bluuebunny/crossref_metadata_2025_split huggingface dataset:
P-174 Are new machine learning (ML) models worth it: Equivalence of iDA, KIDscore, and Gardner Scoring in Predicting IVF Pregnancy
Authors: Varghese A , Savage S , Li W , Peek J , Davydova D , Knowlton N 
Published: July 2024

Abstract

Study question
Is there a significant difference in predicting pregnancy outcomes among iDAScore 1.0, KIDScoreD5, and Gardner Score in elective blastocyst transfers?

Summary answer
Contrary to previous studies, iDAScore v1.0 does not demonstrate a significant Receiver Operating Characteristic (ROC) curve advantage over the traditional Scores in predicting pregnancy outcomes.

What is known already
iDAScore 1.0, a deep neural network integrated into the EmbryoScope system, and KIDscoreD5 have shown potential in ML-driven embryo assessment, potentially easing the workload of embryologists. While recent studies have highlighted their superior performance in predicting pregnancy outcomes, our study offers a contrasting perspective.

Study design, size, duration
This retrospective analysis encompassed 1762 embryos from 1112 cycles with 1424 fresh and 338 frozen single embryo transfer cycles conducted from November 2018 to September 2023 across three IVF clinics in New Zealand. No PGT cases were included. All embryos that fulfilled the defined study criteria and transferred were included in this analysis. An extended Gardner Scoring was used at our clinics: A, B, C and X, where X being poorest grades, get discarded.

Participants/materials, setting, methods
Retrospectively computed KID and iDAScores were analyzed alongside the pregnancy prediction accuracy of conventional grading. Gardner scores were converted to a ranked ordinal value with ‘AA’ (5), ‘AB’ and ‘BA’ at 4, ‘BB’ at 3, and both ‘AC’, ‘BC’ as 2 and ‘CC’ as 1 among the age groups; &lt;35, 35-37, 38-40, 41-42, &gt;42. Differences in overall predictive capacity were compared via AUC curves within age groups via paired Delong tests. P-values reported are nominal.

Main results and the role of chance
The study found no statistically significant differences in AUC between any of the 3 tests examined even before adjusting for multiple comparisons. Notably, in 35-37 years olds (n = 495), AUCs were 0.63 for iDAScore, 0.62 for KIDScore, and 0.61 for Gardner criteria, showing a robust ability to predict pregnancy across all methods. Similar patterns were observed in all other age groups, with no significant disparities in pregnancy prediction models (P-value &gt; 0.05).

Limitations, reasons for caution
Given its retrospective nature, this study has inherent limitations. A prospective, controlled study would provide more definitive insights.

Wider implications of the findings
ML-based models are innovative, but they do not significantly exceed the predictive ability of traditional embryo assessment across a range of patient ages. Such models are not a panacea yet, but a data tool to increase reproducibility that might have over-promised and under delivered on clinical impact.

Trial registration number
not applicable
P-279 Significant increased isolation of escherichia coli in Iranian women with endometriosis: a case control – study
Authors: Askary E 
Published: July 2024

Abstract

Study question
Considering the role of bacterial infection in causing endometriosis, we decided to compare the cultures of endometriosis-affected women a in this study

Summary answer
Considering the possible role of E. coli in the progression and/or recurrence of endometriosis and also infertility

What is known already
(5). Due to the finding of endotoxin of E. coli species in the peritoneal cavity and menstrual fluid of endometriosis patients, infection with this bacterium has recently been proposed as an effective factor in the occurrence and growth of endometriosis lesions.

Study design, size, duration
This prospective case-control study was carried out in the Women’s Department of Shiraz University of Medical Sciences in collaboration with the Bacteriology and Virology Department between 60 participants.

Participants/materials, setting, methods
30 women with endometriosis in stages 3 and 4 of the disease, and 30 women without endometriosis who were candidates for surgery due to benign uterine diseases, underwent endometrial biopsy with Novak Kort in sterile conditions before starting their operation, and the results of their endometrial culture were analyzed and compared in terms of the presence of Enterobacter spp., Klebsiella spp., and E. coli species.

Main results and the role of chance
Based on the comparison between the two groups, only E. coli species had a significant association with the presence of endometriosis (P = 0.001). There was no significant relationship between the location of endometriosis in the pelvic cavity and culture results. Parity among the E. coli negative group was significantly higher compared to the E. coli positive group (P &lt; 0.001).

Limitations, reasons for caution
Lack of sample trail for repeat testing and antibiotic susceptibility testing, low taxonomical resolution, and costly laboratory setup and maintenance are other limitations of this technology

Wider implications of the findings
we suggest that in women who have endometriosis and recurrent IVF failure and also in cases of endometriosis recurrence after surgical treatment, treatment of couples with appropriate antibiotics and repeated culture along with subsequent antibiotic susceptibility testing until their culture becomes negative could be beneficial.

Trial registration number
IR.SUMS.MED.REC.1400.097
P-317 Risk of endometrial polyps and hyperplasia after tamoxifen treatment in women with breast cancer: a population-based study in Taiwan
Authors: Hsu C , Eing-Mei T , Hui-min H 
Published: July 2024

Abstract

Study question
This study aimed to examine the association between tamoxifen treatment and incident risks of uterine disease among breast cancer patients in Taiwan.

Summary answer
We found tamoxifen treatment group may have greater risk of endometrial polyps and hyperplasia than unexposured group after adjusting for age and body mass index.

What is known already
In the worldwide Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) breast cancer treatment trail reported that the women continue tamoxifen up to 10 years, compared with 5 years may reduce breast cancer recurrence and mortality rate. However, tamoxifen use has been reported to be associated with the cumulative risk of subsequently endometrial cancer during 5–14 years was 3.1%. Specifically, several Western studies have showed that the high incidence of endometrial cancer in breast cancer survivors with tamoxifen treatment.

Study design, size, duration
We conducted a retrospective cohort study using population-based data from Taiwan Cancer Registry and the National Health Insurance Research Database (NHIRD), and the National Population Registry Data set from 2011 to 2020.

Participants/materials, setting, methods
A total 138,934 newly diagnosed breast cancer female patients with age greater than 18 years old were included. We further used a 1-to-1 propensity score matching to generate comparable exposure and un-exposure groups. Cox proportional hazard regression models were used to examine the research question. All statistical analysis was performed using SAS version 9.4, and p-values &lt; 0.05 were considered statistically significant

Main results and the role of chance
Incidence rate ratio (IRR) to compare incidence rate of uterine disease between tamoxifen treatment groups and unexposed group, adjusting for age and BMI. Our results showed that IRR were 1.36, 0.33, 3.73, 0.63, endometrial polyps, endometrial carcinoma, endometrial hyperplasia and uterine carcinosarcoma, respectively. This study found possible correlations between tamoxifen exposure with endometrial polyps and hyperplasia among breast cancer. During the 10-year study period, tamoxifen group did not significantly increase the risk of endometrial cancer in breast cancer survivors at aged 40 and over.

Limitations, reasons for caution
Our cohort study with 10-year period is its short study period, Tamoxifen group did not significantly increase the risk of endometrial cancer.

Wider implications of the findings
This cohort study found higher endometrial polyps and hyperplasia incidence rates among women with breast cancer who received tamoxifen women than those not treated with tamoxifen. Results of this study suggest that clinicians should consider the risk of uterine disease among tamoxifen use and counsel patients accordingly.

Trial registration number
KMUHIRB-G(II)20200217
P-591 Per- and Polyfluoroalkyl Substances Serum Concentrations and Polycystic Ovary Syndrome among Women Attending a Fertility Clinic
Authors: Zhang Y , Martin L , Mustieles V , Ghaly M , Archer M , Yang S , Torres N , Coburn-Sanderson A , Souter I , Petrozza J , Yixin W , Messerlian C 
Published: July 2024

Abstract

Study question
What is the association between serum per- and poly-fluoroalkyl substances (PFAS) concentrations and polycystic ovary syndrome (PCOS) risk in populations with low-level PFAS exposure.

Summary answer
Higher serum concentrations of perfluorooctane sulfonate (PFOS) and perfluorohexane sulfonate (PFHxS) were associated with elevated risk of PCOS among women attending a U.S. fertility clinic.

What is known already
Previous studies reported that exposure to high-levels of PFAS exposure was associated with elevated risk of PCOS. However, studies evaluating PCOS risk in populations with exposure to lower levels of PFAS are limited.

Study design, size, duration
A cohort study of 502 females who sought fertility evaluation for medically assisted reproduction in a U.S. fertility clinic and had similar PFAS exposure level as the general U.S. population.

Participants/materials, setting, methods
Nine PFAS were quantified in non-fasting serum samples collected at study entry. Diagnosis of PCOS was based on the Rotterdam criteria after study entry before treatment. We used logistic regression to examine the odds ratio (OR) of PCOS in relation to PFAS concentrations (continuous and by tertiles). We applied quantile g-computation (QGC) and Bayesian Kernel Machine Regression (BKMR) to examine the joint associations of PFAS mixture with PCOS.

Main results and the role of chance
A total of 38 (7.6%) females were diagnosed with PCOS. Doubling of serum PFOS and PFHxS concentrations were associated with higher odds of PCOS [OR (95%CI): 1.70 (1.06, 2.81) and 1.45 (1.02, 2.08), respectively]. There was a dose-response relationship of PFOS with PCOS risk (p of trend by tertiles = 0.07). Both QGC and BKMR identified PFOS as the most important contributor among the PFAS mixture to PCOS risk. No clear joint effect was found for other examined PFAS nor for PFAS as a total mixture on PCOS risk.

Limitations, reasons for caution
Findings in this subfertile population may not be directly generalizable to reproductive aged women in the general population.

Wider implications of the findings
Our findings are consistent with existing evidence from populations with higher concentrations of some of the evaluated PFAS and supports the potential adverse effects of PFAS on female reproductive function. Larger prospective studies are needed to validate the findings.

Trial registration number
NA
Sublime music
Authors: Levinson Jerrold 
Published: July 2024

Abstract
The goal of this essay is to identify the species of music that is most justifiably denominated sublime and to characterize it as fully as possible, in part through a suggested taxonomy of the species, illustrated by a wide range of musical examples. After a general discussion of sublimity in its original sphere of application—the natural world—I go on to consider the nature of sublime musical experience. I propose that categorizing music as some species of sublime is at base a matter of what it is most like or most resembles among natural phenomena. This results in a scheme which recognizes five distinguishable kinds of sublime music: negatively transcendent, positively transcendent, mixedly transcendent, energizing, and transcendent-energizing. I distinguish sublime music from other valuable music kinds and finish by pointing to some rewards that come with the experience of sublime music.
Dyslipidemia and hyperglycemia induce overexpression of Syndecan-3 in erythrocytes and modulate erythrocyte adhesion
Authors: Mallanna Smitha Honnalagere , Thimmulappa Rajesh K , Chilkunda Nandini D 
Published: July 2024

Abstract
Erythrocytes are important vascular components that play vital roles in maintaining vascular homeostasis, in addition to carrying oxygen. Previously, we reported that the changes in the internal milieu (e.g. hyperglycemia or hypercholesterolemia) increase erythrocyte adhesion to various extracellular matrix components, potentially through altering glycosaminoglycans (GAGs). In this study, we have investigated the expression of syndecan (Sdc) family members that could be involved in mediating cytoadherence under conditions of dyslipidemia and hyperglycemia. Among the Sdc family members analysed, we found significant overexpression of Sdc-3 in erythrocyte membranes harvested from high-fat-fed control and diabetic animals. Animal studies revealed a positive correlation between Sdc-3 expression, blood sugar levels and erythrocyte adhesion. In the human study, diabetic cohorts with body mass index &gt;24.9 showed significantly increased expression of Sdc-3. Interestingly, blocking the Sdc-3 moiety with an anti-Sdc-3 antibody revealed that the core protein might not be directly involved in erythrocyte adhesion to fibronectin despite the GAGs bringing about adhesion. Lastly, Nano liquid chromatography-mass spectrometry/MS verified the presence of Sdc-3 in erythrocyte membranes. In conclusion, the high-fat diet and diabetes modulated Sdc-3 expression in the erythrocyte membrane, which may alter its adhesive properties and promote vascular complications.
Genetic Enhancement, Human Rights, and Regioglobal Bioethics
Authors: Fan Ruiping 
Published: July 2024

Abstract
This article examines the cross-cultural bioethical concerns stemming from the potential use of CRISPR-Cas9 for genetic enhancement projects. It emphasizes the need to differentiate between basic and non-basic human rights when considering genetic enhancement, as recent international declarations lack this distinction. Basic rights possess a universal nature and are applicable across cultures, while non-basic rights are culturally specific and should be determined within respective regions. To illustrate this, the study explores the acceptance or rejection of non-basic rights related to genetic enhancement in two distinct cultural categories: Type-A and Type-B cultures. Type-A cultures predominantly adhere to a liberal moral framework, while Type-B cultures are rooted in Confucian morality. Additionally, the article argues for two basic rights in genetic enhancement: the right to be free from bodily harm and the right to be free from deception. These rights differ from non-basic rights and should be universally upheld in all cultures. By analyzing a hypothetical case and drawing parallels with the He Jiankui incident, the article investigates the violation of these two basic rights in each scenario, regardless of cultural context. Consequently, both cases should be unequivocally rejected in both Type-A and Type-B cultures.
Optimizing early phase clinical trial washout periods: a report from the Therapeutic Advances in Childhood Leukemia and Lymphoma consortium
Authors: Schafer Eric S , Rushing Teresa , Crews Kristine R , Annesley Colleen , Colace Susan I , Kaiser Nicole , Pommert Lauren , Ramsey Laura B , Sabnis Himalee S , Wong Kenneth , Chang Bill H , Cooper Todd M , Shah Nirali N , Rheingold Susan R , Place Andrew E , Chi Yueh-Yun , Bhojwani Deepa , Wayne Alan S , Bernhardt M Brooke 
Published: July 2024

Abstract

Background
The National Cancer Institute (NCI) issued a 2021 memorandum adopting the American Society of Clinical Oncology (ASCO) and Friends of Cancer Research (Friends) task force recommendations to broaden clinical study eligibility criteria. They recommended that washout periods be eliminated for most prior cancer therapy and when required to utilize evidence- and/or rationale-based criteria. The Therapeutic Advances in Childhood Leukemia and Lymphoma (TACL) consortium responded to this guidance.

Methods
A TACL task force reviewed the consortium’s research portfolio, the relevant literature and guidance documents from ASCO-Friends, NCI, and US Food and Drug Administration to make expert consensus and evidence-based recommendations for modernizing, broadening, and codifying TACL-study washout periods while ensuring consistency with pediatric ethics, and federal regulations. TACL’s screening log was reviewed to estimate the impact that updated washout periods would have on patient inclusivity and recruitment.

Results
Over a 19-year period, 42 (14.6% of all screened ineligible patients [n = 287]) patients were identified as excluded from TACL early phase studies exclusively because of not meeting washout criteria. An additional 6 (2.1%) did not meet washout and at least 1 other exclusion criterion. A new TACL washout guidance document was developed and then adopted for use. Where washout criteria were not eliminated, rationale- and/or evidenced-based criteria were established with citation.

Conclusion
In an effort to reduce unnecessary exclusion from clinical trials, TACL created rationale- and/or evidenced-based washout period standards largely following guidance from the NCI and ASCO-Friends recommendations. These new, expanded eligibility criteria are expected to increase access to TACL clinical trials while maintaining safety and scientific excellence.
Understanding the Genetic Basis of Variation in Meiotic Recombination: Past, Present, and Future
Authors: Johnston Susan E 
Published: July 2024

Abstract
Meiotic recombination is a fundamental feature of sexually reproducing species. It is often required for proper chromosome segregation and plays important role in adaptation and the maintenance of genetic diversity. The molecular mechanisms of recombination are remarkably conserved across eukaryotes, yet meiotic genes and proteins show substantial variation in their sequence and function, even between closely related species. Furthermore, the rate and distribution of recombination shows a huge diversity within and between chromosomes, individuals, sexes, populations, and species. This variation has implications for many molecular and evolutionary processes, yet how and why this diversity has evolved is not well understood. A key step in understanding trait evolution is to determine its genetic basis—that is, the number, effect sizes, and distribution of loci underpinning variation. In this perspective, I discuss past and current knowledge on the genetic basis of variation in recombination rate and distribution, explore its evolutionary implications, and present open questions for future research.
Impact of Intrathecal Dexmedetomidine versus Intrathecal Fentanyl as Adjuvants to Bupivacaine on Post Spinal Urinary Retention in Knee Joint Arthroscopic Surgeries
Authors: Bassiouny Mohsen , Samir Ghada Mohamed , Nabil Tamer , Al Sharabasy Toqa Hamdy 
Published: July 2024

Abstract

Background
Patients undergoing orthopedic surgery are prone to developing postoperative urinary retention (POUR). They have an estimated relative risk of 8% to 55% higher than other surgical patients. This inability to void increases patient’s risk of urinary tract infections (UTIs) and bacteremia, and can lead to chronic voiding difficulties due to bladder architecture alterations. A great degree of variability exists among studies describing the prevalence and risk factors of postoperative urinary retention and its management strategies.

Objective
To compare the effects of Dexmedetomidine or Fentanyl added to intrathecal bupivacaine in knee arthroscopic procedures in terms of the occurrence of postoperative urinary retention.

Patients and Methods
This prospective randomized clinical study was conducted at tertiary care hospital at Ain Shams University hospitals from September 2021 till Mars 2022 and performed on a total of 70 patients who assigned for knee joints orthoscopic surgery.

Results
The current study results revealed that the incidence of postoperative urine retention in dexmedetomidine group was 5.7% while was 28.6% in Fentanyl group, the difference was statistically significant. however, the need to postoperative urinary catheterization was statistically non-significantly among the two groups. The current study results revealed that the Time to achieve maximum block was significantly shorter in dexmedetomidine group and the duration of motor block statistically was significantly longer in dexmedetomidine group.

Conclusion
On the basis of current evidence, when compared to fentanyl, our study revealed that intrathecal dexmedetomidine, as adjuvant to local anesthetics for intrathecal injection, can statistically significantly prolong the duration of sensory and motor block, as well as the pain free period, meanwhile significantly reducing the incidence of urinary retention. Intrathecal dexmedetomidine seems to be an attractive alternative as an adjuvant to spinal bupivacaine in surgical procedures, especially those requiring long time. It has excellent quality of postoperative analgesia with minimal side effects.
Opioid-Free Anesthesia with a Mixture of Dexmedetomidine, Ketamine and Lidocaine in Severely Obese Patients Undergoing Laparoscopic Cholecystectomy
Authors: EL-Said Kamel Amr Mohamed , Khalaf Khaled Mostafa , Abdelghaffar Abdelrahman Mabrouk , Mohamed El-ghanam Ahmed Samy 
Published: July 2024

Abstract

Background
Opioids have historically been a first-line therapy for surgical pain control. They were considered optimum and the mainstay for balanced anesthesia but recently the concerns about their side effects were raised. The concept of opioid free anesthesia (OFA) was introduced to provide a safer alternative that would provide benefits to selective group of patients as well as enhance recovery after surgery.

Methods
The current study compares the use of a mixture of dexmedetomidine and ketamine infusion with traditional fentanyl infusion intra-operative on many variables both intra-operative and post- operative in laparoscopic surgeries. Number of patients who will need rescue narcotics after extubation and total nalbuphine consumption, hemodynamic events (bradycardia, hypotension and hypertension), time to extubation, time to reach Alderete score of 9, post-operative hypoxemia, vomiting, pain scores were recorded and compared with the traditional balanced anesthesia (TBA).

Results
Forty patients were enrolled in the study, 20 patients in each group. The 2 groups, TBA and OFA, were comparable in demographic data (age, sex, body mass index (BMI), lean body weight (LBW)) and duration of surgery. There was significant decrease in pain scores, number of patients who will need rescue narcotics after extubation and nalbuphine consumption in the OFA group that extended to 24 h post-operative. TBA group showed statistically significant less time needed for extubation (P-value 0.018) and reaching Aldrete score of 9 (P-value 0.02).

Conclusions
OFA has a better profile than TBA as regard to post-operative pain score and opioid consumption post-operative but they have relative increase in time to extubation and time to reach Aldrete score of 9, and they were equally safe regarding post operative hypoxia and hemodynamics.