Cumulative live birth rates with autologous oocytes plateau with fewer number of cycles for each year of age > 42.

OBJECTIVE: To disaggregate the Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) age category of " > 42" and compare age-stratified cumulative live birth rates (CLBR) > 42 years old. DESIGN: Retrospective cohort study of autologous linked ART cycles. SETTING: United States (US) National ART Database. PATIENT(S): Women > 42 years old without a history of prior ART cycles who underwent ART between 2014-2020 as reported to the SART CORS database. INTERVENTION(S): Disaggregate the SART CORS age category of " > 42" into age-stratified cumulative live birth rates (CLBR). MAIN OUTCOME MEASURE(S): Age-stratified cumulative live birth rates (CLBR) for women ≥ 43 years old. RESULTS: Between 2014-2020, 24,650 women > 42 years old without history of prior ART underwent 58,132 cycles, resulting in 1,982 live births. Women ages 43, 44, 45, 46, 47, 48, 49, ≥ 50 achieved maximal CLBR of 9.7%, 8.6%, 5.0%, 3.6%, 2.5%, 1.5%, 2.7%, 1.3%, respectively. CLBR for women between 43-45 were significantly higher compared to those 46 and older (p < 0.05). Among women 46 and older, CLBR were not significantly different. Women ages 43 and 44 did not exhibit a significant increase in CLBR beyond the 5th cycle. Age 45 and 46 reached CLBR plateau by the 3rd cycle. Age ≥ 47 CLBR plateaued after the first cycle. After adjusting for age, race/ethnicity, BMI, nulliparity, etiology of infertility, number of oocytes retrieved, embryos transferred, blastocyst transfer, use of ICSI, PGT, and ART treatment cycle number, there was no association between markers of ovarian reserve (day 3 FSH and random AMH levels) and live birth for women > 42. CONCLUSIONS: While CLBR of autologous cycles from women 42 or younger generally plateau by cycle number 5, age-stratified cycles from women > 42 plateau after fewer cycles to maximize CLBR. Patient and physician expectations for maximum CLBR beyond 42 may be practically based on fewer planned cycles before reaching an age-specific CLBR plateau than may have been previously expected.

Low E-visibility of embryologists on fertility clinic websites: a web-based cross-sectional study.

PURPOSE: This study assessed the visibility of embryologists on fertility clinic websites among Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member clinics. METHODS: During a 1-month interval (March 2022), all Society for Assisted Reproductive Technology (SART) and the Human Fertilisation and Embryology Authority (HFEA) member fertility clinic websites were evaluated. The professional representation of the primary care team was examined including specialties, the presence of headshots, and biographies. RESULTS: A total of 446 fertility clinic websites were scanned in the search. The embryology team has the least common professional identification by their names (53.58%) compared to gynecology clinicians (96.21%, p < 0.001) and nurses (55.58%, p < 0.001). This trend also applies to other types of professional identifiers, such as headshots and biographies. Professional headshots of embryologists (50.34%) were less prominent than those of gynecology clinicians (93.51%, p < 0.001). A similar trend was observed in the biographies of the embryology team (47.20%) compared to gynecology clinicians (95.08%, p < 0.001). CONCLUSION: The present study revealed that embryologists have low professional visibility on fertility clinic websites. Fertility clinics may prioritize enhancing the online visibility of their embryology laboratory team. This approach could potentially enhance the recognition of their team, foster transparency, and provide accessible information about the skills and expertise of healthcare professionals involved in the treatment process.

The Role of State and Trait Self-Control on the Sustained Attention to Response Task.

OBJECTIVE: This study aimed to assess the plausibility of self-control depletion, or ego-depletion, as the underlying cognitive resource responsible for performance decrements on the sustained attention to response task. BACKGROUND: Researchers suggested that self-control is a limited cognitive resource used to complete a myriad of processes, including sustained attention. Past research showed that trait self-control affects some sustained attention tasks. However, little research has investigated the effect of self-control as a limited cognitive resource that varies over time (i.e., as a state-dependent variable). METHODS: This experiment investigated the effect of self-control (trait and state) on a sustained motor-inhibition task (e.g., sustained attention to response task; SART). State self-control was manipulated using a between-subjects design-participants in the experimental condition completed a task designed to deplete state self-control prior to performing the SART while the control condition completed a modified version that did not deplete self-control. RESULTS: Trait self-control predicted performance on the SART, but the depletion task (state self-control) had no detectable effect. CONCLUSION: Given the evidence, it is unlikely that state self-control plays a causal role in performance decrements in the SART, but there appears to be some association between performance on the SART and trait self-control. APPLICATION: Trait self-control ought to be considered in future work for personnel selection in real-world tasks that the SART models such as long-distance driving, air traffic control, and TSA operations.

Using eye movements to evaluate the effectiveness of the situation awareness rating technique scale in measuring situation awareness for smart manufacturing.

Physiological indicators, including eye-tracking measures, may provide insight into human internal states in many domains, such as smart manufacturing. The Situation Awareness Rating Technique (SART) scale has been criticised for not assessing situation awareness (SA) accurately. In this study, we investigated the precision of the SART scale for assessing SA by comparing the scores to eye movement data. Thirty participants were recruited to complete a process plant monitoring task. Participants' eye movements and SART scores were recorded and analysed. Our results moderately supported the idea that the SART scale did not accurately measure SA. We found that four dimensions in the SART scale need to be revised to reflect real SA, which may partially solve the divergence between objective and subjective SA measurements. Moreover, these findings provided solutions for designing a revised SART scale to measure the internal states of operators for smart manufacturing. Practitioner summary: Situation awareness (SA) is a critical component of decision-making and performance for smart manufacturing. The present study examines the relationships among eye movement, the SART scale, and SA for smart manufacturing in a refinery control room.

SART CORS IVF registry: looking to the past to shape future perspectives.

PURPOSE: The SART CORS database is an informative source of IVF clinic-specific linked data that provides cumulative live birth rates from medically assisted reproduction in the United States (US). These data are used to develop best practice guidelines, for research, quality assurance, and post-market surveillance of assisted reproductive technologies. Here, we sought to investigate the key areas of current research focus (higher-order categories), discover gaps or underserved areas of ART research, and examine the potential application and impact of newer ART adjuvants, future data collection, and analysis needs. METHODS: We conducted a systematic review (PRISMA guidelines) to quantify unique output metrics of the SART CORS database. Included were SART member reporting clinics: full-length publications from 2004 to 2021 and conference abstracts from 2015 to 2021, the two key timepoints when the SART CORS database underwent transformative shifts in data collection. RESULTS: We found 206 abstracts presented from 2015 to 2021, 189 full-length peer-reviewed publications since 2004, with 654 unique authors listed on these publications. A total of 19 publications have been highly impactful, garnering over 100 citations at the time of writing. Several higher-order categories, such as endometriosis and tubal infertility, have few publications. The conversion of conference abstracts to full-length papers ranged from 15 to 35% from 2015 to 2021. CONCLUSIONS: A substantial body of literature has been generated by analyzing the SART CORS database. Full-length publications have increased year over year. Some topic areas, such as endometriosis and tubal infertility, may be underrepresented. Conversion of conference abstracts to full-length publications has been low, indicating that more organizational support may be needed to ensure that research is methodologically sound and researchers supported to reach full publication status.

Novel function of SART1 in HNF4α transcriptional regulation contributes to its antiviral role during HBV infection.

BACKGROUND & AIMS: Our understanding of the interactions between HBV and its host cells is still quite limited. Spliceosome associated factor 1 (SART1) has recently been found to restrict HCV. Thus, we aimed to dissect its role in HBV infection. METHODS: SART1 was knocked down by RNA interference and over-expressed by lentiviral or adeno-associated virus (AAV) vectors in HBV-infected cell cultures and in vivo in HBV-infected mice. Luciferase reporter assays were used to determine viral or host factor promoter activities, and chromatin immunoprecipitation (ChIP) was used to investigate protein-DNA interactions. RESULTS: In HBV-infected cell cultures, downregulation of SART1 did not affect covalently closed circular HBV DNA but resulted in markedly enhanced HBV RNA, antigen expression and progeny virus production. On the other hand, HBV transcription and replication were significantly inhibited by overexpression of SART1. Similar results were observed in AAV-HBV-infected mice persistently replicating HBV. Inhibition of Janus kinases had no effect on SART1-mediated inhibition of HBV replication. HBV promoter assays revealed that SART1 reduced HBV core promoter activity. By screening known HBV transcription factors, we found that SART1 specifically suppressed the expression of hepatocyte nuclear factor 4α (HNF4α). Luciferase reporter and ChIP assays demonstrated a direct downregulation of HNF4α expression by association of SART1 with the HNF4α proximal P1 promoter element. CONCLUSIONS: We identify SART1 as a novel host factor suppressing HBV cccDNA transcription. Besides its effect on interferon-stimulated genes, SART1 exerts an anti-HBV activity by suppressing HNF4α expression, which is essential for transcription of HBV cccDNA. LAY SUMMARY: Hepatitis B virus (HBV) infects hepatocytes and persists in the form of covalently closed circular DNA (cccDNA), which remains a major obstacle to successful antiviral treatment. In this study, using various HBV models, we demonstrate that the protein SART1 restricts HBV cccDNA transcription by suppressing a key transcription factor, HNF4α.

Utilization of preimplantation genetic testing in the USA.

PURPOSE: To evaluate the use of preimplantation genetic testing (PGT) and live birth rates (LBR) in the USA from 2014 to 2017 and to understand how PGT is being used at a clinic and state level. METHODS: This study accessed SART data for 2014 to 2017 to determine LBR and the CDC for years 2016 and 2017 to identify PGT usage. Primary cycles included only the first embryo transfer within 1 year of an oocyte retrieval; subsequent cycles included transfers occurring after the first transfer or beyond 1 year of oocyte retrieval. RESULTS: In the SART data, the number of primary PGT cycles showed a significant monotonic annual increase from 18,805 in 2014 to 54,442 in 2017 (P = 0.042) and subsequent PGT cycles in these years increased from 2946 to 14,361 (P = 0.01). There was a significant difference in primary PGT cycle use by age, where younger women had a greater percentage of PGT treatment cycles than older women. In both PGT and non-PGT cycles, the LBR per oocyte retrieval decreased significantly from 2014 to 2017 (P<0001) and younger women had a significantly higher LBR per oocyte retrieval compared to older women (P < 0.001). The CDC data revealed that in 2016, just 53 (11.4%) clinics used PGT for more than 50% of their cycles, which increased to 99 (21.4%) clinics in 2017 (P< 0.001). CONCLUSIONS: A growing number of US clinics are offering PGT to their patients. These findings support re-evaluation of the application for PGT.

The RNA-binding protein SART3 promotes miR-34a biogenesis and G1 cell cycle arrest in lung cancer cells.

MicroRNAs (miRNAs or miRs) are small, noncoding RNAs that are implicated in the regulation of most biological processes. Global miRNA biogenesis is altered in many cancers, and RNA-binding proteins play a role in miRNA biogenesis, presenting a promising avenue for targeting miRNA dysregulation in diseases. miR-34a exhibits tumor-suppressive activities by targeting cell cycle regulators CDK4/6 and anti-apoptotic factor BCL-2, among other regulatory pathways such as Wnt, TGF-ß, and Notch signaling. Many cancers exhibit down-regulation or loss of miR-34a, and synthetic miR-34a supplementation has been shown to inhibit tumor growth in vivo However, the post-transcriptional mechanisms that cause miR-34a loss in cancer are not entirely understood. Here, using a proteomics-mediated approach in non-small-cell lung cancer (NSCLC) cells, we identified squamous cell carcinoma antigen recognized by T-cells 3 (SART3) as a putative pre-miR-34a-binding protein. SART3 is a spliceosome recycling factor and nuclear RNA-binding protein with no previously reported role in miRNA regulation. We found that SART3 binds pre-miR-34a with higher specificity than pre-let-7d (used as a negative control) and elucidated a new functional role for SART3 in NSCLC cells. SART3 overexpression increased miR-34a levels, down-regulated the miR-34a target genes CDK4/6, and caused a cell cycle arrest in the G1 phase. In vitro binding experiments revealed that the RNA-recognition motifs within the SART3 sequence are responsible for selective pre-miR-34a binding. Our results provide evidence for a significant role of SART3 in miR-34a biogenesis and cell cycle progression in NSCLC cells.

Potential regulatory factors in the pathogenesis of ankylosing spondylitis.

Ankylosing spondylitis (AS) is a chronic rheumatic disease that mainly affects the spinal joints (vertebrae). Spondylitis means inflammation of the spine, and ankylosing spondylitis means that bones tend to fuse. The AS causes the vertebrae to swell in the spine. Therefore, based on protein interaction network analysis, we conducted in-depth research on the molecular mechanism of key regulatory factors in the AS disease process. We carried out a differential analysis of the expression of miRNAs in disease samples and miRNAs in normal samples. Protein network interaction analysis is performed according to a group of target genes regulated by significant differentially expressed miRNAs and clustered into an interaction module. In addition, enrichment analysis of functions and pathways was performed on these modular genes. Based on the predictive analysis of multidimensional regulators, we identified a range of regulatory factors that have potential regulatory effects on AS, such as endogenous genes and transcription factors. We obtained 20 differentially expressed miRNAs and 7082 target genes and clustered into 11 modules. Enrichment results showed that these modular genes are mainly involved in the functions and pathways of protein polyubiquitination, neutrophil activation involved in immune response, and Wnt signaling pathway. We revealed ten transcription factors (MYC, NFKB1, and TP53). After network connectivity analysis, we obtained 12 internal drive genes (UBE2D1, CCNF, and NEDD4). These core genes are thought to be potential regulators of AS. MYC is also considered to be a core factor that inhibits SART3 phosphorylation and plays a vital role in the immunological pathogenesis of AS. The combination of the above analysis results can provide a new idea for biologists and medical scientists to study the immune pathogenesis of AS and can provide a valuable reference for subsequent treatment options.

rs2072580T>A Polymorphism in the Overlapping Promoter Regions of the SART3 and ISCU Genes Associated with the Risk of Breast Cancer.

We analyzed association of potentially regulatory polymorphisms (rs590352, rs11542583, rs3829202, rs207258, and rs4796672) with breast cancer. A significant association was found between this disease and rs2072580T>A (p=0.001) located in the overlapping promoter regions of the SART3 and ISCU genes. In women with AA and AT genotypes, the risk of breast cancer is higher by 6.7 times (p=0.001) and 12 times (p=0.001), respectively, in comparison with TT genotype. Under a codominant model of inheritance (AT vs AA+TT), the risk of breast cancer was increased by 4.2 times (р=0.001) for the AT genotype. Under a recessive model of inheritance (TT vs AA+TT), the risk of disease was 10-fold higher (р=0.001) for the TT genotype. It has been demonstrated that the T>A substitution affects the binding properties of transcription factors CREB1 and REST.

Tip110/SART3 regulates IL-8 expression and predicts the clinical outcomes in melanoma.

Tip110, an important regulator of several oncogenic proteins, was significantly downregulated in human metastatic melanoma cells exposed to a hypoxic condition. Therefore, in this study, we set to determine whether differential expression of Tip110 could be an important indicator for melanoma tumorigenesis and metastasis. We found that in melanoma, but not in other cancer types, Tip110 knockdown enhanced significant expression and secretion of IL-8 and melanoma cells invasions. This induction was further potentiated under hypoxia and by inflammatory cytokine and found independent of TNF-α autocrine signaling. We further showed that Tip110 knockdown-mediated IL-8 induction involved IL-8 mRNA stability. Furthermore, the transcriptomic profiling data and survival from 455 melanoma patients demonstrated that the correlation between Tip110 expression and the clinical outcomes in melanoma was stage-dependent. These findings uncover important roles of Tip110 in melanoma tumorigenesis and metastasis through regulation of IL-8 and hope to provide new clues for future therapeutic strategies.

Stress enhances gait disturbance induced by lumbar disc degeneration in rat.

PURPOSE: Although psychological factors are assumed to be the primary cause of stress-related back pain, there have been no studies of the relationships between stress and low back pain in an animal model. The purpose of this study was to examine the influence of specific alternation of rhythm in temperature (SART) stress on gait abnormality using the CatWalk method in a rat model of low back pain caused by lumbar facetectomy. METHODS: Sixty rats were divided into three groups: the control, sham and experimental groups. Each group was then divided into non-SART stress and SART stress subgroups. We evaluated the behavioral changes 7 weeks postoperatively using the von Frey test and the CatWalk method. RESULTS: Threshold values for the hind paw in the SART stress subgroups were significantly lower than those in the non-SART stress subgroups. In the experimental group, significant changes by CatWalk in step cycle, stand time and average speed were observed under non-SART stress conditions, but SART stress resulted in additional significant changes in not only these parameters, but in other parameters including the duty cycle and swing time, compared with those in the control and sham groups. CONCLUSIONS: The demonstration by CatWalk analysis may indicate that SART stress enhanced gait disturbance. In this animal model, we demonstrated for the first time that stress may be a factor involved in worsening of low back pain.

Birth outcomes of singleton vaginal deliveries to ART-treated, subfertile, and fertile primiparous women.

PURPOSE: To determine whether differences in birth outcomes among assisted reproductive technology (ART)-treated, subfertile, and fertile women exist in primiparous women with, singleton, vaginal deliveries. METHODS: Society for Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) data were linked to Massachusetts vital records and hospital discharges for deliveries between July 2004 and December 2010. Primiparous women with in-state vaginal deliveries, adequate prenatal care, and singleton birth at ≥ 20 weeks (n = 117,779) were classified as ART-treated (linked to ART data from SART CORS, n = 3138); subfertile (not ART-treated but with indicators of subfertility, n = 1507); or fertile (neither ART-treated nor subfertile, n = 113,134). Outcomes of prematurity (< 37 weeks), low birthweight (< 2500 g), perinatal death (death at ≥ 20 weeks to ≤ 7 days), and maternal prolonged length of hospital stay (LOS > 3 days) were compared using multivariable logistic regression. RESULTS: Compared to fertile, higher odds were found for prematurity among ART-treated (adjusted odds ratio [AOR] 1.40, 95% confidence interval [CI] 1.25-1.50) and subfertile (AOR 1.25, 95% CI 1.03-1.50) women, low birthweight among ART-treated (AOR 1.41, 95% CI 1.23-1.62) and subfertile (AOR 1.40, 95% CI 1.15-1.71) women, perinatal death among subfertile (AOR 2.64, 95% CI 1.72-4.05), and prolonged LOS among ART-treated (AOR 1.33, 95% CI 1.19-1.48) women. Differences remained despite stratification by young age and absence of pregnancy/delivery complications. CONCLUSIONS: Greater odds of prematurity and low birthweight in ART-treated and subfertile, and perinatal death in subfertile deliveries are evident among singleton vaginal deliveries. The data suggest that even low-risk pregnancies to ART-treated and subfertile women be managed for adverse outcomes.

Earlier day of blastocyst development is predictive of embryonic euploidy across all ages: essential data for physician decision-making and counseling patients.

PURPOSE: The purpose of this study is to evaluate whether day of blastocyst development is associated with embryo chromosomal status as determined by high-density oligonucleotide microarray comparative genomic hybridization (aCGH). METHODS: This is a retrospective cohort analysis, including women who underwent in vitro fertilization (IVF) with trophectoderm biopsy at a single private fertility center from January 2014 to December 2014. Repeat cycles were excluded. Cycles were assessed for percentage of blastocysts biopsied on days 5, 6, or 7 and rate of euploid embryos per cycle. Cycles were stratified by Society for Assisted Reproductive Technology (SART) age groups (< 35, 35-37, 38-40, 41-42, > 42) and by donor status. RESULTS: A total of 388 IVF cycles and 2132 biopsied blastocysts were evaluated. The percentages of blastocysts biopsied on days 5, 6, and 7 were 62.5, 35.8, and 1.7%, respectively. Blastocyst euploid rates on days 5, 6, and 7 were 49.5, 36.5, and 32.9%, respectively. Earlier blastocyst development was associated with a significantly increased euploid rate (p < 0.0001). Younger maternal age (p < 0.0001) and higher number of blastocysts biopsied per patient (p = 0.0063) were both independently associated with greater percentage of euploidy. CONCLUSIONS: Earlier blastocyst development is independently associated with a higher likelihood of embryonic euploidy in both autologous and donor embryos. In non-biopsied embryos, these data support selection of day 5 blastocysts for transfer over later-developing embryos. These results can assist with patient counseling regarding expectations and outcomes. To our knowledge, this is the first study to examine embryonic euploidy as stratified by both day of blastocyst development and SART age group.

Comparison of perinatal outcomes following frozen embryo transfer cycles using autologous versus donor oocytes in women 40 to 43 years old: analysis of SART CORS data.

OBJECTIVE: To study the differences in perinatal outcomes after frozen embryo transfer cycles using autologous or donor oocytes in women of advanced maternal age. DESIGN: Historical cohort study. SETTING: US national database from the Society of Assisted Reproductive Technology Clinic Outcome Reporting System (SART CORS) from 2009 to 2013. PATIENT(S): Women at 40-43 years of age undergoing autologous frozen embryo transfers (a-FET) or donor oocyte frozen embryo transfers (d-FET) resulting in singleton pregnancies that were entered in the SART CORS database from 2009 to 2013. RESULTS: a-FET resulted in 4402 singleton live births whereas d-FET resulted in 2703 singleton live births. d-FET resulted in a higher risk of preterm births (< 37 weeks), with adjusted odds ratio (aOR) 1.33 (95% CI 1.02-1.75), but similar risk of small for gestational age (SGA), with aOR 1.75 (95% CI 0.85-3.7), when compared to a-FET. However, when only single blastocyst transfer cycles are considered, d-FET and a-FET showed no difference in preterm births or other adverse perinatal outcomes. CONCLUSIONS: Singletons resulting from d-FET are at increased risk for perinatal morbidity. However, the risk was diminished in single blastocyst transfer cycles. Our study supports the current American Society for Reproductive Medicine (ASRM) guidelines of transferring a single blastocyst in d-FET cycles.

Spherically symmetric volume elements as basis functions for image reconstructions in computed laminography.

BACKGROUND: Laminography is a tomographic technique that allows three-dimensional imaging of flat and elongated objects that stretch beyond the extent of a reconstruction volume. Laminography images can be reconstructed using iterative algorithms based on the Kaczmarz method. OBJECTIVE: This study aims to develop and demonstrate a new reconstruction algorithm that may provide superior image reconstruction quality for this challenged imaging application. METHODS: The images are initially represented using the coefficients over basis functions, which are typically piecewise constant functions (voxels). By replacing voxels with spherically symmetric volume elements (blobs) based on the generalized Kaiser-Bessel window functions, the images are reconstructed using this new adapted version of the algebraic image reconstruction technique. RESULTS: Band-limiting properties of blob functions are beneficial particular in the case of noisy projections and with only a limited number of available projections. Study showed that using blob basis functions improved full-width-at-half-maximum resolution from 10.2±1.0 to 9.9±0.9 (p < 0.001). Signal-to-noise ratio also improved from 16.1 to 31.0. The increased computational demand per iteration was compensated by using a faster convergence rate, such that the overall performance is approximately identical for blobs and voxels. CONCLUSIONS: Despite the higher complexity, tomographic reconstruction from computed laminography data should be implemented using blob basis functions, especially if noisy data is expected.

Use of ICSI in IVF cycles in women with tubal ligation does not improve pregnancy or live birth rates.

STUDY QUESTION: Does ICSI improve outcomes in ART cycles without male factor, specifically in couples with a history of tubal ligation as their infertility diagnosis? SUMMARY ANSWER: The use of ICSI showed no significant improvement in fertilization rate and resulted in lower pregnancy and live birth (LB) rates for women with the diagnosis of tubal ligation and no male factor. WHAT IS KNOWN ALREADY: Prior studies have suggested that ICSI use does not improve fertilization, pregnancy or LB rates in couples with non-male factor infertility. However, it is unknown whether couples with tubal ligation only diagnosis and therefore iatrogenic infertility could benefit from the use of ICSI during their ART cycles. STUDY DESIGN, SIZE, DURATION: Longitudinal cohort of nationally reported cycles in the Society for Assisted Reproductive Technology Clinic Outcomes Reporting System (SART CORS) of ART cycles performed in the USA between 2004 and 2012. PARTICIPANTS/MATERIALS, SETTING, METHODS: There was a total of 8102 first autologous fresh ART cycles from women with the diagnosis of tubal ligation only and no reported male factor in the SART database. Of these, 957 were canceled cycles and were excluded from the final analysis. The remaining cycles were categorized by the use of conventional IVF (IVF, n = 3956 cycles) or ICSI (n = 3189 cycles). The odds of fertilization, clinical intrauterine gestation (CIG) and LB were calculated by logistic regression modeling, and the adjusted odds ratios (AORs) with 95% confidence intervals were calculated by adjusting for the confounders of year of treatment, maternal age, race and ethnicity, gravidity, number of oocytes retrieved, day of embryo transfer and number of embryos transferred. MAIN RESULTS AND THE ROLE OF CHANCE: The main outcome measures of the study were odds of fertilization (2PN/total oocytes), clinical intrauterine gestation (CIG/cycle) and live birth (LB/cycle). The fertilization rate was higher in the ICSI versus IVF group (57.5% vs 49.1%); however, after adjustment this trend was no longer significant (AOR 1.14, 0.97-1.35). Interestingly, both odds of CIG (AOR 0.78, 0.70-0.86), and odds of LB were lower (AOR 0.77, 0.69-0.85) in the ICSI group. Plurality at birth, mean length of gestation and birth weight did not differ between the two groups. LIMITATIONS, REASONS FOR CAUTION: This was a retrospective study, therefore only the available parameters could be included, with parameters of interest such as smoking status not available for inclusion. Smoking status may have led practitioners to use ICSI to improve pregnancy and LB outcomes. WIDER IMPLICATIONS OF THE FINDINGS: Studies have shown that in the USA there is an increasing usage of ICSI for non-male factor infertility despite a lack of evidence-based benefit. Our study corroborates this increasing use over the last 8 years, specifically in the tubal ligation only patient population. Even after adjusting for multiple confounders, the patients who underwent ICSI had no statistically significant improvement in fertilization rate and actually had a lower likelihood of achieving a clinical pregnancy and LB. Therefore, our data suggest that the use of ICSI in tubal ligation patients has no overall benefit. This study contributes to the body of evidence that the use of ICSI for non-male factor diagnosis does not improve ART outcomes over conventional IVF. STUDY FUNDING/COMPETING INTERESTS: None.

Go-stimuli proportion influences response strategy in a sustained attention to response task.

The sustained attention to response task (SART) usefulness as a measure of sustained attention has been questioned. The SART may instead be a better measure of other psychological processes and could prove useful in understanding some real-world behaviours. Thirty participants completed four Go/No-Go response tasks much like the SART, with Go-stimuli proportions of .50, .65, .80 and .95. As Go-stimuli proportion increased, reaction times decreased while both commission errors and self-reported task-related thoughts increased. Performance measures were associated with task-related thoughts but not task-unrelated thoughts. Instead of faster reaction times and increased commission errors being due to absentmindedness or perceptual decoupling from the task, the results suggested participants made use of two competing response strategies, in line with a response strategy or response inhibition perspective of SART performance. Interestingly, performance measures changed in a nonlinear manner, despite the linear Go proportion increase. A threshold may exist where the prepotent motor response becomes more pronounced, leading to the disproportionate increase in response speed and commission errors. This research has implications for researchers looking to employ the SART and for more applied contexts where the consequences of response inhibition failures can be serious.

The Attention-Lapse and Motor Decoupling accounts of SART performance are not mutually exclusive.

There is an ongoing debate about the mechanisms purported to underlie performance in the Sustained-Attention-to-Response Task (SART). Whereas the Attention-Lapse account posits that SART errors result from attentional disengagement, the Motor Decoupling account proposes that SART errors result from failures to inhibit a fast, prepotent motor response, despite adequate attention to the task. That SART performance might be fully accounted for by motor decoupling is problematic for a Attention-Lapse account, and for the use of the SART as an index of attention lapses. To test whether SART performance is in fact fully accounted for by motor decoupling, I examined the relation between SART performance and attention lapses while controlling for motor decoupling. The results were clear: The SART was associated with attention lapses independently of motor decoupling. Thus, the present study suggests that both accounts are correct and that the SART is a valid measure of attention lapses.

The effect of task-relevant and irrelevant anxiety-provoking stimuli on response inhibition.

The impact of anxiety-provoking stimuli on the Sustained Attention to Response Task (SART; Robertson, Manly, Andrade, Baddeley, & Yiend, 1997), and response inhibition more generally, is currently unclear. Participants completed four SARTs embedded with picture stimuli of two levels of emotion (negative or neutral) and two levels of task-relevance (predictive or non-predictive of imminent No-Go stimuli). Negative pictures had a small but detectable adverse effect on performance regardless of their task-relevance. Overall, response times and rates of commission errors were more dependent upon the predictive value (relevance) of the pictures than their attention-capturing nature (i.e., negative valence). The findings raise doubt over whether anxiety improves response inhibition, and also lend support to a response strategy perspective of SART performance, as opposed to a mindlessness or mind-wandering explanation.