'Luteal coasting' after GnRH agonist trigger - individualized, HCG-based, progesterone-free luteal support in 'high responders':a case series

This study reports 21 IVF cases with excessive ovarian response, who received gonadotrophin-releasing hormone agonist (GnRHa) triggering for final oocyte maturation, followed by a human chorionic gonadotrophin (HCG)-based, progesterone-free, luteal support, individually timed ('luteal coasting') according to endogenous luteal progesterone concentrations. One patient developed a brief early-onset moderate ovarian hyperstimulation syndrome (OHSS) condition. Six clinical pregnancies were achieved, two of which have resulted in live births thus far. To further individualize the luteal phase support post GnRHa trigger, the same principle that holds for follicular coasting, used in the context of OHSS prevention, may be valid. Monitoring luteal progesterone concentrations from the day of oocyte retrieval, and administering a bolus of HCG (1500 IU) when the concentration drops significantly, seems to facilitate fresh embryo transfer, even in patients with excessive ovarian responses.</p

AI Without Math: Making AI and ML Comprehensible

If we want nontechnical stakeholders to respond to artificial intelligence developments in an informed way, we must help them acquire a more-than-superficial understanding of artificial intelligence (AI) and machine learning (ML). Explanations involving formal mathematical notation will not reach most people who need to make informed decisions about AI. We believe it is possible to teach many AI and ML concepts without slipping into mathematical notation

Differential marker expression by cultures rich in mesenchymal stem cells

Background: Mesenchymal stem cells have properties that make them amenable to therapeutic use. However, the acceptance of mesenchymal stem cells in clinical practice requires standardized techniques for their specific isolation. To date, there are no conclusive marker (s) for the exclusive isolation of mesenchymal stem cells. Our aim was to identify markers differentially expressed between mesenchymal stem cell and non-stem cell mesenchymal cell cultures. We compared and contrasted the phenotype of tissue cultures in which mesenchymal stem cells are rich and rare. By initially assessing mesenchymal stem cell differentiation, we established that bone marrow and breast adipose cultures are rich in mesenchymal stem cells while, in our hands, foreskin fibroblast and olfactory tissue cultures contain rare mesenchymal stem cells. In particular, olfactory tissue cells represent non-stem cell mesenchymal cells. Subsequently, the phenotype of the tissue cultures were thoroughly assessed using immuno-fluorescence, flow-cytometry, proteomics, antibody arrays and qPCR. Results: Our analysis revealed that all tissue cultures, regardless of differentiation potential, demonstrated remarkably similar phenotypes. Importantly, it was also observed that common mesenchymal stem cell markers, and fibroblast-associated markers, do not discriminate between mesenchymal stem cell and non-stem cell mesenchymal cell cultures. Examination and comparison of the phenotypes of mesenchymal stem cell and non-stem cell mesenchymal cell cultures revealed three differentially expressed markers – CD24, CD108 and CD40. Conclusion: We indicate the importance of establishing differential marker expression between mesenchymal stem cells and non-stem cell mesenchymal cells in order to determine stem cell specific markers

Follicle size on day of trigger most likely to yield a mature oocyte

Funding: MRC, BBSRC and NIHR and supported by the NIHR/Wellcome Trust Imperial Clinical Research Facility and Imperial Biomedical Research Centre.Objective: To identify follicle sizes on the day of trigger most likely to yield a mature oocyte following hCG, GnRH agonist (GnRHa), or kisspeptin during IVF treatment. Design: Retrospective analysis to determine the size of follicles on day of trigger contributing most to the number of mature oocytes retrieved using generalized linear regression and random forest models applied to data from IVF cycles (2014–2017) in which either hCG, GnRHa, or kisspeptin trigger was used. Setting: HCG and GnRHa data were collected at My Duc Hospital, Ho Chi Minh City, Vietnam, and kisspeptin data were collected at Hammersmith Hospital, London, UK. Patients: Four hundred and forty nine women aged 18–38 years with antral follicle counts 4–87 were triggered with hCG (n = 161), GnRHa (n = 165), or kisspeptin (n = 173). Main outcome measure: Follicle sizes on the day of trigger most likely to yield a mature oocyte. Results: Follicles 12–19 mm on the day of trigger contributed the most to the number of oocytes and mature oocytes retrieved. Comparing the tertile of patients with the highest proportion of follicles on the day of trigger 12–19 mm, with the tertile of patients with the lowest proportion within this size range, revealed increases of 4.7 mature oocytes for hCG (P < 0.0001) and 4.9 mature oocytes for GnRHa triggering (P < 0.01). Using simulated follicle size profiles of patients with 20 follicles on the day of trigger, our model predicts that the number of oocytes retrieved would increase from a mean 9.8 (95% prediction limit 9.3–10.3) to 14.8 (95% prediction limit 13.3–16.3) oocytes due to the difference in follicle size profile alone. Conclusion: Follicles 12–19 mm on the morning of trigger administration were most likely to yield a mature oocyte following hCG, GnRHa, or kisspeptin.Publisher PDFPeer reviewe

Hormonal, functional and genetic biomarkers in controlled ovarian stimulation: tools for matching patients and protocols

Variability in the subfertile patient population excludes the possibility of a single approach to controlled ovarian stimulation (COS) covering all the requirements of a patient. Modern technology has led to the development of new drugs, treatment options and quantitative methods that can identify single patient characteristics. These could potentially be used to match patients with the right treatment options to optimise efficacy, safety and tolerability during COS. Currently, age and follicle-stimulating hormone (FSH) level remain the most commonly used single patient characteristics in clinical practice. These variables only provide a basic prognosis for success and indications for standard COS treatment based on gross patient categorisation. In contrast, the anti-Müllerian hormone level appears to be an accurate predictor of ovarian reserve and response to COS, and could be used successfully to guide COS. The antral follicle count is a functional biomarker that could be useful in determining the dose of FSH necessary during stimulation and the success of treatment. Finally, in the future, genetic screening may allow an individual patient's response to stimulation during COS to be predicted based on genotype. Unfortunately, despite the predictive power of these measures, no single biomarker can stand alone as a guide to determine the best treatment option. In the future, hormonal, functional and genetic biomarkers will be used together to personalise COS

Pinocchio Syndrome Relationship with the Mutinous Boy in Carlo Collodi’s Novel

ازداد الكذب على نطاق واسع عبر الإنترنت ووسائل التواصل الاجتماعي والأخبار المزيفة وأصبح تحديًا للمجتمعات المعاصرة. يهدف البحث الحالي إلى معرفة ما إذا كانت هناك علاقة بين الكذب ومتلازمة بينوكيو، وما إذا كانت ظاهرة الكذب المرتبطة بالأنف الطويل هي مجرد صورة نمطية تنتقل من جيل إلى جيل عبر المجتمع الجماعي. اللاوعي عبر مختلف الثقافات والبلدان. هل التغيير الفسيولوجي في أنف الإنسان، في بعض الحالات، مرتبط بالكذب، أو إنه مجرد فرضية وضعها كارلو كولودي لروايته "مغامرات بينوكيو"؟ أو ما إذا كان البطل الصغير المتمرد في رواية كارلو كولودي قد لجأ إلى الكذب وسيلة للتمرد على مقدمي الرعاية له. توصلت الدراسة أخيرًا إلى استنتاج أهمية التعليم في القضاء على العديد من المشكلات الاجتماعية ومنها الكذب - يكتشف بينوكيو في نهاية رحلته، إذ واجه العديد من المعوقات، أهمية التعليم في اكتساب قيم أخلاقية سامية مثل الصدق، والأمانة، ونكران الذات. ومن ثم، يتحرر بينوكيو من جسده الخشبي.Lying is a social malady that has a negative impact on the social fabric of society. Despite the positive side of technological progress, it was not without its negative aspects, as lies spread through the Internet, social media, fake news and propaganda. The current research aims to find out whether there is a relationship between lying and Pinocchio syndrome and whether the phenomenon of lying associated with the long nose is just a stereotype passed from generation to generation through the collective subconscious mind across different cultures and countries. Is the physiological change in the human nose, in some cases, related to lying, or is it just a hypothesis developed by Carlo Collodi for his novel The Adventures of Pinocchio? Or whether Collodi’s little mutinous protagonist resorts to lying as a way to rebel against his caregivers. The study finally comes to a conclusion of the importance of education to eliminate many social problems, including lying — Pinocchio discovers, at the end of his journey, where he faces many obstacles, the importance of education in acquiring lofty moral values such as honesty and selflessness. Consequently, he is liberated from the inanimate wooden body

Evaluation of Novel Biomarker of Early Atherosclerosis in Patients With Chronic Kidney Disease in Wasit Governorate

The aim of the study was to evaluate some Biomarkers in patients with athreoscelerosis in Wasit Province. Atherosclerosis is a chronic arterial disease and a major cause of vascular death. Fatty streaks in arterial walls gradually develop into atheroma and characteristic plaques. The acute rupture of these atheromatous plaques causes local thrombosis, leading to partial or total occlusion of the affected artery. The clinical consequences of these plaques depend on their site and the degree and speed of vessel occlusion . Its major clinical manifestations include ischemic heart disease (IHD), ischemic stroke, and peripheral arterial disease. The study took place in the a hemodialysis unit Al-Zahraa Teaching Hospital in Wasit Governorate during the period from November 2023 to April 2024. This study aimed to examine risk factors (age, gender, high blood pressure, smoking, left ventricular hypertrophy, diabetes mellitus, dyslipidemia, physical inactivity) for atherosclerosis in the general population and patients with chronic kidney disease. Also studying the effect of some novel biomarkers (Homocysteine, Fibrinogen, myeloperoxidase, lipoprotein-associated phospholipase A2, pentraxin 3). The study include (90) samples: (60) patients suffering from early atherosclerosis and chronic kidney disease (dialysis stage) and 30 samples of healthy people (control group), their ages ranged from (40 to 70 years). The samples were divided into two age groups, where the first group had an average age of 40-55 years and the second group was 56-70 years old , the categories were divided equally into males and females Samples were collected based on the incidence of kidney disease first, and then the main risk factors of early atherosclerosis were relied upon, which are (smoking, age, sex, dyslipidemia, hypertension, diabetes, left ventricle valve, physical inactivity).&nbsp; The results of our study regarding diagnostic markers of atherosclerosis showed a significant increase in biomarkers (MPO, PTX3, HCy, FG and LpPLA2)of&nbsp; infected people at p ≥ 0.5. In patients with atherosclerosis the level of new biomarkers showed a significant increase in serum of infected people compared to healthy people at p&lt;0.5. This is an important indication of the importance of these biomarkers in detecting the disease