Follicular and Luteal Phase Aspects of Ovarian Stimulation for In Vitro Fertilization

De auteur van dit proefschrift, Nicole Geertje Maria Beckers werd geboren op 25 februari 1964 te Den Haag. In 1982 behaalde zij het eindexamen Atheneum aan het Niels Stensen College te Utrecht. In mei 1990 behaalde zij het artsexamen aan de Erasmus Universiteit te Rotterdam. Vanaf mei 1990 was zij gedurende 1 jaar werkzaam als arts- assistent/poortarts in het Hofpoort Ziekenhuis te Woerden. Aansluitend werkte zij een aantal maanden als arts-assistent niet in opleiding op de afdeling Gynaecologie en Verloskunde in het Kennemergasthuis te Haarlem. Vanaf november 1991 is zij werkzaam als fertiliteitsarts op de subafdeling Voortplantingsgeneeskunde afdeling Verloskunde en Vrouwenziekten van ErasmusMC te Rotterdam.In this chapter the endocrine profiles during the normal menstrual cycle have been described. In addition, a short overview of the history of ovarian hyperstimulation for in vitro fertilization is given. The development of the newly designed long acting FSH preparation has been described. Furthermore, differences between GnRH agonists and GnRH antagonists are discussed as well as the currently used clinical protocols with these GnRH analogues. The impact of the final oocyte maturation performed with hCG has been described and finally the available knowledge on the early luteolysis after ovarian hyperstimulation for IVF has been discussed

Détermination des acides aminés limitants chez le taurillon BBBc recevant une ration à base d'ensilage de maïs

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Превентивная сущность промышленного дизайна в современном образовании и обществе

The article is devoted to Future design - modern prognostic directions of design activity. The article evaluates the prospects of introducing methods of technological forecasting in the curriculum of industrial design. We present here the list of relevant topics for lectures of the subject

Nonsupplemented luteal phase characteristics after the administration of recombinant human chorionic gonadotropin, recombinant luteinizing hormone, or gonadotropin-releasing hormone (GnRH) agonist to induce final oocyte maturation in in vitro fertilization patients after ovarian stimulation with recombinant follicle-stimulating hormone and GnRH antagonist cotreatment

Replacing GnRH agonist cotreatment for the prevention of a premature rise in LH during ovarian stimulation for in vitro fertilization (IVF) by the late follicular phase administration of GnRH antagonist may render supplementation of the luteal phase redundant, because of the known rapid recovery of pituitary function after antagonist cessation. This randomized two-center study was performed to compare nonsupplemented luteal phase characteristics after three different strategies for inducing final oocyte maturation. Forty patients underwent ovarian stimulation using recombinant (r-)FSH (150 IU/d, fixed) combined with a GnRH antagonist (antide; 1 mg/d) during the late follicular phase. When at least one follicle above 18 mm was observed, patients were randomized to induce oocyte maturation by a single injection of either r-human (h)CG (250 microg) (n = 11), r-LH (1 mg) (n = 13), or GnRH agonist (triptorelin; 0.2 mg) (n = 15). Retrieved oocytes were fertilized by either IVF or intracytoplasmatic sperm injection, depending on sperm quality. Embryo transfer was performed 3-4 d after oocyte retrieval. No luteal support was provided. Serum concentrations of FSH, LH, estradiol (E(2)), progesterone (P), and hCG were assessed at fixed intervals during the follicular and luteal phase. The median duration of the luteal phase was 13, 10, and 9 d for the r-hCG, the r-LH, and the GnRH agonist group, respectively (P = 0.005). The median area under the curve per day (from 4 d post randomization until the onset of menses) for LH was 0.50, 2.34, and 1.07 for the r-hCG, the r-LH, and the GnRH agonist group, respectively (P = 0.001). The median area under the curve per day for P was 269 vs. 41 and 16 for the r-hCG, the r-LH, and the GnRH agonist group, respectively (P < 0.001). Low pregnancy rates (overall, 7.5%; range, 0-18% per started cycle) were observed in all groups. In conclusion, the nonsupplemented luteal phase was insufficient in all three groups. In the patients receiving r-hCG, the luteal phase was less disturbed, compared with both other groups, presumably because of prolonged clearance of hCG from the circulation and the resulting extended support of the corpus luteum. Despite high P and E(2) concentrations during the early luteal phase in all three groups, luteolysis started prematurely, presumably because of excessive negative steroid feedback resulting in suppressed pituitary LH release. Hence, support of corpus luteum function remains mandatory after ovarian stimulation for IVF with GnRH antagonist cotreatment

Health impacts of extreme weather events – Cascading risks in a changing climate

Background: Extreme weather events represent one of the most tangible impacts of anthropogenic climate change. They have increased in number and severity and a further increase is expected. This is accompanied by direct and indirect negative consequences for human health. Methods: Flooding events, storms and droughts are analysed here for Germany from a systemic perspective on the basis of a comprehensive literature review. Cascading risks beyond the initial event are also taken into account in order to depict downstream consequences. Results: In addition to the immediate health burdens caused by extreme weather events, such as injuries, long-term consequences such as stress-related mental disorders occur. These stresses particularly affect certain vulnerable groups, e.g. older persons, children, pregnant women or first responders. Conclusions: A look at the cascading risks described in the international literature allows us to develop precautionary measures for adaptation to the consequences of climate change. Many adaptation measures protect against different risks at the same time. In addition to planning measures, these include, above all, increasing the population's ability to protect itself through knowledge and strengthening of social networks. This is part of a series of articles that constitute the German Status Report on Climate Change and Health 2023

Gesundheitliche Auswirkungen von Extremwetterereignissen – Risikokaskaden im anthropogenen Klimawandel

Hintergrund: Extremwetterereignisse stellen eine der greifbarsten Auswirkungen des anthropogenen Klimawandels dar. Sie haben in Zahl und Ausprägung zugenommen und eine weitere Zunahme wird erwartet. Damit gehen unmittelbare und mittelbare negative Folgen für die menschliche Gesundheit einher. Methode: Überschwemmungsereignisse, Stürme und Dürren werden hier für Deutschland aus systemischer Perspektive auf Basis einer umfassenden Literaturrecherche analysiert, wobei über das konkrete Schadensereignis hinausgehende Risikokaskaden in den Blick genommen werden, um auch nachgelagerte Folgen darzustellen. Ergebnisse: Neben den unmittelbaren gesundheitlichen Belastungen durch Extremwetterereignisse, wie Verletzungen, treten langfristige Folgen, wie psychische Belastungsstörungen, auf. Diese Belastungen betreffen bestimmte vulnerable Gruppen, z. B. ältere Menschen, Kinder, Schwangere oder Einsatzkräfte, in besonderem Maße. Schlussfolgerungen: Der Blick auf die in der internationalen Literatur beschriebenen Risikokaskaden erlaubt es, Vorsorgemaßnahmen für die Anpassung an die Folgen des Klimawandels zu entwickeln. Viele Anpassungsmaßnahmen schützen dabei vor unterschiedlichen Risiken gleichzeitig. Neben planerischen Maßnahmen ist dies vor allem auch die Erhöhung der Selbstschutzfähigkeit in der Bevölkerung durch Wissen und die Stärkung sozialer Netzwerke. Dieser Artikel ist Teil der Beitragsreihe zum Sachstandsbericht Klimawandel und Gesundheit 202

Gesundheitliche Auswirkungen von Extremwetterereignissen – Risikokaskaden im anthropogenen Klimawandel

Hintergrund: Extremwetterereignisse stellen eine der greifbarsten Auswirkungen des anthropogenen Klimawandels dar. Sie haben in Zahl und Ausprägung zugenommen und eine weitere Zunahme wird erwartet. Damit gehen unmittelbare und mittelbare negative Folgen für die menschliche Gesundheit einher. Methode: Überschwemmungsereignisse, Stürme und Dürren werden hier für Deutschland aus systemischer Perspektive auf Basis einer umfassenden Literaturrecherche analysiert, wobei über das konkrete Schadensereignis hinausgehende Risikokaskaden in den Blick genommen werden, um auch nachgelagerte Folgen darzustellen. Ergebnisse: Neben den unmittelbaren gesundheitlichen Belastungen durch Extremwetterereignisse, wie Verletzungen, treten langfristige Folgen, wie psychische Belastungsstörungen, auf. Diese Belastungen betreffen bestimmte vulnerable Gruppen, z. B. ältere Menschen, Kinder, Schwangere oder Einsatzkräfte, in besonderem Maße. Schlussfolgerungen: Der Blick auf die in der internationalen Literatur beschriebenen Risikokaskaden erlaubt es, Vorsorgemaßnahmen für die Anpassung an die Folgen des Klimawandels zu entwickeln. Viele Anpassungsmaßnahmen schützen dabei vor unterschiedlichen Risiken gleichzeitig. Neben planerischen Maßnahmen ist dies vor allem auch die Erhöhung der Selbstschutzfähigkeit in der Bevölkerung durch Wissen und die Stärkung sozialer Netzwerke. Dieser Artikel ist Teil der Beitragsreihe zum Sachstandsbericht Klimawandel und Gesundheit 202

Atherosclerotic plaque destabilization in Mice: A comparative study

Atherosclerosis-Associated diseases are the main cause ofmortality and morbidity in western societies. The progression of atherosclerosis is a dynamic process evolving from early to advanced lesions thatmay become rupture-prone vulnerable plaques. Acute coronary syndromes are the clinical manifestation of life-Threatening thrombotic events associated with high-risk vulnerable plaques. Hyperlipidemic mouse models have been extensively used in studying the mechanisms controlling initiation and progression of atherosclerosis. However, the understanding of mechanisms leading to atherosclerotic plaque destabilization has been hampered by the lack of proper animalmodelsmimicking this process. Although various mouse models generate atherosclerotic plaques with histological features of human advanced lesions, a consensus model to study atherosclerotic plaque destabilization is still lacking. Hence, we studied the degree and features of plaque vulnerability in different mouse models of atherosclerotic plaque destabilization and find that the model based on the placement of a shear stress modifier in combination with hypercholesterolemia represent with high incidence the most human like lesions compared to the other models

After the honeymoon: The Obama effect on political attitudes and participation

My dissertation takes a mixed-methods approach to investigating the possibility of a lasting Obama Effect on the political attitudes and behaviors of Obama supporters from 2008. Defining the Obama Effect as the extraordinary enthusiasm surrounding Barack Obama’s 2008 campaign, I argue that a short term Obama Effect was clearly present in 2008 based on Obama’s electoral success, fundraising prowess, and ability to inspire volunteerism, as well as on the historic nature of his candidacy. But I ask, was it a lasting effect? My quantitative analyses—built upon panel survey data from the American National Election Studies—suggest little evidence of a lasting campaign effect that was positive and/or unique to Obama supporters. With regard to attitudes and behaviors such as political interest, political efficacy, or attendance of political events, Obama supporters often showed relative declines or stagnation over time when compared to nonsupporters or supporters of previous presidents. My qualitative analysis—based upon interviews with 30 former volunteers from the 2008 Obama campaign—does, however, indicated that the Obama Effect had a deep and lasting impact on his most enthusiastic support base, those who volunteered for his campaign. Many former Obama volunteers remained highly interested, civically engaged, and continually inspired as a result of their activism for the 2008 Obama campaign. In sum, I conclude that while that campaign may not have had its desired transformational effect on the broader American electorate, it did produce a positive and indeed a lasting impact on its most enthusiastic supporters

Регулируемый электропривод конвейера Распадской обогатительной фабрики

Цель работы – разработка и исследование регулируемого электропривода ленточного конвейера. Произведен расчет конвейера и выбор основного электрооборудования, построены электромеханические и механические характеристики асинхронного электродвигателя. Построены переходные процессы для различных режимов работы.The work purpose – development and research of the adjustable electric drive of the tape conveyor. Calculation of the conveyor and the choice of the capital electric equipment is made, electromechanical and mechanical characteristics of the asynchronous electric motor are constructed. Transition processes for various operating modes are constructed