Should We Continue to Measure Endometrial Thickness in Modern-Day Medicine? The Effect on Live Birth Rates and Birth Weight

The evaluation of endometrial thickness (EMT) is still part of standard cycle monitoring during IVF, despite the lack of robust evidence of any value of this measurement to predict little revalidation in contemporary medical practice; other tools, however, such as endocrine profile monitoring, have become increasingly popular. The aim of this study was to reassess whether EMT affects the outcome of a fresh embryo transfer in modern-day medicine, using a retrospective, single-centre cohort of 3350 IVF cycles (2827 women) carried out between 2010 and 2014. In the multivariate regression analysis, EMT was non-linearly associated with live birth, with live birth rates being the lowest with an EMT less than 7.0 mm (21.6%; P < 0.001) and then between 7.0 mm and 9.0 mm (30.2%; P = 0.008). An EMT less than 7.0 mm was also associated with a decrease in neonatal birthweight z-scores (-0.40; 95% CI -0.69 to -0.12). In conclusion, these results reaffirm the use of EMT as a potential prognostic tool for live birth rates and neonatal birthweight in contemporary IVF, namely when considered together with other ovarian stimulation monitoring methods, such as the late-follicular endocrine profile.info:eu-repo/semantics/publishedVersio

The Mediterranean Moored Multi-sensor Array (M3A): system development and initial results

International audienceOperational forecasting of ocean circulation and marine ecosystem fluctuations requires multi-parametric real-time measurements of physical and biochemical properties. The architecture of a system that is able to provide such measurements from the upper-thermocline layers of the Mediterranean Sea is described here. The system was developed for the needs of the Mediterranean Forecasting System and incorporates state-of-the-art sensors for optical and chemical measurements in the upper 100 m and physical measurements down to 500 m. Independent moorings that communicate via hydro-acoustic modems are hosting the sensors. The satellite data transfer and the large autonomy allow for the operation of the system in any open-ocean site. The system has been in pre-operational use in the Cretan Sea since January 2000. The results of this pilot phase indicate that multi-parametric real-time observations with the M3A system are feasible, if a consistent maintenance and re-calibration program is followed. The main limitations of the present configuration of M3A are related: (a) to bio-fouling that primarily affects the turbidity and secondarily affects the other optical sensors, and (b) to the limited throughput of the currently used satellite communication system. Key words. Atmospheric composition and structure (instruments and techniques.) Oceanography: general (ocean prediction) Oceanography: physical (upper ocean process

Generalised Pustular Psoriasis (von Zumbusch type) following renal Transplantation. Report of a case and review of the literature

Generalized pustular psoriasis appears as an uncommon variant form of psoriasis consisting of widespread pustules on an erythematous background (von Zumbusch). A 39-year old male patient with a history of plaque psoriasis since the age of 9 who had an acute onset of generalized pustular psoriasis 12 days after he underwent renal transplantation is presented. Despite administered immunosuppression for transplantation the addition of cyclosporine A and methotrexate did not reverse the ongoing process of disease and the patient died on the 57th post-transplant day due to multiorgan failure following severe bone marrow suppression

Controversy and consensus on indications for sperm DNA fragmentation testing in male infertility: a global survey, current guidelines, and expert recommendations.

PURPOSE: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND METHODS: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. RESULTS: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. CONCLUSIONS: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians

The Historical Perspective of the Problem of Interpersonal Comparisons of Utility

The starting-point of the article is the inconsistency between the established practice of acceptance in many cases, of economic policy (i.e. progressive taxation, national insurance policies) and the theoretical rejection of interpersonal comparisons of utility who see it as an unscientific value judgement. The inconsistency is explained by identifying three groups of theorists: (1) those who thought of comparability as a value judgement and unacceptable for economic policy considerations (positivists), (2) those who agreed with the positivists, on the normative nature of comparability but accepted it as a basis for economic policy, and (3) those who thought of it as part of a scientific economics. The implication was that, despite the dominance of positivist methodology in other sub-fields, the historical experience points to the difficulty of applying positivist methodology to the issue of comparability. If the inconsistency is thus due to the inappropriateness of the positivist approach, the only possible solution is the explicit abandonment of this approach at least in matters related to the collective aspects of economics

Controversy and consensus on the management of elevated sperm DNA fragmentation in male infertility: a global survey, current guidelines, and expert recommendations

PURPOSE: Sperm DNA fragmentation (SDF) has been associated with male infertility and poor outcomes of assisted reproductive technology (ART). The purpose of this study was to investigate global practices related to the management of elevated SDF in infertile men, summarize the relevant professional society recommendations, and provide expert recommendations for managing this condition. MATERIALS AND METHODS: An online global survey on clinical practices related to SDF was disseminated to reproductive clinicians, according to the CHERRIES checklist criteria. Management protocols for various conditions associated with SDF were captured and compared to the relevant recommendations in professional society guidelines and the appropriate available evidence. Expert recommendations and consensus on the management of infertile men with elevated SDF were then formulated and adapted using the Delphi method. RESULTS: A total of 436 experts from 55 different countries submitted responses. As an initial approach, 79.1% of reproductive experts recommend lifestyle modifications for infertile men with elevated SDF, and 76.9% prescribe empiric antioxidants. Regarding antioxidant duration, 39.3% recommend 4-6 months and 38.1% recommend 3 months. For men with unexplained or idiopathic infertility, and couples experiencing recurrent miscarriages associated with elevated SDF, most respondents refer to ART 6 months after failure of conservative and empiric medical management. Infertile men with clinical varicocele, normal conventional semen parameters, and elevated SDF are offered varicocele repair immediately after diagnosis by 31.4%, and after failure of antioxidants and conservative measures by 40.9%. Sperm selection techniques and testicular sperm extraction are also management options for couples undergoing ART. For most questions, heterogenous practices were demonstrated. CONCLUSIONS: This paper presents the results of a large global survey on the management of infertile men with elevated SDF and reveals a lack of consensus among clinicians. Furthermore, it demonstrates the scarcity of professional society guidelines in this regard and attempts to highlight the relevant evidence. Expert recommendations are proposed to help guide clinicians

Combined deformation and solidification-driven porosity formation in aluminum alloys

In die-casting processes, the high cooling rates and pressures affect the alloy solidification and deformation behavior, and thereby impact the final mechanical properties of cast components. In this study, isothermal semi-solid compression and subsequent cooling of aluminum die-cast alloy specimens were characterized using fast synchrotron tomography. This enabled the investigation and quantification of gas and shrinkage porosity evolution during deformation and solidification. The analysis of the 4D images (3D plus time) revealed two distinct mechanisms by which porosity formed; (i) deformation-induced growth due to the enrichment of local hydrogen content by the advective hydrogen transport, as well as a pressure drop in the dilatant shear bands, and (ii) diffusion-controlled growth during the solidification. The rates of pore growth were quantified throughout the process, and a Gaussian distribution function was found to represent the variation in the pore growth rate in both regimes. Using a one-dimensional diffusion model for hydrogen pore growth, the hydrogen flux required for driving pore growth during these regimes was estimated, providing a new insight into the role of advective transport associated with the deformation in the mushy region

Economics education and value change: The role of program-normative homogeneity and peer influence

In the light of corporate scandals and the recent financial crisis, there has been an increased interest in the impact of business education on the value orientations of graduates. Yet our understanding of how students' values change during their time at business school is limited. In this study,weinvestigate the effects of variations in the normative orientations of economics programs. We argue that interaction among economics students constitutes a key mechanism of value socialization, the effects of which are likely to vary across more-or-less normatively homogeneous economics programs. In normatively homogeneous programs, students are particularly likely to adopt economics values as a result of peer interaction. We specifically explore changes in power, hedonism, and self-direction values in a 2-year longitudinal study of economics students (N 5 197) in a normatively homogeneous and two normatively heterogeneous economics programs. As expected, for students in a normatively homogeneous economics program, interaction with peers was linked with an increase in power and hedonism values, and a decrease in self-direction values. Our findings highlight the interplay between program normative homogeneity and peer interaction as an important factor in value socialization during economics education and have important practical implications for business school leaders