Health of singletons born after frozen embryo transfer until early adulthood : a Finnish register study

STUDY QUESTION Is the health of singletons born after frozen embryo transfer (FET) comparable to that of singletons born after fresh embryo transfer (ET) until early adulthood? SUMMARY ANSWER The health of singletons born after FET does not differ from that of singletons born after fresh ET. WHAT IS KNOWN ALREADY The differences in perinatal outcomes of children born after FET and fresh ET are well known. FET is associated with an increased risk of large-for-gestational-age but diminished risks of preterm birth (PTB), small-for-gestational-age and decreased perinatal mortality compared to fresh ET. However, knowledge on the long-term health after FET is scarce. STUDY DESIGN, SIZE, DURATION This retrospective register-based cohort study compares singletons born after FET (n = 1825) between the years 1995 and 2006 to those born after fresh ET (n = 2933) and natural conception (NC, n = 31 136) with a mean follow-up time of 18-20 years. PARTICIPANTS/MATERIALS, SETTING, METHODS Singletons born after FET were compared to those born after fresh ET and NC regarding the frequencies of diagnoses in the main ICD-10 chapters (International Statistical Classification of Diseases and Related Health Problems, 10th revision), the number of outpatient visits and hospital admissions, and mortality. Adjustments were made for PTB, maternal age, parity, socioeconomic status based on mother's occupation and offspring sex. The study combines data from the Finnish Medical Birth Register, the Finnish Care Register for Health Care (CRHC) and the Cause-of-Death Register at Statistics Finland. The Student's T-test was used for continuous variables, and the Chi-square test was used for categorical variables. Cox regression was used to estimate crude and adjusted hazard ratios (HRs and aHRs, respectively). A general linear model was used to compare the means of outpatient visits, hospital admissions and lengths of hospital stays per person. MAIN RESULTS AND THE ROLE OF CHANCE No significant differences between the FET and fresh ET groups were found in the frequency of diagnoses in any of the ICD-10 chapters or in the parameters describing the need for hospital care. However, compared to the NC group, higher proportions in the FET group had outpatient visits in the hospital (93.5% vs 92.2%, aHR 1.23, 95% CI 1.17, 1.30) or hospital admissions (48% vs 46.5%, aHR 1.28, 95% CI 1.19, 1.37). Compared to the NC group, the FET group had elevated adjusted risks of diagnoses of infectious and parasitic diseases (aHR 1.24; 95% CI 1.11, 1.38), neoplasms (aHR 1.68; 95% CI 1.48, 1.91), diseases of the eye and adnexa, the ear or mastoid process (aHR 1.11; 95% CI 1.01, 1.21), the respiratory system (aHR 1.15; 95% CI 1.06, 1.23), the digestive system (aHR 1.17; 95% CI 1.05, 1.32), the skin or subcutaneous tissue (aHR 1.28; 95% CI 1.14, 1.43) and the genitourinary system (aHR 1.27; 95% CI 1.11, 1.45), as well as congenital malformations or chromosomal abnormalities (aHR 1.31; 95% CI 1.14, 1.50) and symptoms, signs or abnormal clinical or laboratory findings (aHR 1.25, 95% CI 1.16, 1.34). LIMITATIONS, REASONS FOR CAUTION Only hospital-based inpatient and outpatient care is covered by the CRHC register, excluding milder cases diagnosed elsewhere. We were not able to study the effect of ART treatments and subfertility separately in our setting. In addition, although our cohort is reasonably sized, even larger cohorts would be needed to reliably study rare outcomes, such as cancer. WIDER IMPLICATIONS OF THE FINDINGS For many ICD-10 chapters, we present the first published data on the long-term outcome of singletons born after FET. The results on FET versus fresh ET are reassuring, whereas the results on FET versus NC warrant further investigation. STUDY FUNDING/COMPETING INTEREST(S) Finnish government research funding was obtained for this study. Funding was also obtained from the Finnish Medical Society Duodecim, the Paivikki and Sakari Sohlberg Foundation, Orion Research Foundation, Finnish Society of Obstetrics and Gynaecology (research grants to A.M.T.) and Finnish government research funding. The funding sources were not involved in the planning or execution of the study. The authors have no competing interests to declare.Peer reviewe

Multiwavelength study of the high-latitude cloud L1642: chain of star formation

L1642 is one of the two high galactic latitude (|b| > 30deg) clouds confirmed to have active star formation. We examine the properties of this cloud, especially the large-scale structure, dust properties, and compact sources in different stages of star formation. We present high-resolution far-infrared and submm observations with the Herschel and AKARI satellites and mm observations with the AzTEC/ASTE telescope, which we combined with archive data from near- and mid-infrared (2MASS, WISE) to mm observations (Planck). The Herschel observations, combined with other data, show a sequence of objects from a cold clump to young stellar objects at different evolutionary stages. Source B-3 (2MASS J04351455-1414468) appears to be a YSO forming inside the L1642 cloud, instead of a foreground brown dwarf, as previously classified. Herschel data reveal striation in the diffuse dust emission around L1642. The western region shows striation towards NE and has a steeper column density gradient on its southern side. The densest central region has a bow-shock like structure showing compression from the west and a filamentary tail extending towards east. The differences suggest that these may be spatially distinct structures, aligned only in projection. We derive values of the dust emission cross-section per H nucleon for different regions of the cloud. Modified black-body fits to the spectral energy distribution of Herschel and Planck data give emissivity spectral index beta values 1.8-2.0 for the different regions. The compact sources have lower beta values and show an anticorrelation between T and beta. Markov chain Monte Carlo calculations demonstrate the strong anticorrelation between beta and T errors and the importance of mm Planck data in constraining the estimates. L1642 reveals a more complex structure and sequence of star formation than previously known.Comment: 22 pages, 18 figures, accepted to Astronomy & Astrophysics; abstract shortened and figures reduced for astrop

High arachis hypogaea allergen 2 immunoglobulin E levels predict responses to exposure to a small amount of peanut protein

Non peer reviewe

Detecting suicidality among adolescent outpatients: evaluation of trained clinicians' suicidality assessment against a structured diagnostic assessment made by trained raters

<p>Abstract</p> <p>Background</p> <p>Accurate assessment of suicidality is of major importance. We aimed to evaluate trained clinicians' ability to assess suicidality against a structured assessment made by trained raters.</p> <p>Method</p> <p>Treating clinicians classified 218 adolescent psychiatric outpatients suffering from a depressive mood disorder into three classes: 1-no suicidal ideation, 2-suicidal ideation, no suicidal acts, 3-suicidal or self-harming acts. This classification was compared with a classification with identical content derived from the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS-PL) made by trained raters. The convergence was assessed by kappa- and weighted kappa tests.</p> <p>Results</p> <p>The clinicians' classification to class 1 (no suicidal ideation) was 85%, class 2 (suicidal ideation) 50%, and class 3 (suicidal acts) 10% concurrent with the K-SADS evaluation (γ²= 37.1, df 4, p = 0.000). Weighted kappa for the agreement of the measures was 0.335 (CI = 0.198–0.471, p < 0.0001). The clinicians under-detected suicidal and self-harm acts, but over-detected suicidal ideation.</p> <p>Conclusion</p> <p>There was only a modest agreement between the trained clinicians' suicidality evaluation and the K-SADS evaluation, especially concerning suicidal or self-harming acts. We suggest a wider use of structured scales in clinical and research settings to improve reliable detection of adolescents with suicidality.</p

Planck 2015 results. XXVIII. The Planck Catalogue of Galactic Cold Clumps

We present the Planck Catalogue of Galactic Cold Clumps (PGCC), an all-sky catalogue of Galactic cold clump candidates detected by Planck. This catalogue is the full version of the Early Cold Core (ECC) catalogue, which was made available in 2011 with the Early Release Compact Source Catalogue (ERCSC) and which contained 915 high signal-to-noise sources. It is based on the Planck 48-month mission data that are currently being released to the astronomical community. The PGCC catalogue is an observational catalogue consisting exclusively of Galactic cold sources. The three highest Planck bands (857, 454, and 353 GHz) have been combined with IRAS data at 3 THz to perform a multi-frequency detection of sources colder than their local environment. After rejection of possible extragalactic contaminants, the PGCC catalogue contains 13188 Galactic sources spread across the whole sky, i.e., from the Galactic plane to high latitudes, following the spatial distribution of the main molecular cloud complexes. The median temperature of PGCC sources lies between 13 and 14.5 K, depending on the quality of the flux density measurements, with a temperature ranging from 5.8 to 20 K after removing the sources with the top 1% highest temperature estimates. Using seven independent methods, reliable distance estimates have been obtained for 5574 sources, which allows us to derive their physical properties such as their mass, physical size, mean density, and luminosity.The PGCC sources are located mainly in the solar neighbourhood, but also up to a distance of 10.5 kpc in the direction of the Galactic centre, and range from low-mass cores to large molecular clouds. Because of this diversity and because the PGCC catalogue contains sources in very different environments, the catalogue is useful for investigating the evolution from molecular clouds to cores. Finally, it also includes 54 additional sources located in the Small and Large Magellanic Clouds

Clinical characteristics and airway inflammation profile of COPD persistent sputum producers

SummaryBackgroundCOPD patients with chronic bronchitis include a subgroup with persistent sputum production on most or every day. We hypothesized that COPD patients with persistent sputum production have a different profile of airway inflammation, and more severe clinical characteristics.ObjectiveTo compare the airway inflammation profile and clinical characteristics of COPD persistent and non-persistent sputum producers.MethodsCOPD persistent sputum producers (n = 26) and non-persistent sputum producers (n = 26) underwent sputum induction and pulmonary function tests. Exacerbation history was recorded; the St. George's Respiratory Questionnaire, Modified Medical Research Council Dyspnoea scale and COPD Assessment Tool were completed. 33 COPD patients provided sputum for bacteriology.ResultsPersistent sputum producers had lower post-bronchodilator FEV1% predicted (p = 0.01), diffusion capacity (p = 0.04), 6 min walk test distance (p = 0.05), and higher closing volume (p = 0.01), BODE index (p = 0.01), rate of bacterial colonization (p = 0.004) and exacerbations (p = 0.03) compared to non-persistent sputum producers. The mean SGRQ and CAT scores were higher in persistent sputum producers (p = 0.01 and 0.03 respectively). Sputum neutrophil and eosinophil total cell counts were higher in persistent sputum producers (p = 0.02 and 0.05 respectively). Sputum levels of eotaxin (p = 0.02), MCP-1 (p = 0.02), TNF-α (p = 0.03) and IL-6 (p = 0.05) were higher in persistent sputum producers.ConclusionCOPD persistent sputum producers have more severe clinical characteristics and increased concentrations of some inflammatory mediators in the airways

Changes in hemostasis parameters in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia complicated by endocarditis or thromboembolic events : a prospective gender-age adjusted cohort study

The aim of this study was to examine the changes in hemostasis parameters in endocarditis and thromboembolic events in nonfatal methicillin-sensitive Staphylococcus aureus bacteremia (MS-SAB) - a topic not evaluated previously. In total, 155 patients were recruited and were categorized according to the presence of endocarditis or thromboembolic events with gender-age adjusted controls. Patients who deceased within 90 days or patients not chosen as controls were excluded. SAB management was supervised by an infectious disease specialist. Patients with endocarditis (N = 21), compared to controls (N = 21), presented lower antithrombin III at day 4 (p <0.05), elevated antithrombin III at day 90 (p <0.01), prolonged activated partial thromboplastin time at days 4 and 10 (p <0.05), and enhanced thrombin-antithrombin complex at day 4 (p <0.01). Thromboembolic events (N = 8), compared to controls (N = 34), significantly increased thrombin-antithrombin complex at day 4 (p <0.05). In receiver operating characteristic analysis, the changes in these hemostasis parameters at day 4 predicted endocarditis and thromboembolic events (p <0.05). No differences in hemoglobin, thrombocyte, prothrombin fragment, thrombin time, factor VIII, D-dimer or fibrinogen levels were observed between cases and controls. The results suggest that nonfatal MS-SAB patients present marginal hemostasis parameter changes that, however, may have predictability for endocarditis or thromboembolic events. Larger studies are needed to further assess the connection of hemostasis to complications in SAB.Peer reviewe