Evaluation of Endometrial Urocortin Secretion for Prediction of Pregnancy after Intrauterine Insemination

Abstract Background: Urocortin is a neuropeptide produced by the human endometrium and has biological effects putatively important for promoting blastocyst implantation. We measured urocortin concentrations in samples of endometrial wash fluid collected from women with unexplained infertility who underwent intrauterine insemination (IUI). Methods: Patients 28–42 years of age (n = 71) were consecutively enrolled after a complete clinical evaluation. Endometrial wash fluid was retrieved before IUI, at the time of ultrasound evaluation of endometrial thickness. Urocortin concentrations were assayed with a specific ELISA. Results: After IUI, 28 patients (39%) became pregnant. Urocortin concentrations were significantly higher in women who became pregnant than in those who did not (0.38 μg/L vs 0.13 μg/L, P <0.0001). At a cutoff of 0.321 μg/L, urocortin results were positive in 61% [95% confidence interval (CI), 41%–78%] of women who had successful implantation and negative in 98% (95% CI, 88%–99.6%) of those who did not. The pregnancy rate for women with urocortin concentrations >0.32 μg/L was 94%, which differed significantly (P <0.05) from the overall pregnancy rate of 39% in the study population. Conclusions: Urocortin is measurable in endometrial wash fluid, and its concentrations before IUI are higher in women who subsequently achieve pregnancy. These data suggest that the probability of having a successful pregnancy-producing IUI may be better estimated by measuring urocortin in endometrial wash fluid

ARSB IS REQUIRED FOR BONE REMODELING

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COVID-19 in patients with thoracic malignancies (TERAVOLT): first results of an international, registry-based, cohort study

Background: Early reports on patients with cancer and COVID-19 have suggested a high mortality rate compared with the general population. Patients with thoracic malignancies are thought to be particularly susceptible to COVID-19 given their older age, smoking habits, and pre-existing cardiopulmonary comorbidities, in addition to cancer treatments. We aimed to study the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on patients with thoracic malignancies. Methods: The Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) registry is a multicentre observational study composed of a cross-sectional component and a longitudinal cohort component. Eligibility criteria were the presence of any thoracic cancer (non-small-cell lung cancer [NSCLC], small-cell lung cancer, mesothelioma, thymic epithelial tumours, and other pulmonary neuroendocrine neoplasms) and a COVID-19 diagnosis, either laboratory confirmed with RT-PCR, suspected with symptoms and contacts, or radiologically suspected cases with lung imaging features consistent with COVID-19 pneumonia and symptoms. Patients of any age, sex, histology, or stage were considered eligible, including those in active treatment and clinical follow-up. Clinical data were extracted from medical records of consecutive patients from Jan 1, 2020, and will be collected until the end of pandemic declared by WHO. Data on demographics, oncological history and comorbidities, COVID-19 diagnosis, and course of illness and clinical outcomes were collected. Associations between demographic or clinical characteristics and outcomes were measured with odds ratios (ORs) with 95% CIs using univariable and multivariable logistic regression, with sex, age, smoking status, hypertension, and chronic obstructive pulmonary disease included in multivariable analysis. This is a preliminary analysis of the first 200 patients. The registry continues to accept new sites and patient data. Findings: Between March 26 and April 12, 2020, 200 patients with COVID-19 and thoracic cancers from eight countries were identified and included in the TERAVOLT registry; median age was 68·0 years (61·8-75·0) and the majority had an Eastern Cooperative Oncology Group performance status of 0-1 (142 [72%] of 196 patients), were current or former smokers (159 [81%] of 196), had non-small-cell lung cancer (151 [76%] of 200), and were on therapy at the time of COVID-19 diagnosis (147 [74%] of 199), with 112 (57%) of 197 on first-line treatment. 152 (76%) patients were hospitalised and 66 (33%) died. 13 (10%) of 134 patients who met criteria for ICU admission were admitted to ICU; the remaining 121 were hospitalised, but were not admitted to ICU. Univariable analyses revealed that being older than 65 years (OR 1·88, 95% 1·00-3·62), being a current or former smoker (4·24, 1·70-12·95), receiving treatment with chemotherapy alone (2·54, 1·09-6·11), and the presence of any comorbidities (2·65, 1·09-7·46) were associated with increased risk of death. However, in multivariable analysis, only smoking history (OR 3·18, 95% CI 1·11-9·06) was associated with increased risk of death. Interpretation: With an ongoing global pandemic of COVID-19, our data suggest high mortality and low admission to intensive care in patients with thoracic cancer. Whether mortality could be reduced with treatment in intensive care remains to be determined. With improved cancer therapeutic options, access to intensive care should be discussed in a multidisciplinary setting based on cancer specific mortality and patients' preference

Multifractal Analysis of Calcium Silicate Hydrate (C\u2013S\u2013H) Mapped by X-ray Diffraction Microtomography

An investigation of Calcium Silicate Hydrate (C\u2013S\u2013H) topological distribution and modes of precipitation is performed by combining X-ray powder diffraction tomography, performed on an ordinary Portland cement sample, with a numerical scheme that simulates C\u2013S\u2013H precipitation. C\u2013S\u2013H distribution maps obtained both experimentally and numerically are analyzed by means of a quantitative method based on the principles of multifractal systems. The combination of these methods allows C\u2013S\u2013H spatial distribution and modes of precipitation and aggregation to be assessed quantitatively. In particular, the multifractal spectra obtained from the digital images of the cement paste microstructure, act as a structural probe, which is able to quantify the tendency of C\u2013S\u2013H to form clusters. The results of this combined approach suggest that a multifractal network forms by aggregation of C\u2013S\u2013H clusters heterogeneously nucleated on clinker grains and preexisting clusters that are partly homogeneously nucleated in the porous space

Diffraction-enhanced Computed Tomography of Cement Pastes: 3D Imaging of the Nucleation Processes

The properties of cementitious materials are related to the microstructure of their binder matrix, which forms by a sequence of dissolution-precipitation reactions converting the clinker phases into hydrates, among which the main hydration product is calcium silicate hydrate (C-S-H). Here, we monitor non-invasively the evolution of the cement paste microstructure during hydration by synchrotron X-ray diffraction-enhanced computed micro-tomography (XRD-CT). This innovative technique yields phase-resolved images of the hydrating cement paste at different stages, which are combined to map the sites where dissolution and precipitation processes occur. The results indicate that the nucleation mechanism of C-S-H changes when cement hydrates in the presence of poly-carboxylate ether (PCE) superplasticizers, which are commonly used to control the paste rheology. The observed change is essential to understand the development of the cement microstructure and to provide a direct link between the reaction kinetics and the physico-mechanical properties of the system

Direct Imaging of Nucleation Mechanisms by Synchrotron Diffraction Micro-Tomography: Superplasticizer-Induced Change of C\u2013S\u2013H Nucleation in Cement

The properties of cementitious materials are related to the microstructure of their binder matrix, which develops, during cement hydration, by a sequence of dissolution 12precipitation reactions. Here, microstructural development is monitored during hydration by synchrotron X-ray diffraction-enhanced computed microtomography (XRD-CT). This innovative, non invasive technique yields images of the crystallographic phases present in the hydrating cement paste at different stages, which are combined to map the sites where dissolution and precipitation occur. The results indicate that the nucleation mechanism of the main hydration product (a calcium-silicate hydrate commonly referred to as C 12S 12H) changes in the presence of polycarboxylate ether (PCE) superplasticizers. The observed change is essential to understand the development of the cement microstructure and to provide a direct link between the reaction kinetics and the physicomechanical properties of the system

3D imaging of complex materials: the case of cement

Absorption-based X-ray micro-tomography (X-\u3bcCT) provides fundamental in-situ information on the 3D microstructure of complex multiphase materials such as cements. However, since the phases present in a hydrating cement paste may be characterized by similar values of the attenuation coefficient, leading to low absorption contrast between different crystalline or amorphous phases, micro-structural interpretation can be equivocal. 3D phase mapping by X-ray diffraction micro-tomography proved to be a successful technique for investigating the spatial distribution of the products in the paste during the hydration process, in a totally non-invasive mode and with enhanced phase selectivity compared to absorption tomography. Phase-selective maps, in the case of crystalline phases, can be extracted from single Bragg peaks or from the Rietveld-refined scale factor. However, even poorly crystalline and/or amorphous phases present in the cement paste, such as calcium silicate hydrates, can be successfully mapped by the use of selected portions of the measured powder data containing the relevant scattering of the phase. The reconstructed maps can be directly modeled by multifractal analysis and compared with computer-generated distributions