bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-powered wearable sensors design considerations
Authors: Han Weiqiao , Anaya David Vera , Wu Taiyang , Wu Fan , Yuce Mehmet Rasit 
Published: June 2022

Abstract
Wearable sensors have been implemented widely to provide comfortable and continuous long-term monitoring in many applications. Minimal requirements on maintenance is a main characteristic of wearable sensors, but unfortunately, many of them are still powered by battery with limited capacity which need to be charged or replaced regularly. Energy harvesting technologies are applied to provide a reliable solution to this issue. This paper presents several design considerations for self-powered wearable sensors. Suitable energy sources are discussed, such as ambient energy sources (solar, radio frequency, and ultrasonic energy), human body energy (mechanical, piezoelectric, triboelectric, electromagnetic, electrostatic, and thermal energy). Moreover, power management integrated circuits, energy storage options, and the material selection and conditioning circuit of triboelectric nanogenerator are discussed. Five case studies utilizing different energy harvesting techniques are discussed and evaluated in terms of their system implementation and performance to provide some deeper understandings of wearable sensors.
Development and validation of a nomogram to predict indolent course in patients with ulcerative colitis: a single-center retrospective study
Authors: Li Na , Zhan Shukai , Liu Caiguang , Li Tong , Tu Tong , Chen Baili , He Yao , Chen Minhu , Zeng Zhirong , Zhuang Xiaojun 
Published: June 2022

Abstract

Background
The natural disease course for patients with ulcerative colitis (UC) is heterogeneous and few data are available on the indolent course of UC and its related factors. We aimed to develop and validate a nomogram to predict indolent course in patients with UC.

Methods
Data of patients diagnosed with UC in the First Affiliated Hospital of Sun Yat-sen University (Guangzhou, China) between April 2007 and February 2021 were retrospectively analysed. Indolent course was defined as a disease course without need for strict interventions (steroids, immunomodulators, biological agents, hospitalization, or surgery therapy) during the follow-up period. The whole cohort was randomly divided into training set and validation set. The nomogram was constructed in the training set based on the results of univariate and multivariate Cox regression analyses. The performance of the nomogram was assessed by the concordance index (C-index), area under the receiver-operating characteristic curve (AUC), and calibration plots. In addition, we internally validated the nomogram via the bootstrap method and the validation set.

Results
Of 969 treatment-naive patients with UC, 771 (79.6%) had an indolent course after diagnosis. Of these, 313 patients were included in the development and validation of the nomogram. The nomogram incorporating age, disease activity, C-reactive protein, and platelet count showed good calibration and discrimination. The C-index was 0.759 (0.741 in bootstrap validation) and the AUC at 2, 4, and 6 years was 0.767, 0.782, and 0.775, respectively. The nomogram performed well when applied to the validation set.

Conclusion
A majority of patients with UC had an indolent course after diagnosis. The nomogram developed in this study might be useful in therapeutic decision-making and follow-up management for patients with UC.
O-005 Reducing inter-observer and intra-observer variability of embryo quality assessment using deep learning
Authors: Saïs E , Mayeur A , Binois O , Hesters L , Puy V , Fossard C , Filali M , Vandame J , Poulain M , Frydman N 
Published: June 2022

Abstract

Study question
Does deep learning for embryo quality assessment reduce inter-observer variability?

Summary answer
An AUC of 87.65% was obtained for predicting blastocyst quality with a deep-learning algorithm trained by five embryologists who had good agreement between themselves

What is known already
Time-Lapse (TL) allows continuous observation of embryo development in a controlled and stable environment. Recently the use of deep learning, in particular convolutional neural networks have been introduced to enhance blastocyst image classification using the growing TL image and video data.

Study design, size, duration
A total of 409 embryos (5 images per embryo for a total of 2 045 images) were included in this retrospective study between 2016 and 2020.

Participants/materials, setting, methods
A machine-learning algorithm (Retinanet) was trained to recognize 2 045 blastocyst images from 409 embryos on 2560x1928 images and output 500x500 images with the blastocyst centered on the image. Five embryologists classified the blastocysts using Gardner’s grading system. Each image was associated with one final grade using a majority voting system. The dataset was split into a training and validation set (1 640 images plus data augmentation) and a testing set (405 images).

Main results and the role of chance
Fair agreement was found between the 5 embryologists when grading the embryo using Gardner’s grading system, with a maximum weighted kappa score of 39.60% reached.
As for the intra-observer variability, we show that for the same embryologist grading the same embryo after a 3 month “wash out” period, in 12% of the cases the embryologist changes the grade and the fate of the embryo, meaning that an embryo that was transferred/frozen during the first annotation period was discarded during the second one, or an embryo that was discarded during the first annotation period was transferred/frozen during the second one.
An Area Under the Curve (AUC) of 87.65% was obtained when testing the quality of 81 embryos (405 images) after training our algorithm on 54 038 images.
For external validation we tested the algorithm with annotations of the test set from embryologists coming from another fertility center. An AUC of 82.72% was obtained.

Limitations, reasons for caution
The scarce number of images available in our training set compared with data sets from other more consequent clinics, and the fact that the algorithm was trained by embryologists does not suppress variability entirely. The GoogLeNet algorithm was not fined tune and was used as is.

Wider implications of the findings
AI is showing precious value the field of embryology, from enhancing blastocyst quality prediction to removing inter-observer subjectivity. A possible evolution to our framework would be to predict the Gardner’s grading system for each morphological parameter.

Trial registration number
not applicable
O-053 ART treatment and pregnancy during covid 19 pandemia: what we learned
Authors: Veiga A 
Published: June 2022

Abstract
In 2020, SARS-CoV-2 and the COVID-19 pandemic had a huge impact on the access to and provision of ART treatments. Gradually, knowledge about the virus and its transmission has become available and has allowed ART activities to resume with certain restrictions. Still, questions on the impact of the virus on fertility and ART treatments remain.
Regarding the possible consequences of COVID-19 in men, ACE2 and TMPRSS2, the receptors required for the viral penetration into cells, are highly expressed in the testis and the presence of SARS-CoV-2 has been demonstrated in the testicular tissue and the ejaculate in a small percentage of males with active and severe COVID-19 infection. Impairment of the sperm quality has been described during the acute and recovery phase of infection.
In the female scenario, low levels of ACE2 have been reported in ovarian tissue and co-expression of ACE2 and TMPRSS2 has been demonstrated in oocytes, zygotes and blastocysts that are thus potentially susceptible to SARS-CoV-2 infection upon exposure to the virus. The endometrium has been shown to be at a low risk of infection. Although infrequent, vertical transmission of SARS-CoV-2 has been reported in cases of severe maternal infection.
The effects of SARS-CoV-2 infection have been analysed in ART patients. Certain studies suggest that ovarian function might be altered and that IVF results could be poorer in patients that have recovered from COVID-19 while others show no evidence of compromised follicular function. The possible effects of vaccination in male and in female patients have also been explored. Neither the ovarian response nor the sperm quality is affected by the administration of COVID-19 vaccines, which are highly recommended in couples planning a pregnancy, either spontaneous or through ART.
During the different waves of the COVID-19 pandemic, the ESHRE COVID-19 Working Group has produced recommendations and publications to guide patients and professionals in their journey through ART during these difficult times.
O-095 The persistent Y hypothesis
Authors: Waters P D , Ruiz-Herrera A 
Published: June 2022

Abstract
The Y chromosome has been touted as a wimpy relic of the X, with its survival dependent on a few critical functions in spermatogenesis and sex determination, the loss of which would signal its demise. Why then has it survived since its origin (∼165 MYA) in all but a handful of therian mammal species? This is in stark contrast to the high turnover of sex chromosomes observed in other vertebrate linages, so the mammal Y turns out to be an exception of persistence, rather than the rule. Here we propose a novel explanation for such perseverance. The Y chromosome bears so-called ‘executioner genes’ that are critical for successful meiotic progression. Their expression is required to initiate meiotic sex chromosome inactivation, but then must be subject to this very silencing they induce to ensure germ cell survival. Whenexecutioners are translocated to an autosome they escape meiotic silencing and, being pachytene-lethal, cease meiosis. Therefore, these meiotic executioners act as their own judge, jury and executioner, posing strong evolutionary constraint for the Y chromosome to persist in eutherian mammals.
O-097 Building the perfect cleanroom IVF lab and maintaining it
Authors: Janssens R , Neelke D M , Johan G 
Published: June 2022

Abstract
Designing and installing a new ART laboratory is not something one does every day and the challenges one faces are many. Putting together a planning team with all concerned parties and stakeholders already in the very early phase of the project is crucial. The aim of the planning team is to critically consider all wishes and requirements, to weigh all the pros and cons and make realistic choices. The final scenario should comply with regulations and/or legislation. This implicated that IVF laboratory facilities should be constructed according to cleanroom regulations to control air-borne contaminants.
The construction costs of laboratory space per square meter is about the same as the cost of an operating room. That's why it's so important to discuss space needs and layout well in advance in the planning team. To avoid future bottlenecks during operation, is might be wise to construct multifunctional facilities i.e. an room dedicated to embryo replacements can be designed without much extra cost in such a way that it is also suitable for performing egg retrieval if necessary.
Once the cleanroom is build and the HVAC is working, compliance with the designated classification has to be demonstrated in the formal process of qualification (or validation). Provide enough space for cryostorage. This storage room should be a dedicated, locked room ideally not too far from the laboratory cleanroom and should be easily accessed for liquid nitrogen supply. As an alternative, a centralized liquid nitrogen distribution via a vacuum isolated pressured line (VIP) can be considered.
One of the most important choices in terms of space requirements and layout is the type and number of workstations, equipment and incubators. Once the number and exact types are known, their exact position should be drawn on the plans in order to determine the necessary outlet points for medical gasses, electricity plugs and network connections.
O-098 Changing the IVF lab in qualitative way: tips on how to handle infrastructural changes in the cleanroom IVF lab
Authors: Van den Bergh M J G 
Published: June 2022

Abstract
The infrastructure of an IVF laboratory must include all the fundamental facilities and systems that ensure its continuous functionality according to standards stipulated in a quality management with the focus on continuous improvement. The values for the key performance indicators proposed by ESHRE are the ideal benchmarks for ensuring high quality. The geo-localisation of the laboratory or its implantation in an existing facility corresponds to the first level at which a qualitative improvement can possibly be made.
When choosing a location, the quality of the outside air plays a primary role. Any possible source of air pollution, especially from volatile organic compounds, must be estimated beforehand and will determine the choice of the type of air filtration system. This choice can vary from large filter complexes on the roof to mobile indoor cartridge units. Useful information has been published in the Cairo consensus.
The next level on which improvements can be made is the choice of building materials for the premises. The use of organic paints, polished concrete floors, floor, and ceiling tiles free from or containing low levels of VOCs must be preferred. Before the laboratory is put into operation, a period of degassing is usually recommended by raising the room temperature and vigorous ventilation.
Despite numerous publications, too little attention is still paid to the light used in the laboratory. Red light is the least and blue the most harmful to embryo culture. Working with red light is difficult in practice but placing yellow filters in the microscopes and using “sleep mode” light offers a simple and cheap solution.
Even if the current tendency is to let the embryo culture proceed undisturbed under video control, the Petri dishes must still be removed from the incubators for certain procedures. The cooling down during these operations is very fast but can be strongly reduced using heated plates with grooves that allow an exchange of heat on the basis of conduction.
The infrastructure systems include all devices that must ensure the correct operation of the laboratory. Uninterrupted power supply is always present in hospitals, but small units must have it, even if power cuts are rare and usually short in our western countries.
The infrastructure systems include all devices that must ensure the correct operation of the laboratory. Uninterrupted power supply is always present in hospitals, but small units must have it, even if power cuts are rare and usually short in our western countries.
When selecting equipment, particular attention must be paid to the prompt availability of technical support. The staff must be well trained in the correct use of all devices. Maintenance and calibration must be planned on a regular basis.
For laboratories with a long standing experience, it is always possible to introduce qualitative improvements based on the analysis of the risk management and fulfil the basis steps of a quality management: Plan-Do-Check-Act
O-111 The International Fertility Education Initiative
Authors: De Mouzon J , Harper J , Hammarberg K 
Published: June 2022

Abstract

Awareness Raising. The International Fertility Education Initiative
Jacques de Mouzon, Joyce Harper, Karin Hammarberg, and the IFEI group
Clearly, from the international reports on Assisted reproductive technology, more and more patients go to be treated by ART everywhere in the World, even in the richest countries where access is not limited by economic constraints. At the same time, there is a large tendency of maternal age increase at conception and birth, whereas it is well known that there is a fertility decline both with women’s and men’s age. It clearly appears that one driver concerns the lack of awareness of people of reproductive age on the factors affecting the chance of conceiving and of getting a healthy baby.
Thus, to improve fertility awareness in the public, a group of 45 specialists in infertility from about twenty countries met in 2020 and decided to launch an initiative, together with patients’ associations, the International Fertility Education initiative (IFEI). The group includes experts of various scientific fields: clinicians, nurses / midwifes, scientists, psychologists, ethicists, public health, patients. The chair is Pr. Joyce Harper, who was at the initiative of this initiative
The IFEI objectives and creation were published in Human Reproduction open in 2021. Objectives include research and actions to improve fertility awareness. The mission can be summarized as follows: To increase fertility awareness using the life course approach, in order to improve reproductive health and facilitate decision-making in family planning among adolescents, people of reproductive age, primary healthcare, education professionals, and policymakers through development, evaluation and dissemination of inclusive educational resources. Four strategic goals have been identified
5 working groups have been designed to cover the mission and strategic goals:
IFEI has regular meetings where each group progresses are discussed. The groups advancements will be presented at the ESHRE annual meeting in Milano, during the special session entitled “Awareness Raising”. In 2021, IFEI has established links with ESHRE, under the umbrella of the special interest group Global and Socio-cultural Aspects of Infertility. In 2022, links are being established also with IFFS and FIGO, to develop a consistent action.
In conclusion, IFEI is rapidly progressing towards its objectives and several countries has already developed specific national action plans that are consistent with the general aim on fertility awareness

Trial registration number
O-147 Genomic analyses in 101,127 UK women show that previously reported monogenic genes are not common causes of premature ovarian insufficiency
Authors: Shekari S , Stankovic S , Ruth K. S , Prague J , Perry J , Murray A 
Published: June 2022

Abstract

Study question
What is the penetrance of variants in previously reported genes for premature ovarian insufficiency (POI) in the general population?

Summary answer
Heterozygous genetic variants in previously reported monogenic genes are not a common, highly penetrant cause of POI.

What is known already
Premature ovarian insufficiency (POI), defined as menopause before 40, has been associated with variants in over 70 genes. However, the evidence to support the causality of individual genetic variants varies between studies. As genomic data becomes more accessible, it is essential to ascertain the penetrance of variants in the absence of family history information. We identified 75 genes associated with POI from the literature, including family segregation studies, consanguineous pedigrees and cohort analyses of whole-exome/targeted sequencing data. Functional evaluation was also available for many of the genes.

Study design, size, duration
We used data from 101,127 females of European ancestry in the UK Biobank, to study the role of previously reported monogenic causal genes on ovarian function. We tested the association of 301 previously reported variants with POI and ANM, plus more than 2.5 million rare variants which were annotated and had not been implicated in POI previously. Genomic variants were tested individually and also combined into a gene burden test.

Participants/materials, setting, methods
Age at natural menopause (ANM) was derived from self-reported questionnaire data from the age at last menstrual period, excluding those with surgical menopause or taking hormone replacement therapy. POI cases were classified as women with ANM under 40 years (N = 2,213). Linked primary care records were used to identify a clinical cohort of POI cases, including primary amenorrhea (N = 113).

Main results and the role of chance
All of the previously reported individual variants we identified in our POI cases were also detected in the control group. Moreover, the gene burden tests were not associated with POI or ANM as a quantitative trait. Our results indicate that autosomal dominant causes of POI are rare; a single predicted loss-of-function (LOF) or non-synonymous genetic variant in one of the previously reported genes is generally not pathogenic.

Limitations, reasons for caution
The penetrance of monogenic disease-causing variants is likely to be lower in population-based cohorts such as UK Biobank than in clinically-ascertained cohorts.

Wider implications of the findings
Heterozygous LOF or non-synonymous variants in previously reported POI genes should be interpreted with caution and are unlikely to cause POI. The findings have implications for clinicians diagnosing causes of POI.

Trial registration number
Not applicable
O-153 Unravelling the causes of male infertility: the role of genetics
Authors: Tüttelmann F 
Published: June 2022

Abstract
Infertility is a common multifactorial disease and global health problem affecting 10-15% of couples. It can often be overcome by medically assisted reproduction (MAR), offering couples that fail to conceive naturally the chance for parenthood. In half of the couples, the infertility is due to male-factors. Despite advances in the past decade, in the majority of infertile men, the underlying genetic, molecular, cellular, and/or organ defect(s) still remain ill-defined or unknown altogether. Thereby, evidence-based treatment decisions for testicular sperm extraction (TESE) and MAR, estimating and counselling as to risks for both the men and their offspring, and potential preventive measures are largely precluded.
However, in recent years, the number of male infertility cases “solved” by genetic analyses, most importantly exome sequencing, increases continuously. We and others have contributed significantly to 1) identifying novel genes and causal variants (mutations), 2) functionally scrutinising them, and 3) translating findings into the clinic. Most attention is currently focussed on azoospermia, supposedly affecting up to 1% of the male population, and specific sperm defects clinically detected as morphological aberrations or decreased/completely lacking motility.
Crypto- and azoospermia (very few/no sperm in the semen) are main contributors to male factor infertility. Genetic causes for spermatogenic failure (SPGF) include Klinefelter syndrome (47,XXY) and Y-chromosomal AZF microdeletions, and CFTR mutations for obstructive azoospermia (OA). However, the majority of cases remain unexplained because monogenic causes are not analysed. The clinical distinction between azoospermia due to SPGF (non-obstructive azoospermia, NOA) and obstructive azoospermia (OA) is challenging but critical for counselling patients prior to surgical sperm retrieval procedures: men with OA have high success rates for TESE and subsequent intracytoplasmic sperm injection (ICSI), while rates for NOA patients range from virtually zero up to ∼50% depending on the genotype.
One focus of the talk will be the recent results of our four years prospective exome sequencing study in crypto-/azoospermic men and the impact for predicting TESE and MAR success based on identified mutations. Another focus will be the genetic makeup of morphologically abnormal sperm and the consequences for MAR/ICSI. Lastly, a previously underestimated cause for infertility and IVF failure will be reviewed.