Factors Influencing Pregnancy Outcome Following Slow Cooling Cryoembryo Transfer and Risk of Multiple Conception

Objective To investigate the factors that influence the potential for cryoembryo implantation and multiple pregnancy. Methods In this retrospective study, a total of 93 7 thawing cycles （859 couples） in which 3286 d 3-embryos were thawed. Rates of implantation, clinical pregnancy and multiple conception following FET were observed. Results There were significant differences in female age （P〈0.05） and number of good quality embryos （P〈0. 05） between cycles that resulted in pregnancy and those did not. There was a trend toward decreasing rates of implantation, clinical pregnancy and multiple pregnancy with increasing female age. Compared with transferring 1 good quality embryo, clinical pregnancy rate of transferring 2 and 3 good quality embryos was increased significantly （P〈0. 001）, there was no significant difference in clinical pregnancy rate between transferring 2 and 3 good quality embryos. Multiple pregnancy rate was increased significantly in the group of transferring 3 good quality embryos （P〈0.05）,but there was no significant differences in multiple pregnancy rate between transferring 1 and 2 good quality embryos. Younger women （≤ 30 years） also had a significantly higher multiple pregnancy rates （28.13%） than the older ones（〉35 years） （13.64%）. With an increase in age from ≤ 30 years to〉40 years, clinical pregnancy rate declined from 47 61% to 25.00%.Conclusion Female age and the number of gooa quality embryos transferred are important factors influencing the clinical and multiple pregnancy rate, reducing the number of good quality embryos transferred may decrease the rate of multiple pregnancy but do not affect the clinical pregnancy rate.

AlertInsight:Mining Multiple Correlation For Alert Reduction

Modern cloud services are monitored by numerous multidomain and multivendor monitoring tools,which generate massive numbers of alerts and events that are not actionable.These alerts usually carry isolated messages that are missing service contexts.Administrators become inundated with tickets caused by such alert events when they are routed directly to incident management systems.Noisy alerts increase the risk of crucial warnings going undetected and leading to service outages.One of the feasible ways to cope with the above problems involves revealing the correlations behind a large number of alerts and then aggregating the related alerts according to their correlations.Based on these guidelines,AlertInsight,a framework for alert event reduction,is proposed in this paper.In AlertInsight,the correlations among event sources are found by mining a sequence of historical events.Then,event correlation knowledge is employed to build an online detector targeting the correlated events that are hidden in the event stream.Finally,the correlated events are aggregated into a single high-level event for alert reduction.Because of theweaknesses of the commonly used pairwise correlation analysis methods in complex environments,an innovative approach for multiple correlation mining,which overcomes computational complexity challenges by scanning panoramic views of historical episodes from the perspective of holism,is proposed in this paper.In addition,a neural network-based correlated event detector that can learn the event correlation knowledge generated from correlation mining and then detect the correlated events in a sequence online is proposed.Experiments are conducted to test the effectiveness of AlertInsight.The experimental results(precision=0.92,recall=0.93,and F1-score=0.93)demonstrate the performance of AlertInsight for the recognition of multiple correlated alerts and its competence for alert reduction.

Sonography Cervical Assessment in Multiple Pregnancy in Correlation with Gestational Age

Objective: Observe and correlate the cervical length by ultrasound and likelihood of cervical incompetence and premature delivery in multiple gestations. Materials and Methods: Retrospective study in multiple pregnancy (twin, triplet, quadruplet) delivered between 2002-2003, in King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. A total of 68 multiple pregnancies underwent routine ultrasound for fetal assessment between 16 - 32 weeks when the cervix was observed. The sonographic measurements included cervix > 2.5 cm and <2.5 cm. The time of ultrasound was divided in five groups by gestational age from 18 - 20 weeks, 21 - 24 weeks, 25 - 26 weeks, 29 - 32 weeks and >32 weeks. The gestational age at delivery was our outcome parameter. The data was analyzed statistically using Fisher’s exact test and P-value below 0.05 was considered significant. Results: Endovaginal ultrasongoraphic cervical measurement in multiple pregnancies predicted increased preterm delivery risk regardless of maternal age, previous history of preterm deliveries or presence of vaginal infection. It was found that spontaneous preterm labor < 32 weeks is a relatively rate outcome with cervix > 25 mm;this majority reached > 32 weeks while the patient who had cervix < 25 mm, 1 in 25 of the women who underwent a cervical ultrasound assessment will have preterm labor. The finding in ultrasound justifies the results of higher aggressive management inpatient with cervix Conclusion: Cervical assessment during routine ultrasound in multiple gestations seems to be useful for prediction of preterm delivery and counseling the patient without risk factors regarding cervical cerclage. Because of restricted number of patients, we suggest further study with bigger sample and prospective trial for valued conclusions.

Physical,mental and psychomotor development of children born after multifetal pregnancy reduction:a retrospective case-control study

Objective:To assess the perinatal and developmental outcomes of assisted reproductive technologies(ART) children born after multifetal pregnancy reduction(MPR). Methods:Twenty-four ART children born after MPR were compared to 9 triplets without MPR,and 24 matched IVF children without MPR and 24 naturally conceived.Mental and psychological development was assessed by Bayley Scales.of Infant.The outcomes compared included perinatal characteristics,body mass index(BMI), mental development index(MDI) and psychomotor development index(PDI). Results:MPR singletons/twins had better neonatal outcomes than non-MPR triplets.Moreover,PDI of the MPR singletons/twins was significantly higher than that of the non-MPR triplets.There were no significantly difference in perinatal characteristics,BMI,MDI and PDI among 24 MPR children,24 matched IVF children without MPR and 24 matched naturally conceived children. Conclusion:Multifetal pregnancy reduction could improve perinatal outcomes and would not affect physical, mental and psychomotor development for children born after it.

Adverse Maternal Outcomes in High-Order Multiple Pregnancies in a Private Health Facility in Nigeria: A 10-Year Experience

Background: Naturally occurring high-order multiple (HOM) pregnancies are rare (1 - 7 per 10,000) even in Nigeria noted to have the highest twinning rates. Worldwide multiple pregnancies are increasing and are associated with increased adverse maternal outcomes. Materials and Methods: This was a retrospective study of all patients with HOM pregnancy in Prime Medical Consultants between Jan 2004 to Dec 2013. We identified all the patients with high-order multiple pregnancy and extracted relevant data from the ante-natal and labour ward records, theatre records, and patients case notes. Demographic characteristics, gestational age at delivery, preterm rupture of membranes, preterm labour, hypertensive disease in pregnancy, proteinuria, anaemia, and postpartum haemorrhage were data extracted from the records. Results: The incidence of HOM pregnancy in this hospital was 0.24%. The mean maternal age was 35.7 ± 1.81 years. Over 85% of all the high-order multiple pregnancies in this hospital were from in-vitro fertilization and embryo transfer treatments for infertility. About 11% of the HOM pregnancy ended as spontaneous miscarriages. The mean gestational age at birth was 31 ± 1.5 weeks, and primary postpartum haemorrhage (22.2%) was the most common maternal adverse outcome from birth. Conclusion: The high incidence of HOM pregnancy in this hospital was mainly from in-vitro fertilization and embryo transfer. The HOM pregnancies are associated with high occurrence of preterm labour, caesarean sections and primary postpartum haemorrhage.

The Acoustic Performance of 3D Printed Multiple Jet Nozzles with DifferentConfigurations

This work investigated multiple jet nozzles with various geometrical shape,number of exits,and material on reducing noise radiated from jet flows.Nozzles are categorized in two groups with few and many exit numbers,each with various exit shapes,slot and circular,and geometry.Firstly,nozzles are designed and then fabricated by a 3D printer,Form Labs,Form2USA,with polymeric resin.Also,the nozzle with the most noise reduction made of stainless steel.Noise and air thrust were measured at three air pressure gauges,3,5,7 BAR and directions from nozzle apex,30°,90°,135°.Nozzles with slot exit shape made of both plastic and stainless steel revealed the most noise reduction among all nozzles with few exit numbers,nearly 11–14 dB(A)and 11.5–15 dB(A),respectively.On average,slotted nozzle noise reduction was nearly 5–6 dB(A)more than finned nozzle.However,nozzles with more exit numbers,finned and finned-central exit,illustrated much more noise reduction than nozzles with few exit numbers,by almost 16–18 dB(A),they represented similar sound.All tested nozzles and open pipe demonstrated equal air thrust at each pressure gauges.The nozzles with slotted exit shape,either plastic or stainless steel,can provide reasonable noise reduction in comparison to other configuration with few exit numbers.In contrast,nozzles with more exit numbers demonstrated the most noise reduction.

Contribution of Multiple Cropping Systems to Greenhouse Gas Mitigation in the Municipality of Abomey-Calavi in Southern Benin

In the world at large, while agricultural yields are increasing with constant land area, in Sub-Saharan Africa, more land is needed to increase production. In this region of Africa, agriculture therefore remains essentially extensive and contributes to environmental degradation, especially deforestation. Thus, the objective of this research is to assess and compare the quantities of greenhouse gases produced by multiple and mono-specific cropping systems. To this end, the quantity of greenhouse gases (GHG) produced by several cropping systems installed on an experimental farm in Kpotomey in the municipality of Abomey-Calavi (Benin) was estimated. The estimation of GHG quantities was made on the basis of IPCC work and data from the experiments carried out. Comparisons were made between mono-specific crops and multiple crops. The results show that the quantities of GHG emitted per ton of production are more or less identical and vary on average from 0.6 to 0.11 teqCO2. However, the advantage of multiple cropping systems is that they reduce the clearing of new land and thus avoid about 31.5 tons of CO2 if the plant formation to be replaced was a forest. Multiple cropping with moderate fertilization in the presence of organic matter increases production while preserving the environment.

Variable precision rough set for multiple decision attribute analysis

A variable precision rough set (VPRS) model is used to solve the multi-attribute decision analysis (MADA) problem with multiple conflicting decision attributes and multiple condition attributes. By introducing confidence measures and a β-reduct, the VPRS model can rationally solve the conflicting decision analysis problem with multiple decision attributes and multiple condition attributes. For illustration, a medical diagnosis example is utilized to show the feasibility of the VPRS model in solving the MADA problem with multiple decision attributes and multiple condition attributes. Empirical results show that the decision rule with the highest confidence measures will be used as the final decision rules in the MADA problem with multiple conflicting decision attributes and multiple condition attributes if there are some conflicts among decision rules resulting from multiple decision attributes. The confidence-measure-based VPRS model can effectively solve the conflicts of decision rules from multiple decision attributes and thus a class of MADA problem with multiple conflicting decision attributes and multiple condition attributes are solved.

Fetal reduction by bipolar cord coagulation in managing complicated monochorionic multiple pregnancies： preliminary experience in China

Background Monochorionic multiple pregnancies （MMPs） are associated with higher rates of perinatal morbidity and mortality caused by interfetal vascular anastomoses in the monochorionic placenta, which can lead to fetal health interactions. In some circumstances, selective feticide of the affected fetus is necessary to save the healthy co-twin. We evaluated the effects and safety of our initial experiences using bipolar cord coagulation for the management of complicated MMPs. Methods Using ultrasound-guided bipolar cord coagulation, we performed selective feticide on 14 complicated MMPs （5 with twin-twin transfusion syndrome, 4 with acardia, 3 with discordant structural anomalies, and 2 with severe selective intrauterine growth restriction）. One patient with monochorionic triplets received the procedure twice to terminate 2 affected fetuses for different JndJcatJons. Data regarding the operations, complications and neonatal outcomes were analyzed. Results Cord occlusions were successfully performed in 13/14 （93%） cases. The failure happened in an acardiac fetus and the pregnancy was terminated by induction. The included cases delivered at a mean gestational age of 35.4 weeks with a perinatal survival rate of 11/13 （85%）. Three operation-related complications occurred （21%）, including membrane rupture of the terminated sac （1 case）, preterm labor at 28 weeks gestation （1 case）, and chorioamniotic membrane separation （1 case）. Amnioinfusion was indicated in 11 procedures to expand the target sacs for entering the trocar and obtaining sufficient working space. However, in all 4 cases of acardia, the acardiac sacs showed extreme oligohydramnios and could not be well expanded by infusion; thus, the trocar had to be inserted from the sac of the preserved co-twin. Conclusions The application of bipolar cord coagulation in complicated MMPs is safe and improves the prognosis. Amnioinfusion is useful in helping to expand the target sac when the working space is limited.

Maternal and neonatal outcomes in multiple pregnancy: A multicentre study in the Beijing population

Objective:To compare the adverse maternal and neonatal outcomes of multiple pregnancy and singleton pregnancy from multiple medical centers in Beijing.Methods:Data concerning maternal and neonatal adverse outcomes in multiple and singleton pregnancies were collected from 15 hospitals in Beijing by a systemic cluster sampling survey conducted from 20 June to 30 November 2013.The SPSS software (version 20.0) was used for data analysis.The x2 test was used tbr statistical analyses.Results:The rate of caesarean deliveries was much higher in women with multiple pregnancies (85.8％) than that in women with singleton pregnancies (42.6％,X2 =190.8,P ＜ 0.001).The incidences of anemia (X2 =40.023,P ＜ 0.001),preterm labor (X2 =1021.172,P ＜ 0.001),gestational diabetes mellitus (X2 =9.311,P ＜ 0.01),hypertensive disorders (X2 =122.708,P ＜ 0.001)and post-partum hemorrhage (X2-48.550,P ＜ 0.001) was significantly increased with multiple pregnancy.In addition,multiple pregnancy was associated with a significantly higher rate of small-for-gestational-age infants (X2 =92.602,P ＜ 0.001),low birth weight (X2 =1141.713,P ＜ 0.001),and neonatal intensive care unit (NICU) admission (X2 =340.129,P＜ 0.001).Conclusions:Multiple pregnancy is a significant risk factor for adverse maternal and neonatal outcomes in Beijing.Improving obstetric care for multiple pregnancy,particularly in reducing preterm labor,is required to reduce the risk to mothers and infants.

Developmental toxicity and programming alterations of multiple organs in offspring induced by medication during pregnancy

Medication during pregnancy is widespread,but there are few reports on its fetal safety.Recent studies suggest that medication during pregnancy can affect fetal morphological and functional development through multiple pathways,multiple organs,and multiple targets.Its mechanisms involve direct ways such as oxidative stress,epigenetic modification,and metabolic activation,and it may also be indirectly caused by placental dysfunction.Further studies have found that medication during pregnancy may also indirectly lead to multi-organ developmental programming,functional homeostasis changes,and susceptibility to related diseases in offspring by inducing fetal intrauterine exposure to too high or too low levels of maternal-derived glucocorticoids.The organ developmental toxicity and programming alterations caused by medication during pregnancy may also have gender differences and multi-generational genetic effects mediated by abnormal epigenetic modification.Combined with the latest research results of our laboratory,this paper reviews the latest research progress on the developmental toxicity and functional programming alterations of multiple organs in offspring induced by medication during pregnancy,which can provide a theoretical and experimental basis for rational medication during pregnancy and effective prevention and treatment of drug-related multiple fetal-originated diseases.

Comparative effects of insulin pump and injection on gestational diabetes mellitus pregnancy outcomes and serum biomarkers

BACKGROUND Insulin injection is the basic daily drug treatment for diabetic patients.AIM To evaluate the comparative impacts of continuous subcutaneous insulin infusion(CSII).METHODS Based on the treatment modality received,the patients were allocated into two cohorts:The CSII group and the multiple daily injections(MDI)group,with each cohort comprising 210 patients.Comparative assessments were made regarding serum levels of serum-secreted frizzled-related protein 5,homocysteine,and C1q/TNF-related protein 9.Furthermore,outcomes such as fasting plasma glucose,2-hour postprandial glucose levels,pain assessment scores,and the incidence of complications were evaluated post-treatment.RESULTS The CSII group displayed notably lower fasting plasma glucose and 2-h postprandial glucose levels in comparison to the MDI group(P<0.05).Subsequent analysis post-treatment unveiled a significantly higher percentage of patients reporting no pain in the CSII group(60.00%)in contrast to the MDI group(36.19%)(P<0.05).Additionally,the CSII group exhibited a markedly reduced occurrence of fetal distress and premature rupture of membranes compared to the MDI group(P<0.05).However,there were no significant variances observed in other pregnancy outcomes between the two groups(P>0.05).A statistical analysis revealed a significant difference in the incidence of complications between the groups(χ^(2)=11.631,P=0.001).CONCLUSION The utilization of CSII via an insulin pump,as opposed to MDI,can significantly enhance the management of insulin administration in patients with GDM by diversifying the sites of insulin delivery.This approach not only promotes optimal glycemic control but also regulates metabolic factors linked to blood sugar,reducing the likelihood of adverse pregnancy outcomes and complications.The clinical relevance and importance of CSII in GDM management highlight its wide-ranging clinical usefulness.

多时间尺度下考虑源-荷协同降碳的综合能源系统分布鲁棒低碳调度

为了降低综合能源系统运行过程中的碳排放水平,并考虑源-荷不确定性对调度结果的影响,提出多时间尺度下考虑源-荷协同降碳的综合能源系统分布鲁棒低碳调度策略。在考虑氢能的储液式碳捕集电厂中加入余热发电装置,建立碳捕集与封存-电制氢-有机朗肯循环模型。在荷侧引入综合需求响应,构建源-荷协同降碳机制,结合荷侧的“削峰填谷”进一步降低系统的碳排放。为了减少可再生能源出力不确定性对系统的影响,提出日前-日内多时间尺度滚动优化策略,日前阶段构建基于数据驱动的分布鲁棒优化模型;日内阶段基于日前调度结果,通过短时间尺度滚动优化降低功率波动的影响。算例仿真结果表明:所提模型和策略可以很好地实现系统低碳性和经济性的均衡。

Application of fetoscopy in the management of monochorionic multiple pregnancies

The complications of monochorionic （MC） multiple pregnancies include twin-reversed arterial perfusion（TRAP） and twin-to-twin transfusion syndrome （TTTS）. Currently, the most effective treatment for stages Ⅱ,Ⅲ, and Ⅳ TTTS is generally considered to be fetoscopic laser occlusion of chorioangiopagous vessels （FLOC）.3 MC twins who are severely discordant for growth or demonstrate anomalies may undergo selective reduction by means of a variety of different techniques.4 Radiofrequency ablation （RFA） of an acardiac twin has also proved to be an effective method of improving survival of the pump twin in the TRAP. Therefore, care for these complex pregnancies is ideally a coordinated multidisciplinary effort between perinatology, pediatric/fetal surgery, pediatric neurology, radiology/ ultrasound, genetics, social services, neonatology, and labor and delivery.

Lattice-reduction-aided MMSE precoding for correlated MIMO channels and performance analysis

The lattice-reduction （LR） has been developed to im- prove the performance of the zero-forcing （ZF） precoder in multiple input multiple output （MIMO） systems. Under the assumptions of uncorrelated flat fading channel model and perfect channel state information at the transmitter （CSIT）, an LR-aided ZF precoder is able to collect the full transmit diversity. With the complex Lenstra- Lenstra-Lov^sz （LLL） algorithm and limited feedforward structure, an LR-aided linear minimum-mean-square-error （LMMSE） pre- coder for spatial correlated MIMO channels and imperfect CSIT is proposed to achieve lower bit error rate （BER）. Assuming a time division duplexing （TDD） MIMO system, correlated block flat fad- ing channel and LMMSE uplink channel estimator, it is proved that the proposed LR-aided LMMSE precoder can also obtain the full transmit diversity through an analytical approach. Furthermore, the simulation results show that with the quadrature phase shift keying （QPSK） modulation at the transmitter, the uncoded and coded BERs of the LR-aided LMMSE precoder are lower than that of the traditional LMMSE precoder respectively when Eb-No is greater than 10 dB and 12 dB at all correlation coefficients.

A case study of multi-seam coal mine entry stability analysis with strength reduction method

In this paper,the advantage of using numerical models with the strength reduction method(SRM) to evaluate entry stability in complex multiple-seam conditions is demonstrated.A coal mine under variable topography from the Central Appalachian region is used as a case study.At this mine,unexpected roof conditions were encountered during development below previously mined panels.Stress mapping and observation of ground conditions were used to quantify the success of entry support systems in three room-and-pillar panels.Numerical model analyses were initially conducted to estimate the stresses induced by the multiple-seam mining at the locations of the affected entries.The SRM was used to quantify the stability factor of the supported roof of the entries at selected locations.The SRM-calculated stability factors were compared with observations made during the site visits,and the results demonstrate that the SRM adequately identifies the unexpected roof conditions in this complex case.It is concluded that the SRM can be used to effectively evaluate the likely success of roof supports and the stability condition of entries in coal mines.

Lattice Reduction Aided MMSE Tomlinson-Harashima Precoding Based on VBLAST Algorithm for MIMO Systems

A lattice reduction aided (LRA) minimum mean square error (MMSE) Tomlinson-Harashima pre-coding (THP) was proposed based on vertical Bell Labs layered space time (VBLAST) algorithm for multiple input multiple output (MIMO) systems. The extended channel was used to provide optimal tradeoff between residual interference and noise amplification. The processing based on lattice reduction method helps achieve maximal diversity order. The VBLAST algorithm was applied to get the optimal processing ordering for successive interference cancellation (SIC) at transmitter. Simulation results show that the proposed algorithm outperforms conventional THP and the LRA zero-forcing (ZF) THP with full diversity order.

Soft-output stack algorithm with lattice-reduction for MIMO detection

A computationally efficient soft-output detector with lattice-reduction （LR） for the multiple-input multiple-output （MIMO） systems is proposed. In the proposed scheme, the sorted QR de- composition is applied on the lattice-reduced equivalent channel to obtain the tree structure. With the aid of the boundary control, the stack algorithm searches a small part of the whole search tree to generate a handful of candidate lists in the reduced lattice. The proposed soft-output algorithm achieves near-optimal perfor- mance in a coded MIMO system and the associated computational complexity is substantially lower than that of previously proposed methods.

An Efficient Multiple Imputation Approach for Estimating Equations with Response Missing at Random and High-Dimensional Covariates

Empirical-likelihood-based inference for parameters defined by the general estimating equations of Qin and Lawless(1994) remains an active research topic. When the response is missing at random(MAR) and the dimension of covariate is not low, the authors propose a two-stage estimation procedure by using the dimension-reduced kernel estimators in conjunction with an unbiased estimating function based on augmented inverse probability weighting and multiple imputation(AIPW-MI) methods. The authors show that the resulting estimator achieves consistency and asymptotic normality. In addition, the corresponding empirical likelihood ratio statistics asymptotically follow central chi-square distributions when evaluated at the true parameter. The finite-sample performance of the proposed estimator is studied through simulation, and an application to HIV-CD4 data set is also presented.

Correlated Extra Reductions Defeat Fixed Window Exponentiation

The security of modular power algorithm is a very important research topic, which is the core operation of public key cryptography algorithm. Since the first timing attack was public in 1996, the attacker can exploit time differences between specific events to recover a secret key. In 2016, Dugardin took advantage of extra reductions to attack a regular exponentiation algorithm, which did not entirely adapt the fixed window method with Montgomery’s algorithm. The central thesis of this paper is that there exists a positive correlation between extra reductions of pre-computation and post-computation when the calculation has the same multiplier factor. In this article, basing on this dependency we present an attack method, and confirm the feasibility and effectiveness of it by conducting simulation experiments. Experimental results verify that the method can effectively attack modular power algorithm.