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Rhipidomys is a Sigmodontinae genus with a great diversity in western Amazonia, including Rhipidomys gardneri and Rhipidomys leucodactylus. These species shared the same diploid number of 44, however, two fundamental numbers were attributed to R. leucodactylus and one to R. gardneri. A new karyotype for R. leucodactylus is described, with a diploid and fundamental number shared by other Rhipidomys species. Data confirmed three karyotypes for R. leucodactylus, only one for R. gardneri, the presence of R. leucodactylus in the Brazilian state of Acre and extend the distribution of R. gardneri to Manoel Urbano, in Acre, showing both species occurring in the high Purus River basin. [ABSTRACT FROM AUTHOR]

Brain reconstruction, specially of the cerebral cortex, is a challenging task and even more so when it comes to highly gyrified brained animals. Here, we present Stitcher, a novel tool capable of generating such surfaces utilizing MRI data and manual segmentation. Stitcher makes a triangulation between consecutive brain slice segmentations by recursively adding edges that minimize the total length and simultaneously avoid self-intersection. We applied this new method to build the cortical surfaces of two dolphins: Guiana dolphin (Sotalia guianensis), Franciscana dolphin (Pontoporia blainvillei); and one pinniped: Steller sea lion (Eumetopias jubatus). Specifically in the case of P. blainvillei, two reconstructions at two different resolutions were made. Additionally, we also performed reconstructions for sub and non-cortical structures of Guiana dolphin. All our cortical mesh results show remarkable resemblance with the real anatomy of the brains, except P. blainvillei with low-resolution data. Sub and non-cortical meshes were also properly reconstructed and the spatial positioning of structures was preserved with respect to S. guianensis cerebral cortex. In a comparative perspective between methods, Stitcher presents compatible results for volumetric measurements when contrasted with other anatomical standard tools. In this way, Stitcher seems to be a viable pipeline for new neuroanatomical analysis, enhancing visualization and descriptions of non-primates species, and broadening the scope of compared neuroanatomy. [ABSTRACT FROM AUTHOR]

Purpose: Galcanezumab is a calcitonin gene‐related peptide monoclonal antibody indicated for migraine prevention in adults. Due to the long half‐life of galcanezumab and the prevalence of migraine in women of childbearing age, galcanezumab exposure may occur during pregnancy. However, real‐world use and safety of galcanezumab during pregnancy has not been fully described. To help fill this gap, galcanezumab has two ongoing pregnancy safety studies, one of which is an insurance claims database study. Methods: This database study is actively identifying and following pregnancies exposed to galcanezumab using commercial claims from the Healthcare Integrated Research Database (HIRD). Patient accrual is planned from September 2018 to June 2026, with a final study report planned for December 2027. This study requires 430 galcanezumab‐exposed pregnancies with linked infants to reach power for comparative analysis of major congenital malformations. Results: Recent monitoring of patient accrual, including data from 28 September 2018 to 31 January 2023, identified 207 galcanezumab‐exposed pregnancies in women with migraine in the HIRD, of which 110 were live births and 73 of which were linked to an infant. This represents an annual accrual rate of approximately 17 pregnancies linked to infants, which is substantially lower than the 55 required annually to reach target size within current regulatory‐committed study timelines. Conclusions: The accrual of a sufficient number of galcanezumab‐exposed pregnancies represents a substantial, but not uncommon, barrier to conducting comparative analyses in pregnancy studies. Potential solutions that would allow for timely dissemination of important safety information to patients and providers may be available. [ABSTRACT FROM AUTHOR]

Understanding the intricate pathways of protein secretion in bacteria is crucial for advancing research on bacterial diseases and their potential treatments, particularly in the case of non-classical protein secretion pathways. These pathways pose unique challenges due to the complex signaling mechanisms involved. To address this, we employed advanced machine learning techniques and gathered physical–chemical characteristics of amino acids from the AA index site. Through a meticulous six-step methodology, we curated a comprehensive dataset by filtering raw genome data and juxtaposing it with a positive dataset comprising 141 proteins from authoritative literature sources. Leveraging a conventional Random Forest machine learning algorithm, we achieved an impressive accuracy rate of approximately 91% in classifying non-classical secreted proteins. This validation was conducted on a dataset of 14 positive and 92 negative proteins, resulting in a sensitivity of 91% and a specificity of 86%. Notably, our study distinguishes itself by its rapid execution of non-classical secretion pathway analyses, rendering it particularly suitable for large datasets. This speed does not compromise accuracy, allowing for comprehensive Omics analyses. Consequently, our research underscores the significance of carefully selecting appropriate descriptors and constructing a robust training dataset to enhance Omics analyses of bacterial protein secretion via non-classical pathways. For further details, please refer to the complete study available at https://github.com/santosardr/non-CSPs. [ABSTRACT FROM AUTHOR]

Background: As the use of donor eggs for in vitro treatment has increased, both medically affiliated and private donor egg agencies have turned to online advertisements to recruit donors. The American Society for Reproductive Medicine provides recommendations encouraging ethical recruitment of donors, however there is no formal regulation for the informed consent process for egg donor recruitment and compensation. Underrepresentation of risks and targeted financial incentives may pose a risk to the informed consent process. Methods: Data from online advertisements for egg donors active between January 1 - August 31, 2020, were collected to analyze content related to risks, Covid-19 precautions, donor payment, and desired donor characteristics. Advertisements for egg donors on Google, Craigslist, and social media were analyzed. Primary outcomes included the mention of the risks of egg donation, including the risk of Covid-19 exposure, in donor egg advertisements. Secondary outcomes included language targeting specific donor characteristics and financial compensation. Results: 103 advertisements were included. 35.9% (37/103) of advertisements mentioned some risk of the egg donation process, and 18.5% (19/103) mentioned risks or precautions related to Covid-19 exposure. Of advertisements for private donor egg agencies, 40.7% (24/59) mentioned any risk, compared to 29.6% (13/44) of medically affiliated egg donation programs; the difference was not statistically significant (p-value = 0.24). Agencies targeting students and donors of a specific race were more likely to offer payments over $10,000 for an egg donation cycle. Among advertisements offering over $20,000 for donor compensation, 72.7% (8/11) recruited women under the age of 21. Conclusion: Egg donor recruitment advertisements, for both medically affiliated programs and private agencies, were unlikely to mention risks including the risk of exposure to Covid-19. Non-medically affiliated private donor egg agencies were more likely to violate multiple American Society for Reproductive Medicine ethics guidelines, including offering higher than average compensation, and recruiting donors from young and vulnerable populations. [ABSTRACT FROM AUTHOR]

Purpose: In 2015, assisted reproductive technology (ART) accounted for 1.7% of all U.S. births, donor eggs accounted for over 17,000 started cycles in 2015, and donor sperm accounting for 6.2% of all cycles started in 2014. With increasing utilization of donor gametes as a method of assisting patients with infertility, the number of babies born each year utilizing gamete donation will also continue to increase. This study aimed to elucidate factors impacting decision to donate, amongst a representative national population. Methods: A survey was distributed via the internet utilizing SurveyMonkey Enterprise with HIPAA compliance. Univariate regressions and frequencies were conducted between each demographic and personal characteristic and the willingness to donate. Log Binomial and linear regression was used categorical and continuous variables, and Risk ratios were calculated. Results: In this large survey study, 64% of men and 50% of women reported they would be willing to donate gametes, with the majority desiring monetary compensation. Men with a high Consumer Financial Protection Bureau score were less likely to report that they would consider donating sperm compared to a medium high CFPB score. No other financial indicators were associated with considering donating sperm. There were no associations between CFPB score and egg donation outcomes. Black or African American women were less likely to consider donating their eggs compared to other groups, and more likely to desire > $5000 in compensation. Conclusions: In this large survey study, a small minority of participants reported they would be willing to donate to an unknown infertility patient for reproductive purposes. High and very high CFPB scores were associated with willingness to donate games, but not with desire for monetary compensation or amount. [ABSTRACT FROM AUTHOR]

Despite growing evidence demonstrating the association between racial and ethnic discrimination and traumatic stress symptoms in adult populations, the research among youth remains sparse. Drawing upon race-based traumatic stress models, and following the PRISMA-2020 guidelines, this systematic review and meta-analysis aimed to identify the state of the empirical evidence in the association between racism-related experiences and traumatic stress symptoms in ethnoracially minoritized youth. Scientific databases were searched to identify articles with ethnoracially minoritized youth participants under age 18 years old that examined the association between racial and/or ethnic discrimination and traumatic stress symptoms. A total of 18 articles comprising 16 studies (N = 4,825 participants) met inclusion criteria. Studies were largely cross-sectional, used nonrandom sampling strategies, focused on Black and Latinx youth, and were conducted in the United States. Furthermore, most studies were theoretically grounded and operationalized racism-related experiences as frequency of direct, personal, everyday discrimination. Few studies examined other dimensions of racism-related experiences. The meta-analysis demonstrated a significant positive association with a medium effect size, rpooled =.356, 95% confidence interval [CI] = 0.27, 0.44, between racism-related experiences and traumatic stress symptoms. No evidence of moderation by age, sex/gender, race/ethnicity, country, or recruitment setting was detected. Racism-related experiences may confer risk for traumatic stress symptoms in ethnoracially minoritized youth. Attending to racism-related experiences is critical to improve the cultural responsiveness of trauma-informed services. [ABSTRACT FROM AUTHOR]

Purpose: Real‐world evidence (RWE) is increasingly used for medical regulatory decisions, yet concerns persist regarding its reproducibility and hence validity. This study addresses reproducibility challenges associated with diversity across real‐world data sources (RWDS) repurposed for secondary use in pharmacoepidemiologic studies. Our aims were to identify, describe and characterize practices, recommendations and tools for collecting and reporting diversity across RWDSs, and explore how leveraging diversity could improve the quality of evidence. Methods: In a preliminary phase, keywords for a literature search and selection tool were designed using a set of documents considered to be key by the coauthors. Next, a systematic search was conducted up to December 2021. The resulting documents were screened based on titles and abstracts, then based on full texts using the selection tool. Selected documents were reviewed to extract information on topics related to collecting and reporting RWDS diversity. A content analysis of the topics identified explicit and latent themes. Results: Across the 91 selected documents, 12 topics were identified: 9 dimensions used to describe RWDS (organization accessing the data source, data originator, prompt, inclusion of population, content, data dictionary, time span, healthcare system and culture, and data quality), tools to summarize such dimensions, challenges, and opportunities arising from diversity. Thirty‐six themes were identified within the dimensions. Opportunities arising from data diversity included multiple imputation and standardization. Conclusions: The dimensions identified across a large number of publications lay the foundation for formal guidance on reporting diversity of data sources to facilitate interpretation and enhance replicability and validity of RWE. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess risk of anaphylaxis among patients with type 2 diabetes mellitus who are initiating therapy with a glucagon-like peptide 1 receptor agonist (GLP-1 RA), with a focus on those starting lixisenatide therapy. RESEARCH DESIGN AND METHODS: A cohort study was conducted in three large, U.S. claims databases (2017–2021). Adult (aged ≥18 years) new users of a GLP-1 RA who had type 2 diabetes mellitus and ≥6 months enrollment in the database before GLP-1 RA initiation (start of follow-up) were included. GLP-1 RAs evaluated were lixisenatide, an insulin glargine/lixisenatide fixed-ratio combination (FRC), exenatide, liraglutide or insulin degludec/liraglutide FRC, dulaglutide, and semaglutide (injectable and oral). The first anaphylaxis event during follow-up was identified using a validated algorithm. Incidence rates (IRs) and 95% CIs were calculated within each medication cohort. The unadjusted IR ratio (IRR) comparing anaphylaxis rates in the lixisenatide cohort with all other GLP-1 RAs combined was analyzed post hoc. RESULTS: There were 696,089 new users with 456,612 person-years of exposure to GLP-1 RAs. Baseline demographics, comorbidities, and use of other prescription medications in the 6 months before the index date were similar across medication cohorts. IRs (95% CIs) per 10,000 person-years were 1.0 (0.0–5.6) for lixisenatide, 6.0 (3.6–9.4) for exenatide, 5.1 (3.7–7.0) for liraglutide, 3.9 (3.1–4.8) for dulaglutide, and 3.6 (2.6–4.9) for semaglutide. The IRR (95% CI) for the anaphylaxis rate for the lixisenatide cohort compared with the pooled other GLP-1 RA cohort was 0.24 (0.01–1.35). CONCLUSIONS: Anaphylaxis is rare with GLP-1 RAs. Lixisenatide is unlikely to confer higher risk of anaphylaxis than other GLP-1 RAs. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate if social media (SM) impacts a patient's provider choice in the field of reproductive endocrinology and infertility (REI). Methods: This was a survey-based study completed in July 2022. A survey link was distributed using Amazon Mechanical Turk, which directed participants to a Qualtrics-based survey. Participants were 18–50 years old. The primary outcome was to identify the preferred method for finding a REI provider based on time spent on SM (< 1 h, 1–3 h, 3 + h). Results: A total of 336 responses were analyzed. Fifty-four percent of respondents used SM < 1 h, 33.33% used 1–3 h, and 12.80% used 3 + h. The majority (69.05%) of respondents stated that they would seek out a REI provider/clinic if they had difficulty conceiving. Most respondents identified asking their primary care physician (44.64%) as the primary means for finding an REI provider/clinic and did not prefer to use SM. Although Facebook (< 1 h: 30.94%, 1–3 h: 31.25%, 3 + h: 27.91%) was the most utilized SM platform among respondents, YouTube was the preferred SM platform if respondents were to follow a REI clinic with a preference for posts focusing on education (< 1 h: 55.68%, 1–3 h: 43.12%, 3 + h: 58.14%) or stress management (< 1 h: 17.61%, 1–3 h: 29.36%, 3 + h: 20.94%). Conclusion: Most respondents utilize traditional methods when choosing their REI provider or clinic and would not utilize SM. However, SM, primarily through YouTube, may be helpful for educating infertility patients and providing support and stress relief while they undergo treatment. [ABSTRACT FROM AUTHOR]

Purpose: The present study aimed to assess whether there was an increase in physical aggression in women treated in Belo Horizonte, Minas Gerais, through the mandatory quarantine. Methods: Data from a cross-sectional study were collected and analyzed, from March 1 to December 31, 2020. Additionally, data from the same period the previous year were collected for comparison. Results: Of the etiologies reviewed for 2020, physical aggression had the highest percentage increase (+ 4.9%) and was the only etiology that showed a significant difference (p = 0.045). The mean age of the included patients was 34.05 years in 2019 and 33.97 in 2020, and most of the women had facial fractures, with nasal fractures being the most frequent, followed by jaw fractures. There was a significant increase (p = 0.34) in the conservative treatment of fractures from 2019 (48.6%) to 2020 (71.7%) and a minor (p = 0.088) increase in aggression toward intimate partners (2019, 40.9%; 2020, 63.9%). Conclusion: Physical aggression against women increased during the period of mandatory social isolation that resulted from the COVID-19 pandemic. Health professionals, including emergency services professionals, must be trained to identify victims and refer them to specialized care. [ABSTRACT FROM AUTHOR]

Hepatic and pulmonary lesions are common in cetaceans, despite their poorly understood viral etiology. Herpesviruses (HV), adenoviruses (AdV) and hepatitis E virus (HEV) are emerging agents in cetaceans, associated with liver and/or pulmonary damage in mammals. We isolated and molecularly tested DNA for HV and AdV (n = 218 individuals; 187 liver and 108 lung samples) and RNA for HEV (n = 147 animals; 147 liver samples) from six cetacean families. All animals stranded or were bycaught in Brazil between 2001 and 2021. Positive-animals were analyzed by histopathology. Statistical analyses assessed if the prevalence of viral infection could be associated with the variables: species, family, habitat, region, sex, and age group. All samples were negative for AdV and HEV. Overall, 8.7% (19/218) of the cetaceans were HV-positive (4.8% [9/187] liver and 11.1% [12/108] lung), without HV-associated lesions. HV-prevalence was statistically significant higher in Pontoporiidae (19.2%, 10/52) when compared to Delphinidae (4.1%, 5/121), and in southeastern (17.1%, 13/76)—the most industrialized Brazilian region—when compared to the northeastern region (2.4%, 3/126). This study broadens the herpesvirus host range in cetaceans, including its description in pygmy sperm whales (Kogia breviceps) and humpback whales (Megaptera novaeangliae). Further studies must elucidate herpesvirus drivers in cetaceans. [ABSTRACT FROM AUTHOR]

Background: Treatment exposures for childhood cancer reduce ovarian reserve. However, the success of assisted reproductive technology (ART) among female survivors is not well established. Methods: Five‐year survivors of childhood cancer in the Childhood Cancer Survivor Study were linked to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System, which captures national ART outcomes. The authors assessed the live birth rate, the relative risk (RR) with 95% confidence intervals (95% CIs), and associations with treatment exposure using generalized estimating equations to account for multiple ovarian stimulations per individual. Siblings from a random sample of survivors were recruited to serve as a comparison group. Results: Among 9885 female survivors, 137 (1.4%; median age at diagnosis, 10 years [range, 0–20 years]; median years of follow‐up after age 18 years, 11 years [range, 2–11 years]) underwent 224 ovarian stimulations using autologous or donor eggs and/or gestational carriers (157 autologous ovarian stimulation cycles, 67 donor ovarian stimulation cycles). In siblings, 33 (1.4%) underwent 51 autologous or donor ovarian stimulations. Of those who used embryos from autologous eggs without using gestational carriers, 97 survivors underwent 155 stimulations, resulting in 49 live births, for a 31.6% chance of live birth per ovarian stimulation (vs. 38.3% for siblings; p =.39) and a 43.9% chance of live birth per transfer (vs. 50.0%; p =.33). Prior treatment with cranial radiation therapy (RR, 0.44; 95% CI, 0.20–0.97) and pelvic radiation therapy (RR, 0.33; 95% CI, 0.15–0.73) resulted in a reduced chance of live birth compared with siblings. The likelihood of live birth after ART treatment in survivors was not affected by alkylator exposure (cyclophosphamide‐equivalent dose, ≥8000 mg/m2 vs. none; RR, 1.04; 95% CI, 0.52–2.05). Conclusions: Childhood cancer survivors are as likely to undergo treatment using ART as sibling controls. The success of ART treatment was not reduced after alkylator exposure. The results from the current study provide needed guidance on the use of ART in this population. Linking the Childhood Cancer Survivor Study database to the Society for Assisted Reproductive Technology Clinic Outcome Reporting System revealed that childhood cancer survivors are as likely to undergo treatment with assisted reproductive technology as their siblings. The success of assisted reproductive technology was not reduced after alkylator exposure. [ABSTRACT FROM AUTHOR]

STUDY QUESTION What are the effects of male anxiety and depression on IVF outcomes? SUMMARY ANSWER Men with anxiety had lower final total motile sperm counts (fTMSC) during IVF compared to men without anxiety; however, there were no differences in live birth rates (LBRs). WHAT IS KNOWN ALREADY Studies have shown that male anxiety causes low sperm motility, worse sperm morphology, and increased DNA fragmentation, which are known to be influential factors on fertilization rates and embryo quality during IVF. However, data are lacking on whether there is a direct association between male anxiety and/or depression and IVF outcomes. STUDY DESIGN, SIZE, DURATION This was a survey-based, retrospective cohort study completed at a single, large hospital-affiliated fertility center with 222 respondents who underwent IVF with or without ICSI. The study was conducted between 6 September 2018 and 27 December 2022. PARTICIPANTS/MATERIALS, SETTING, METHODS Male partners of couples who underwent IVF or IVF/ICSI completed a Hospital Anxiety and Depression Scale (HADS) questionnaire. They were separated into two groups for both anxiety (HADS-A ≥ 8 or HADS-A < 8) and depression (HADS-D ≥ 8 or HADS-D < 8). Men with an elevated HADS-A or HADS-D score ≥8 were considered to have anxiety or depression, respectively. The primary outcome was LBR. Secondary outcomes included semen parameters at the time of IVF, cycle outcomes, pregnancy outcomes, and prevalence of erectile dysfunction and low libido. MAIN RESULTS AND THE ROLE OF CHANCE There were a total of 222 respondents, of whom 22.5% had a HADS-A ≥ 8 and 6.5% had a HADS-D ≥ 8. The average age of respondents was 37.38 ± 4.90 years old. Antidepressant use was higher in the respondents with a HADS-A or HADS-D ≥ 8 (P  < 0.05). Smoking use was similar between groups for both HADS-A and HADS-D (P  > 0.05). When adjusted for male BMI, antidepressant use and smoking, men with a HADS-A or HADS-D ≥ 8 had similar rates of erectile dysfunction (adjusted relative risk (aRR) = 1.12 (95% CI 0.60, 2.06)) and low libido (aRR = 1.70 (95% CI 0.91, 3.15)) compared to those with a HADS-A or HADS-D ≤ 8. Men with a HADS-A ≥ 8 were more likely to have a lower fTMSC on the day of oocyte retrieval (11.8 ≥ 8 vs 20.1 < 8, adjusted ß = −0.66 (95% CI −1.22, −0.10)). However, the LBR per embryo transfer (ET) was similar between the HADS-A groups (43.2% ≥8 vs 45.1% <8, adjusted relative risk = 0.90 (95% CI 0.65, 1.06)). Although depression was uncommon in the entire cohort, the HADS-D groups were clinically similar for fTMSC (18.7 ≥ 8 vs 16.0 < 8) and LBR per ET (46.7% ≥8 vs 45.4% <8). LIMITATIONS, REASONS FOR CAUTION Limitations of our study are the survey-based design, the lack of sperm morphology assessment at the time of IVF, our inability to fully assess the HADS-D ≥ 8 cohort due to the small sample size and the large Caucasian demographic. WIDER IMPLICATIONS OF THE FINDINGS Couples undergoing IVF have an increased likelihood of suffering from anxiety and/or depression. There is currently a debate on whether or not men should be treated with antidepressants while attempting to conceive due to potential detrimental effects on sperm quality. Our study shows that, regardless of antidepressant use, couples with men who did or did not report anxiety and/or depression have similar LBRs when undergoing IVF. Therefore, it is important to assess both partners for mental health and to not withhold treatment due to a concern about a potential impact of antidepressants or anxiety/depression on sperm quality. STUDY FUNDING/COMPETING INTEREST(S) There was no funding to report for this study. Z.W. is a contributing author for UptoDate. S.S.S. is on the advisory board for Ferring Pharmaceuticals. E.G. was a medical consultant for Hall-Matson Esq, Teladoc, and CRICO and is a contributing author for UptoDate. The remaining authors have nothing to report. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

The Atlantic Forest harbors a large species richness and high levels of endemism, but the processes that shaped its biodiversity are poorly studied, especially for mammals. Among them are the endemic mice Juliomys, which comprise forest dwellers distributed in southeastern and southern Brazil, northeastern Argentina, and eastern Paraguay. In this study, we investigate the phylogenetic relationships among species and perform phylogeographic analyses to evaluate the population structure and demographic scenarios through mitochondrial gene cytochrome b sequences. We investigate three hypotheses of diversification (forest refuges, montane isolate, and geomorphological events) to understand the evolution of the Juliomys species. Phylogenetic analyses recovered five clades/lineages, four of which are congruent with species currently recognized. The fifth lineage expands the range of the genus 659 km to the north and may represent a new species. The observed demographic and geographic structure of genetic diversity does not match the forest refuge hypothesis as mechanism to explain the diversification in Juliomys. Our results recovered J. rimofrons and J. ximenezi as sister species, supporting predictions of montane isolate hypothesis. We also detected a shallow genetic structure in J. pictipes and J. ossitenuis. Both phylogeographic breaks were congruent with limits of the São Paulo Basin, an area that has undergone Neogene reactivations of tectonic faults. It is suggested that geomorphological events led to a deformed landscape that influenced the dynamics of sedimentary basins and promoted an incipient population structure in J. pictipes and J. ossitenuis. Our findings demonstrate that the divergences whithin Juliomys species occurred during the Quaternary, too recently to have produced strong geographic structure. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to assess if very-low–dose Lupron (VLDL) and ultra-low–dose Lupron (ULDL) protocols can have comparable cycle outcomes when compared to other "poor responder" stimulation protocols based on POSEIDON classification groups 3 (PG3) and 4 (PG4). Methods: A retrospective cohort study at a single, large academic center was performed. Women in PG3 (age < 35, AMH < 1.2 ng/mL) or PG4 (age ≥ 35, AMH < 1.2 ng/mL) undergoing in vitro fertilization using an ULDL (Lupron 0.1 to 0.05 mg daily), VLDL (Lupron 0.2 to 0.1 mg daily), microflare (Lupron 0.05 mg twice a day), estradiol priming/antagonist, antagonist, or minimal stimulation protocols from 2012 to 2021 were included. The primary outcome was the number of mature oocytes (MII) obtained. The secondary outcome was live birth rate (LBR). Results: The cohort included 3601 cycles. The mean age was 38.1 ± 3.8 years. In the PG3 group, ULDL and VLDL protocols produced a comparable number of MIIs (5.8 ± 4.3 and 5.9 ± 5.4, respectively) and live births (33.3% and 33.3%, respectively) when compared to other protocols. In the PG4 group, ULDL and VLDL protocols resulted in a higher percentage of MIIs when compared to microflare or minimal stimulation (Microflare/ULDL: adjusted relative risk (aRR) 0.78 (95% CI 0.65, 0.95); min stim/ULDL: aRR 0.47 (95% CI 0.38, 0.58); microflare/VLDL: aRR 0.77 (95% CI 0.63, 0.95); min stim/VLDL: aRR 0.47 (95% CI 0.38, 0.95)). There were no significant differences in LBR. Conclusion: Dilute Lupron downregulation protocols have comparable outcomes to other poor responder protocols and are reasonable to use. [ABSTRACT FROM AUTHOR]

Leptospirosis is a zoonosis with ubiquitous distribution caused by spirochetes belonging to the genus Leptospira sp., endemic mainly in tropical and subtropical regions of the world and capable of infecting domestic animals, free-living animals, and humans. Although well documented in terrestrial animals and humans, little information is available on its distribution and impact on marine animals. There are few studies assessing cetaceans' health status, and even scarcer are those focused on leptospirosis research. In this context, considering the One Health approach, the present study aimed to investigate the occurrence of pathogenic Leptospira sp. in cetaceans on the Brazilian coast. Kidneys of 142 cetaceans belonging to 19 species were collected. DNA was extracted, and the diagnosis was performed by LipL32-polymerase chain reaction. Genetic characterization was conducted based on secY gene sequencing. Pathogenic Leptospira sp. DNA was detected in 14.8% (21/142) of the tested cetaceans, with coastal species presenting a significantly higher frequency (p-value = 0.03) of infected individuals (25%, 17/68) than oceanic species (7.5%, 4/53). It was possible to amplify and sequence three strains (one for Sotalia guianensis, one for Stenella clymene, and one for Pontoporia blainvillei), all of them identified as Leptospira interrogans, with high similarity with sequences from Icterohaemorrhagiae serogroup. Phylogenetic analysis revealed sequences from the present study grouped in species-specific unique clusters but very close to pinnipeds in the same area, evidencing the presence of two distinct haplotypes circulating on marine mammals in the region. We could demonstrate that cetaceans can act as carriers of pathogenic leptospires. Moreover, the proximity with anthropogenic areas could play an important role in leptospirosis' dynamics of transmission in a One Health context. [ABSTRACT FROM AUTHOR]

Background and Purpose: Adapting cross-culturally the Hospital Ethical Climate Survey to Brazilian nurses. Methods: A methodological study comprising translation, back translation, multidisciplinary committee, expert panel, pilot test and validation of the instrument. The validation was carried out with 269 nurses of a university hospital in the South of Brazil. Results: In the validation step, the quadratic weighted Kappa test–retest and the correlation coefficient ranged from 0.15 to 0.74. All factor loadings were higher than 0.4, ranging from 0.445 to 0.859. The Portuguese version of the instrument had a 0.93 Cronbach's alpha and the confirmatory analysis demonstrated the model's suitability with five factors and 26 items validated. Conclusions: The version of the instrument adapted to Brazilian Portuguese was considered valid and reliable in this sample. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate follicular phase progesterone elevation (≥ 1.5 ng/mL) prior to trigger during IVF stimulation and its effects on live birth rate (LBR), clinical pregnancy rate (CPR), and implantation rate (IR) in fresh IVF cycles. Methods: This was a retrospective cohort study within an academic clinic. A total of 6961 fresh IVF and IVF/ICSI cycles from October 1, 2015 to June 30, 2021 were included and grouped by progesterone (PR) prior to trigger: PR < 1.5 ng/mL (low PR group) and PR ≥ 1.5 ng/mL (high PR group). Main outcome measures included LBR, CPR, and IR. Results: Among all cycle starts, 1568 (22.5%) were in the high PR group and 5393 (77.5%) were in the low PR group. Of the cycles which proceeded to an embryo transfer, 416 (11.1%) were in the high PR group and 3341 (88.9%) were in the low PR group. The high PR group had significantly lower IR (RR 0.75; 95% CI 0.64–0.88), CPR (aRR 0.74; 95% CI 0.64–0.87), and LBR (aRR 0.71; 95% CI 0.59–0.85) compared to the low PR group. When stratified by progesterone on the day of trigger (TPR), there was a clinically notable decrease in IR (16.8% vs 23.3%), CPR (28.1% vs 36.0%), and LBR (22.8% vs 28.9%) in the high PR group compared to the low PR group even when TPR < 1.5 ng/mL. Conclusions: In fresh IVF cycles in which TPR < 1.5 ng/mL, progesterone elevation ≥ 1.5 ng/mL at any point in time prior to trigger negatively impacts IR, CPR, and LBR. This data supports testing of serum progesterone in the follicular phase prior to trigger, as these patients may benefit from a freeze-all approach. [ABSTRACT FROM AUTHOR]

Taking into account that the transport of grains can be carried out over long distances and that the mass of grains during transport often has high moisture content, there may be risks of heat and moisture transfer and heating of the grains mass, proving quanti-qualitative losses. Thus, this study aimed to validate a method with probe system for real-time monitoring of temperature, relative humidity and carbon dioxide in the grain mass of corn during transport and storage to detect early dry matter losses and predict possible changes on the grain physical quality. The equipment consisted of a microcontroller, system's hardware, digital sensors to detect air temperature and relative humidity, a non-destructive infrared sensor to detect CO2 concentration. Real-time monitoring system determined early and satisfactorily in an indirect way the changes in the physical quality of the grains confirming by the physical analyses of electrical conductivity and germination. The equipment in real-time monitoring and the application of Machine Learning was effective to predict dry matter loss, due to the high equilibrium moisture content and respiration of the grain mass on the 2-h period. All machine learning models, except support vector machine, obtained satisfactory results, equaling the multiple linear regression analysis. [ABSTRACT FROM AUTHOR]

Purpose: The present study aims to describe a case study of large penetrating orbital trauma and treatment guidelines associated with a review of English-language literature of large foreign bodies impacting the orbit from 1997 to 2020. Patients and Methods: Five patients suffered large penetrating orbital trauma and required emergency surgical procedures. Results: Together with this present study, a total of 33 cases were selected. The present work has data similar to the literature, and emergency surgical treatment was required in the majority of the cases. Conclusion: Penetrating orbital trauma by large objects is a challenge. The initial assessment and treatment are fundamental to determine the case severity. The large foreign body should be surgically removed by a trained and experienced team in an advanced hospital unit as soon as possible to minimize visual, functional and aesthetic sequelae. [ABSTRACT FROM AUTHOR]

This paper presents a numerical methodology to analyze frame structures supported on footing foundations subjected to slow strains caused by consolidation settlements. A building project on a subsurface layer of soft soil has been analyzed. The Boundary Element Method with the Mindlin fundamental solution has been applied to compute the displacement resulting from the interference between pressure bulbs on the foundation. The rheological Kelvin–Voigt model has also been used for soil–structure interactions. Terzaghi's Theory of Consolidation was used to fit the displacement–time curves. Finally, the rheological model was coupled through an iterative procedure, employing structural non-linear geometric effects. The results are consistent with settlement predicted effects and revealed that the slow distribution of efforts can cause relevant increases in some regions in the structure of the building. [ABSTRACT FROM AUTHOR]

Background: Around 2% of births in Ontario, Canada involve the use of assisted reproductive technology (ART), and it is rising due to the implementation of a publicly funded ART program in 2016. To better understand the impact of fertility treatments, we assessed perinatal and pediatric health outcomes associated with ART, hormonal treatments, and artificial insemination compared with spontaneously conceived births. Methods: This population-based retrospective cohort study was conducted using provincial birth registry data linked with fertility registry and health administrative databases in Ontario, Canada. Live births and stillbirths from January 2013 to July 2016 were included and followed to age one. The risks of adverse pregnancy, birth and infant health outcomes were assessed by conception method (spontaneous conception, ART – in vitro fertilization and non-ART – ovulation induction, intra-uterine or vaginal insemination) using risk ratios and incidence rate ratios with 95% confidence intervals (CI). Propensity score weighting using a generalized boosted model was applied to adjust for confounding. Result(s): Of 177,901 births with a median gestation age of 39 weeks (IQR 38.0–40.0), 3,457 (1.9%) were conceived via ART, and 3,511 (2.0%) via non-ART treatments. There were increased risks (adjusted risk ratio [95% CI]) of cesarean delivery (ART: 1.44 [1.42–1.47]; non-ART: 1.09 [1.07–1.11]), preterm birth (ART: 2.06 [1.98–2.14]; non-ART: 1.85 [1.79–1.91]), very preterm birth (ART: 2.99 [2.75–3.25]; non-ART: 1.89 [1.67–2.13]), 5-min Apgar < 7 (ART: 1.28 [1.16–1.42]; non-ART: 1.62 [1.45–1.81]), and composite neonatal adverse outcome indicator (ART: 1.61 [1.55–1.68]; non-ART: 1.29 [1.25–1.34]). Infants born after fertility treatments had increased risk of admission to neonatal intensive care unit (ART: 1.98 [1.84–2.13]; non-ART: 1.59 [1.51–1.67]) and prolonged birth admission (≥ 3 days) (ART: 1.60 [1.54–1.65]; non-ART: 1.42 [1.39–1.45]). The rate of emergency and in-hospital health services use within the first year was significantly increased for both exposure groups and remained elevated when limiting analyses to term singletons. Conclusion(s): Fertility treatments were associated with increased risks of adverse outcomes; however, the overall magnitude of risks was lower for infants conceived via non-ART treatments. [ABSTRACT FROM AUTHOR]

Background: Ethical climate can be defined as the healthcare professionals' perceptions of the ethical treatment of healthcare issues and human interactions in their work environment. A number of studies on ethical climate are being carried out in several countries. In Brazil, however, research on the matter is still incipient, especially among hospital nurses. Aim: To assess nurses' perception of the ethical climate in a university hospital in the South of Brazil. Methods: Cross-sectional study carried out with 269 nurses from a university hospital, using a sociodemographic and occupational profiling survey and the Hospital Ethical Climate Survey – Brazilian version. Data analysis was done through descriptive statistics. Results: The nurses' perception of the ethical climate was positive (3.68 ± 0.55). Among the five assessment factors, 'peers' had the highest score (4.07 ± 0.57), whereas 'physicians' had the lowest score (3.26 ± 0.70) for ethical climate. Conclusion: In general, the ethical climate was perceived as positive, with small variations between the factors of the instrument. Ethical climate could be enhanced through strategies that encourage interpersonal relationships. This study shows the importance of a positive ethical climate based on good relationships between healthcare professionals for ensuring better care. [ABSTRACT FROM AUTHOR]

Machine learning has the potential to transform how healthcare is delivered. It can support clinical decision making, determine the risk, presence and prognosis of disease and help optimise patient pathways. Widespread use and access to digital health records mean implementing machine learning models is quicker and easier than ever before. It is imperative for clinical and operational leads to understand the principles behind machine learning, so they can evaluate how it may be helpful to them and their teams. This article provides an overview of machine learning and how it can be used to help solve common healthcare-related problems. [ABSTRACT FROM AUTHOR]

Copyright of Revista de Enfermagem da UFSM is the property of Universidade Federal de Santa Maria and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Revista Gaucha de Enfermagem is the property of Revista Gaucha de Enfermagem and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Purpose: To assess if there is an optimal oocyte retrieval (OR) technique to retrieve a maximum number of oocytes and mature oocytes (MII). Methods: Retrospective cohort study in which nine physicians completed a survey on OR techniques. Number of oocytes/follicle cohort, MIIs/follicle cohort, and MIIs/oocytes retrieved (%MII) were assessed for each technique for patients undergoing OR from 3/2013 to 7/2019. Data were stratified by number of follicles on ultrasound on day of trigger (< 6, 6–10, > 10). Results: Patient demographics were equivalent between techniques. For < 6 follicles, three techniques resulted in significantly fewer oocyte/follicle (0.97 ± 0.48, 0.95 ± 0.66, and 0.90 ± 0.41) compared to the top-performing technique (TPT) (1.11 ± 0.55). For 6–10 follicles, two techniques resulted in significantly fewer oocyte/follicle (0.95 ± 0.39 and 0.93 ± 0.35) compared to the TPT (1.06 ± 0.42). A different technique had higher %MII (0.77 ± 0.19) compared to two techniques (0.74 ± 0.21 and 0.72 ± 0.22). For > 10 follicles, two techniques resulted in significantly fewer oocyte/follicle (1.01 ± 0.42 and 1.07 ± 0.40) compared to the TPT (1.15 ± 0.41). These two techniques also resulted in fewer MII/follicle (0.75 ± 0.33 and 0.81 ± 0.34 vs. 0.87 ± 0.34). There was no consistent TPT across follicle number groups or for all outcome variables. Conclusions: There does not appear to be a clear TPT, even for patients with few follicles. Providers who perform OR in a similar fashion to physicians at our institution should feel confident that those techniques obtain equivalent oocyte yields. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to clarify which pre-wash total motile count are associated with improved clinical pregnancy rate (CPR) and live birth rate (LBR) based on maternal age, AMH level, stimulation regimen, and infertility diagnosis. Methods: This was a retrospective cohort study of first completed IUI cycles at two academic fertility centers from 5/2015 to 9/2019. Cycles were stratified by pre-wash TMC, maternal age, AMH level, stimulation regimen, and infertility diagnosis. The primary outcome was CPR and secondary outcomes were live birth and miscarriage. Results: One thousand one hundred fifty-four cycles were analyzed. Of the 162 cycles that resulted in a CPR (14.0%), most had an insemination TMC > 20 million. Compared to TMC > 20 million, there was no difference in CPR or LBR for lower TMC categories, excluding the TMC < 2 million group, in which there were no pregnancies. When TMC was stratified by deciles, there was also no difference in CPR and LBR, including within the lowest decile (TMC 0.09–8.6 million). Younger age and higher ovarian reserve parameters were associated with higher pregnancy and LBR when stratified by TMC. There was no difference in pregnancy and LBR when considering different stimulation protocols. Conclusions: Our data suggest that pregnancy and LBR are equivalent above a TMC of 2 million. Data stratified by TMC and patient parameters can be used to counsel patients pursuing ART. [ABSTRACT FROM AUTHOR]

Eriocaulaceae is a pantropical family whose main center of biodiversity is in Brazil. In general, the family has about 1200 species, in which phytochemical and biological studies have shown a variety of structures and activities. The aim of this research is to compile the compounds isolated in the Eriocaulaceae family and carry out a computational study on their biological targets. The bibliographic research was carried out on six databases. Tables were built and organized according to the chemical class. In addition, a summary of the methods of isolating the compounds was also made. In the computational study were used ChEMBL platform, DRAGON 7.0, and the KNIME 4.4.0 software. Two hundred and twenty-two different compounds have been isolated in sixty-eight species, divided mainly into flavonoids and naphthopyranones, and minor compounds. The ligand-based virtual screening found promising molecules and molecules with multitarget potential, such as xanthones 194, 196, 200 and saponin 202, with xanthone 194 as the most promising. Several compounds with biological activities were isolated in the family, but the chemical profiles of many species are still unknown. The selected structures are a starting point for further studies to develop new antiparasitic and antiviral compounds based on natural products. [ABSTRACT FROM AUTHOR]

Purpose: To compare clinical outcomes following transfer of euploid blastocysts of varying quality biopsied on day 5 versus day 6. Methods: Retrospective cohort study to evaluate embryo transfer outcomes for women undergoing autologous cryopreserved next generation sequencing euploid single embryo transfer from 10/2015 to 2/2022 at an academic IVF program. The primary outcome was live birth rate (LBR). Secondary outcomes included ongoing pregnancy rate (OPR), implantation rate (IR), and miscarriage rate (SAB rate). Results: Five hundred and fifty-five transfers from 418 patients were analyzed. Euploid embryos biopsied on day 5 resulted in higher LBR compared to those biopsied on day 6 (62.3% vs. 49.6%; aRR 0.81 95% CI 0.65–0.996). When stratified by biopsy day and blastocyst quality, there was no difference in IR, OPR, and SAB rate for good, fair, and poor quality blastocysts biopsied on day 5 versus day 6. However, day 5 good quality embryos were associated with a higher LBR compared to day 6 good quality embryos (74.3% vs. 51.3%; aRR 0.69; 95% CI 0.48–0.999). There were no significant differences in LBR for fair and poor quality embryos biopsied on day 5 versus day 6. Conclusion: Overall LBR are higher for euploid embryos biopsied on day 5 versus day 6. When stratified by embryo quality and day of biopsy, LBR are significantly higher for good quality day 5 versus day 6 embryos. When choosing between multiple euploid embryos, day 5 biopsied good quality embryos should be preferentially selected for transfer over day 6 embryos of the same quality. [ABSTRACT FROM AUTHOR]

This study describes the structure of DNA polymerase I from Thermus phage G20c, termed PolI_G20c. This is the first structure of a DNA polymerase originating from a group of related thermophilic bacteriophages infecting Thermus thermophilus, including phages G20c, TSP4, P74‐26, P23‐45 and phiFA and the novel phage Tth15‐6. Sequence and structural analysis of PolI_G20c revealed a 3′–5′ exonuclease domain and a DNA polymerase domain, and activity screening confirmed that both domains were functional. No functional 5′–3′ exonuclease domain was present. Structural analysis also revealed a novel specific structure motif, here termed SβαR, that was not previously identified in any polymerase belonging to the DNA polymerases I (or the DNA polymerase A family). The SβαR motif did not show any homology to the sequences or structures of known DNA polymerases. The exception was the sequence conservation of the residues in this motif in putative DNA polymerases encoded in the genomes of a group of thermophilic phages related to Thermus phage G20c. The structure of PolI_G20c was determined with the aid of another structure that was determined in parallel and was used as a model for molecular replacement. This other structure was of a 3′–5′ exonuclease termed ExnV1. The cloned and expressed gene encoding ExnV1 was isolated from a thermophilic virus metagenome that was collected from several hot springs in Iceland. The structure of ExnV1, which contains the novel SβαR motif, was first determined to 2.19 Å resolution. With these data at hand, the structure of PolI_G20c was determined to 2.97 Å resolution. The structures of PolI_G20c and ExnV1 are most similar to those of the Klenow fragment of DNA polymerase I (PDB entry 2kzz) from Escherichia coli, DNA polymerase I from Geobacillus stearothermophilus (PDB entry 1knc) and Taq polymerase (PDB entry 1bgx) from Thermus aquaticus. [ABSTRACT FROM AUTHOR]

The use of silo and raffia bags for the temporary grain storage has been increasing in recent years. However, the methods for monitoring a stored product are limited to visual inspections and sampling. Thus, this research aimed to real‐time equilibrium moisture content monitoring to predict grain quality of corn stored in different conditions in silo and raffia bags using wireless sensor network prototype, Internet of Things (IoT) platform, and neural network algorithms. Experiments were conducted using corn grain with two initial water contents of 13% and 18% (w.b.), three storage environments with temperatures of 30, 23, and 17°C, and two types of packaging, that is, silo and raffia bags, for a 3‐month storage evaluation. During the monitoring of stored grain, variations in equilibrium moisture hygroscopic content were observed, which inferred changes in the corn quality. Water contents of 13% under a storage condition of 17°C showed the highest quality results, whereas storage in silo bags with water contents of 13% and 18% showed no differences at 23°C; however, at a temperature of 30°C, the grain suffered a high level of deterioration. The storage time influenced the reduction of grain quality for all factors. The physicochemical quality prediction results indicated a high coefficient of determination of the trained models, presenting itself as a promising perspective, mainly in developing embedded technologies for monitoring and predicting the qualitative variables of grain stored in silo and raffia bags. Practical Applications: The application of sensor technology and the Internet of Thing (IoT) to monitor the temperature and relative humidity of intergranular air in real time for the determination of equilibrium moisture content became possible to predict the physical and physicochemical quality of grains stored in bag silos and raffia bags using artificial neural networks (ANN) algorithms. The results obtained were satisfactory and can replace the punctual sampling of the grains mass stored in hermetic packages. The application of a set of technologies possible to monitor the grain quality in real time and predict the grain storage time in bag and raffia silos to reduce losses. [ABSTRACT FROM AUTHOR]

In this article, Roberts et al discuss the importance of SNOMED CT in improving electronic health records, and the benefits this can bring healthcare organisations, professionals and patients. [ABSTRACT FROM AUTHOR]

Copyright of Law Studies Journal / Revista Novos Estudos Juridicos is the property of Novos Estudos Juridicos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Tropical landscapes are rapidly changing due to deforestation and agricultural expansion, entailing the loss and fragmentation of natural habitats. Understanding how these changes affect the genetic diversity and gene flow in key native pollinators is of great importance to assure their survival and provision of pollination services. In this context, we studied how landscape features influence genetic diversity and gene flow in one of the most widespread species of stingless bees in the Neotropical region, Tetragonisca angustula. We evaluated bees from 46 nests sampled across forested, agricultural and urban landscapes within the Atlantic Forest, genotyped at 745 single-nucleotide polymorphisms (SNPs). We found that forest cover negatively influenced the heterozygosity at a 500-m scale, although inbreeding and gene flow were not influenced by landscape features. Gene flow was explained mainly by geographic distance, indicating that T. angustula can disperse across heterogeneous and human-altered landscapes. [ABSTRACT FROM AUTHOR]

The ethical climate is the perception of health professionals about the work environment, meaning the reflection on care practices and ethical-related decisions. There are extensive studies in the international literature about the ethical climate, but there are still theoretical gaps about it in health services. In this reflection article, the objective was to explore conceptual components about the ethical climate, proposing new elements of analysis of the construct. The starting point was the accumulated knowledge itself, the possibilities for expansion, and the conceptual progress emerging from contributions from studies on nursing ethics. It was understandable that the ethical climate is considered in its procedural model and cyclically, being articulated with organizational elements, as established in the literature, and, expanding the concept, with the worker's health and the ethical expressiveness at work. Regarding this last contribution, the suggestion is to think about the potential for work to allow, limit, or favor professionals to express their ethical and esthetic values in the most daily decisions and relationships, in care, management, and education. The conceptual framework of this study progressed by addressing the ethical climate as a process articulating several concepts and elements regarding the organizational aspect, ethics, and the workers' well-being. [ABSTRACT FROM AUTHOR]

Purpose: Supraphysiologic serum estradiol levels may negatively impact the likelihood of conception and live birth following IVF. The purpose of this study is to determine if there is an association between serum estradiol level on the day of progesterone start and clinical outcomes following programmed frozen blastocyst transfer cycles utilizing oral estradiol. Methods: This is a retrospective cohort study at an academic fertility center analyzing 363 patients who underwent their first autologous single (SET) or double frozen embryo transfer (DET) utilizing oral estradiol and resulting in blastocyst transfer from June 1, 2012, to June 30, 2018. Main outcome measures included implantation, clinical pregnancy, live birth, and miscarriage rates. Cycles were stratified by quartile of serum estradiol on the day of progesterone start and separately analyzed for SET cycles only. Poisson and Log binomial regression were used to calculate relative risks (RR) with 95% confidence intervals (CI) for implantation, clinical pregnancy, live birth, and miscarriage with adjustments made for age and BMI. Results: Cycles with the highest quartile of estradiol (mean 528 pg/mL) were associated with lower risks of implantation (RR 0.66, CI 0.50–0.86), ongoing pregnancy (RR 0.66, CI 0.49–0.88), and live birth (RR 0.70, CI 0.52–0.94) compared with those with the lowest estradiol quartile (mean 212 pg/mL). Similar findings were seen for analyses limited to SETs. There was no significant difference in miscarriage rate or endometrial thickness between groups. Conclusion: High levels of serum estradiol on the day of progesterone start may be detrimental to implantation, pregnancy, and live birth following frozen blastocyst transfer. [ABSTRACT FROM AUTHOR]

Objective: The goal of preimplantation genetic testing for monogenic or single gene defects (PGT‐M) is to identify inherited pathogenic variants in the embryo prior to embryo transfer, increasing the likelihood of an unaffected child. Prenatal diagnostic testing is recommended to confirm the results of PGT‐M. The purpose of this study was to characterize the population undergoing PGT‐M over time. Methods: This retrospective study examined patients who had a positive pregnancy test after PGT‐M from 2012 to 2019. A query of the internal assisted reproductive technology database and chart review were used. Results: One hundred and 42 patients completed IVF cycles for PGT‐M during this time period and progressed past 10 weeks gestation. There were more PGT‐M cycles over time with 46 cycles between 2012 and 2015 and 96 cycles between 2016 and 2019. Patients varied on the decision to pursue prenatal diagnostic testing after PGT‐M. For those with known follow‐up (130/142), 16 patients underwent diagnostic testing (12%) and 114 did not. Conclusion: As PGT‐M is increasingly utilized prior to pregnancy, it is important for genetic counselors and OB/GYNs to understand the characteristics and outcomes of the population of patients undergoing PGT‐M, including how to counsel about the residual risk of an affected pregnancy after PGT‐M. Key points: What is already known about this topic? PGT‐M is used to identify inherited pathogenic variants in the embryo prior to embryo transfer, increasing the likelihood of an unaffected child.Indications for PGT‐M have traditionally included childhood lethal or childhood onset conditions.Prenatal diagnostic testing is recommended after PGT‐M to confirm the results of the embryo biopsy. What does this study add? Most individuals undergoing PGT‐M are not pursuing diagnostic prenatal testing.There are certain factors about an individual and their pregnancy history that make someone more likely to pursue prenatal diagnostic testing after PGT‐M.The indications for PGT‐M are becoming broader encompassing, in some cases, adult‐onset conditions. [ABSTRACT FROM AUTHOR]