Provision of Fertility Preservation for Young Women with Early-Stage Breast Cancer

Breast cancer is the most common cancer in women worldwide, constituting 25% of all cancer diagnoses. Even though it is only affecting 4% - 6% of women under the age of 40, it remains the most common malignancy among younger patients. Advancement in the treatment and earlier detection gives excellent 5 years of survival. However, the standard treatment that comprises surgical-chemo radiation therapy or hormonal treatment often results in an increased incidence of treatment-induced infertility. Therefore, adding fertility preservation to primary cancer treatment may offer the best opportunity for future fertility. However, despite advancements in Assisted Reproductive Technology (ART), the uptake of fertility services in this group remains low. In this review, we highlighted the effect of all breast cancer treatments on women’s fertility, the effectiveness and safety of ART in breast cancer patients as well as the safety of pregnancy in breast cancer survivors. Our aim is to improve awareness of fertility preservation for breast cancer to ensure all women diagnosed with breast cancer have multidisciplinary approaches with early referral to fertility specialists to discuss regarding potential risks and benefits of fertility preservation to improve the uptake of fertility preservation among this group of patients.

Elective oocyte freezing for the preservation of fertility

Oocyte cryopreservation has recently emerged as an option for women to preserve their fertility for medical (e.g. treatable malignancy) or elective indications (e.g. advancing age). This report describes an IRB-approved study of over 200 oocyte cryopreservation cycles at one center. Patients presenting for oocyte cryopreservation (January 2005 to 2010) were analyzed for day 3 follicle stimulating hormone (FSH), basal antral follicle count (BAFC), gonadotropin usage and the number of oocytes retrieved and cryopreserved. New patient consultations were performed on 516 women, of whom 175 (34%) proceeded to initiate a total of 233 cryopreservation cycles. Twenty-four cycles were cancelled (10%) after starting follicular stimulation due to poor ovarian response or self-withdrawal of the patients. Patients whose cycles were cancelled demonstrated a higher Day 3 FSH and a lower BAFC than patients who completed cycles (p < 0.01). In the 209 completed cycles, the most important predictors of a successful cycle included BAFC (r = 0.36), FSH (r = –0.25) and age (r = –0.18) with the mean number of oocytes cryopreserved at 13.6 ± 8.8. Information about long-term fertility preservation must reach both patients and health care providers so that more women can be educated about the benefits of proactive early physiological reproductive assessment and possible interventions available.

Dynamic channel reservation scheme based on priorities in LEO satellite systems

According to low earth orbit（LEO） satellite systems with users of different levels, a dynamic channel reservation scheme based on priorities is proposed. Dynamic calculation of the thresholds for reserved channels is the key of this strategy. In order to obtain the optimal thresholds, the traffic is predicted based on the high-speed deterministic movement property of LEO satellites firstly. Then, a channel allocation model based on Markov is established. Finally, the solution of the model is obtained based on the genetic algorithm. Without user location, this strategy effectively reduces handover failures and improves channel utilization by adjusting dynamically the thresholds according to traffic conditions. The simulation results show that the system＇s overall quality of service can be improved by this strategy.

Effect and satisfaction of outpatient services by precision valuation reservation registration

BACKGROUND Due to improvements in living standards,people are now paying more attention to their health.In China,more patients choose to go to large or well-known hospitals,which leads to constant crowding of outpatient clinics in these hospitals.AIM To establish precision valuation reservation registration aimed at shortening waiting time,improving patient experience and promoting the satisfaction of outpatients and medical staff.METHODS On the basis of the implementation of a conventional appointment system,more reasonable time intervals were set for different doctors by evaluating the actual capacity of each doctor to receive patients,and appointment times were made more accurate through intervention.The change in consultation waiting time of patients was then compared.Correlations between the consultation waiting time of patients and the satisfaction of patients or satisfaction of medical staff were analyzed.RESULTS After precision valuation reservation registration,the average consultation waiting time of patients reduced from 18.47 min to 10.11 min(t=8.90,P<0.001).The satisfaction score of patients increased from 91.33 to 96.27(t=-8.62,P<0.001),and the satisfaction score of medical staff increased from 90.51 to 96.04(t=-10.50,P<0.001).The consultation waiting time of patients was negatively correlated with their satisfaction scores(γ=-0.89,P<0.001).The consultation waiting time of patients was also negatively correlated with medical staff satisfaction scores(γ=-0.96,P<0.001).CONCLUSION Precision valuation reservation registration significantly shortened outpatient waiting times and improve the satisfaction of not only patients but also medical staff.This approach played an important role in improving outpatient services,provided a model that is supported by relevant evidence and could continuously improve the quality of management.Precision valuation reservation registration is worth promoting and applying in the clinic.

A Novel Peak-to-Average Power Ratio Reduction Scheme via Tone Reservation in OFDM Systems

In this paper, a novel signal-to-clipping noise ratio and least squares approximation tone reservation scheme(SCR-LSA TR) is proposed to reduce the peak-to-average power ratio for orthogonal frequency division multiplexing systems. During the SCR procedure, only the element with the maximal amplitude is picked for processing, which not only decreases the algorithm complexity, but also helps to overcome the BER deterioration. With the LSA method, the amplitude of the peak-cancelling signals can approximate to that of the original clipping noise as much as possible. Through the combination of the optimization factor in the LSA method, the classic SCR method can achieve better PAPR reduction with faster convergence. Simulation results show that the proposed SCR-LSA TR scheme has less in-band distortion and smaller out-of-band spectral radiation. The BER of the proposed scheme shows a better performance especially under the 16-QAM over the additive white Gaussian noise channel.

Development and Reservation of Geographical Indication Products in China

With more than 5000-year civilization, China has gradually formed in its different regions hundreds of the geographic indication products, such as Longjing Tea, Maotai Liquor, Shaoxing Rice Wine, Jinghua Ham, Beijing Roast Duck, Xinjiang Honey Jelon, etc. They are the precious creatures of Chinese nation.

Dynamic random channel reservation protocol

Demand assignment MAC protocols have been used widely in wireless networks. It can effectively utilize wireless bandwidth. Some strategies can he used by demand assignment MAC protocols to further improve their efficiency. The concept of transmit probability is introduced. This concept allows a request slot to be assigned to many different traffic classes at the same time. Based on it, the dynamic random channel reservation （DRCR） protocol is proposed. The DRCR protocol operates dynamically by observing the traffic conditions. It uses information about the recent traffic conditions to assign transmit probability with which an mobile station can select request slots with lower traffic. The performance of DRCR is evaluated and compared with RSCA. The results show that DRCR is more stable than RSCA, it offers shorter delays of requests than RSCA and can relieve heavily stressed traffic classes faster than RSCA.

Agriculture Resource Management Planning on the Wind River Indian Reservation: An Integrative Approach

The Wind River Indian Reservation undertook the development of an agricultural resource management plan in 2015. The reservation is 8903 sq.km of which 63% is in crop and grazing lands. This project’s aim was to create a community-based integrated plan. A series of community meetings identified 83 issues and topics relating to agricultural development on the reservation. Using information from community meetings, the final agricultural resource management plan consists of 9 major elements, with 12 goals, 46 objectives and 88 policies. Three key issues are addressed in the plan: provide the reservation with a plan that leads to self-management of their agricultural resources;integrate the major agricultural elements as defined by the community into policies;and, create a governance structure that fosters agricultural development into the future.

reservation酒店预订 姗姗走来

过去我们常在外国电影中看到这样的镜头:大公司的高级白领出差前拿起电话,吩咐秘书:"给我订一间××城市的××酒店。"今天,这种商务活动不仅普及到了中国,而且随着长假的推行,普通百姓出游的增多,以及旅游旺季酒店供不应求的局面,也使更多的旅游者在出行前拿起了电话"

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Parking reservation techniques:A review of research topics,considerations,and optimization methods

Growing private vehicle use and a limited supply of parking resources have increased competition for parking spaces.Ineffective searching for parking spaces is a significant barrier to smooth traffic flow.Smart technology-generated parking reservations are regarded as an excellent way to increase parking efficiency and lessen traffic.Although there is increased attention on smart parking research and parking reservation optimization,a scoping review is currently lacking.Therefore,the purpose of this paper is to provide a comprehensive review of the research literature related to parking reservations.Out of the original 438 publications identified in this search,99 were eventually chosen for analysis.The review categorized parking reservations into four research topics:inventory control,allocation decisions,pricing strategies,and performance evaluation.The elements considered in these research themes,modeling techniques,and evaluation criteria are explored in detail.In addition,the challenges and further enhancements of parking reservation optimization are discussed.It is believed that the findings from this study will be beneficial in further research on parking reservations.

Prepartition: Load Balancing Approach for Virtual Machine Reservations in a Cloud Data Center

Load balancing is vital for the efficient and long-term operation of cloud data centers.With virtualization,post(reactive)migration of virtual machines(VMs)after allocation is the traditional way for load balancing and consolidation.However,it is not easy for reactive migration to obtain predefined load balance objectives and it may interrupt services and bring instability.Therefore,we provide a new approach,called Prepartition,for load balancing.It partitions a VM request into a few sub-requests sequentially with start time,end time and capacity demands,and treats each sub-request as a regular VM request.In this way,it can proactively set a bound for each VM request on each physical machine and makes the scheduler get ready before VM migration to obtain the predefined load balancing goal,which supports the resource allocation in a fine-grained manner.Simulations with real-world trace and synthetic data show that our proposed approach with offline version(PrepartitionOff)scheduling has 10%–20%better performance than the existing load balancing baselines under several metrics,including average utilization,imbalance degree,makespan and Capacity_makespan.We also extend Prepartition to online load balancing.Evaluation results show that our proposed approach also outperforms state-of-the-art online algorithms.

Relaxed resource advance reservation policy in grid computing

The advance reservation technique has been widely applied in many grid systems to provide end-to-end quality of service （QoS）. However, it will result in low resource utilization rate and high rejection rate when the reservation rate is high. To mitigate these negative effects brought about by advance reservation, a relaxed advance reservation policy is proposed, which allows accepting new reservation requests that overlap the existing reservations under certain conditions. Both the benefits and the risks of the proposed policy are presented theoretically. The experimental results show that the policy can achieve a higher resource utilization rate and lower rejection rate compared to the conventional reservation policy and backfilling technique. In addition, the policy shows better adaptation when the grid systems are in the presence of a high reservation rate.

Variability of soil organic carbon reservation capability between coastal salt marsh and riverside freshwater wetland in Chongming Dongtan and its microbial mechanism

Two representative zones in Chongming Dongtan which faced the Yangtze River and East China Sea respectively were selected to study the variability of soil organic carbon （SOC） reservation capability between coastal wetland and riverside wetland in the Chongming Dongtan wetland as well as its mechanism by analyzing soil characteristics and plant biomass.The results showed the SOC content of riverside wetland was only 48.61% （P=0.000 〈 0.05） that of coastal wetland.As the organic matter inputs from plant litter of the coastal wetland and riverside wetland were approximately the same,the higher soil microbial respiration （SMR） of riverside wetland led to its lower SOC reservation capability.In the riverside wetland,the high soil microbial biomass,higher proportion of β-Proteobacteria,which have strong carbon metabolism activity and the existence of some specific aerobic heterotrophic bacteria such as Bacilli and uncultured Lactococcus,were the important reasons for the higher SMR compared to the coastal wetland.There were additional differences in soil physical and chemical characteristics between the coastal wetland and riverside wetlands.Path analysis of predominant bacteria and microbial biomass showed that soil salinity influenced β-Proteobacteria and microbial biomass most negatively among these physical and chemical factors.Therefore the low salinity of the riverside area was suitable for the growth of microorganisms,especially β-Proteobacteria and some specific bacteria,which led to the high SMR and low SOC reservation capability when compared to the coastal area.

High quality repair of osteochondral defects in rats using the extracellular matrix of antler stem cells

BACKGROUND Cartilage defects are some of the most common causes of arthritis.Cartilage lesions caused by inflammation,trauma or degenerative disease normally result in osteochondral defects.Previous studies have shown that decellularized extracellular matrix(ECM)derived from autologous,allogenic,or xenogeneic mesenchymal stromal cells(MSCs)can effectively restore osteochondral integrity.AIM To determine whether the decellularized ECM of antler reserve mesenchymal cells(RMCs),a xenogeneic material from antler stem cells,is superior to the currently available treatments for osteochondral defects.METHODS We isolated the RMCs from a 60-d-old sika deer antler and cultured them in vitro to 70%confluence;50 mg/mL L-ascorbic acid was then added to the medium to stimulate ECM deposition.Decellularized sheets of adipocyte-derived MSCs(aMSCs)and antlerogenic periosteal cells(another type of antler stem cells)were used as the controls.Three weeks after ascorbic acid stimulation,the ECM sheets were harvested and applied to the osteochondral defects in rat knee joints.RESULTS The defects were successfully repaired by applying the ECM-sheets.The highest quality of repair was achieved in the RMC-ECM group both in vitro(including cell attachment and proliferation),and in vivo(including the simultaneous regeneration of well-vascularized subchondral bone and avascular articular hyaline cartilage integrated with surrounding native tissues).Notably,the antler-stem-cell-derived ECM(xenogeneic)performed better than the aMSC-ECM(allogenic),while the ECM of the active antler stem cells was superior to that of the quiescent antler stem cells.CONCLUSION Decellularized xenogeneic ECM derived from the antler stem cell,particularly the active form(RMC-ECM),can achieve high quality repair/reconstruction of osteochondral defects,suggesting that selection of decellularized ECM for such repair should be focused more on bioactivity rather than kinship.

Peat properties of a tropical forest reserve adjacent to a fire-break canal

Tropical peat comprises decomposed dead plant material and acts like a sponge to absorb water,making it fully saturated.However,drought periods dry it readily and increases its vulnerability to fire.Peat fires emit greenhouse gases and particles contributing to haze,and prevention by constructing fire-break canals to reduce fire spread into forest reserves is crucial.This paper aims to determine peat physical and chemical properties near a fire-break canal at different fire frequency areas.Peat sampling was conducted at two forest reserves in Malaysia which represent low fire frequency and high fire frequency areas.The results show that peat properties were not affected by the construction of a fire-break canal,however lignin and cellulose content increased significantly from the distance of the canal in both areas.The study concluded that fire frequency did not significantly influence peat properties except for porosity.The higher fibre content in the high frequency area did not influence moisture content nor the ability to regain moisture.Thus,fire frequency might contribute differently to changes in physical and chemical properties,hence management efforts to construct fire-break canals and restoration efforts should protect peatlands from further degradation.These findings will benefit future management and planning for forest reserves.

Swelling pressure evolution characterization of strong expansive soil considering the influence of reserved expansion deformation

Numerous engineering cases have demonstrated that the expansive soil channel slope remains susceptible to damage with the implementation of a rigid or closed protective structure. It is common for the protective structure to experience bulging failure due to excessive swelling pressure. To investigate the swelling pressure properties of expansive soil, the constant volume test was employed to study the influence of water content and reserved expansion deformation on the characteristics of swelling pressure in strong expansive soils, and also to explore the evolution mechanism of the swelling pressure. The findings demonstrate that the swelling pressure-time curve can be classified into swelling pressure-time softening and swelling pressure-time stability type. The swelling pressuretime curve of the specimen with low water content is the swelling pressure-time softening type, and the softening level will be weakened with increasing reserved expansion deformation. Besides, the maximum swelling pressure Psmax decreases with increasing water content and reserved expansion deformation, especially for expansion ratio η from 24% to 37%. The reserved deformation has little effect on reducing Psmax when it is beyond 7% of the expansion rate. The specimen with low water content has a more homogeneous structure due to the significant expansion-filling effect, and the fracture and reorganization of the aggregates in the specimens with low water content cause the swelling pressure-time softening behavior. In addition, the proposed swelling pressure-time curve prediction model has a good prediction on the test results. If necessary, a deformation space of about 7% expansion rate is recommended to be reserved in the engineering to reduce the swelling pressure except for keeping a stable water content.

Sourcing Decisions with Capacity Reservations under Supply Disruptions

Firms employing both offshore outsourcing and nearshore sourcing strategies may face supply disruption,demand uncertainty,and quality risks simultaneously.Sourcing decisions become inevitably important and complicated when both profit and the customer-service level are taken into consideration.In this paper,we model a scenario where a manufacturer who faces stochastic demand procures major modules from an overseas supplier and two local suppliers.The overseas supplier offers quality products while being susceptible to disruption risks;if the local suppliers,who are completely reliable and serve as a backup,offer products that are of inferior quality,it may result in lower market acceptance and a bad experience for the final customers.The manufacturer has to reserve capacity with backup suppliers before urgent orders are placed,when the primary source experiences a shortfall.We explicitly derive the manufacturer’s optimal order quantities and reservation quantities,which are functions of the heterogeneous suppliers’wholesale prices,reservation prices,and other parameters.The impacts of the fill-rate constraint and customer-experience quality constraint on the manufacturer’s purchasing decisions are investigated.Interesting managerial insights on the merits of backup sourcing with capacity reservations for managing demand uncertainties and supply disruption risks are also discussed.

Changes in renal function and morphological variations of kidney diseases in rheumatoid arthritis patients

Objective:Rheumatoid nephropathy is one of the most severe extra-articular manifestations of rheumatoid arthritis(RA)associated with a very unfavorable prognosis.This study aimed to identify changes in renal function and morphological variations of kidney diseases in RA patients.Methods:The study enrolled patients(126 patients)between 18 and 55 years of age with a confirmed active RA of more than 12 months.Each patient underwent the following range of laboratory and instrumental research methods:general clinical analysis of blood and urine,performing urinalysis according to Nechiporenko method;determining daily proteinuria;determining the blood content of glucose,urea,creatinine,uric acid,total bilirubin,liver transaminase level,ionogram,lipidogram,and coagulogram;determining the blood content of rheumatoid factor,anti-streptolysin O,and C-reactive protein;and X-ray of the joints of hands and feet.Renal function was examined by estimating glomerular filtration rate,tubular reabsorption index,and renal functional reserve.For studying the morphological changes in the kidneys under ultrasound examination,renal biopsy was performed in 31 patients with RA with urinary syndrome(proteinuria more than 0.3 g per day and hematuria).Results:Nephropathy in RA is characterized by impaired renal function and manifested by an increased blood creatinine and a decrease in glomerular filtration rate and renal functional reserve.Among morphological variations of nephropathy at RA,mesangial proliferative glomerulonephritis prevails,accounting for 48.4%of patients.Other disorders include the secondary amyloidosis(29.0%of patients),tubulointerstitial nephritis(16.1%),membranous glomerulonephritis(3.2%),and focal-segmental glomerulosclerosis(3.2%).Conclusion:Kidney damage is a common systemic manifestation of RA with a long and active course,a major nephropathy trigger.

Deferred revascularization in diabetic patient according to combined invasive functional and intravascular imaging data:A case report

BACKGROUND Invasive functional evaluation by fractional flow reserve(FFR)is considered as a gold standard for the evaluation of intermediate coronary stenosis.However,in patients with diabetes due to accelerated progression of atherosclerosis the outcome may be worse even in the presence of negative functional testing.CASE SUMMARY We present a case of 55-year-old male diabetic patient who was admitted for chest pain.Diagnostic coronary angiography disclosed 2 intermediate stenoses of the obtuse marginal branch with no evidence of restenosis on previously implanted stent.Patient undergone invasive functional testing of intermediate lesion with preserved FFR(0.88),low coronary flow reserve(1.2)and very high index of microvascular resistance(84).Due to discrepancy in invasive functional parameters,intravascular imaging with optical coherence tomography showed fibrotic stenoses without signs of thin-sup fibroatheroma.Because of the preserved FFR and no signs of vulnerable plaque,the interventional procedure was deferred and the patient continued with optimal medications.CONCLUSION Combined functional and anatomic imaging of intermediate coronary stenosis in diabetic patients represent comprehensive contemporary decision pathway in the management of the patients.