Total stimulation gonadotropin dose per oocyte retrieved and fresh embryo quality affect live birth rate after frozen-thawed embryo transfer

Koeputkihedelmöityshoidoissa (IVF) ja munasolujen mikroinjektiohoidoissa (ICSI) elävän lapsen syntymisen todennäköisyyteen vaikuttavia tekijöitä ovat muun muassa kerättyjen munasolujen lukumäärä, saatu gonadotropiinihormonin (FSH) annos sekä luotujen korkealaatuisten alkioiden määrä. Tämän tutkimuksen tarkoituksena oli selvittää, mitkä ominaisuudet alkion tuoresiirtovaiheessa vaikuttavat syntymän todennäköisyyteen jatkossa, jos naiselle tehdään myöhemmin hedelmöityshoidossa pakastetun alkion siirto. Tutkimusaineistona oli yhteinen Suomen lapsettomuusklinikoista kerätty tietokanta, joka sisälsi tiedot yhteensä 9465 pakastusalkionsiirto-tyyppisestä hedelmöityshoidosta vuosilta 2000-2017. Tuorealkionsiirtoja tutkittiin verraten näitä samojen naisten myöhempiin pakastealkionsiirtoihin. Luteaalisen kierron hormonaalista tukea sai naisista 42.9 %, hormonaalisesti indusoitu kuukautiskierto ja ovulaatio oli 40.7 % naisista, ja 16.1 % naisista kuukautiskierto oli täysin spontaani. FSH-annosta/munasolu käytettiin munasarjojen vasteen arviointiin. Tutkimuksessa selvisi, että vertailussa matalin FSH/munasolu -annossuhde <200 IU/munasolu sai aikaan suurimman todennäköisyyden elävän lapsen syntymälle pakastealkionsiirron jälkeen. Korkeampi annossuhde 300-399 IU/munasolu sen sijaan laski merkittävästi tätä todennäköisyyttä. Potilaan hormonaalisesti indusoitu ovulaatiokierto niin ikään assosioitui matalampaan syntymän todennäköisyyteen kuin kierto, jossa oli annettu hormonaalista tukea vain luteaalivaiheessa. Mikäli ainakin yksi korkealaatuinen alkio oli saatavilla hoitojen alussa, oli syntymän todennäköisyys suurempi läpi koko prosessin. Naisen yli 35 vuoden ikä laski syntymän todennäköisyyttä. Hedelmöityshoidoissa FSH/munasolu-annossuhde kuvastaa mahdollisesti munasarjojen toimintaa ja munasolujen laatua. Annossuhde tulisi pyrkiä pitämään mahdollisimman alhaisena, jotta vältytään korkeampiin annoksiin liittyvältä syntymän todennäköisyyden laskulta

Development and implementation of a vehicle-pedestrian conflict analysis method: Adaptation of a vehicle-vehicle technique

This paper examines the development, use, and evaluation of a new traffic conflict analysis technique that specifically addresses pedestrian-vehicle conflicts with the intention of being applicable to shared-space environments. The method is based on an existing, well-established, and widely used vehicle-vehicle conflict analysis technique, but is adapted to consider the movement of pedestrians, which differs significantly from that of vehicles. The new method is then implemented on the Exhibition Road site of West London with the use of video data collected from locations with a potentially high concentration of vehicle-pedestrian conflicts, and the results of the analysis are presented. Finally, the results are compared with those obtained by other conflict analysis techniques and also against accident data to assess not only the accuracy but also the functionality of the new technique

Analysis of pedestrian-vehicle traffic conflicts in street designs with elements of shared space

This paper investigates changes in pedestrian-vehicle traffic conflicts in urban streets redesigned according to the principles of shared space, using a recently developed Pedestrian-Vehicle Conflicts Analysis (PVCA) method. In a first step, the PVCA method is revised to more accurately reflect the features of shared space: this includes the definition of a systematic process for identifying conflict occurrences on one hand, and the full quantification of the conflict severity grading process on the other. Then, the refined PVCA method is applied to a case study in London, using video data from periods before and after the redevelopment of the Exhibition Road site from a conventional dual carriageway to a modern design with some elements of shared space. The results of the comparative analysis carried out indicate a general decrease in traffic conflict rates as a result of the redesign, but also highlight specific issues that may require additional analysis

Review of AAC interventions in persons with dementia

© 2019 Royal College of Speech and Language Therapists Background: Communication is an important priority in dementia research. Communication strategies and scaffolds, specifically through augmentative and alternative communication (AAC), offer vital compensatory support for persons with dementia in an attempt to maintain the latter's quality of life and well-being through participation with others. To date, no research review has been published that synthesizes the current research of AAC in the field of dementia. Aims: To provide an overview of current AAC strategies and techniques used for supporting communication in dementia by surveying the literature base in a systematic manner, synthesizing the findings and highlighting trends and gaps. Methods & Procedures: A multifaceted search strategy included nine electronic database searches, using specific keywords. Application of predefined selection criteria during screening procedures led to the inclusion of 39 studies. Data were extracted and studies synthesized according to communication partners; description of AAC strategies and techniques; outcome measures; and communication outcomes. Main Contribution: This review shows that the majority of the research to date has focused on supporting the interactions of persons with dementia of the Alzheimer's type (DAT) using non-electronic memory and communication aids. Future research should focus on social participation and person-centred communication to optimize functional communication with AAC. Training programmes targeting dyadic interaction and supporting persons with dementia from diverse ethnic backgrounds are avenues for further research. Conclusions: Research trends and, more importantly, the gaps highlighted in this research review present speech–language therapists and researchers with a set of current priorities that are necessary for the advancement of the knowledge base

Reconceptualizing CSR in the media industry as relational accountability

In this paper, we reconceptualize CSR in the media industries by combining empirical data with theoretical perspectives emerging from the communication studies and business ethics literature. We develop a new conception of what corporate responsibility in media organizations may mean in real terms by bringing Bardoel and d’Haenens’ (European Journal of Communication 19 165–194 2004) discussion of the different dimensions of media accountability into conversation with the empirical results from three international focus group studies, conducted in France, the USA and South Africa. To enable a critical perspective on our findings, we perform a philosophical analysis of its implications for professional, public, market, and political accountability in the media, drawing on the insights of Paul Virilio. We come to the conclusion that though some serious challenges to media accountability exist, the battle for responsible media industries is not lost. In fact, the speed characterizing the contemporary media environment may hold some promise for fostering the kind of relational accountability that could underpin a new understanding of CSR in the media

Comparison of phenol red and polyethyleneglycol as nonabsorbable markers for the study of intestinal absorption in humans

When phenol red and polyethyleneglycol were used simultaneously as nonabsorbable markers in perfusion studies of the absorptive capacity of high jejunum in humans, apparent absorption was the same when calculated from either marker. This similar indication of dilution and of absorption by the two markers was found in normal subjects and in patients with nontropical sprue, whether aqueous or saline solutions of dextrose were infused. The similarity strengthens the evidence that either phenol red or polyethyleneglycol is a satisfactory “nonabsorbable” marker compound to indicate dilution in perfusion studies of dextrose and electrolyte absorption in limited segments of human intestine.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/44368/1/10620_2005_Article_BF02233070.pd

Doing narrative research? Thinking through the narrative process

Across social science disciplines there has been a growth in narrative research—the so called ‘narrative turn’. This turn echoes broader shifts associated with more complex social worlds, epistemological challenges and feminist responses. Narrative research typically involves exploring individual, subjective experiences through interview-based research, but can also range across researching group and organisational dynamics to document-based analysis. In this chapter the question of what constitutes narrative research is explored and illuminated using data from a qualitative longitudinal study on transition to first-time motherhood. The importance of developing a theoretical rationale when choosing a narrative research approach, together with suggested ways of analysing data once collected, is noted. Researching individual accounts of subjective experience and transitions as a feminist researcher provides opportunities, but challenges too

What is psychiatry? Co-producing complexity in mental health

What is psychiatry? Such a question is increasingly important to engage with in light of the development of new diagnostic frameworks that have wide-ranging and international clinical and societal implications. I suggest in this reflective essay that ‘psychiatry' is not a singular entity that enjoins consistent forms of critique along familiar axes; rather, it is a heterogeneous assemblage of interacting material and symbolic elements (some of which endure, and some of which are subject to innovation). In underscoring the diversity of psychiatry, I seek to move towards further sociological purchase on what remains a contested and influential set of discourses and practices. This approach foregrounds the relationships between scientific knowledge, biomedical institutions, social action and subjective experience; these articulations co-produce both psychiatry and each other. One corollary of this emphasis on multiplicity and incoherence within psychiatric theory, research and practice, is that critiques which elide this complexity are rendered problematic. Engagements with psychiatry are, I argue, best furthered by recognising its multifaceted nature

Species-Area Relationships Are Controlled by Species Traits

The species-area relationship (SAR) is one of the most thoroughly investigated empirical relationships in ecology. Two theories have been proposed to explain SARs: classical island biogeography theory and niche theory. Classical island biogeography theory considers the processes of persistence, extinction, and colonization, whereas niche theory focuses on species requirements, such as habitat and resource use. Recent studies have called for the unification of these two theories to better explain the underlying mechanisms that generates SARs. In this context, species traits that can be related to each theory seem promising. Here we analyzed the SARs of butterfly and moth assemblages on islands differing in size and isolation. We tested whether species traits modify the SAR and the response to isolation. In addition to the expected overall effects on the area, traits related to each of the two theories increased the model fit, from 69% up to 90%. Steeper slopes have been shown to have a particularly higher sensitivity to area, which was indicated by species with restricted range (slope  = 0.82), narrow dietary niche (slope  = 0.59), low abundance (slope  = 0.52), and low reproductive potential (slope  = 0.51). We concluded that considering species traits by analyzing SARs yields considerable potential for unifying island biogeography theory and niche theory, and that the systematic and predictable effects observed when considering traits can help to guide conservation and management actions