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Direct reciprocity is a powerful mechanism for cooperation in social dilemmas. The very logic of reciprocity, however, seems to require that individuals are symmetric, and that everyone has the same means to influence each others' payoffs. Yet in many applications, individuals are asymmetric. Herein, we study the effect of asymmetry in linear public good games. Individuals may differ in their endowments (their ability to contribute to a public good) and in their productivities (how effective their contributions are). Given the individuals' productivities, we ask which allocation of endowments is optimal for cooperation. To this end, we consider two notions of optimality. The first notion focuses on the resilience of cooperation. The respective endowment distribution ensures that full cooperation is feasible even under the most adverse conditions. The second notion focuses on efficiency. The corresponding endowment distribution maximizes group welfare. Using analytical methods, we fully characterize these two endowment distributions. This analysis reveals that both optimality notions favor some endowment inequality: More productive players ought to get higher endowments. Yet the two notions disagree on how unequal endowments are supposed to be. A focus on resilience results in less inequality. With additional simulations, we show that the optimal endowment allocation needs to account for both the resilience and the efficiency of cooperation.
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Administração Financeira , Resiliência Psicológica , Humanos , Comportamento Cooperativo , Eficiência , Seguridade Social , Teoria dos JogosRESUMO
Immortalized or continuous cell lines are invaluable tools in basic and preclinical research. However, the widespread use of misidentified cell lines is a serious threat to scientific reproducibility. Based on the experiences of mandatory cell line authentication at the International Journal of Cancer (IJC), we provide an overview of the issues pertinent to misidentified cell lines and discuss available solutions. We also summarize the lessons learned, revealing that at least 5% of the human cell lines used in manuscripts considered for peer review are misidentified. About 4% of the considered manuscripts are rejected for severe cell line problems, and most are subsequently published in other journals. In order to diminish such malpractice and its consequences for the scientific record, we postulate that strict multi-layered quality control is essential. Besides journals and publishers, we encourage scientists, research institutions, and funders to take action on the matter and revise their respective policies. Hence, we provide concrete recommendations on introducing regular authentication schemes and staff training, and discuss future steps for enhancing good cell culture practices.
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Pesquisa Biomédica , Autenticação de Linhagem Celular , Técnicas de Cultura de Células , Linhagem Celular , Humanos , Reprodutibilidade dos TestesRESUMO
Sexual conflict can arise when males evolve traits that improve their mating success but in doing so harm females. By reducing female fitness, male harm can diminish offspring production in a population and even drive extinction. Current theory on harm is based on the assumption that an individual's phenotype is solely determined by its genotype. But the expression of most sexually selected traits is also influenced by variation in biological condition (condition-dependent expression), such that individuals in better condition can express more extreme phenotypes. Here, we developed demographically explicit models of sexual conflict evolution where individuals vary in their condition. Because condition-dependent expression readily evolves for traits underlying sexual conflict, we show that conflict is more intense in populations where individuals are in better condition. Such intensified conflict reduces mean fitness and can thus generate a negative association between condition and population size. The impact of condition on demography is especially likely to be detrimental when the genetic basis of condition coevolves with sexual conflict. This occurs because sexual selection favors alleles that improve condition (the so-called good genes effect), producing feedback between condition and sexual conflict that drives the evolution of intense male harm. Our results indicate that in presence of male harm, the good genes effect in fact easily becomes detrimental to populations.
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Comunicação Celular , Reprodução , Feminino , Masculino , Animais , Alelos , Genótipo , Densidade DemográficaRESUMO
Machine learning (ML) techniques are increasingly prevalent in education, from their use in predicting student dropout to assisting in university admissions and facilitating the rise of massive open online courses (MOOCs). Given the rapid growth of these novel uses, there is a pressing need to investigate how ML techniques support long-standing education principles and goals. In this work, we shed light on this complex landscape drawing on qualitative insights from interviews with education experts. These interviews comprise in-depth evaluations of ML for education (ML4Ed) papers published in preeminent applied ML conferences over the past decade. Our central research goal is to critically examine how the stated or implied education and societal objectives of these papers are aligned with the ML problems they tackle. That is, to what extent does the technical problem formulation, objectives, approach, and interpretation of results align with the education problem at hand? We find that a cross-disciplinary gap exists and is particularly salient in two parts of the ML life cycle: the formulation of an ML problem from education goals and the translation of predictions to interventions. We use these insights to propose an extended ML life cycle, which may also apply to the use of ML in other domains. Our work joins a growing number of meta-analytical studies across education and ML research as well as critical analyses of the societal impact of ML. Specifically, it fills a gap between the prevailing technical understanding of machine learning and the perspective of education researchers working with students and in policy.
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Objetivos , Aprendizado de Máquina , Estudantes , HumanosRESUMO
Extracellular proteases are a class of public good that support growth of Bacillus subtilis when nutrients are in a polymeric form. Bacillus subtilis biofilm matrix molecules are another class of public good that are needed for biofilm formation and are prone to exploitation. In this study, we investigated the role of extracellular proteases in B. subtilis biofilm formation and explored interactions between different public good producer strains across various conditions. We confirmed that extracellular proteases support biofilm formation even when glutamic acid provides a freely available nitrogen source. Removal of AprE from the NCIB 3610 secretome adversely affects colony biofilm architecture, while sole induction of WprA activity into an otherwise extracellular protease-free strain is sufficient to promote wrinkle development within the colony biofilm. We found that changing the nutrient source used to support growth affected B. subtilis biofilm structure, hydrophobicity and architecture. We propose that the different phenotypes observed may be due to increased protease dependency for growth when a polymorphic protein presents the sole nitrogen source. We however cannot exclude that the phenotypic changes are due to alternative matrix molecules being made. Co-culture of biofilm matrix and extracellular protease mutants can rescue biofilm structure, yet reliance on extracellular proteases for growth influences population coexistence dynamics. Our findings highlight the intricate interplay between these two classes of public goods, providing insights into microbial social dynamics during biofilm formation across different ecological niches.
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Bacillus subtilis , Proteínas de Bactérias , Biofilmes , Matriz Extracelular , Peptídeo Hidrolases , Biofilmes/crescimento & desenvolvimento , Bacillus subtilis/genética , Bacillus subtilis/fisiologia , Bacillus subtilis/metabolismo , Proteínas de Bactérias/metabolismo , Proteínas de Bactérias/genética , Matriz Extracelular/metabolismo , Peptídeo Hidrolases/metabolismo , Peptídeo Hidrolases/genética , Nitrogênio/metabolismo , Interações Hidrofóbicas e Hidrofílicas , Ácido Glutâmico/metabolismo , Proteínas de Membrana TransportadorasRESUMO
Mesenchymal stem cells (MSCs) are one of the few stem cell types used in clinical practice as therapeutic agents for immunomodulation and ischemic tissue repair, due to their unique paracrine capacity, multiple differentiation potential, active components in exosomes, and effective mitochondria donation. At present, MSCs derived from tissues such as bone marrow and umbilical cord are widely applied in preclinical and clinical studies. Nevertheless, there remain challenges to the maintenance of consistently good quality MSCs derived from different donors or tissues, directly impacting their application as advanced therapy products. In this review, we discuss the promises, problems, and prospects associated with translation of MSC research into a pharmaceutical product. We review the hurdles encountered in translation of MSCs and MSC-exosomes from the research bench to an advanced therapy product compliant with good manufacturing practice (GMP). These difficulties include how to set up GMP-compliant protocols, what factors affect raw material selection, cell expansion to product formulation, establishment of quality control (QC) parameters, and quality assurance to comply with GMP standards. To avoid human error and reduce the risk of contamination, an automatic, closed system that allows real-time monitoring of QC should be considered. We also highlight potential advantages of pluripotent stem cells as an alternative source for MSC and exosomes generation and manufacture.
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Exossomos , Células-Tronco Mesenquimais , Humanos , Diferenciação Celular , Células-Tronco , Proliferação de CélulasRESUMO
Microbes encounter a wide range of polymeric nutrient sources in various environmental settings, which require processing to facilitate growth. Bacillus subtilis, a bacterium found in the rhizosphere and broader soil environment, is highly adaptable and resilient due to its ability to utilise diverse sources of carbon and nitrogen. Here, we explore the role of extracellular proteases in supporting growth and assess the cost associated with their production. We provide evidence of the essentiality of extracellular proteases when B. subtilis is provided with an abundant, but polymeric nutrient source and demonstrate the extracellular proteases as a shared public good that can operate over a distance. We show that B. subtilis is subjected to a public good dilemma, specifically in the context of growth sustained by the digestion of a polymeric food source. Furthermore, using mathematical simulations, we uncover that this selectively enforced dilemma is driven by the relative cost of producing the public good. Collectively, our findings reveal how bacteria can survive in environments that vary in terms of immediate nutrient accessibility and the consequent impact on the population composition. These findings enhance our fundamental understanding of how bacteria respond to diverse environments, which has importance to contexts ranging from survival in the soil to infection and pathogenesis scenarios.
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Bacillus subtilis , Peptídeo Hidrolases , Bacillus subtilis/genética , Endopeptidases , SoloRESUMO
Good leadership is important for the efficient functioning of an organization. PhD and postdoctoral research is a mentally challenging job, and a good mentor must be able to both treat students with compassion and provide motivation. Coronavirus disease 2019 (COVID-19) has resulted in the decline of the mental health of a large fraction of mentees.
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Liderança , Saúde Mental , Motivação , COVID-19 , Comunicação , Humanos , MentoresRESUMO
The growth and success of many bacteria appear to rely on a stunning range of cooperative behaviours. But what is cooperation and how is it studied?
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Altruísmo , Comportamento Cooperativo , Evolução Biológica , Bactérias/genéticaRESUMO
Many recent societal trends have led to the need for fertility education, including the age at which individuals become parents, the development of new reproductive technologies, and family diversity. Fertility awareness has emerged as a concept very recently and is increasingly gaining recognition. However, fertility education is often neglected as there is no consensus on the appropriate content, target populations, or on who should provide it. This article attempts to provide an overview of the use of interventions to improve fertility education. We emphasize the importance of delivering evidence-based information on fertility and reproductive health through various methods while providing guidelines for their standardization and systematization. Recommendations are provided to aid the development and implementation of fertility education tools, including: the establishment of a comprehensive understanding of the target populations; the incorporation of theories of behavioural change; the inclusion of the users' perspectives and the use of participatory research; and the use of specific guidelines for increasing engagement. By following these recommendations, it is expected that fertility education resources can contribute to improving fertility literacy, empowering individuals and couples to make informed reproductive decisions, and ultimately reducing the incidence of infertility and need for fertility treatment.
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Infertilidade , Alfabetização , Humanos , Fertilidade , Aconselhamento , Reprodução , Infertilidade/terapiaRESUMO
PURPOSE: We evaluated the efficacy of low-dose radiotherapy for painful shoulder syndrome from an orthopedic perspective. METHODS: Patients with painful shoulder syndrome were recruited for this retrospective clinical quality assessment from January 2011 to December 2017. Patients were treated with a linear accelerator or an orthovoltage device at individual doses of 0.5-1.0â¯Gy and total doses of 3.0-6.0â¯Gy. To assess response, we used the von Pannewitz score with five levels: "worsened," "unaffected," "improved," "significantly improved," and "symptom free." "Good treatment success" was defined as "significantly improved" and "symptom free." Within-group and between-group differences were statistically evaluated. RESULTS: Of 236 recruited patients (150 women, 86 men; mean age 66.3 [range 31-96] years), 180 patients underwent radiotherapy with a linear accelerator and 56 with an orthovoltage device. Fractionation was 12â¯× 0.5â¯Gy in 120 patients, 6â¯× 0.5â¯Gy in 74, and 6â¯× 1â¯Gy in 42 patients. Treatments were completed in one series for 223 and in two series at least 6 weeks apart for 13 patients. Of the 236 patients, 163 patients (69.1%) agreed to be re-interviewed at a median of 10.5 (range 4-60) months after radiotherapy completion. Directly after radiotherapy, 30.9% (73 patients) had "good treatment success," which had increased to 55.2% (90 patients) at follow-up. CONCLUSION: Protracted pain improvement with low-dose radiotherapy is possible in painful shoulder syndrome. Patients with refractory pain because of subacromial syndrome or shoulder osteoarthritis should also be evaluated for radiotherapy.
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BACKGROUND AIMS: The relationship between blood establishments and advanced cellular therapies is evident in several European countries, with some involved in research and development and/or in manufacturing. The aim of the present study was to understand the advanced therapy medicinal product (ATMP) infrastructural, regulatory and logistic requirements needed for the Irish Blood Transfusion Service to support advanced therapeutics in Ireland. METHODS: An online survey consisting of 13 questions was distributed in a targeted manner to the identified ATMP stakeholders in Ireland, namely those working in industry, health care, regulatory agencies or education. Subject matter experts in the field were approached and interviewed to gain further insight into the relationship between blood and tissue establishments (BTEs) and ATMPs, to explore the advantages these institutions have in development and to highlight potential challenges for implementation. RESULTS: In total, 84.9% of survey respondents stated that BTEs have a role in the development of advanced therapeutics. Key BTE services identified as applicable to the ATMP sector from both surveys and interviews include the provision of starting materials for research and manufacturing, donor management, use of existing quality and traceability frameworks, product logistic strategies and Good Manufacturing Practice. Challenges for BTE expansion into the sector currently include high costs associated with ATMPs, lack of expertise in these therapies, limited therapeutic populations and no national ATMP strategic plan for Ireland. CONCLUSIONS: Blood establishments have services and expertise that can be extended into the advanced therapy sector. The existing knowledge and skill base of BTEs in Ireland should be leveraged to accelerate the development of ATMP strategies for industry and healthcare.
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Terapia Baseada em Transplante de Células e Tecidos , Humanos , Irlanda , Inquéritos e Questionários , Terapia Baseada em Transplante de Células e Tecidos/métodos , Bancos de Sangue , Transfusão de Sangue/métodosRESUMO
BACKGROUND AIMS: Regulatory T cells (Tregs) are the main mediators of peripheral tolerance. Treg-directed therapy has shown promising results in preclinical studies of diverse immunopathologies. At present, the clinical applicability of adoptive Treg transfer is limited by difficulties in generating Tregs at sufficient cell dose and purity. METHODS: We developed a Good Manufacturing Practice (GMP) compliant method based on closed-system multiparametric Fluorescence-Activated Cell Sorting (FACS) to purify Tregs, which are then expanded in vitro and gene-marked with a clinical grade retroviral vector to enable in vivo fate tracking. Following small-scale optimization, we conducted four clinical-scale processing runs. RESULTS: We showed that Tregs could be enriched to 87- 92% purity following FACS-sorting, and expanded and transduced to yield clinically relevant cell dose of 136-732×106 gene-marked cells, sufficient for a cell dose of at least 2 × 106 cells/kg. The expanded Tregs were highly demethylated in the FOXP3 Treg-specific demethylated region (TSDR), consistent with bona fide natural Tregs. They were suppressive in vitro, but a small percentage could secrete proinflammatory cytokines, including interferon-γ and interleukin-17A. CONCLUSIONS: This study demonstrated the feasibility of isolating, expanding and gene-marking Tregs in clinical scale, thus paving the way for future phase I trials that will advance knowledge about the in vivo fate of transferred Tregs and its relationship with concomitant Treg-directed pharmacotherapy and clinical response.
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Citometria de Fluxo , Fatores de Transcrição Forkhead , Linfócitos T Reguladores , Linfócitos T Reguladores/imunologia , Humanos , Citometria de Fluxo/métodos , Fatores de Transcrição Forkhead/metabolismo , Fatores de Transcrição Forkhead/genética , Separação Celular/métodos , Vetores Genéticos/genéticaRESUMO
Since their first production in 2007, human induced pluripotent stem cells (iPSCs) have provided a novel platform for the development of various cell therapies targeting a spectrum of diseases, ranging from rare genetic eye disorders to cancer treatment. However, several challenges must be tackled for iPSC-based cell therapy to enter the market and achieve broader global adoption. This white paper, authored by the Japanese Society for Regenerative Medicine (JSRM) - International Society for Cell Therapy (ISCT) iPSC Committee delves into the hurdles encountered in the pursuit of safe and economically viable iPSC-based therapies, particularly from the standpoint of the cell therapy industry. It discusses differences in global guidelines and regulatory frameworks, outlines a series of quality control tests required to ensure the safety of the cell therapy, and provides details and important considerations around cost of goods (COGs), including the impact of automated advanced manufacturing.
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Terapia Baseada em Transplante de Células e Tecidos , Células-Tronco Pluripotentes Induzidas , Medicina Regenerativa , Humanos , Células-Tronco Pluripotentes Induzidas/citologia , Terapia Baseada em Transplante de Células e Tecidos/métodos , Medicina Regenerativa/métodos , Controle de QualidadeRESUMO
BACKGROUND: To evaluate the impact of embryo quality and quantity, specifically a poor quality embryo (PQE) in combination with a good quality embryo (GQE), by double embryo transfer (DET) on the live birth rate (LBR) and neonatal outcomes in patients undergoing frozen-thawed embryo transfer (FET) cycles. METHODS: A study on a cohort of women who underwent a total of 1462 frozen-thawed cleavage or blastocyst embryo transfer cycles with autologous oocytes was conducted between January 2018 and December 2021. To compare the outcomes between single embryo transfer (SET) with a GQE and DET with a GQE and a PQE, propensity score matching (PSM) was applied to control for potential confounders, and a generalized estimating equation (GEE) model was used to determine the association between the effect of an additional PQE and the outcomes. Subgroup analysis was also performed for patients stratified by female age. RESULTS: After PS matching, DET-GQE + PQE did not significantly alter the LBR (adjusted odds ratio [OR] 1.421, 95% CI 0.907-2.228) compared with SET-GQE in cleavage-stage embryo transfer but did increase the multiple birth rate (MBR, [OR] 3.917, 95% CI 1.189-12.911). However, in patients who underwent blastocyst-stage embryo transfer, adding a second PQE increased the live birth rate by 7.8% ([OR] 1.477, 95% CI 1.046-2.086) and the multiple birth rate by 19.6% ([OR] 28.355, 95% CI 3.926-204.790), and resulted in adverse neonatal outcomes. For patients who underwent cleavage-stage embryo transfer, transferring a PQE with a GQE led to a significant increase in the MBR ([OR] 4.724, 95% CI 1.121-19.913) in women under 35 years old but not in the LBR ([OR] 1.227, 95% CI 0.719-2.092). The increases in LBR and MBR for DET-GQE + PQE compared with SET-GQE in women older than 35 years were nonsignificant toward. For patients who underwent blastocyst-stage embryo transfer, DET-GQE + PQE had a greater LBR ([OR] 1.803, 95% CI 1.165-2.789), MBR ([OR] 24.185, 95% CI 3.285-178.062) and preterm birth rate (PBR, [OR] 4.092, 95% CI 1.153-14.518) than did SET-GQE in women under 35 years old, while no significant impact on the LBR ([OR] 1.053, 95% CI 0.589-1.884) or MBR (0% vs. 8.3%) was observed in women older than 35 years. CONCLUSIONS: The addition of a PQE has no significant benefit on the LBR but significantly increases the MBR in patients who underwent frozen-thawed cleavage-stage embryo transfer. However, for patients who underwent blastocyst-stage embryo transfer, DET-GQE + PQE resulted in an increase in both the LBR and MBR, which may lead to adverse neonatal outcomes. Thus, the benefits and risks of double blastocyst-stage embryo transfer should be balanced. In patients younger than 35 years, SET-GQE achieved satisfactory LBR either in cleavage-stage embryo transfer or blastocyst-stage embryo transfer, while DET-GQE + PQE resulted in a dramatically increased MBR. Considering the low LBR in women older than 35 years who underwent single cleavage-stage embryo transfer, selective single blastocyst-stage embryo transfer appears to be a more promising approach for reducing the risk of multiple live births and adverse neonatal outcomes.
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Fertilização in vitro , Nascimento Prematuro , Gravidez , Feminino , Humanos , Recém-Nascido , Adulto , Fertilização in vitro/métodos , Nascimento Prematuro/etiologia , Transferência Embrionária/métodos , Gravidez Múltipla , Transferência de Embrião Único/efeitos adversos , Nascido Vivo , Taxa de Gravidez , Estudos RetrospectivosRESUMO
INTRODUCTION: Thymic epithelial tumors (TETs) are rare neoplasms often associated with immune-related disorders. Patients with Good's syndrome (GS), an adult-acquired TET-related immunodeficiency, are at a high risk of mortality due to infectious diseases. This study aims to examine COVID-19 occurrence and severity in TET patients, with or without GS. METHODS: Clinical records of TET patients referred to the Regional Coordinating Center for Rare Tumors of Campania Region were retrospectively collected. During the observation period, elapsing from March 2020 to April 2023, the following data were collected: occurrence of SARS-CoV-2 infection; COVID-19 severity, according to the National Institute of Health (NIH) illness categories; COVID-19 treatment. COVID-19 occurrence and severity were assessed in the overall population and correlated with the presence of GS and/or other immune-related dysregulations. RESULTS: Overall, 47 TET patients were included in the study; 27 of these (57.4%) had GS. All participants had received a full cycle of mRNA vaccine for SARS-CoV2., Thirty-one patients (66.0%) experienced COVID-19, of whom 18 (58.0%) had previously received a diagnosis of GS. No significant association of GS and/or other immune-related dysregulations with SARS-CoV-2 infection occurrence was detected (Fisher's exact test p = 1 and p = 0.3587, respectively). Among patients with GS, 8 (45.0%) reported a COVID-19 severity score of ≥ 3; whereas, only 1 of the 13 patients without GS (7.7%) had a severity score of ≥ 3. The correlation between presence of GS and COVID-19 severity (score 1 or 2 vs. ≥ 3) was statistically significant (p = 0.0448). No statistically significant association between COVID-19 severity and other immune-related syndromes were found (p = 1). Of note, all the hospitalized patients for NIH 4 and 5 COVID-19 had GS. CONCLUSIONS: Our data suggest that TET patients, especially those with GS, require a careful multidisciplinary monitoring for SARS-CoV-2 infection, in order to establish tailored treatments and prophylactic protocols.
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COVID-19 , Neoplasias Epiteliais e Glandulares , Neoplasias do Timo , Humanos , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/imunologia , Neoplasias do Timo/complicações , Neoplasias do Timo/epidemiologia , Neoplasias do Timo/imunologia , Masculino , Estudos Retrospectivos , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Neoplasias Epiteliais e Glandulares/virologia , Neoplasias Epiteliais e Glandulares/patologia , SARS-CoV-2/isolamento & purificação , Índice de Gravidade de Doença , Doenças da Imunodeficiência Primária/complicações , Doenças da Imunodeficiência Primária/epidemiologia , Idoso de 80 Anos ou mais , Itália/epidemiologiaRESUMO
Viability indicator traits are expected to be integrated extensively across the genome yet sex-limited to ensure that any benefits are sexually concordant. Understanding how such expectations are accommodated requires elucidating the quantitative genetic architecture of candidate traits in and across the sexes. Here we applied an animal modelling approach to partition the autosomal, allosomal, and direct maternal bases of variation in sexual versus non-sexual dorsal wing colouration in the butterfly Eurema hecabe. The sexual colour trait-coherently scattered ultraviolet that is under strong directional selection due to female choice-is brighter and more expansive in males, and overlays non-sexual pigmentary yellow markings that otherwise dominate both wing surfaces in each sex. Our modelling estimated high and sexually equivalent autosomal variances for ultraviolet reflectance (furnishing h2 ~ 0.58 overall and ~0.75 in males), accompanied by smaller but generally significant Z-linked and maternal components. By contrast, variation in non-sexual yellow was largely attributed to Z-linked sources. Intersexual genetic correlations based upon the major source of variation in each trait were high and not different from 1.0, implying regulation by a pool of genes common to each sex. An expansive autosomal basis for ultraviolet is consistent with its hypothesized role as a genome-wide viability indicator and ensures that both sons and daughters will inherit their father's attractiveness.
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Borboletas , Pigmentação , Asas de Animais , Animais , Borboletas/genética , Borboletas/fisiologia , Masculino , Feminino , Pigmentação/genética , Caracteres Sexuais , Herança Materna/genética , Variação GenéticaRESUMO
Clinical embryology is a dynamic and ever-evolving field, and as such clinical practice guidelines must be regularly reviewed and updated. Accordingly, this document supersedes previous good clinical practice in clinical embryology guidance, developing, and updating where necessary, existing good practice guidelines. The Association of Reproductive and Clinical Scientists (ARCS) suggests this Good Laboratory Practice framework as appropriate and effective to ensure the best possible care for all individuals undertaking fertility treatment. Efforts have been made to ensure that the language used is inclusive and reflective of the wide range of patients who seek treatment. The guidance provided within this document aims to be relevant within an international context and to consider the range of regulatory considerations affecting clinical embryology laboratories. This guideline was written to guide best practice but is not intended as a tool to judge the practice of centres within the UK or beyond.
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RESEARCH QUESTION: Does the co-transfer of a good-quality embryo and a poor-quality embryo influence pregnancy outcomes in comparison to the transfer of a single good-quality embryo in vitrified-warmed blastocyst transfer cycles? DESIGN: This retrospective cohort study involved a total of 11,738 women who underwent IVF/intracytoplasmic sperm injection cycles and vitrified-warmed blastocyst transfer at a tertiary-care academic medical from January 2015 to June 2022. The study population was categorized into two groups: single-blastocyst transfer (SBT; participants who underwent single good-quality embryo transfer, nâ¯=â¯9338) versus double-blastocyst transfer (DBT; participants who underwent transfers with a poor and a good-quality embryo, nâ¯=â¯2400). RESULTS: The live birth rate (LBR) was significantly higher in the DBT group in comparison with the SBT group (65.6% versus 56.3%, P < 0.001). Multivariable logistic regression analysis showed that DBT was an independent predictor for LBR with a strong potential impact (adjusted odds ratio 1.55, 95% confidence interval 1.41-1.71; P < 0.001). However, the multiple birth rate was significantly higher in the good-quality embryo and poor-quality embryo group compared with patients undergoing a single good-quality embryo transfer (41.4% versus 1.8%; P < 0.001). CONCLUSIONS: In vitrified-warmed blastocyst transfer cycles, LBR was higher following DBT with one good-quality and one poor-quality embryo compared with SBT. However, this was at the expense of a marked increase in the likelihood of multiple gestations. Physicians should still balance the benefits and risks of double-embryo transfer.
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Transferência Embrionária , Resultado da Gravidez , Vitrificação , Humanos , Feminino , Gravidez , Adulto , Transferência Embrionária/métodos , Estudos Retrospectivos , Taxa de Gravidez , Coeficiente de Natalidade , Blastocisto , Fertilização in vitro/métodos , CriopreservaçãoRESUMO
Process design strategies are important to prevent or reduce food safety risks in production systems. In this sense, the Codex Alimentarius presents a set of principles for good hygiene practices to guide food producers. However, studies in food safety often focus on analyzing and controlling implemented production processes without a policy of designing them with a preventive logic, leading to resource misallocation and noncompliance. This study aims to gather and analyze techniques, drivers, challenges, and research opportunities for food safety-driven process design. A systematic literature review was carried out following three steps: (i) Data collection, including 52 studies; (ii) Bibliometric analysis; and (iii) Content analysis, identifying techniques, drivers, challenges, and research opportunities. Three main themes in the subject were identified: process assessment models, risk assessment, and whole-chain traceability. Eleven design techniques were identified and compared according to their typology, structure, and coverage of themes addressed by the Codex Alimentarius. There is a gap in techniques addressing employee competence and personal hygiene. We suggest developing a tool encompassing the Codex Alimentarius good hygiene practices themes in process design to guide food safety-driven process development.