bluuebunny/crossref_metadata_2025_split huggingface dataset:
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

BackgroundPatients 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.MethodsThis 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.ResultsAmong 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).ConclusionsThe 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.
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

AbstractIn 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.
#258 : Evaluating the Clinical Utility of Physiological ICSI
Authors: Tomari Hiroyuki , Nagata Mayu , Kunitake Katsuko , Uchimura Keiko , Gondo Saki , Saito Kensuke , Sano Yukako , Honjo Kou , Nagata Yumi 
Published: January 2024

Background and Aims: Physiologic ICSI (PICSI) is a method of ICSI in which sperm attached to hyaluronic acid (HA) are selected. It is known that mature sperm express receptors for adhesion to the HA due to reconstruction of the protoplasmic membrane. In fact, it has been confirmed that sperm that can adhere to HA are mature sperm, and it has been reported that their DNA is highly normal. However, previous studies on the clinical outcomes of PICSI have shown inconsistent results. Therefore, the purpose of this study was to evaluate the clinical usefulness of PICSI using sibling oocytes. Method: The 365 cycles in which two or more mature oocytes were obtained in ICSI cycles were included, and the sibling oocytes of the same cycle were equally divided between conventional ICSI and PICSI methods. Sperm selection was based on sperm morphology and motility in the conventional method, while adhesion to HA was taken into account in the PICSI method. The evaluation items were embryonic developmental potential and clinical pregnancy and miscarriage rates after single frozen thawed blastocyst transfer. Results: The normal fertilization rates for the conventional and PICSI methods were 81.3% and 80.8%, respectively; the blastocyst rates were 64.7% and 68.2%, respectively; and the good blastocyst rates were 30.8% and 31.8%, respectively. There were no significant differences in any of the endpoints (Table 1). There were no significant differences between the two groups in clinical pregnancy and miscarriage rates after single frozen thawed blastocyst transfer (Table 2). Conclusion: In the patients in this study, the clinical outcomes of PICSI were equivalent to those of the conventional method, and the clinical benefit of PICSI was not demonstrated. In the future, it will be necessary to examine the conditions under which PICSI is effective.
Negative Hyperselection of Resistance Mutations for Panitumumab Maintenance in RAS Wild-Type Metastatic Colorectal Cancer (PanaMa Phase II Trial, AIO KRK 0212)
Authors: Stahler Arndt , Kind Andreas J. , Sers Christine , Mamlouk Soulafa , Müller Lothar , Karthaus Meinolf , Fruehauf Stefan , Graeven Ullrich , Fischer von Weikersthal Ludwig , Sommerhäuser Greta , Kasper Stefan , Hoppe Beeke , Kurreck Annika , Held Swantje , Heinemann Volker , Horst David , Jarosch Armin , Stintzing Sebastian , Trarbach Tanja , Modest Dominik P. 
Published: January 2024

Abstract

Purpose:
We evaluated additional mutations in RAS wild-type (WT) metastatic colorectal cancer (mCRC) as prognostic and predictive biomarkers for the efficacy of added panitumumab to a 5-fluorouracil plus folinic acid (FU/FA) maintenance as pre-specified analysis of the randomized PanaMa trial.

Patients and Methods:
Mutations (MUT) were identified using targeted next-generation sequencing (NGS; Illumina Cancer Hotspot Panel v2) and IHC. RAS/BRAF V600E/PIK3CA/AKT1/ALK1/ERBB2/PTEN MUT and HER2/neu overexpressions were negatively hyperselected and correlated with median progression-free survival (PFS) and overall survival (OS) since start of maintenance treatment, and objective response rates (ORR). Univariate/multivariate Cox regression estimated hazard ratios (HR) and 95% confidence intervals (CI).

Results:
202 of 248 patients (81.5%) of the full analysis set (FAS) had available NGS data: hyperselection WT, 162 (80.2%); MUT, 40 (19.8%). From start of maintenance therapy, hyperselection WT tumors were associated with longer median PFS as compared with hyperselection MUT mCRC (7.5 vs. 5.4 months; HR, 0.75; 95% CI, 0.52–1.07; P = 0.11), OS (28.7 vs. 22.2 months; HR, 0.53; 95% CI, 0.36–0.77; P = 0.001), and higher ORR (35.8% vs. 25.0%, P = 0.26). The addition of panitumumab to maintenance was associated with significant benefit in hyperselection WT tumors for PFS (9.2 vs. 6.0 months; HR, 0.66; 95% CI, 0.47–0.93; P = 0.02) and numerically also for OS (36.9 vs. 24.9 months; HR, 0.91; 95% CI, 0.61–1.36; P = 0.50), but not in hyperselection MUT tumors. Hyperselection status interacted with maintenance treatment arms in terms of PFS (P = 0.06) and OS (P = 0.009).

Conclusions:
Extended molecular profiling beyond RAS may have the potential to improve the patient selection for anti-EGFR containing maintenance regimens.
IL15 and IL21: Better When Membrane-Tethered Together on Antitumor T Cells
Authors: Ruffin Ayana T. , Wittling Megen C. , Cole Anna C. , Paulos Chrystal M. 
Published: January 2024

SummarySystemic administration of homeostatic γ-chain cytokines mediates antitumor responses in some patients treated with adoptive immunotherapy. Yet many patients experience toxic side effects. New work presented herein suggests these limitations can be overcome by membrane-tethering IL15 and IL21 to T-cell products. This finding has major implications in advancing medicine.See related article by Nguyen et al., p. 1555