Errors and omissions in learning. Classical worlds and modern society

En esta comunicación presentaremos someramente los resultados obtenidos en la primera fase del proyecto «Los mundos clásicos en la sociedad actual. Errores y omisiones que dificultan el aprendizaje». El ámbito de aplicación consiste en el alumnado de varias asignaturas del grado en Estudios clásicos y de otros grados en los que impartimos docencia, como el grado en Estudios ingleses o un grupo específico para el aprendizaje del latín: Latín nivel 0. El objetivo era detectar y valorar las carencias que dificultan el aprendizaje y la adquisición de competencias relacionadas con la influencia de los mundos clásicos (greco-latino y árabe) en la sociedad actual, así como trazar con claridad el perfil del alumnado que cursaba estas asignaturas. Para ello necesitábamos saber la concepción y conocimientos que poseían sobre los mundos clásicos. El método que utilizamos fue una encuesta doble con una parte centrada en el mundo clásico grecolatino y otra, paralela, dedicada al mundo árabe clásico. El análisis de los resultados permitió concluir que asocian mundo clásico a historia, mitología, cultura o cocina, pero no a la lengua; que la mayoría conoce la mitología porque es un tema de gran interés para los medios de entretenimiento (cine, televisión, videojuegos) que son la fuente de su conocimiento. En el caso del árabe, su interés se centra en temas culturales en los que se integra la religión considerada un aspecto cultural más, pues su conocimiento procede de los medios de entretenimiento entre los que mencionan libros de lectura como las novelasIn this paper we will briefly present the results obtained in the first phase of the project «The Classical Worlds in Today’s Society. Errors and omissions that make learning difficult». The scope of application consists of the students of several subjects of the degree in Classical Studies and of other degrees in which we participate, as the degree in English Studies or a specific group for the learning of Latin, Latin level 0. The objective was to detect the deficiencies that make learning difficult and to acquire competences related to the influence of the classical worlds (Greco-Latin and Arabic) in modern society, as well as to outline the profile of the students who studied these subjects. We needed to know the conception and knowledge they had on the classical world. The method we used was a double survey with one part centered on the classic Greco-Roman world and another dedicated to the classical Arab world. The analysis of the results allowed to conclude they associate classic world with history, mythology, culture or cuisine, but not with language; the majority knows mythology because it is a subject of great interest for the entertainment media (cinema, television, video games), main source of its knowledge. In the case of Arabic world, their interest is focused on cultural issues in which religion is considered a cultural aspect, since their knowledge comes from the entertainment media as cinema, video games and novels

Prediction of Recurrent Pregnancy Loss by a New Thrombophilia Based Genetic Risk Score

We  examined the predictive ability of the new thrombophilia-based genetic risk score that has been developed (TiC-RPL)  to acutely determine the risk of recurrent pregnancy loss (RPL) closely related to thrombophilia and to compare it with the ability of the classical genetic thrombophilia variants F5 rs6025 and F2 rs1799963. This is a case-control observational study, with retrospective data analysis. We included 180 healthy women with at least one uncomplicated pregnancy to term and no previous miscarriage and 184 cases of idiopathic recurrent pregnancy loss (RPL). The predictive ability was assessed in terms of discrimination (AUC), sensitivity, specificity, positive and negative predictive values (PPV, NPV), and positive and negative likelihood ratios (PLR and NLR). TiC-RPL has a better AUC (95 CI) than F5 rs6025+F2 rs1799963 [0.763 (0.715-0.811) vs 0.540 (0.514-0.567); p<0.0001], with a sensitivity of 70.65%, a specificity of 67.78%, a PPV of 69.15%, an NPV of 69.32%, a PLR of 2.19, and an NLR of 0.43. Our results show that the new score TiC-RPL is significantly better than F5 rs6025+F2 rs1799963 in identifying RPL women in whom RPL appears to be associated with thrombophilia. This identification can guide a personalized approach in the prevention of RPL

GnRH Analogues in the Prevention of Ovarian Hyperstimulation Syndrome

The GnRH analogue (agonist and antagonist GnRH) changed ovarian stimulation. On the one hand, it improved chances of pregnancy to obtain more oocytes and better embryos. This leads to an ovarian hyper-response, which can be complicated by the ovarian hyperstimulation syndrome (OHSS). On the other hand, the GnRH analogue can prevent the incidence of OHSS: GnRH antagonist protocols, GnRH agonist for triggering final oocyte maturation, either together or separately, coasting, and the GnRH analogue may prove useful for avoiding OHSS in high-risk patients. We review these topics in this article

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

This study has analysed the relationship between ovarian response and the number of euploid embryos. This is a post hoc analysis of a subset of data generated during a prospective cohort study previously published. Forty-six oocyte donors were subjected to ovarian stimulation with 150 IU of rFSH and 75 IU of hp-hMG in a GnRH agonist long protocol. Preimplantation genetic screening was performed in all viable embryos. We observed a positive relationship between ovarian response and the number of euploid embryos. When ovarian response was above the median (≥17 oocytes), the mean number of euploid embryos per donor was 5.0 ± 2.4, while when <17 oocytes were obtained the mean number of euploid embryos was 2.7 ± 1.4 ( = 0.000). Aneuploidy rate did not increase with ovarian response or gonadotropin doses. Also, the number of euploid embryos was inversely related to the amount of gonadotropins needed per oocyte obtained (ovarian sensitivity index). These results suggest that the number of euploid embryos available for embryo transfer increases as the number of oocytes obtained does. Considering the total number of euploid embryos seems more relevant than the aneuploidy rate

A Higher Ovarian Response after Stimulation for IVF Is Related to a Higher Number of Euploid Embryos

This study has analysed the relationship between ovarian response and the number of euploid embryos. This is a post hoc analysis of a subset of data generated during a prospective cohort study previously published. Forty-six oocyte donors were subjected to ovarian stimulation with 150 IU of rFSH and 75 IU of hp-hMG in a GnRH agonist long protocol. Preimplantation genetic screening was performed in all viable embryos. We observed a positive relationship between ovarian response and the number of euploid embryos. When ovarian response was above the median (≥17 oocytes), the mean number of euploid embryos per donor was 5.0 ± 2.4, while when <17 oocytes were obtained the mean number of euploid embryos was 2.7 ± 1.4 (p=0.000). Aneuploidy rate did not increase with ovarian response or gonadotropin doses. Also, the number of euploid embryos was inversely related to the amount of gonadotropins needed per oocyte obtained (ovarian sensitivity index). These results suggest that the number of euploid embryos available for embryo transfer increases as the number of oocytes obtained does. Considering the total number of euploid embryos seems more relevant than the aneuploidy rate

Prediction of recurrent pregnancy loss by a new thrombophilia based genetic risk score

We examined the predictive ability of the new thrombophilia-based genetic risk score that has been developed (TiC-RPL) to acutely determine the risk of recurrent pregnancy loss (RPL) closely related to thrombophilia and to compare it with the ability of the classical genetic thrombophilia variants F5 rs6025 and F2 rs1799963. This is a case-control observational study, with retrospective data analysis. We included 180 healthy women with at least one uncomplicated pregnancy to term and no previous miscarriage and 184 cases of idiopathic recurrent pregnancy loss (RPL). The predictive ability was assessed in terms of discrimination (AUC), sensitivity, specificity, positive and negative predictive values (PPV, NPV), and positive and negative likelihood ratios (PLR and NLR). TiC-RPL has a better AUC (95 CI) than F5 rs6025+F2 rs1799963 [0.763 (0.715-0.811) vs 0.540 (0.514-0.567); p<0.0001], with a sensitivity of 70.65%, a specificity of 67.78%, a PPV of 69.15%, an NPV of 69.32%, a PLR of 2.19, and an NLR of 0.43. Our results show that the new score TiC-RPL is significantly better than F5 rs6025+F2 rs1799963 in identifying RPL women in whom RPL appears to beassociated with thrombophilia. This identification can guide a personalized approach in the prevention of RPL

Cumulative newborn rates increase with the total number of transferred embryos according to an analysis of 15,792 ovum donation cycles

Objective: To measure the success of in vitro fertilization (IVF) of donated ova according to cumulative newborn rates (CNBR) per number of embryos required to achieve at least one newborn (EmbR), considering in addition the relevance of age and infertility etiology. Design: Survival curves and Kaplan-Meier methods were employed to analyze CNBR with respect to the number of EmbR in a retrospective cohort of oocyte donation recipients. Setting: University-affiliated infertility center. Patient(s): Infertile couples undergoing IVF with oocyte donation. Intervention(s): None. Main Outcome Measure(s): CNBR per EmbR. Result(s): The CNBR increased radically (up to 64.8%) between 1 and 5 EmbR, moderately (85.2%) between 5 and 15, and slowly thereafter, reaching a plateau at 15 embryos (92.4%) and peaking after 25 EmbR (96.8%), thus demonstrating that the chances of success vary as failed attempts accumulate. Patient age was not a negative factor, and indication for oocyte donation was also irrelevant to the outcome. The data showed an overall mean number of 2.6 embryo transfers and 5.8 transferred embryos per newborn. Conclusion(s): The relationship between CNBR and number of EmbR provides pragmatic and exact information about the probability of success with oocyte donation, which is of obvious relevance to patient counseling

Serum progesterone is lower in ovarian stimulation with highly purified HMG compared to recombinant FSH owing to a different regulation of follicular steroidogenesis: a randomized controlled trial

STUDY QUESTION Does ovarian stimulation with highly purified (hp)-HMG protect from elevated progesterone in the follicular phase compared to recombinant FSH (r-FSH) cycles through a different regulation of follicular steroidogenesis? SUMMARY ANSWER hp-HMG enhanced the Δ4 pathway from pregnenolone to androstenodione leading to lower serum progesterone at the end of the cycle, while r-FSH promoted the conversion of pregnenolone to progesterone causing higher follicular phase progesterone levels. WHAT IS KNOWN ALREADY Elevated progesterone in the follicular phase has been related to lower clinical outcome in fresh IVF cycles. Progesterone levels are positively correlated to ovarian response, and some studies have shown that when r-FSH alone is used for ovarian stimulation serum progesterone levels on the day of triggering are higher than when hp-HMG is given. Whether this is caused by a lower ovarian response in hp-HMG cycles or to a difference in follicular steroidogenesis in the two ovarian stimulation regimens has not been well characterized STUDY DESIGN, SIZE, DURATION A randomized controlled trial including 112 oocyte donors undergoing ovarian stimulation with GnRH antagonists and 225 IU/day of r-FSH (n = 56) or hp-HMG (n = 56) was carried out in a university-affiliated private infertility clinic. Subjects were recruited between October 2016 and June 2018. PARTICIPANTS/MATERIALS, SETTING, METHODS The women were aged 18-35 years with a regular menstrual cycle (25-35 days) and normal ovarian reserve (serum anti-Müllerian hormone (AMH) = 10-30 pMol/l) undergoing ovarian stimulation for oocyte donation. FSH, LH, estradiol (E2), estrone, progesterone, pregnenolone, 17-OH-progesterone, androstenodione, dehidroepiandrostenodione, and testosterone were determined on stimulation Days 1, 4, 6, and 8 and on day of triggering in serum and in follicular fluid. Samples were frozen at −20°C until assay. Total exposures across the follicular phase were compared by polynomic extrapolation