. Overall, the results corroborate the importance of preserving the native endophytic community structure and functions during plant microbiome engineering.

IMPORTANCE

A better comprehension of bacterial colonization processes and outcomes could benefit the use of plant probiotics in the field. In this study, we applied two different beneficial bacteria to grapevine micropropagated plantlets and described how the inoculation of these strains impacts endophytic microbiota assembly. We showed that under nutritional deficit conditions, the response of the receiving endophytic bacterial communities to the invasion of the beneficial strains related to the manifestation of plant growth promotion effects by the inoculated invading strains.
Rhizobium
sp. GR12 was able to preserve the native microbiome structure despite its effective colonization, highlighting the importance of the plant-endophyte associations for the holobiont performance. Moreover, our approach showed that the use of micropropagated plantlets could be a valuable strategy to study the interplay among the plant, its native microbiota, and the invader on a wider portfolio of species besides model plants, facilitating the application of new knowledge in agriculture.
Molecular determinants of multidrug-resistant tuberculosis in Sierra Leone
Authors: Blankson Harriet N. A. , Kamara Rashidatu Fouad , Barilar Ivan , Andres Sönke , Conteh Ousman S. , Dallenga Tobias , Foray Lynda , Maurer Florian , Kranzer Katharina , Utpatel Christian , Niemann Stefan
Published: January 2024

Multidrug-resistant tuberculosis (MDR-TB) management has become a serious global health challenge. Understanding its epidemic determinants on the regional level is crucial for developing effective control measures. We used whole genome sequencing data of 238 of
Mycobacterium tuberculosis
complex (MTBC) strains to determine drug resistance profiles, phylogeny, and transmission dynamics of MDR/rifampicin-resistant (RR) MTBC strains from Sierra Leone. Forty-two strains were classified as RR, 196 as MDR, 5 were resistant to bedaquiline (BDQ) and clofazimine (CFZ), but none was found to be resistant to fluoroquinolones. Sixty-one (26%) strains were resistant to all first-line drugs, three of which had additional resistance to BDQ/CFZ. The strains were classified into six major MTBC lineages (L), with strains of L4 being the most prevalent, 62% (
n
= 147), followed by L6 (
Mycobacterium africanum
) strains, (21%,
n
= 50). The overall clustering rate (using ≤d12 single-nucleotide polymorphism threshold) was 44%, stratified into 31 clusters ranging from 2 to 16 strains. The largest cluster (
n
= 16) was formed by sublineage 2.2.1 Beijing Ancestral 3 strains, which developed MDR several times. Meanwhile, 10 of the L6 strains had a primary MDR transmission. We observed a high diversity of drug resistance mutations, including borderline resistance mutations to isoniazid and rifampicin, and mutations were not detected by commercial assays. In conclusion, one in five strains investigated was resistant to all first-line drugs, three of which had evidence of BDQ/CFZ resistance. Implementation of interventions such as rapid diagnostics that prevent further resistance development and stop MDR-TB transmission chains in the country is urgently needed.

IMPORTANCE

A substantial proportion of MDR-TB strains in Sierra Leone were resistant against all first line drugs; however this makes the all-oral-six-month BPaLM regimen or other 6-9 months all oral regimens still viable, mainly because there was no FQ resistance.Resistance to BDQ was detected, as well as RR, due to mutations outside of the hotspot region. While the prevalence of those resistances was low, it is still cause for concern and needs to be closely monitored.
Supplemental Material: Multimethod dating of ice-rafted dropstones reveals hidden localized glacial erosion in Wilkes Subglacial Basin, Antarctica
Authors: Kodama Samuel , al. et
Published: January 2024

Contains age data and metadata for all chronometers and HeFTy model inputs and statistics, and material including more detailed methods and a discussion on the dispersion of ZHe ages in dropstone O-1.
Impact of AI-aided colonoscopy in clinical practice: a prospective randomised controlled trial
Authors: Schöler Johanna , Alavanja Marko , de Lange Thomas , Yamamoto Shunsuke , Hedenström Per , Varkey Jonas
Published: January 2024

Objective

Colorectal cancer (CRC) has a significant role in cancer-related mortality. Colonoscopy, combined with adenoma removal, has proven effective in reducing CRC incidence. However, suboptimal colonoscopy quality often leads to missed polyps. The impact of artificial intelligence (AI) on adenoma and polyp detection rate (ADR, PDR) is yet to be established.

Design

We conducted a randomised controlled trial at Sahlgrenska University Hospital in Sweden. Patients underwent colonoscopy with or without the assistance of AI (AI-C or conventional colonoscopy (CC)). Examinations were performed with two different AI systems, that is, Fujifilm CADEye and Medtronic GI Genius. The primary outcome was ADR.

Results

Among 286 patients, 240 underwent analysis (average age: 66 years). The ADR was 42% for all patients, and no significant difference emerged between AI-C and CC groups (41% vs 43%). The overall PDR was 61%, with a trend towards higher PDR in the AI-C group. Subgroup analysis revealed higher detection rates for sessile serrated lesions (SSL) with AI assistance (AI-C 22%, CC 11%, p=0.004). No difference was noticed in the detection of polyps or adenomas per colonoscopy. Examinations were most often performed by experienced endoscopists, 78% (n=86 AI-C, 100 CC).

Conclusion

Amidst the ongoing AI integration, ADR did not improve with AI. Particularly noteworthy is the enhanced detection rates for SSL by AI assistance, especially since they pose a risk for postcolonoscopy CRC. The integration of AI into standard colonoscopy practice warrants further investigation and the development of improved software might be necessary before enforcing its mandatory implementation.

Trial registration number

NCT05178095.
Personalising haemodialysis treatment with incremental dialysis for incident patients with end-stage kidney disease: an implementation study protocol
Authors: Armstrong Marni , Wityk Martin Tracy Lynn , Zimmermann Gabrielle L , Drall Kelsea , Pannu Neesh I
Published: January 2024

Introduction

Incremental dialysis is a personalised dialysis prescription based on residual kidney function that allows for the initial use of shorter duration, less frequent and less intense dialysis. It has been associated with enhanced quality of life and decreased healthcare costs when compared with conventional dialysis. While nephrologists report prescribing incremental dialysis, few dialysis programmes offer a systematic approach in offering and evaluating its use. To move evidence into practice, and in order to improve the safety and quality of providing incremental dialysis care, we have designed an implementation study. This study aims to evaluate the systematic assessment of patients starting facility-based haemodialysis for eligibility for incremental dialysis, and the prescription and monitoring of incremental dialysis treatment.

Methods and analysis

A hybrid effectiveness and implementation study design is being used to evaluate the implementation of the programme at dialysis sites in Alberta, Canada. The Reach, Effectiveness, Adoption, Implementation and Maintenance framework will be used to capture individual-level and organisational-level impact of the project. Clinical outcomes related to kidney function will be monitored on an ongoing basis, and patient-reported outcomes and experience measures will be collected at baseline and then quarterly throughout the first year of dialysis.

Ethics and dissemination

The study was approved by the Health Research Ethics Board of the University of Alberta. The study is funded by the Strategic Clinical Networks of Alberta Health Services. The study will help answer important questions on the effectiveness of incremental dialysis, and inform the acceptability, adoption, feasibility, reach and sustainability of incremental dialysis within provision of haemodialysis care.
Utilisation of community healthcare services among older adults with disabilities in Luohu district, Shenzhen: a community-based survey
Authors: Shi Lu , Pang Tiantian , Zheng Qingming , Liu Gang , Zhang Wei , Leung Willie
Published: January 2024

Objective

China faces the challenge of an ageing population with disabilities. Community healthcare centres (CHCs) serve as frontline community healthcare providers for older adults with and without disabilities. Despite their significance, there is a lack of literature examining the utilisation of CHC services among older adults. This study aims to examine and compare the utilisation and satisfaction of CHC healthcare services among older adults with and without disabilities.

Setting

Data from the 2019 Community Health Diagnosis Questionnaire, which interviewed 259 older adults residing in the Luohu district of Shenzhen, were used in the current study.

Primary outcome measures

Participants self-reported outcomes including use of CHCs, use of home health services from CHCs and satisfaction with CHCs. Five different disability types and an integrated disability variable were assessed as independent variables. Linear probability models were used to determine the relationship between disability types and outcome variables.

Results

Among 259 older adults aged 60 years and older, 70.66% self-identified as having a disability. No statistically significant associations were found between the use of CHCs, the use of home health services from CHCs and satisfaction with CHCs, and disability status. However, older adults with mobility and cognitive disabilities were more likely to receive home health services from CHCs.

Conclusion

Community health promotion policies should be implemented to improve access to health services for older adults with and without disabilities. In addition, CHCs should implement effective health management plans to ensure the health needs of older adults with disabilities.
Investigating the characteristics of health-related data collection tools used in randomised controlled trials in low-income and middle-income countries: protocol for a systematic review
Authors: Karthikeyan Rithvik , Al-Shamaa Noor , Kelly Eve Jacqueline , Henn Patrick , Shiely Frances , Divala Titus , Fadahunsi Kayode Philip , O'Donoghue John
Published: January 2024

Introduction

Health-related data collection tools, including digital ones, have become more prevalent across clinical studies in the last number of years. However, using digital data collection tools in low-income and middle-income countries presents unique challenges. In this review, we aim to provide an overview of the data collection tools currently being used in randomised controlled trials (RCTs) conducted in low-resource settings and evaluate the tools based on the characteristics outlined in the modified Mobile Survey Tool framework. These include functionality, reliability, usability, efficiency, maintainability, portability, effectiveness, cost–benefit, satisfaction, freedom from risk and context coverage. This evidence may provide a guide to selecting a suitable data collection tool for researchers planning to conduct research in low-income and middle-income countries for future studies.

Methods and analysis

Searches will be conducted in four electronic databases: PubMed, CINAHL, Web of Science and EMBASE. For inclusion, studies must be a RCT, mention a health-related data collection tool and conducted in a low- and middle-income country. Only studies with available full-text and written in English will be included. The search was restricted to studies published between January 2005 and June 2023. This systematic review will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) tool. Two review authors will screen the titles and abstracts of search results independently for inclusion. In the initial screening process, the full-text articles will be retrieved if the abstract contains limited information about the study. Disagreements will be resolved through discussion. If the disagreement cannot be resolved, a third author (JO’D) will adjudicate. The study selection process will be outlined in a PRISMA flow-diagram. Data will be analysed using a narrative synthesis approach. The included studies and their outcomes will be presented in a table.

Ethics and dissemination

Formal ethical approval is not required as primary data will not be collected in this study. The findings from this systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42023405738.
Neuroimaging of neuropsychological disturbances following ischaemic stroke (CONNECT): a prospective cohort study protocol
Authors: Chao Xian , Wang Jinjing , Dong Yiran , Fang Yirong , Yin Dawei , Wen Jie , Wang Peng , Sun Wen
Published: January 2024

Introduction

Neuropsychiatric distubance is a common clinical manifestation in acute ischemic stroke. However, it is frequently overlooked by clinicians. This study aimed to explore the possible aetiology and pathogenesis of neuropsychiatric disturbances following ischaemic stroke (NDIS) from an anatomical and functional perspective with the help of neuroimaging methods.

Method and analysis

CONNECT is a prospective cohort study of neuroimaging and its functional outcome in NDIS. We aim to enrol a minimum of 300 individuals with first-ever stroke. The neuropsychological disturbances involved in this study include depression, anxiety disorder, headache, apathy, insomnia, fatigue and cognitive impairment. Using scales that have been shown to be effective in assessing the above symptoms, the NDIS evaluation battery requires at least 2 hours at baseline. Moreover, all patients will be required to complete 2 years of follow-up, during which the NDIS will be re-evaluated at 3 months, 12 months and 24 months by telephone and 6 months by outpatient interview after the index stroke. The primary outcome of our study is the incidence of NDIS at the 6-month mark. Secondary outcomes are related to the severity of NDIS as well as functional rehabilitation of patients. Functional imaging evaluation will be performed at baseline and 6-month follow-up using specific sequences including resting-state functional MRI, diffusion tensor imaging, T1-weighted imaging, T2-weighted imaging, diffusion-weighted imaging, arterial spin labelling, quantitative susceptibility mapping and fluid-attenuated inversion recovery imaging. In addition, we collect haematological information from patients to explore potential biological and genetic markers of NDIS through histological analysis.

Ethics and dissemination

The CONNECT Study was approved by the Ethics Review Committee of the First Hospital of the University of Science and Technology of China (2021-ky012) and written informed consent will be obtained from all participants. Results will be disseminated via a peer-reviewed journal.

Trial registration number

ChiCTR2100043886.
Diagnostic utility of diagnostic investigations to identify neuropathic pain in low back-related leg pain: protocol for a systematic review
Authors: Mistry Jai , Walton David M , Noblet Tim , Bowling Benjamin , Heneghan Nicola R , Rushton Alison B
Published: January 2024

Introduction

Neuropathic pain in low back-related leg pain has gained increasing interest in contemporary research. Identification of neuropathic pain in low back-related leg pain is essential to inform precision management. Diagnostic investigations are commonly used to identify neuropathic pain in low back-related leg pain; yet the diagnostic utility of these investigations is unknown. This systematic review aims to investigate the diagnostic utility of diagnostic investigations to identify neuropathic pain in low back-related leg pain.

Methods and analysis

This protocol has been designed and reported in accordance with the Cochrane Handbook for Diagnostic Test Accuracy studies, Centre for Reviews and Dissemination and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols checklist, respectively. The search strategy will involve two independent reviewers searching electronic databases (CINAHL, EMBASE, MEDLINE, Web of Science, Cochrane Library, AMED, Pedro), key journals (Spine, The Clinical Journal of Pain, PAIN, European Journal of Pain, The Journal of Pain, Musculoskeletal Science and Practice) and grey literature (British National Bibliography for report literature, OpenGrey, EThOS) from inception to 31 July 2023 to identify studies. Studies evaluating the diagnostic accuracy of diagnostic investigation to identify neuropathic pain in patients with low back-related leg pain will be eligible, studies not written in English will be excluded. The reviewers will extract the data from included studies, assess risk of bias (Quality Assessment of Diagnostic Accuracy Studies 2) and determine confidence in findings (Grading of Recommendations, Assessment, Development and Evaluation guidelines). Methodological heterogeneity will be assessed to determine if a meta-analysis is possible. If pooling of data is not possible then a narrative synthesis will be done.

Ethics and dissemination

Ethical approval is not required. Findings will be published in a peer-reviewed journal, presented at relevant conferences and shared with the Patient Partner Advisor Group at Western University, Canada.

PROSPERO registration number

CRD42023438222.
Carotid webs: a review of pathophysiology, diagnostic findings, and treatment options
Authors: Chen Huanwen , Colasurdo Marco , Costa Matias , Nossek Erez , Kan Peter
Published: January 2024

A carotid web (CaW) is an atypical form of fibromuscular dysplasia characterized by a fibrous, shelf-like intimal flap originating from the posterior wall of the internal carotid bulb projecting into the arterial lumen. CaWs disturb normal blood flow and create stasis between the intimal reflection and the carotid wall, thereby promoting thrombogenesis and increasing the risk of downstream embolic strokes. Observational data have suggested that CaWs are associated with strokes with otherwise unknown etiology, particularly in young patients without other stroke factors, and stroke recurrence rates of symptomatic CaWs have been reported to be as high as 20% over 2 years. Despite its clinical importance, there are currently no clear guidelines on the management of CaWs. In this narrative review, we discuss the epidemiology, pathogenesis, pathophysiology, diagnosis, and treatment options for this under-recognized entity.
Implementing a comprehensive STEMI protocol to improve care metrics and outcomes in patients with in-hospital STEMI: an observational cohort study
Authors: Kanaan Christopher N , Kassis Nicholas , Nair Raunak M , Kumar Anirudh , Huded Chetan P , Kravitz Kathleen , Reed Grant W , Krishnaswamy Amar , Lincoff A Michael , Khatri Jaikirshan , Puri Rishi , Ziada Khaled , Nair Ravi , Kapadia Samir , Khot Umesh
Published: January 2024

Background

Patients who experience in-hospital ST-segment elevation myocardial infarction (iSTEMI) represent a uniquely high-risk cohort owing to delays in diagnosis, prolonged time to reperfusion and increased mortality. Quality initiatives aimed at improving the care of this vulnerable, yet understudied population are needed.

Methods

This study included consecutive patients with iSTEMI treated with percutaneous coronary intervention (PCI) between 1 January 2011 and 15 July 2019 at a single, tertiary referral centre. A comprehensive iSTEMI protocol (CSP) was implemented on 15 July 2014, incorporating: (1) cardiology fellow activation of the catheterisation lab using standardised criteria, (2) nursing chest pain protocol, (3) improved electronic access to electrocardiographic studies, (4) checklist for initial triage and management, (5) 24/7/365 catheterisation lab readiness and (6) radial-first PCI approach. Key metrics and clinical outcomes were compared before and after CSP implementation.

Results

Among 125 total subjects, the post-CSP cohort (n=81) was younger, had more males and were more likely to be hospitalised for cardiac-related reasons relative to the pre-CSP cohort (n=44) who were more likely hospitalised for operative-related aetiologies. After CSP adoption, median ECG-to-first-device-activation time decreased from 113 min to 64 min (p<0.001), goal ECG-to-first-device-activation time increased from 36% to 76% of patients (p<0.001), administration of guideline-directed medical therapy prior to PCI increased from 27.3% to 65.4% (p<0.001), trans-radial access increased from 16% to 70% (p<0.001) and rates of discharge home increased from 56.8% to 76.5% (p=0.04). Statistically insignificant numerical reductions were observed post-CSP in in-hospital mortality (18.2% vs 9.9%, p=0.30), 30-day mortality (15.9% vs 12.3%, p=0.78) and 1-year mortality (27.3% vs 21.0%, p=0.57).

Conclusions

The implementation of a CSP was associated with marked enhancements in key care metrics among patients with iSTEMI. Among a larger cohort, the use of a CSP yielded a significant reduction in ECG-to-first-device-activation time in a particularly vulnerable population at high risk of death.
Theoretical framework for large-strain shear resistance of Kaolin clays under chemo-mechanical loadings
Authors: Srivastava Ankti , Bharat Tadikonda Venkata
Published: January 2024

The normal stress, strain rate, and pore fluid chemistry significantly influence the large-strain shear response of clays and received great attention for engineering practice. The effect of inundation pressure, consolidation pressure, pH of aqueous solutions, and di-electric on the shear response of kaolin was experimentally investigated. The strain-softening behaviour was observed under normally consolidated (NC) conditions as observed in the past studies on different clays. However, this anomalous shear response with volumetric contraction is not understood. Thus, for the first time, the strain-softening behaviour of NC clays was addressed from an effective stress approach using physico-chemical analysis of kaolin. In this study, the drained shear strength response of NC kaolin was investigated under physico-chemical influence using ring shear tests. A theoretical framework was developed by including micromechanism of clay fabric evolution during shear and explicit expressions for electro-chemical forces. The proposed framework was used to estimate the shear resistance from the modified effective stress approach to interpret the experimental results. The proposed framework provides useful expressions for predicting the shear strength behaviour of kaolin clays, which were validated with experimental data from the present study and literature studies. The new conceptual framework satisfactorily explained the peak and residual shear strength variations under different chemo-mechanical loading for NC conditions. The proposed model adequately predicted the effective stress paths, peak, and residual envelopes in ring shear stress conditions for NC kaolin soils.
Doubly-heavy tetraquark at finite temperature in a holographic model
Authors: Guo Xi , Jiang Jia-Jie , Liu Xuan , Chen Xun , Xiang Dong , Li Xiao-Hua
Published: January 2024

In this paper, we employ gauge/gravity duality to investigate the string breaking and melting of doubly-heavy tetraquark that includes two heavy quarks and two light antiquarks in a holographic model at finite temperature. Firstly, four different configurations of$${{\textrm{QQ}}}\bar{{\textrm{q}}}\bar{{\textrm{q}}}$$QQq¯q¯are studied at different separation distances of the heavy quarks at finite temperatures. At high temperature,$${{\textrm{QQ}}}\bar{{\textrm{q}}}\bar{{\textrm{q}}}$$QQq¯q¯will melt at certain distances and the screening distance has been given for different temperatures. As the temperature continues to increase, some configurations of doubly-heavy tetraquark can not exist. Furthermore, we investigate three decay modes of$${{\textrm{QQ}}}\bar{{\textrm{q}}}\bar{{\textrm{q}}}$$QQq¯q¯and compare the potential energy of$${{\textrm{QQ}}}\bar{{\textrm{q}}}\bar{{\textrm{q}}}$$QQq¯q¯with that of$${\textrm{QQq}}$$QQqat finite temperature.
Surrogacy in Our Region - How Do We Help Our Patients Who Have No Other Options?
Authors: Manipalviratn Somjate
Published: January 2024

Gestational surrogacy is a well-established fertility treatment with promising treatment success. Gestational surrogacy has multiple dimensions to consider such as medical, psychological, legal, and ethical aspects. Gestational surrogacy is allowed/supported only in some countries which limit access of the couples who require treatment in many countries. Many countries have surrogacy law to regulate gestational surrogacy and to provide legal rights of the intended parents over the birth of their child from the surrogate mother. Surrogacy law also provide protection to the right of the surrogate mother as well. Surrogacy law differs from countries to countries which lead to an increasing trend of cross-border gestational surrogacy treatment toward the countries which allow legal gestational surrogacy or to the country with no law to regulate gestational surrogacy. The intended parents may face legal problems before returning to their countries of origin or when trying to have their children legally recognized in their countries. The intended parents exploring cross-border surrogacy treatment should get legal counsel in their own country to assist with immigration, parentage, and citizenship for the child born through a surrogacy arrangement outside their own country.

Due to limitation to gain access to gestational surrogacy for couples in many countries, there is rapidly growing research on the uterus transplantation with reported success on giving birth to healthy children. This could be an alternative to gestational surrogacy for women with uterine factor infertility. However, this also pose some ethical challenge on the uterus donation as organ.
#271 : Association Between Monoaromatic Hydro Exposure and Vaginal Microbiota Disorder in Recurrent Implantation Failure
Authors: Chen Peigen , Fang Cong
Published: January 2024

Background and aims: MACHs are present in common everyday products and are defined as endocrine disrupting chemicals (EDCs) that can negatively impact human health by interfering with the endocrine system. There is a lack of human studies on the association between MACHs and the microbiota in the female reproductive tract. In this study, we recruited a prospective randomized controlled cohort to investigate potential correlations between MACHs exposure and the vaginal microbiota, as well as their potential impacts on embryo implantation.

Methods: This study recruited a randomized controlled cohort prospectively to investigate the correlation between MACHs exposure and the vaginal microbiota, as well as their potential impact on embryo implantation. The types and concentrations of MACHs exposure were detected using LC-MS, while the vaginal microbiota was characterized by metagenomics.

Results: The findings reveal that exposure to MEHP, Methyl N-methylanthranilate, and Benzene was associated with a disruption of the microbial community structure in the recurrent implantation failure (RIF). The RIF group exhibited an instable vaginal microbial community structure, with reduced abundance of Lactobacillus spp. and increased abundance of potentially pathogenic bacteria, such as Streptococcus anginosus, Peptoniphilus asaccharolyticus. The atypical composition of the vaginal microbiota was associated with unfavorable pregnancy outcomes. Impairment of sphingolipid metabolism was a crucial factor for abnormal microbiota to trigger unfavorable pregnancy outcomes. Furthermore, exposure to Methyl N-methylanthranilate and MEHP was associated with reduced abundance of Lactobacillus spp. (including L.crispatus and L.jensenii) and reduction of the protective barrier function of the reproductive tract.

Conclusions: Multiple MACHs, such as Benzene, Methyl N-methylanthranilate, and MEHP, were associated with changes in the RIF group’s vaginal microbiota. MACHs exposure might cause embryo implantation failure by affecting the vaginal microbial composition.
#381 : Can Serum Progesterone Concentration Direct a Fresh or Freeze-All Transfer Strategy in the First In Vitro Fertilisation Cycle?
Authors: Hunt Sarah , Liu Jing , Luo Pulin , Zhong Ying , Mol Ben , Chi Ling , Wang Rui
Published: January 2024

Background and Aims: The role of progesterone in preparing the endometrium for implantation and sustaining early pregnancy is well established in ART, however the role of serum progesterone measurement within cycles in determining the outcome of embryo transfer (ET) is not defined. This study aimed to examine the interaction between serum progesterone concentration on the day of HCG trigger and choice of freeze-all and fresh transfer strategies on live birth.

Method: We retrospectively studied 26661 women (Chengdu Xinan Hospital) commencing their first IVF cycle using autologous gametes between January 2015 and September 2019. We excluded cycles where oocyte retrieval was cancelled or no embryos were available for transfer, cycles where fresh or frozen transfer was determined by patient preference, and when serum progesterone on day of HCG was [Formula: see text] 2.0 or [Formula: see text] 20 oocytes were collected. The primary outcome of interest was live birth after 28 weeks gestation following first ET and expressed as an odds ratio (OR).

Results: The predicted odds of live birth were greater in the frozen ET group at all progesterone concentrations. The effect was more pronounced with progressive increase in progesterone concentration (Figure 1) and maintained in both unadjusted and adjusted models. For women >35 years (n=4687), a positive interaction between progesterone and treatment effect was present although the treatment effect curve was flattened (p for interaction = 0.01).

Conclusion: In an unselected population undergoing IVF/ICSI, there is an increased chance of pregnancy with a freeze all ET strategy at different progesterone concentrations on HCG trigger day. The effect appears to be dose related with increasing magnitude of effect with rising progesterone concentration. This interaction was also observed in subsets of women with single ET and women > 35 years old, however the benefit of a freeze-all policy appears low in these women.
#247 : Correlation Between the Embryo Morphokinetic Parameters Up To Cleavage Stage and Blastocyst Implantation Capability in Frozen Embryo Transfer Cycles
Authors: Tu Anh Phi Thi , Mai Anh Vu Thi , Dinh Hop Vu , Lien Huong Nguyen Thi
Published: January 2024

I. BACKGROUND AND AIMS: Many studies have shown predicted value for embryo development potential or morpho-kinetic parameters. This study aims to determine the correlation between the embryo morpho-kinetic parameters up to the cleavage stage and blastocyst implantation capability in frozen embryo transfer (FET) cycles.

II. METHODS: A retrospective cohort study was conducted on 383 good-quality blastocysts of FET cycles from March 2020 to December 2022 at Tam Anh General Hospital. The study evaluated the differences in parameters, including tPNa, tPNf, t2 - t8, cc1, cc2, cc3, s2, s3, and abnormal division (direct, reverse cleavage) between the implant and non-implant groups. Using R’s rpart package, a hierarchical implantation model was created using the decision tree approach. The prognostic value of the model was assessed using ROC.

III. RESULTS: 383 blastocysts from 368 FET cycles were examined in our study, of which 222 (57.9%) were implanted and 161 (42.1%) were not.

Timing parameters of implanted embryos tended to be longer than that in the non-implanted group, and the division process of blastomeres was more synchronized, however not statistically. Embryos with direct cleavage had a significantly reduced implantation rate compared with non-direct groups (29.0% and 61.0%, p < 0.05)

Analysis of morpho-kinetic parameters enabled us to develop a hierarchical model that places the direct cleavage, tPNa, and cc1 as the variables with the best prognosis of implantation. The AUC value of the model was 0.641.

IV. CONCLUSION: The study showed that morpho-kinetic parameters at the early division stage have the predictive value of blastocyst implantation and can supplement traditional morphological assessment in embryo selection.
#264 : 3D Time-Lapse Refractive-Index Imaging of Intact Mouse Embryos for Non-Invasive Evaluation of the Embryonic Development
Authors: Lee Chungha , Lee Sangho , Shin Taeseop , Kim Geon , Do Jieun , Do Jaephil , Kim Ji Hyang , Choi Kyoung Hee , Kim Jae Young , Park YongKeun
Published: January 2024

Background and Aims: Time-lapse technology is an emerging assisted reproductive technology (ART) that enables simultaneous culture and monitoring of embryos in vitro during their development. It provides extra information on key events during embryo development, which can assist embryologists in selecting embryos alongside traditional morphology evaluations. Various imaging technologies have been utilised to visualise and evaluate embryos such as brightfield microscopy, darkfield microscopy, and Hoffman modulation contrast microscopy. Although these imaging technologies allow for non-invasive imaging of human embryos in a clinical setting, 3D imaging of a whole embryo with subcellular resolution remains a challenge.

Method: We demonstrate 3D time-lapse label-free imaging of live mouse embryos using the 3D refractive index (RI) imaging technique. The proposed method is a quantitative phase imaging technique that measures multiple-intensity images of transmitted light through the embryos via axial scanning to reconstruct the 3D RI map of the embryos.

Results: Using the proposed method, live mouse embryos were monitored at different developmental stages, ranging from 2-cell embryos to expanded blastocysts. The measured 3D RI maps of the developing embryos reveal 3D landscape of subcellular features inside the embryos (Fig. 1). In the quantitative assessment of embryonic development, various morphokinematic parameters were extracted from the measured 3D RI maps of the embryos.

Conclusion: Based on the results, we envision that our method has broad applications where non-invasive and quantitative assessment of embryonic development is required.
#308 : Comparative Outcomes of Robot-Assisted and Conventional Laparoscopic Ovarian Cystectomy for Endometrioma: Evaluating Ovarian Reserve, Recurrence, and Pregnancy Success
Authors: Choi Hyunji , Paik Haerin , Hong Yeon Hee , Kim Seul Ki , Lee Jung Ryeol
Published: January 2024

Background and Aims: Laparoscopic ovarian cystectomy has been the mainstay of surgical methods for endometriosis. Recently, robot-assisted ovarian cystectomy using Da VinciⓇ Xi™surgical system has been successfully introduced into clinical practice and provides specific technical advantages. We aimed to compare robot-assisted ovarian cystectomy (RAOC) and laparoscopic ovarian cystectomy (LOC) in terms of ovarian reserve, recurrence, and pregnancy outcomes.

Method: This was a retrospective study in a single tertiary hospital. Patients who underwent RAOC from January 2018 to December 2022 were identified. Propensity score matching was performed on a 1:1 ratio based on age, initial anti-Müllerian hormone (AMH), and BMI with those who underwent LOC during the same period.

Results: Patients in the RAOC group (n=43) and LOC (n=43) had similar age (33.2±6.2 vs. 32.8±6.6 years), BMI (21.2±2.9 vs. 21.2±3.0 kg/m2) and AMH (3.25±2.73 vs 3.40±2.36 ng/mL). The cyst was unilateral in 25 cases all for both groups (58.1%) and bilateral in 18 cases (41.9%). The number of ovarian cysts and diameter of the largest cyst were comparable (1.7±0.9 vs. 1.5±0.7; 5.9±2.4 vs. 6.3±1.7 cm, respectively). RAOC had a longer operation time (106±31 vs. 59±20 mins, [Formula: see text]<0.001), but the duration of hospital stays, and postoperative hemoglobin change were similar (2.0±0.0 vs. 2.1±0.2 days; -1.8±0.8 vs. -1.6±0.9 g/dl, respectively). Compared to LOC group, RAOC group had less AMH decrement after six months (-30.6±33.7 vs. -50.8±25.5%, [Formula: see text] =0.007). However, both groups had comparable AMH decrements after 12 and 24 months. Recurrence rates after 24 months follow-up was similar (15.8 vs. 31.3%). There were no statistical differences in clinical pregnancy rate (75.0 vs 14.3%, [Formula: see text]=0.088).

Conclusion: Robot-assisted ovarian cystectomy is a feasible treatment option for endometrioma, and it may lead to less short-term decline in ovarian reserve. This approach could be especially beneficial for those who plan to conceive soon after the operation, although the long-term benefits are still unclear.
#111 : MMP-9 to TIMP-1 Expression Ratio on Endometrioma Favors Tissue Invasion: A Study on Chicken Chorioallantoic Membrane (CAM)
Authors: Sari Vidia , Jenie Riris Istighfari , Widad Shofwal , Dewanto Agung
Published: January 2024

Background and Aims: Endometrioma occurs through the implantation of endometrial tissue in the ovary. The establishment of endometriotic lesions requires endometrial cells to invade the ovary by remodelling the extracellular matrix (ECM). It is plausible that these cells express protease. MMP-9 is a significant protease controlled by its natural inhibitor, TIMP-1. The balance between MMP-9 and TMIP-1 plays a critical role in the invasion of endometrioma that has never been investigated before. This study aimed to examine the correlation between MMP-9/TIMP-1 expression ratio and MMP-9 activity with the invasion of endometrioma tissue.

Method: This study was conducted on 35 samples of endometrioma tissue obtained from 27 women with endometriosis at Dr Sardjito General Hospital, Yogjakarta. The tissue was then implanted into CAM to examine its invasion capability. Invasion scores were assessed using hematoxylin-eosin staining. MMP-9/TIMP-1 expressions ratio was analysed using western blot, while MMP-9 activity in degrading ECM components was determined using gelatin zymography. The Spearman correlation assesses the correlation between variables with significance set as p[Formula: see text]0.05.

Results: The results showed a positive linear correlation between the MMP-9/TIMP-1 expression ratio and invasion scores of endometrioma tissue (r=0.486; p=0.003). In addition, the Kruskal-Wallis test showed there was a significant difference between the MMP-9/TIMP-1 expression ratio in each invasion score of endometrioma (p=0.032), and further analysis by Mann-Whitney post hoc tests revealed that significant differences were between invasion score 1 and 3 (p=0.037), also between invasion score 1 and 4 (p=0.010). MMP-9 activity had a strong positive linear correlation with invasion scores of endometrioma tissue (r=0.646; p=0.000).

Conclusion: MMP-9 activity in degrading extracellular matrix promotes the invasion of endometrioma. The imbalance between MMP-9 and TIMP-1 enhances the capacity of endometrioma to break down ECM. Higher MMP-9 expression over TIMP-1 expression gives rise to the invasion of endometrioma.