The risk factors and impact of subchorionic hematoma in the first trimester in IVF twin pregnancies: a prospective cohort study

ObjectiveThis study aimed to identify the risk factors for subchorionic hematoma (SCH) in the first trimester of in vitro fertilization (IVF) twin pregnancies and investigate the impact of SCH on pregnancy outcomes.Study designA prospective cohort study was conducted at Chengdu Women and Children's Central Hospital. The study recruited patients who were identified with twin pregnancies in the first trimester, undergoing IVF treatment from January 2020 to May 2021. The demographic characteristics and pregnancy outcomes were compared between the SCH and the non-SCH groups. A logistic regression analysis was used to determine the risk factors for SCH and adverse pregnancy outcomes.ResultsIn the first trimester, 38% of patients developed SCH. The independent risk factors for SCH included male factor, hydrosalpinx, polycystic ovary syndrome (PCOS), previous miscarriage, and adenomyosis. With respect to the pregnancy outcomes, only the rate of twin pregnancy loss before 20 gestational weeks was significantly higher in the SCH group than in the non-SCH group. After adjusting for the confounding factors, the presence of SCH diminished the ovarian reserve, and previous miscarriage was independently related to twin pregnancy loss before 20 gestational weeks.ConclusionThis may be the first study to evaluate the risk factors of SCH in twin pregnancies who underwent IVF-ET/FET treatment, which may provide some theoretical basis for clinical practice in the future. Furthermore, it was found that the occurrence of SCH was associated with the loss of both pregnancies before 20 gestational weeks. Therefore, these patients should be offered increased surveillance and timely treatment

Comparative study on appropriate drought and flood index selection in a tropical farming island in China

The traditional drought and flood analysis method had not fully considered the proportion analysis of different drought and flood grades in the historical years of each rainfall station. This made results unconvincing and made it difficult to deeply understand the characteristics and applicability of various methods. Based on the daily rainfall data of 88 stations in Hainan Island from 1970 to 2019, the China-Z index and the Standardized Precipitation Index (SPI) were used to compare and analyze the spatial and temporal distribution characteristics of droughts and floods from three different time scales (flood season, non-flood season and the whole year). The results showed that both SPI and China-Z index can well reflect the actual drought and flood situations in Hainan Island. The analysis of the proportions of different drought and flood grades in the historical years of each rainfall station and regional historical drought and flood statistics suggested that the China-Z index had a better indication effect than SPI on the extreme drought and flood grades. The alternation of drought and flood between different eras were obvious. Hainan Island generally presented an east-west reverse drought-flood variation trend, as well as a north-south reverse drought-flood variation trend. The drought and flood in the central mountainous area of Hainan Island had been relatively stable. The distribution pattern of drought and flood had a good spatial consistency in the three periods. On the whole, Hainan Island had shown a trend of flood in the east and drought in the west in the past 50 years

Narrow linewidth hybrid InP-TriPleX photonic integrated tunable laser based on silicon nitride micro-ring resonators

Detailed characterization of a hybrid integrated tunable laser based on micro-ring resonators shows a tuning range of 50 nm with ~40 kHz linewidth. The device demonstrates performance comparable with commercial external cavity lasers in 16QAM coherent system

Fabrication and properties of zirconia/hydroxyapatite composite scaffold based on digital light processing

Zirconia and hydroxyapatite(HA) are two typical implant materials, which have the advantages of excellent mechanical strength and good biological activity respectively. It was found that composite material had good biocompatibility and mechanical strength compared to the single material. In this paper, the porous scaffolds of ZrO2/HA composite were formed by digital light processing (DLP) technology and their performance were evaluated. Cell experiments showed that the addition of HA had a positive effect on cell proliferation and differentiation. Mechanical tests showed that the composite scaffold with 10 wt% HA had the best compressive capacity due to the pinning and bridging effect of a small amount of HA grains. When scaffolds were immersed in the simulated body fluid (SBF), the compressive strengths of the composite scaffolds decreased within the first 14 days and gradually increased after 14 days. The reason for this phenomenon was the degradation of calcium phosphate components and the deposition of apatite. By the 28th day, the compressive strengths of all the composite scaffolds increased to over 20 MPa, close to that of the zirconia scaffolds during the same period (25 MPa). The compressive strengths of all scaffolds met the requirement of cancellous bone during the entire soaking period, and the composite scaffolds have potential application value in bone repair

The 2021 WHO catalogue of Mycobacterium tuberculosis complex mutations associated with drug resistance: a genotypic analysis.

Background: Molecular diagnostics are considered the most promising route to achievement of rapid, universal drug susceptibility testing for Mycobacterium tuberculosis complex (MTBC). We aimed to generate a WHO-endorsed catalogue of mutations to serve as a global standard for interpreting molecular information for drug resistance prediction. Methods: In this systematic analysis, we used a candidate gene approach to identify mutations associated with resistance or consistent with susceptibility for 13 WHO-endorsed antituberculosis drugs. We collected existing worldwide MTBC whole-genome sequencing data and phenotypic data from academic groups and consortia, reference laboratories, public health organisations, and published literature. We categorised phenotypes as follows: methods and critical concentrations currently endorsed by WHO (category 1); critical concentrations previously endorsed by WHO for those methods (category 2); methods or critical concentrations not currently endorsed by WHO (category 3). For each mutation, we used a contingency table of binary phenotypes and presence or absence of the mutation to compute positive predictive value, and we used Fisher's exact tests to generate odds ratios and Benjamini-Hochberg corrected p values. Mutations were graded as associated with resistance if present in at least five isolates, if the odds ratio was more than 1 with a statistically significant corrected p value, and if the lower bound of the 95% CI on the positive predictive value for phenotypic resistance was greater than 25%. A series of expert rules were applied for final confidence grading of each mutation. Findings: We analysed 41 137 MTBC isolates with phenotypic and whole-genome sequencing data from 45 countries. 38 215 MTBC isolates passed quality control steps and were included in the final analysis. 15 667 associations were computed for 13 211 unique mutations linked to one or more drugs. 1149 (7·3%) of 15 667 mutations were classified as associated with phenotypic resistance and 107 (0·7%) were deemed consistent with susceptibility. For rifampicin, isoniazid, ethambutol, fluoroquinolones, and streptomycin, the mutations' pooled sensitivity was more than 80%. Specificity was over 95% for all drugs except ethionamide (91·4%), moxifloxacin (91·6%) and ethambutol (93·3%). Only two resistance mutations were identified for bedaquiline, delamanid, clofazimine, and linezolid as prevalence of phenotypic resistance was low for these drugs. Interpretation: We present the first WHO-endorsed catalogue of molecular targets for MTBC drug susceptibility testing, which is intended to provide a global standard for resistance interpretation. The existence of this catalogue should encourage the implementation of molecular diagnostics by national tuberculosis programmes. Funding: Unitaid, Wellcome Trust, UK Medical Research Council, and Bill and Melinda Gates Foundation

Successful treatment following early recognition of a case of Fournier’s scrotal gangrene after a perianal abscess debridement: a case report

Abstract Background Fournier’s gangrene is an acute surgical emergency characterized by high mortality rates ranging from approximately 13% to 45%. Therefore, aggressive multidisciplinary management is necessary. Case presentation A 29-year-old Asian man who had undergone surgical debridement at another hospital to treat a perianal abscess 5 days earlier was admitted to our hospital for severe scrotal and perianal pain, swelling, and high fever. A physical examination revealed a perianal abscess. Furthermore, the scrotum was gangrenous and exhibited extensive cellulitis in the perineum and bilateral inguinal area. Crepitations between the skin and fascia were palpable. A diagnosis of Fournier’s gangrene was made. The patient was treated with immediate surgical debridement under general anesthesia. He received broad-spectrum antibiotics, and debridement was repeated until the wound exhibited healthy granulation. Because both testes were severely exposed, they were transpositioned back into the scrotum 1 week after surgery. The patient was discharged on the 11th postoperative day. Conclusions The mainstay of treatment for Fournier’s gangrene should include fluid resuscitation, broad-spectrum antibiotic therapy, intensive care, nutritional support, and early aggressive surgical debridement of all necrotic tissue

Perinatal outcomes in intrahepatic cholestasis of pregnancy with monochorionic diamniotic twin pregnancy

Abstract Background The primary aim of the study is to investigate the perinatal outcomes in intrahepatic cholestasis of pregnancy (ICP) with monochorionic diamniotic (MCDA) twin pregnancy. Methods This study is a retrospective observational study for women with ICP and MCDA twin pregnancy. Included cases were divided into mild ICP group (10–39 mmol/L) and severe ICP group (> = 40 mmol/L), whose perinatal outcomes were compared between this two groups and whose predictors of adverse perinatal outcomes were evaluated. Results 37 cases and 21 cases are in mild and severe ICP group respectively, of which, the incidence of gestational diabetes mellitus (GDM) and iatrogenic preterm delivery in severe ICP group are higher than those in mild ICP group. Gestational age (GA) at diagnosis of ICP  40 mmol/l is an independent risk factor for meconium-stained amniotic fluid. Conclusion For women with ICP and MCDA twin pregnancy, GA at diagnosis of ICP  40umol/L are associated with adverse perinatal outcomes