Assessment of Birth Defects and Cancer Risk in Children Conceived via in Vitro Fertilization in the US

Importance: Children with birth defects have a greater risk of developing cancer, but this association has not yet been evaluated in children conceived with in vitro fertilization (IVF). Objective: To assess whether the association between birth defects and cancer is greater in children conceived via IVF compared with children conceived naturally. Design, Setting, and Participants: This cohort study of live births, birth defects, and cancer from Massachusetts, New York, North Carolina, and Texas included 1000639 children born to fertile women and 52776 children conceived via IVF (using autologous oocytes and fresh embryos) during 2004-2016 in Massachusetts and North Carolina, 2004-2015 in New York, and 2004-2013 in Texas. Children were followed up for an average of 5.7 years (6008985 total person-years of exposure). Data analysis was conducted from April 1 to August 31, 2020. Exposures: Conception by IVF for state residents who gave birth to liveborn singletons during the study period. Birth defect diagnoses recorded by statewide registries. Main Outcomes and Measures: Cancer diagnosis as recorded by state cancer registries. Cox proportional hazards regression models were used to estimate hazard ratios (HRs) and 95% CIs for birth defect-cancer associations separately in fertile and IVF groups. Results: A total of 1000639 children (51.3% boys; 69.7% White; and 38.3% born between 2009-2012) were in the fertile group and 52776 were in the IVF group (51.3% boys; 81.3% White; and 39.6% born between 2009-2012). Compared with children without birth defects, cancer risks were higher among children with a major birth defect in the fertile group (hazard ratio [HR], 3.15; 95% CI, 2.40-4.14) and IVF group (HR, 6.90; 95% CI, 3.73-12.74). The HR of cancer among children with a major nonchromosomal defect was 2.07 (95% CI, 1.47-2.91) among children in the fertile group and 4.04 (95% CI, 1.86-8.77) among children in the IVF group. The HR of cancer among children with a chromosomal defect was 15.45 (95% CI, 10.00-23.86) in the fertile group and 38.91 (95% CI, 15.56-97.33) in the IVF group. Conclusions and Relevance: This study found that among children with birth defects, those conceived via IVF were at greater risk of developing cancer compared with children conceived naturally

Governing Boards and Profound Organizational Change in Hospitals

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/69047/2/10.1177_107755878904600204.pd

ENGAGEMENT IN ORGANIZATIONAL BEHAVIOUR PLANE

Örgütlere rekabet üstünlüğü sağlayan birincil ve hayati unsur insandır. Psikolojik ve sosyal bir varlık olan insanın örgüt için üretken hale getirilmesinde örgütsel davranış disiplinine önemli görevler düşmektedir. Örgütsel davranışın ilgilendiği konulardan biri olan adanmışlık, örgüt başarısında etkili bir durumdur. Adanmışlık durumu, birey ve örgüt yapısı çerçevesinde birçok unsurla etkileşim göstermektedir. Tutumlar, davranışlar ve oluşan örgüt kültürü çalışanların adanmışlık seviyesini etkileyen unsurlardandır. Adanmışlık konusununun teorik bir yaklaşımla ortaya konulmaya çalışıldığı bu araştırmada farklı adanmışlık unsurları ve boyutları, adanmışlık durumları, adanmışlığın önemi, adanmışlığı ortaya çıkaran ve arttıran unsurlar irdelenip adanmışlığın tükenmişlikle ilişkisi ortaya konulmaya çalışılmıştır.The major and vital factor providing competitive advantage to the organizations is person. Organizational behavior discipline plays a crucial role in rendering a person that is both psychological and social entity to an efficient being in the organization. Commitment which is one of the issues examined by organizational behavior is an effective condition in the way of reaching to organizational success. The condition of commitment is related to several factors within the frame of individual and organizational structure. Attitudes, behaviors and developing organizational culture affect the commitment degree of workers. In this research, it is aimed to establish a frame on the relation between commitment and burn-out by examining particular commitment factors and dimensions, commitment conditions, the importance of commitment and the factors revealing and increasing the commitmen

Efeitos de Fatores Ambientais na Reprodução de Tartarugas Environmental factors effects in turtles reproduction

Para as espécies de tartaruga que apresentam a determinação sexual dependente da temperatura da incubação o local e o momento da desova, exercem influências que vão além da definição do sexo dos embriões. A influência do local da desova se estende a todo o desenvolvimento embrionário afetando o comportamento e o tamanho dos filhotes. O momento em que ocorre a desova trará conseqüências ao ambiente térmico dos ninhos à medida que a temperatura e a umidade variam ao longo do ano. A umidade será decisiva nas trocas hídricas e gasosas entre os ovos e o meio afetando a absorção do vitelo e o crescimento dos embriões. As cheias e os alagamentos são importantes fatores de perda de ninhos nas espécies de tartaruga de água doce. A desova no momento adequado possibilita uma incubação segura, sem a interferência de alagamentos dos ninhos e conseqüente morte dos embriões. A predação dos ninhos varia de acordo com o local da desova, o tipo e a abundância de predadores e a profundidade da câmara de ovos. A escolha de pontos de desova no interior da vegetação, onde a taxa de predação é geralmente menor, nem sempre é a estratégia mais frequentemente adotada pelas tartarugas, uma vez que esse procedimento pode levar a uma maior exposição das fêmeas aos predadores, à diminuição do sucesso da eclosão ou a alterações na razão sexual provocadas por diferenças na temperatura da incubação.<br>Turtle species in which the sex determination is dependent of incubation temperature, the nest site and the laying moment will affect more than embryo sex determination. The influence of the laying site extends all over the embryonic development, affecting hatching weight and size. The time of the egg-laying will bring consequences to the nest thermal environment, as the temperature and humidity change throughout the year. The humidity will be decisive in gaseous and hydric exchanges between eggs and the environment, affecting yolk absorption and embryo growth. Floods and inundation are important factors related to nest loss in freshwater turtle species. Egg laying at the appropriated time makes a safe incubation possible, without the interference of nest inundation and subsequent embryo death. The nest predation varies according to the egg-laying site, type and abundance of predator and nest depth. The choice of areas in the middle of vegetation, where the predation rate is generally smaller, is not always the most used strategy by turtles, since this procedure can decrease the hatching success or provoke changes in sex ratio