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PURPOSE: To dynamically assess the evolution of live birth predictive factors' impact throughout the in vitro fertilization (IVF) process, for each fresh and subsequent frozen embryo transfers. METHODS: In this multicentric study, data from 13,574 fresh IVF cycles and 6,770 subsequent frozen embryo transfers were retrospectively analyzed. Fifty-seven descriptive parameters were included and split into four categories: (1) demographic (couple's baseline characteristics), (2) ovarian stimulation, (3) laboratory data, and (4) embryo transfer (fresh and frozen). All these parameters were used to develop four successive predictive models with the outcome being a live birth event. RESULTS: Eight parameters were predictive of live birth in the first step after the first consultation, 9 in the second step after the stimulation, 11 in the third step with laboratory data, and 13 in the 4th step at the transfer stage. The predictive performance of the models increased at each step. Certain parameters remained predictive in all 4 models while others were predictive only in the first models and no longer in the subsequent ones when including new parameters. Moreover, some parameters were predictive in fresh transfers but not in frozen transfers. CONCLUSION: This work evaluates the chances of live birth for each embryo transfer individually and not the cumulative outcome after multiple IVF attempts. The different predictive models allow to determine which parameters should be taken into account or not at each step of an IVF cycle, and especially at the time of each embryo transfer, fresh or frozen.
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Tasa de Natalidad , Nacimiento Vivo , Transferencia de Embrión , Femenino , Fertilización In Vitro , Humanos , Nacimiento Vivo/epidemiología , Embarazo , Índice de Embarazo , Estudios RetrospectivosRESUMEN
OBJECTIVES: To examine knowledge, attitudes, beliefs, and behaviors about alternative tobacco products among American Indian tribal college students. PARTICIPANTS: One hundred and five tribal college students. METHODS: Focus groups, one interview, and demographic surveys. RESULTS: Tobacco use varied across the sample with 35.2% of the participants being users of ENDS products and 29.5% were cigarette smokers. Overall, participants viewed electronic nicotine delivery systems and chewing tobacco as primary examples of alternative tobacco products and described a generational divide between alternative and conventional tobacco product use. Alternative tobacco products were not considered suitable for use in traditional contexts. CONCLUSIONS: Previously successful cessation programs in this population have relied on cultural tailoring related to traditional tobacco use in American Indian communities. Our findings suggest that this strategy may be less effective for addressing alternative tobacco use. Reliance on the importance of family relationships may prove more impactful in future programming.
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Nurses who work with patients at risk for seizures should be informed that both adult and pediatric patients are at risk for sudden unexpected death in epilepsy (SUDEP). Although the exact pathophysiology of SUDEP is not determined, patients with mesial temporal lobe epilepsy represent an at-risk population because of autonomic dysregulation. With prompt treatment, patients with near-SUDEP can continue to lead normal productive lives. This case series presents three patients with near-SUDEP diagnosed with temporal lobe epilepsy.
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Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/enfermería , Muerte Súbita/prevención & control , Epilepsia del Lóbulo Temporal/epidemiología , Epilepsia del Lóbulo Temporal/enfermería , Monitoreo Fisiológico , Adolescente , Traumatismos en Atletas/complicaciones , Traumatismos en Atletas/enfermería , Conmoción Encefálica/complicaciones , Conmoción Encefálica/enfermería , Causas de Muerte , Electrocardiografía Ambulatoria , Epilepsia del Lóbulo Temporal/terapia , Femenino , Fútbol Americano/lesiones , Paro Cardíaco/epidemiología , Paro Cardíaco/enfermería , Paro Cardíaco/terapia , Bloqueo Cardíaco/epidemiología , Bloqueo Cardíaco/enfermería , Bloqueo Cardíaco/terapia , Humanos , Neuroestimuladores Implantables , Lamotrigina , Masculino , Persona de Mediana Edad , Triazinas/uso terapéuticoRESUMEN
The mathematical solution for Cerenkov radiation in a novel medium, left-handed medium (LH medium), which has both negative permittivity and permeability, is introduced in this paper. It is shown that the particle motion in the LH medium generates power that propagates backward. In this paper, both dispersion and dissipation are considered for the LH medium. The results show that in such a material, both forward power and backward power exist. In addition, we show that the losses will affect the Cerenkov angle. The idea of building a Cerenkov detector using LH medium is introduced, which could be useful in particle physics to identify charged particles of various velocities.
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We propose an improved method to retrieve the effective constitutive parameters (permittivity and permeability) of a slab of metamaterial from the measurement of S parameters. Improvements over existing methods include the determination of the first boundary and the thickness of the effective slab, the selection of the correct sign of effective impedance, and a mathematical method to choose the correct branch of the real part of the refractive index. The sensitivity of the effective constitutive parameters to the accuracy of the S parameters is also discussed. The method has been applied to various metamaterials and the successful retrieval results prove its effectiveness and robustness.