Search

The aims of the research were (i) to compare the clinical outcome of IVF using follicular-phase depot gonadotropin-releasing hormone (GnRH) agonist (depot agonist) protocol and GnRH antagonist protocol in patients with repeated IVF failure (RIF), (ii) to discover the optimal ovarian stimulation protocol for this group of low prognosis patients. 801 RIF patients with normal ovarian reserve receiving in vitro fertilization/intracytoplasmic sperm injection (IVF/ICSI) were included in this retrospective study. Among them, 492 patients were treated with the depot agonist protocol, and the remaining 309 patients with the antagonist protocol. Multivariable logistic regression analysis was used to find the predictor(s) of the chance of live birth. Higher live birth rate (LBR) and clinical pregnancy rate (CPR) in fresh embryo transfer (ET) cycles were associated with the use of depot agonist compared with the antagonist protocols (44.81% vs. 27.27%, 54.64% vs. 34.93%, respectively; both p < 0.01) and depot agonist protocol was a strong predictor of live birth (OR = 2.182, 95% CI 1.355–3.514, p < 0.01). The CPR in thawed ET cycles was not significantly different between the two groups (38.12% vs. 45.26%, p > 0.05). A higher cumulative live birth rate (CLBR) was achieved in the depot agonist group (46.59% vs. 35.21%, p < 0.01). Beneficial endometrial receptivity in the depot agonist protocol contributed to a higher LBR in fresh ET cycles, rendering this protocol the preferred option in the treatment of RIF patients. [ABSTRACT FROM AUTHOR]

Since its inception in 2000, Mississippi's pavement warranty programme has been used to manage the maintenance activities of the warranty pavement projects. To determine whether a specific maintenance treatment is required on a warranty pavement section, distress measurements are taken and compared against warranty distress thresholds for each distress type. Then, the decisions of what maintenance treatments and scopes should be applied are made by following the warranty specifications. This study aims to identify factors that influence past maintenance decisions and predict future maintenance needs for warranty projects based on past decisions. Statistical methods were employed to identify the relationship between the maintenance decisions and relevant factors based on the historical data of the warranty projects. Moreover, logistic regressions were performed to develop a comprehensive maintenance decision-making prediction model for the warranty pavements. The analysis results showed that the distress measurements at low and medium severity levels in numerical variables and project location and distress type in categorical variables have stronger effects than the others on decisions. The mixed-effects logistic regression model could provide a high accuracy in predicting the remedial actions, which could further provide a trend prediction for the maintenance decision of a warranty pavement section. [ABSTRACT FROM AUTHOR]

Objective: To explore whether sex-specific abdominal visceral fat composition on CT can predict the Fuhrman nuclear grade of clear cell renal cell carcinoma (ccRCC).Methods: One hundred seventy-one patients (123 males and 48 females) from four hospitals (multicentre group) and 159 patients (109 males and 50 females) from the cancer imaging archive (TCIA-KIRC group) with pathologically proven ccRCC (multicentre: 124 low grade and 47 high grade; TCIA-KIRC: 79 low grade and 80 high grade) were retrospectively included. Abdominal fat was segmented into subcutaneous fat area (SFA) and visceral fat area (VFA) on CT using ImageJ. The total fat area (TFA) and relative VFA (rVFA) were then calculated. Clinical characteristics (age, sex, waist circumference and maximum tumour diameter) were also assessed. Univariate and multivariate logistic regression analyses were performed to identify the association between general or sex-specific visceral fat composition and Fuhrman grade.Results: Females with high-grade ccRCC from the multicentre group had a higher rVFA (42.4 vs 31.3, p = 0.001) than those with low-grade ccRCC after adjusting for age. There was no significant difference in males. The rVFA remained a stable and independent predictor for females high-grade ccRCC in both the univariate (multicentre: OR 1.205, 95% CI 1.074-1.352, p = 0.001; TCIA-KIRC: OR 1.171, 95% CI 1.016-1.349, p = 0.029) and multivariate (multicentre: OR 1.095, 95% CI 1.024-1.170, p = 0.003; TCIA-KIRC: OR 1.103, 95% CI 1.024-1.187, p = 0.010) models.Conclusions: Sex-specific visceral fat composition has different values for predicting high-grade ccRCC and could be used as an independent predictor for females with high-grade ccRCC.Key Points: • Visceral fat measurement (rVFA) as an independent predictor for high-grade ccRCC had good predictive power in females, but not in males. • Sex-specific visceral fat composition was significantly associated with high-grade ccRCC in females only. • The rVFA could be considered one of the risk factors for high-grade ccRCC for females. [ABSTRACT FROM AUTHOR]

Background: Gestational diabetes mellitus (GDM) is a growing global epidemic. Our study aims to confirm the association between circulatory coiled-coil domain-containing 80 (CCDC80) in pregnant women with GDM, to investigate the discriminatory power of CCDC80 on GDM, and to explore the relationships between this molecular level and clinical cardiometabolic parameters.Methods: A 1:2 matched case-control study with 61 GDM patients and 122 controls was conducted using a propensity score matching protocol. All participants were screened from a multicenter prospective pre-birth cohort: Born in Shenyang Cohort Study (BISCS). During 24 and 28 weeks of gestation, follow-up individuals underwent an oral glucose tolerance test (OGTT) and blood sampling for cardiometabolic characterization.Results: Following propensity score matching adjustment for clinical variables, including maternal age, gestational age, body mass index, SBP and DBP, plasma CCDC80 levels were significantly decreased in patients with GDM when compared with controls (0.25 ± 0.10 vs. 0.31 ± 0.12 ng/ml, P = 0.003). Conditional multi-logistic regression analyses after adjustments for potential confounding factors revealed that CCDC80 was a strong and independent protective factor for GDM (ORs < 1). In addition, the results of the ROC analysis indicated the CCDC80 exhibited the capability to identify pregnant women with GDM (AUC = 0.633). Finally, multivariate regression analyses showed that CCDC80 levels were positively associated with AST, monoamine oxidase, complement C1q, LDL-C, apolipoprotein A1and B, and negatively associated with blood glucose levels at 1 h post- OGTT.Conclusions: Biomarker CCDC80 could be of great value for the development of prediction, diagnosis and therapeutic strategies against GDM in pregnant women. [ABSTRACT FROM AUTHOR]

Difficulty in regularly analyzing marrow myeloma cells (MMCs) and low frequency of circulating myeloma cells (CMCs) in blood presents challenges for monitoring minimal residual disease (MRD) in multiple myeloma (MM). We have developed a set of method for enrichment of CMCs by immunomagetic beads (IMB) combined with flow cytometry (IMB-FCM) based on CD38-APC/CD138-APC antibodies in U266-spiked samples and in 122 patient samples. U266 cell capture efficiency of CD38/CD138-IMB-FCM (6.960, 2.574) was 6- and 2-fold higher than that of FCM (1.032), and the sensitivity of FCM and IMB-FCM was 0.01% and 0.001%, respectively. In MM cohort, the positive rate of CMCs by IMB-FCM increased from 60.5~70.0 to 85~87.2% in newly diagnosed/relapsed and partial remission (PR) patients compared with by FCM (P < 0.05). Two complete remission (CR) patients contain certain amounts of CMCs by IMB-FCM while no CMCs and MMCs were detectable by FCM. Patients exhibiting PR and CR upon therapy had much lower CMC and MMC counts than newly diagnosed/relapsed patients (P < 0.005). Based on MRD measurement in BM and PB samples, all FCM-negative BM samples were also paired with FCM/IMB-FCM-negative PB samples among newly diagnosed, relapsed, and PR patients, and FCM-positive BM samples were accompanied by IMB-FCM-positive results in 88% of corresponding PB samples. CMCs strongly associated with other clinical biomarkers of disease burden, including elevated MMCs, β2-MG, sCrea, and DS and ISS stages, and more serious anemia, bone destruction, and renal impairment (P < 0.05). Logistic regression analysis revealed that elevated β2-MG and moderate-to-more anemia were significant risk factors for the presence of CMCs (P < 0.05). As a noninvasive "liquid biopsy" of monitoring MRD, the potential of IMB-FCM for CMC detection may complement or minimize bone marrow aspiration in future treatment of MM patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to identify disparities in successful return-to-work outcome rates based on race, gender, and level of educational attainment at closure among veterans with a signed Individualized Plan for Employment (IPE). A randomized split-half cross-model validation research design was used to develop and test a series of logistic regression models for goodness of fit across two samples (i.e., screening and calibration) of case records (N = 11,337) obtained from the national Fiscal Year (FY) 2013 Rehabilitation Services Administration (RSA)-911 database. The final predictive multinomial logistic regression model indicated that (a) the odds of White veterans successfully returning to work were nearly 1½ times the odds of African American veterans returning to work and (b) African American female veterans had the lowest probability for successfully returning to work. Moreover, findings indicated that African American veterans’ successful return-to-work rates in 5 of the 10 RSA regions were below the national benchmark. Recommendations for policy development and future research directions are presented. [ABSTRACT FROM AUTHOR]

• Study on relationship between SCR levels and psychiatric symptoms in patients with anti-NMDAR encephalitis. • Higher SCR level was associated with lower incidence of psychiatric symptoms. • The SCR level was negatively correlated with incidence of psychiatric symptoms. • Higher SCR level could be an independent protective factor for psychiatric symptoms in female patients. Serum creatinine (SCR) has been shown to be associated with many neurodegenerative diseases. In this study, we investigated the relationship between SCR levels and the incidence of psychiatric symptoms in patients with anti -N- methyl- d -aspartate receptor (anti-NMDAR) encephalitis. The SCR levels were tested in 69 patients with anti-NMDAR encephalitis at admission. Clinical characteristics and blood and CSF parameters were compared between the group of patients with psychiatric symptoms (P + group) and the group of those without psychiatric symptoms (P- group). The association between SCR and the incidence of psychiatric symptoms was determined by multivariate-adjusted linear regression analyses. The SCR levels in the P + group were significantly lower than those in the P- group (P < 0.001). In the female subgroup, the SCR levels in the P + group were significantly lower compared to the P- group (P < 0.001), whereas in the male subgroup, the SCR levels did not differ between the two groups (P = 0.084). Furthermore, the highest SCR tercile overall had a significantly lower incidence of psychiatric symptoms than the lowest tercile (P < 0.001), and a significant negative correlation between the SCR levels and the occurrence of psychiatric symptoms was observed (r = −0.392, P < 0.001). Multivariate logistic regression analysis showed that the association was independent after adjusting for age, cystatin C and the modified Rankin Scale (mRS) score (P = 0.001). A similar result was found in the female subgroup (P = 0.010), but not in the male subgroup (P = 0.225). Our study indicated that the SCR level was negatively correlated with incidence of psychiatric symptoms in female patients, and higher SCR level could be a protective factor for psychiatric symptoms in female patients with anti-NMDAR encephalitis. [ABSTRACT FROM AUTHOR]

Highlights • The peripheral NLR is significantly elevated in patients with AIE as compared to the healthy controls. • Peripheral NLR is positively correlated with disease severity in AIE. • Increased NLR level is an independent risk factor for higher severity of AIE. • Peripheral NLR level could be a biomarker to predict progression of AIE. Abstract Objective: Autoimmune encephalitis (AIE) is a group of inflammatory disorders of the brain. The severity of AIE vary among individuals and it is always a challenge to predict. In this study, we measured the neutrophil-to-lymphocyte ratio (NLR), a novel potential biomarker of inflammatory status in other inflammatory diseases, in AIE patients and evaluated NLR as a biomarker for monitoring AIE progression. Methods: The study participants consisted of 34 newly diagnosed AIE patients and 35 ages and sex-matched healthy controls. Demographic and clinical assessment data were reviewed and abstracted retrospectively. NLR levels were calculated from the peripheral blood tests. The relationship between mRS (the modified Ranking Scale) score and NLR levels, total white blood cells, absolute neutrophil counts and absolute lymphocyte counts were investigated. The performance of NLR in predicting severe AIE was also determined. Results: Peripheral NLR level in AIE patients were significantly higher than in healthy controls (p < 0.001). Additionally, median NLR level in patients with severe impairments (using modified Ranking Scale, mRS＞3) was significantly elevated (p < 0.001) compared to patients with mild to moderate impairments (mRS≤3). Spearman correlation analysis indicated that NLR and neutrophil counts were positively associated to mRS score (r = 0.595, p＜0.001 for NLR, and r = 0.392, p = 0.022 for neutrophil counts). While lymphocyte counts were negatively correlated with mRS score (r=−0.522, p = 0.002). Multivariate logistic regression analysis revealed that increased NLR value was an independent risk factor for severe AIE (OR: 2.171, 95% CI: 1.218–3.868, p = 0.009). Furthermore, according to the ROC curve, the best NLR cut-off value to predict severe disease activity of AIE was 4.82, with a sensitivity of 78% and specificity of 88%. Conclusion: Our results suggest that NLR in peripheral blood may be a practical and reliable biomarker to monitor disease progression in patients with AIE. [ABSTRACT FROM AUTHOR]