Season and temperature do not affect cumulative live birth rate and time to live birth in in vitro fertilization.

Objective: To explore whether season and temperature on oocyte retrieval day affect the cumulative live birth rate and time to live birth. Methods: This was a retrospective cohort study. A total of 14420 oocyte retrieval cycles from October 2015 to September 2019. According to the date of oocyte retrieval, the patients were divided into four groups (Spring(n=3634);Summer(n=4414); Autumn(n=3706); Winter(n=2666)). The primary outcome measures were cumulative live birth rate and time to live birth. The secondary outcome measures included the number of oocytes retrieved, number of 2PN, number of available embryos and number of high-quality embryos. Results: The number of oocytes retrieved was similar among the groups. Other outcomes, including the number of 2PN (P=0.02), number of available embryos (p=0.04), and number of high-quality embryos (p<0.01) were different among the groups. The quality of embryos in summer was relatively poor. There were no differences between the four groups in terms of cumulative live birth rate (P=0.17) or time to live birth (P=0.08). After adjusting for confounding factors by binary logistic regression, temperature (P=0.80), season (P=0.47) and duration of sunshine(P=0.46) had no effect on cumulative live births. Only maternal age (P<0.01) and basal FSH (P<0.01) had an effect on cumulative live births. Cox regression analysis suggested no effect of season(P=0.18) and temperature(P=0.89) on time to live birth. Maternal age did have an effect on time to live birth (P<0.01). Conclusion: Although season has an effect on the embryo, there was no evidence that season or temperature affect the cumulative live birth rate or time to live birth. It is not necessary to select a specific season when preparing for IVF.

Retrospective study of ovarian reaction and fertility in women with discordant antimullerian hormone and follicle-stimulating hormone/luteinizing hormone ratios during in vitro fertilization.

OBJECTIVE: The objective of this study was to examine the predictive ability of follicle-stimulating hormone (FSH)/luteinizing hormone (LH) ratio and antimullerian hormone (AMH) levels in the same cohort when both are inconsistent and to identify which has an excellent ability to predict live birth and ovarian response to in vitro fertilization (IVF). METHODS: A retrospective cohort study was performed within 6096 IVF cycles executed between January 2016 and August 2019 at the Center for Assisted Reproduction, The Third Affiliated Hospital of Zhengzhou University, and Jiaozuo Maternity and Child Health Care Hospital. Initially, IVF cycles were classified according to basal FSH/LH ratio and AMH values, and the primary outcome was a comparison of live birth rate per cohort. Secondary outcomes included characteristics of the study individuals such as body mass index (BMI), age, antral follicle count, ovarian sensitivity index, cycle cancellation rate, and cycle outcome data. RESULT(S): Women with FSH/LHhigh ratio and AMHnormal levels had a meaningly higher live birth rate compared with those with FSH/LHnormal ratio and AMHlow levels (46.59% vs. 21.21%, p < 0.001). In addition, women with FSH/LHnormal ratio and AMHlow levels were found to have a higher cancellation rate in their IVF cycles (80.98%). In women with FSH/LHnormal ratio, further multivariate analysis revealed that AMH level, age, number of retrieved oocytes, and FSH dosage were relevant risk factors for live birth. The relative risk of live birth was 0.11 (95% [CI] 0.06-0.20, p < 0.001) in patients with AMHlow compared with patients with AMHnormal . It also suggested that the probability of AMHlow level may be higher as the women's age (≥35 years, odd ratio [OR] 1.94, 95% [CI] 1.44-2.61; p < 0.001) and increasing BMI (≥28 kg/m2 , OR 2.38, 95% [CI] 1.33-4.27; p = 0.004). Receiver operating characteristic curve analysis indicated that AMH had higher sensitivity and specificity to predict live birth compared with FSH/LH (AUC 0.627 vs. 0.539). CONCLUSION(S): AMH levels can be an excellent predictor of the discrepancy between FSH/LH ratio and AMH levels regarding living birth rates in women undergoing IVF.

Intra- and peritumoral radiomics for predicting early recurrence in patients with high-grade serous ovarian cancer.

PURPOSE: To explore values of intra- and peritumoral CT-based radiomics for predicting recurrence in high-grade serous ovarian cancer (HGSOC) patients. METHODS: This study enrolled 110 HGSOC patients from our hospital between Aug 2017 and Apr 2021. All patients underwent contrast-enhanced CT scans before treatment. The least absolute shrinkage and selection operator (LASSO) regression was used to select radiomics features from intra- and peritumoral areas. Radiomics signatures were built based on selected features from Intra-RS, Peri-RS, and in Com-RS. A nomogram was constructed by combining radiomics signatures and clinical parameters with predictive potential. Receiver operating characteristics (ROC), calibration, and decision curve analyses (DCA) curves were used to evaluate performance of the nomogram. RESULTS: The intra- and peritumoral combined Com-RS showed effective ability in predicting recurrent HGSOC in the training (AUCs, Intra-RS vs. Peri-RS vs. Com-RS, 0.861 vs. 0.836 vs. 899) and validation (AUCs, Intra-RS vs. Peri-RS vs. Com-RS, 0.788 vs. 0.762 vs. 815) cohort. The Federation of International of FIGO stage, menstruation, and location were found to be strongly associated with tumor recurrence. The nomogram has the best predictive ability in the training (AUCs, Com-RS vs. clinical model vs. nomogram, 0.899 vs. 0.648 vs. 0.901) and validation (AUCs, Com-RS vs. clinical model vs. nomogram, 0.815 vs. 0.666 vs. 0.818) cohort. CONCLUSION: Our findings suggested values of intra- and peritumoral-based radiomics for predicting recurrent HGSOC. The constructed nomogram may be of importance in clinical application.

Radiomics for prediction of response to EGFR-TKI based on metastasis/brain parenchyma (M/BP)-interface.

PURPOSE: To evaluate the potential of subregional radiomics as a novel tumor marker in predicting epidermal growth factor receptor (EGFR) mutation status and response to EGFR-tyrosine kinase inhibitor (TKI) therapy in NSCLC patients with brain metastasis (BM). MATERIALS AND METHODS: We included 230 patients from center 1, and 80 patients were included from center 2 to form a primary and external validation cohort, respectively. Patients underwent contrast-enhanced T1-weighted and T2-weighted MRI scans before treatment. The individual- and population-level clustering was used to partition the peritumoral edema area (POA) into phenotypically consistent subregions. Radiomics features were calculated and selected from the tumor active area (TAA), POA and subregions, and used to develop models. Prediction values of each region were investigated and compared with receiver operating characteristic curves and Delong test. RESULTS: For predicting EGFR mutations, a multi-region combined model (EGFR-Fusion) was developed based on joint of the partitioned metastasis/brain parenchyma (M/BP)-interface and TAA, and generated the highest prediction performance in the training (AUC = 0.945, SEN = 0.878, SPE = 0.937), internal validation (AUC = 0.880, SEN = 0.733, SPE = 0.969), and external validation (AUC = 0.895, SEN = 0.875, SPE = 0.800) cohorts. For predicting response to EGFR-TKI, the developed multi-region combined model (TKI-Fusion) yielded predictive AUCs of 0.869 (SEN = 0.717, SPE = 0.884), 0.786 (SEN = 0.708, SPE = 0.818), and 0.802 (SEN = 0.750, SPE = 0.800) in the training, internal validation and external validation cohort, respectively. CONCLUSION: Our study revealed that complementary information regarding the EGFR status and response to EGFR-TKI can be provided by subregional radiomics. The proposed radiomics models may be new markers to guide treatment plans for NSCLC patients with BM.

Self-Cleaning and Shape-Adaptive Triboelectric Nanogenerator-Contained TiO2 Nanoparticle Coating.

With the rapid development of triboelectric nanogenerators (TENGs) for flexible wearable devices and electronic skins, challenges have gradually emerged related to the electrification surface, such as pollutant contamination and sophisticated surface adaptability. Hence, we report a simple spraying method to produce a shape-adaptive photocatalytic (SAP) triboelectric material with both self-cleaning and shape-adaptive functions. By spraying the polyvinyl alcohol solution with TiO2 photocatalysts and pre-drying cyclic, the SAP film can be adapted to a varied and intricate substrate. The highest transferred charge density of the SAP film reaches 197.5 µC/m2, when it contacts with the PTFE film. At the same time, it can degrade 74.4% of simulated pollutants under sunlight illumination, and 97% of the transferred charge density can be maintained after the degradation process, indicating good self-cleaning function and stable electrical output. Moreover, the spraying method of this allows it to have shape-adaptive functions. Accordingly, the SAP film can be deposited on the rectangular pyramid and hemispherical surface for fabricating TENGs with special shapes. This low-cost and simple spraying method further promotes the commercialized application of TENGs in the field of wearable devices and skin sensors.

Diagnostic value of a single ß-hCG test in predicting reproductive outcomes in women undergoing cleavage embryo transfer: a retrospective analysis from a single center.

PURPOSE: The present study investigated the role of ß-hCG in predicting reproductive outcomes and established optimal ß-hCG cutoff values in women undergoing cleavage embryo transfer. METHODS: The patients were transferred with fresh or frozen-thawed embryos and had serum ß-hCG levels tested on the 14th day post-embryo transfer. Serum ß-hCG levels were compared between different groups. Different cutoff values of ß-hCG were established and used to divide the patients into different groups. Reproductive outcomes between groups based on ß-hCG levels were compared. RESULTS: Significant discrepancies in general characteristics were observed in the subgroups. The cutoff values of ß-hCG for predicting the presence/absence of pregnancy, biochemical pregnancy/clinical pregnancy, presence/absence of adverse pregnancy outcomes, and singleton/twin live birth in the cleavage groups were 89.6, 241.1, 585.9, and 981.1 mIU/L, respectively. Biochemical pregnancy rates and adverse pregnancy outcome rates significantly decreased from the low ß-hCG group to the higher ß-hCG group in sequence. Significantly higher full-term live birth rates were observed in the highest ß-hCG group (P < 0.001). CONCLUSION: Serum ß-hCG levels were strongly associated with reproductive outcomes. However, the interpretation of ß-hCG levels must consider the number and quality of embryos and transfer protocols. When ß-hCG was tested on a fixed day post-ET, different cutoff values were required for the prediction of early clinical outcomes. The association between ß-hCG and obstetric outcomes must be investigated.

To investigate the association between ß-hCG and reproductive and obstetrical outcomes in women with cleavage ET and to establish different ß-hCG cutoff values for the prediction of reproductive outcomes, this study retrospectively included 6909 infertile women who were divided into different groups based on the number and quality of transferred embryos, age, and transfer protocols. The cutoff values of ß-hCG for predicting the presence/absence of pregnancy, biochemical pregnancy/clinical pregnancy, presence/absence of adverse pregnancy outcomes, singleton/twin live birth in the cleavage groups were 89.6, 241.1, 585.9, and 981.1 mIU/L, respectively. Biochemical pregnancy rates and adverse pregnancy outcome rates decreased significantly in the higher ß-hCG groups. In conclusion, the interpretation of ß-hCG levels must consider the number and quality of embryos and transfer protocols. When ß-hCG was tested on a fixed day post-ET, different cutoff values were required for the prediction of early clinical outcomes.

Immune Subtype Profiling and Establishment of Prognostic Immune-Related lncRNA Pairs in Human Ovarian Cancer.

This study collected immune-related genes (IRGs) and used gene expression data from TCGA database to construct a molecular subtype of ovarian cancer (OV) based on immune-related lncRNA gene pairs (IRLnc_GPs). The relationships between molecular subtypes and prognosis and clinical characteristics were further explored. IRGs were acquired from the ImmPort database, and round-robin pairing of immune-related lncRNAs was performed. The NMF algorithm was used to identify molecular subtypes, and the immune score of a single sample was calculated through ESTIMATE, TIMER, ssGSEA, MCPcounter, and CIBERSORT. The relationship between molecular subtypes and immune microenvironments was identified. A hypergeometric test was used to test the lncRNA pairs among the OV molecular subtypes (C1 and C2 subtypes). The BH method was used to screen the different lncRNA pairs, and a predictive risk model was constructed and verified. Finally, correlation analysis between the risk model, immune checkpoint genes, and chemotherapy drugs was carried out. Based on IRLnc_GP to classify 373 OV samples of TCGA, the samples were divided into two subtypes, and the prognosis between the subtypes showed significant differences. The C1 subtype with a poor prognosis was more related to the pathways of tumor occurrence and development. We identified 180 differential lncRNA pairs between subtypes and constructed a prognostic risk model based on 8 IRLnc_GPs. In the independent dataset, the distribution of subtypes in functional modules was different and highly repeatable. There were significant differences in the molecular and clinical characteristics of the subtypes and the drug sensitivity of immunotherapy/chemotherapy. In conclusion, the risk model established based on IRLnc_GP can better evaluate the prognosis of OV samples and can also assess the effects of different drug treatments in the high- and low-risk groups, providing new insights and ideas for the treatment of OV.

Identification and Validation of Invasion-Related Molecular Subtypes and Prognostic Features for Cervical Cancer.

Background: As one of the main causes leading to female cancer deaths, cervical cancer shows malignant features of local infiltration and invasion into adjacent organs and tissues. This study was designed to categorize novel molecular subtypes according to cervical cancer invasion and screen reliable prognostic markers. Methods: Invasion-related gene sets and expression profiles of invasion-related genes were collected from the CancerSEA database and The Cancer Genome Atlas (TCGA), respectively. Samples were clustered by nonnegative matrix factorization (NMF) to obtain different molecular subgroups, immune microenvironment characteristics of which were further systematically compared. Limma was employed to screen differentially expressed gene sets in different subtypes, followed by Lasso analysis for dimension reduction. Multivariate and univariate Cox regression analysis was performed to determine prognostic characteristics. The Kaplan-Meier test showed the prognostic differences of patients with different risks. Additionally, receiver operating characteristic (ROC) curves were applied to validate the prognostic model performance. A nomogram model was developed using clinical and prognostic characteristics of cervical cancer, and its prediction accuracy was reflected by calibration curve. Results: This study filtered 19 invasion-related genes with prognosis significance in cervical cancer and 2 molecular subtypes (C1, C2). Specifically, the C1 subtype had an unfavorable prognosis, which was associated with the activation of the TGF-beta signaling pathway, focal adhesion, and PI3K-Akt signaling pathway. 875 differentially expressed genes were screened, and 8 key genes were finally retained by the dimension reduction analysis. An 8-gene signature was established as an independent factor predictive of the prognosis of cervical cancer. The signature performance was even stronger when combined with N stage. Conclusion: Based on invasion-related genes, the present study categorized two cervical cancer subtypes with distinct TME characteristics and established an 8-gene marker that can accurately and independently predict the prognosis of cervical cancer.

Monitoring the Degree of Comfort of Shoes In-Motion Using Triboelectric Pressure Sensors with an Ultrawide Detection Range.

Shoes play an important role in sports and human daily life. Here, an in-shoe sensor pad (ISSP) attached to the vamp lining is based on a triboelectric nanogenerator (TENG) for monitoring the real-time stress distribution on the top side of a foot. Each sensor unit on this ISSP is an air-capsule TENG (AC-TENG) consisting of activated carbon/polyurethane (AC/PU) and microsphere array electrodes. The detection range of each AC-TENG reaches 7.27 MPa, which is enough for monitoring the pressure change during different sports. This multifunctional ISSP can realize many typical functions of conventional smart shoes, including step counting and human-machine interaction. Moreover, it can also reveal special information, including the fitness of shoes, the stress concentration on toes, and the in-motion comfort degree. The signal processing and data transmission modules in the system have a hybrid power supply with wireless power transfer, while the real-time information about feet can be observed on a cell phone. Hence, this ISSP provides a potential approach to study the feet motion and comfort degree of shoes in long-term operations, which can guide both athlete training and the customized design of shoes.

Fish-Wearable Data Snooping Platform for Underwater Energy Harvesting and Fish Behavior Monitoring.

Conventional approaches to studying fish kinematics pose a great challenge for the real-time monitoring of fish motion kinematics. Here, a multifunctional fish-wearable data snooping platform (FDSP) for studying fish kinematics is demonstrated based on an air sac triboelectric nanogenerator (AS-TENG) with antibacterial coating. The AS-TENG not only can harvest energy from fish swimming but also serves as the self-powered sensory module to monitor the swimming behavior of the fish. The peak output power generated from each swing of the fishtail can reach 0.74 mW, while its output voltage can reflect the real-time behavior of the fishtail. The antibacterial coating on the FDSP can improve its biocompatibility and the elastic texture of the FDSP allows it to be tightly attached to fish. The wireless communication system is designed to transmit the sensory data to a cell phone, where the detailed parameters of fish motion can be obtained, including swing angle, swing frequency, and even the typical swing gestures. This FDSP has broad application prospects in underwater self-powered sensors, wearable tracking devices, and soft robots.

The Impact of High-Normal TSH Levels on Reproductive Outcomes in Women Undergoing ART Treatment: a Systematic Review and Meta-analysis.

The role of high-normal thyroid-stimulating hormone levels has been of great concern recently. However, the conclusions of different studies are inconsistent. To assess whether high-normal conditions have an impact on reproductive and obstetric outcomes in euthyroid women undergoing ART treatment, a systematic review and meta-analysis was performed. Eligible studies published up to December 30, 2020, were searched from the PubMed, EMBASE, COCHRANE, and CNKI databases. Quality assessment of the included studies, data extraction, and synthesis were performed separately. RevMan 5.2 was used to carry out the meta-analysis. A total of 23 studies that included 25,143 patients were included. We observed similar clinical pregnancy rates (RR = 1.01, 95% CI: 0.99-1.05), miscarriage rates (RR = 0.95, 95% CI: 0.84-1.08), live birth rates (RR = 1.04, 95% CI: 0.99-1.09), birth weights (SMD = 0.07, 95% CI: -0.02 to 0.16), and gestational ages (SMD = 0.07, 95% CI: -0.02 to 0.16) between the high-normal TSH group and low TSH group. Subgroup analysis showed similar results. High-normal TSH levels were associated with similar clinical pregnancy rates, live birth rates, and miscarriage rates to those of women with low TSH levels. The results suggested that preconceptional TSH levels, regardless of potentially being affected by the controlled ovarian stimulation process, had little impact on reproductive and obstetric outcomes and should not be of great concern.

MRI-Based Radiomics Nomogram as a Potential Biomarker to Predict the EGFR Mutations in Exon 19 and 21 Based on Thoracic Spinal Metastases in Lung Adenocarcinoma.

RATIONALE AND OBJECTIVES: Preoperative identifications of epidermal growth factor receptor (EGFR) mutation subtypes based on the MRI image of spinal metastases are needed to provide individualized therapy, but has not been previously investigated. This study aims to develop and evaluate an MRI-based radiomics nomogram for differentiating the exon 19 and 21 in EGFR mutation from spinal bone metastases in patients with primary lung adenocarcinoma. MATERIALS AND METHODS: A total of 76 patients underwent T1-weighted and T2-weighted fat-suppressed MRI scans were enrolled in this study, 38 were positive for EGFR mutation in exon 19 and 38 were in exon 21.MRI imaging features were extracted and selected from each MRI pulse sequence, and used to form the radiomics signature. A radiomics nomogram was developed integrating the radiomics signature and important clinical factors with receiver operating characteristic, calibration and decision curve analysis to assess the nomogram. Clinical characteristics were analyzed with Mann-Whitney U and Chi-Square tests to identify the most important factors. RESULTS: A total of 6 features were selected as the most discriminative predictors from the two MRI pulse sequences. The nomogram integrating the combined radiomics signature, age and CEA level generated good prediction performance in the training (AUCs, nomogram vs. combined radiomics signature vs. clinical model, 0.90 vs. 0.87 vs. 0.59) and validation (AUCs, nomogram vs. combined radiomics signature vs. clinical model, 0.88 vs. 0.86 vs. 0.72) cohort. DCA analysis confirmed the potential clinical utility of the nomogram. CONCLUSION: This study demonstrated that MRI features from spinal bone metastases can be used to prognosticate EGFR mutation subtypes in exon 19 and 21. The developed pre-treatment nomogram can potentially guide treatments for lung adenocarcinoma patients.

Intratumoral and Peritumoral Analysis of Mammography, Tomosynthesis, and Multiparametric MRI for Predicting Ki-67 Level in Breast Cancer: a Radiomics-Based Study.

PURPOSE: To noninvasively evaluate the use of intratumoral and peritumoral regions from full-field digital mammography (DM), digital breast tomosynthesis (DBT), dynamic contrast-enhanced (DCE), and diffusion-weighted (DW) magnetic resonance imaging (MRI) images separately and combined to predict the Ki-67 level based on radiomics. PROCEDURES: A total of 209 patients with pathologically confirmed breast cancer were consecutively enrolled from September 2017 to March 2021, who underwent DM, DBT, DCE-MRI, and DW MRI scans. Radiomics features were calculated from intratumoral and peritumoral regions in each modality and selected with the least absolute shrinkage and selection operator (LASSO) regression. Radiomics signatures (RSs) were built based on intratumoral, peritumoral, and combined intra- and peritumoral regions. The prediction performance of the RSs was evaluated using the area under the receiver operating characteristic curve (AUC), specificity, and sensitivity as comparison metrics. A nomogram was constructed by integrating the multi-model RS and important clinical predictors and assessed by calibration and decision curve analysis. RESULTS: The combined intra- and peritumoral RSs improved the AUC compared with intra- or peritumoral RSs in each modality. The DCE plus DW MRI yielded higher AUC and specificity but lower sensitivity compared with the DM plus DBT. The nomogram incorporating the multi-model RS, age, and lymph node metastasis status achieved the best prediction performance in the training (AUC, nomogram vs. fusion RS vs. clinical model, 0.922 vs. 0.917 vs. 0.672) and validation (AUCs, nomogram vs. fusion RS vs. clinical model, 0.866 vs. 0.838 vs. 0.661) cohorts. DCA analysis confirmed the potential clinical utility of the nomogram. CONCLUSIONS: Peritumoral regions can provide complementary information to intratumoral regions in mammography and MRI for the prediction of Ki-67 levels. The MRI performed better than mammography in terms of AUC and specificity but weaker in sensitivity. The nomogram has a predictive advantage over each modality and could be a potential tool for predicting Ki-67 levels in breast cancer.

Associations between ambient air pollution and IVF outcomes in a heavily polluted city in China.

RESEARCH QUESTION: Is air pollution related to IVF outcomes in a heavily polluted city in China? DESIGN: A retrospective cohort study of 8628 fresh, autologous IVF cycles was conducted for the first time at the Reproductive Medicine Center of The Third Affiliated Hospital of Zhengzhou University between May 2014 and December 2018 (oocyte retrieval date). The exposure was divided into four periods (gonadotrophin injection to oocyte retrieval [P1], oocyte retrieval to embryo transfer [P2], 1 day after embryo transfer to embryo transfer +14 days [P3] and gonadotrophin injection to embryo transfer +14 days [P4]) and four levels (Q1-Q4 according to their 25th, 50th and 75th percentiles). RESULTS: An interquartile range increase (Q2 versus Q1) in particulate matter ≤10 µm (PM10) during P3 and P4 and sulphur dioxide (SO2) during P3 significantly decreased the clinical pregnancy rate (adjusted odds ratio [aOR] 0.81, 95% confidence interval [CI] 0.71-0.92 for PM10 of P3; aOR 0.87, 95% CI 0.76-1.00 for PM10 of P4; aOR 0.82, 95% CI 0.73-0.93 for SO2 of P3). In addition, PM10 was associated with an increased biochemical pregnancy rate (Q3 versus Q1: aOR 1.55, 95% CI 1.09-2.19 for PM10 of P1) and decreased live birth rate (Q2 versus Q1: aOR 0.88, 95% CI 0.77-0.99 for PM10 of P3). The multivariate regression results were consistent with that of multiple treatments propensity score method (PSM) for SO2 pollutants in P3 and PM10 pollutants in P4. CONCLUSION: From the early follicular stage to the pregnancy test period, high concentrations of PM10 and SO2 may have a negative impact on IVF treatment outcomes in the study area.

Endometrial Thickness Is a Risk Factor for Singleton Low Birth Weight From Single Blastocyst Transfer: A Retrospective Cohort Study.

Objective: To explore whether endometrial thickness (EMT) ≤7.5 mm is associated with singleton low birth weight (LBW) from single fresh blastocyst transfer. Methods: This was a retrospective cohort study. Only women ≤ 40 years old who underwent single fresh blastocyst transfer and had singleton live births were included in the study. LBW was the primary outcome of this study. Neonatal malformation was the secondary outcome. Logistic regression was used to evaluate the association between (EMT) ≤7.5 mm and singleton LBW. Results: A total number of 2847 women met the study inclusion criteria. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm group (P<0.001). The rate of LBW in the EMT ≤7.5 mm group was 24.9%, which was significantly higher than the 4.0% in the EMT 7.6~12.0 mm group and the 5.3% in the EMT >12.0 mm group (P<0.001). The total neonatal malformation rate was similar between the groups (1.1%, 0.8% and 1.5%, P=0.21). After logistic regression analysis, EMT ≤7.5 mm was found to be an independent risk factor for LBW (adjusted odds ratio [AOR]: 4.39, 95% CI: 1.85˜10.46, P<0.001). Conclusion: EMT ≤7.5 mm on the hCG trigger day is an independent risk factor for LBW in singleton pregnancies from single fresh blastocyst transfer. The neonatal birthweight in the EMT ≤7.5 mm group was significantly lower than that in the EMT 7.6~12.0 mm and EMT >12.0 mm groups. The total neonatal malformation rate was comparable between the groups.

Analysis of basal serum TSH, FT3, and FT4 levels based on age, sampling time in women with infertility.

BACKGROUND: To analyze the characteristics of basal thyroid hormone levels in infertile women consulting for assisted reproductive technology (ART) treatment. METHODS: This was a retrospective study. Serum TSH, FT3 and FT4 levels of women seeking ART consultation were tested routinely. Analyses were performed based on age and sampling time. One-way ANOVA or Kruskal-Wallis rank sum test was used to compare the continuous data among the groups, and the chi-square test or Fisher's exact test was used to compare categorical data where appropriate. RESULTS: A total of 6426 women were initially included in the study. After exclusion criteria were applied, the remaining 4126 women were categorized into different groups. The prevalence of subclinical hypothyroidism significantly decreased with age and sampling time, from 21.09 to 11.91% and from 28.57 to 10.67%, respectively (P < 0.001, respectively). Mean serum TSH, FT3, and FT4 levels decreased significantly with age (P = 0.017, < 0.001, < 0.001, respectively). In the context of sampling time, TSH levels from early in the morning were significantly higher (P < 0.001), while FT4 and FT3 levels were similar in different groups (P = 0.258, 0.300, respectively). CONCLUSIONS: The prevalence of subclinical hypothyroidism significantly decreased with increasing age and sampling time, as did the serum TSH levels. Even though, the establishment of reference interval of TSH level based on age or sampling time was not recommended. Full consideration of age and sampling time should be carefully taken before initiation of treatment.

Follicle-Stimulating Hormone-Secreting Pituitary Adenoma Inducing Spontaneous Ovarian Hyperstimulation Syndrome, Treatment Using In Vitro Fertilization and Embryo Transfer: A Case Report.

Objective: To describe the management of a patient with a pituitary adenoma secreting follicle-stimulating hormone (FSH) associated with spontaneous ovarian hyperstimulation syndrome (sOHSS) who was treated with in vitro fertilization and embryo transfer (IVF-ET). Methods: We report a clinical case of a woman of reproductive age with menstrual irregularity, infertility and ovarian hyperstimulation due to recurrent pituitary adenoma secreting FSH, which persisted after transsphenoidal surgery.She underwent the diagnosis by magnetic resonance imaging (MRI) and laboratory tests,and finally she was treated with IVF-ET. Results: The patient was plagued by a recurrent pituitary adenoma for many years and tried various treatments. After complete transsphenoidal surgery, sOHSS decreased, as shown by a reduction in oestradiol levels and an improvement in the ultrasonography parameters; however, secondary amenorrhea occurred. Finally, pregnancy was achieved through IVF-ET and the symptoms of ovarian hyperstimulation were relieved. Conclusions: IVF-ET was found to be effective for the treatment of recurrent pituitary adenoma, thus representing a therapeutic option that should be taken into consideration in such cases.

Multiparametric MRI-based Radiomics approaches on predicting response to neoadjuvant chemoradiotherapy (nCRT) in patients with rectal cancer.

PURPOSE: To investigate the value of multiparametric MRI-based radiomics on predicting response to nCRT in patients with rectal cancer. METHODS: This study enrolled 193 patients with pathologically confirmed LARC who received nCRT treatment between Apr. 2014 and Jun. 2018. All patients underwent baseline T1-weighted (T1W), T2-weighted (T2W) and T2-weighted fat-suppression (T2FS) MRI scans before neoadjuvant chemoradiotherapy. Radiomics features were extracted and selected from the MRI data to establish the radiomics signature. Important clinical predictors were identified by Mann-Whitney U test and Chi-square test. The nomogram integrating the radiomics signature and important clinical predictors was constructed using multivariate logistic regression. Prediction capabilities of each model were assessed with receiver operating characteristic (ROC) curve analysis. Performance of the nomogram was evaluated by its calibration and potential clinical usefulness. RESULTS: For the prediction of good response (GR) and pathologic complete response (pCR), the developed radiomics signature comprising 10 and 7 features, respectively, were significantly associated with the therapeutic response to nCRT. The nomogram incorporating the radiomics signature and important clinical predictors (CEA and CA19-9 for predicting GR; CEA, posttreatment length and posttreatment thickness for predicting pCR) achieved favorable prediction efficacy, with AUCs of 0.918 (95% confidence interval [CI]: 0.867-0.971, Sen = 0.972, Spe = 0.828) and 0.944 (95% CI: 0.891-0.997, Sen = 0.943, Spe = 0.828) in the training and validation cohort for predicting GR, respectively; with AUCs of 0.959 (95% CI: 0.927-0.991, Sen = 1.000, Spe = 0.833) and 0.912 (95% CI: 0.843-0.982, Sen = 1.000, Spe = 0.815) in the training and validation cohort for predicting pCR, respectively. Decision curve analysis confirmed potential clinical usefulness of our nomogram. CONCLUSIONS: This study demonstrated that the MRI-based radiomics nomogram is predictive of response to nCRT and can be considered as a promising tool for facilitating treatment decision-making for patients with LARC.

A universal managing circuit with stabilized voltage for maintaining safe operation of self-powered electronics system.

Harvesting mechanical energy via a triboelectric nanogenerator (TENG) is a promising strategy for solving energy problems. However, it is necessary to develop an effective and safe energy managing circuit for preventing high voltage breaking electronic devices. Here, a universal managing circuit is developed to optimize TENG's output performance, which for the first time allows the TENG to safely power various sensor systems with a safe and stable voltage. Based on the circuit, TENG's output can be transformed into a stable voltage with tunable amplitude, while an enhanced short-circuit current of 94 mA with an energy loss lower than 5% is achieved. For demonstrations, three different types of TENGs, respectively, targeting at ocean energy, wind energy, and walking energy have been prepared to reveal the capability of the circuit. This study offers a strategy to greatly enhance the output performance of TENGs to provide useful guidance for constructing self-powered and distributed sensor systems.