Automated Documentation: A Complete Cycle

2020 ◽  
pp. 175-188
Author(s):  
Helen D. Klein
Keyword(s):  
Complete Cycle

scholarly journals Comparative effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa) versus highly purified urinary human menopausal gonadotropin (hMG HP) in assisted reproductive technology (ART) treatments: a non-interventional study in Germany

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Klaus F. Bühler ◽  
Robert Fischer ◽  
Patrice Verpillat ◽  
Arthur Allignol ◽  
Sandra Guedes ◽  
...  
Keyword(s):  
Assisted Reproductive Technology ◽  
Live Birth ◽  
Pregnancy Loss ◽  
Follicle Stimulating Hormone ◽  
Reproductive Technology ◽  
Clinical Pregnancy ◽  
Human Menopausal Gonadotropin ◽  
Ongoing Pregnancy ◽  
Complete Cycle ◽  
Significant Difference

Abstract Background This study compared the effectiveness of recombinant human follicle-stimulating hormone alfa (r-hFSH-alfa; GONAL-f®) with urinary highly purified human menopausal gonadotropin (hMG HP; Menogon HP®), during assisted reproductive technology (ART) treatments in Germany. Methods Data were collected from 71 German fertility centres between 01 January 2007 and 31 December 2012, for women undergoing a first stimulation cycle of ART treatment with r-hFSH-alfa or hMG HP. Primary outcomes were live birth, ongoing pregnancy and clinical pregnancy, based on cumulative data (fresh and frozen-thawed embryo transfers), analysed per patient (pP), per complete cycle (pCC) and per first complete cycle (pFC). Secondary outcomes were pregnancy loss (analysed per clinical pregnancy), cancelled cycles (analysed pCC), total drug usage per oocyte retrieved and time-to-live birth (TTLB; per calendar week and per cycle). Results Twenty-eight thousand six hundred forty-one women initiated a first treatment cycle (r-hFSH-alfa: 17,725 [61.9%]; hMG HP: 10,916 [38.1%]). After adjustment for confounding variables, treatment with r-hFSH-alfa versus hMG HP was associated with a significantly higher probability of live birth (hazard ratio [HR]-pP [95% confidence interval (CI)]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; relative risk [RR]-pFC [95% CI]: 1.09 [1.05, 1.15], ongoing pregnancy (HR-pP [95% CI]: 1.10 [1.04, 1.16]; HR-pCC [95% CI]: 1.13 [1.08, 1.19]; RR-pFC [95% CI]: 1.10 [1.05, 1.15]) and clinical pregnancy (HR-pP [95% CI]: 1.10 [1.05, 1.14]; HR-pCC [95% CI]: 1.14 [1.10, 1.19]; RR-pFC [95% CI]: 1.10 [1.06, 1.14]). Women treated with r-hFSH-alfa versus hMG HP had no statistically significant difference in pregnancy loss (HR [95% CI]: 1.07 [0.98, 1.17], were less likely to have a cycle cancellation (HR [95% CI]: 0.91 [0.84, 0.99]) and had no statistically significant difference in TTLB when measured in weeks (HR [95% CI]: 1.02 [0.97, 1.07]; p = 0.548); however, r-hFSH-alfa was associated with a significantly shorter TTLB when measured in cycles versus hMG HP (HR [95% CI]: 1.07 [1.02, 1.13]; p = 0.003). There was an average of 47% less drug used per oocyte retrieved with r-hFSH-alfa versus hMG HP. Conclusions This large (> 28,000 women), real-world study demonstrated significantly higher rates of cumulative live birth, cumulative ongoing pregnancy and cumulative clinical pregnancy with r-hFSH-alfa versus hMG HP.

scholarly journals Control of switching circuits using complete-cycle solution matrices

2006 ◽  
Author(s):  
Damian Giaouris ◽  
Abdulmajed Elbkosh ◽  
Soumitro Banerjee ◽  
Bashar Zahawi ◽  
Volker Pickert
Keyword(s):  
Complete Cycle ◽  
Switching Circuits

scholarly journals Does it Matter Whom You See?–A Fracture Clinic Audit

2006 ◽  
Vol 88 (6) ◽  
pp. 540-542 ◽  
Author(s):  
TDA Cosker ◽  
A Ghandour ◽  
T Naresh ◽  
K Visvakumar ◽  
SR Johnson
Keyword(s):  
Complex Trauma ◽  
Discharge Rate ◽  
Trauma System ◽  
Presentation Rate ◽  
Fracture Clinic ◽  
Complete Cycle ◽  
Junior Staff ◽  
Number Of Patients ◽  
The Uk

INTRODUCTION A consultant-led service for trauma in the UK has become the accepted norm. Practice in fracture clinics may vary widely between consultants and has an impact on the number of patients seen and, therefore, the time devoted to each patient. PATIENTS AND METHODS A total of 945 patients attending our unit's fracture clinics were analysed over a 6-week period, representing one complete cycle of our trauma system. RESULTS The overall discharge rate was 38% but this differed significantly between consultants. Patients re-presenting for the same complaint were evenly distributed between those discharging aggressively and those re-reviewing regularly. CONCLUSIONS Re-reviewing patients has a significant impact on the number of patients seen in future clinics and, therefore, the time that can be devoted to each patient, individual consultant workload and teaching of junior staff. Since the re-presentation rate between those discharging aggressively and those re-reviewing more frequently was the same, discharge protocols are recommended for common trauma conditions to standardise the process. Specialist clinics are recommended for more complex trauma cases.

P–513 Analysis of the extent of dropout-rates by extraction from cumulative live birth rates in IVF/ICSI: systematic review and meta-analysis

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Vereeck ◽  
A Sugihara ◽  
D D Neubourg
Keyword(s):  
Embryo Transfer ◽  
Live Birth ◽  
Weighted Average ◽  
Dropout Rate ◽  
Dropout Rates ◽  
Birth Rates ◽  
Complete Cycle ◽  
Live Birth Rates ◽  
Cumulative Live Birth ◽  
Icsi Cycle

Abstract Study question The purpose of this systematic review is to calculate dropout-rates of IVF/ICSI treatment by analysing the published cumulative live birth rates of IVF/ICSI treatment. Summary answer One out of three patients stop their treatment after their first IVF/ICSI cycle and dropout-rates tend to increase per consecutive cycle. What is known already Cumulative live birth rates (CLBRs) have created the possibility to present realistic probabilities of having a live birth after IVF/ICSI treatment. However, it is noted that a significant percentage of the patients stop their treatment before having a child (“dropout”). Possible reasons and predicting factors for dropout of treatment are already extensively investigated. However, only a few studies try to report about the incidence of dropout. Publications on CLBRs of large numbers of patients allow the extraction of dropout-rates. These rates will provide insight in the extent of the problem and could be used as a reference for interventional studies. Study design, size, duration Four databases (PubMed, The Cochrane Library, EMBASE, DoKS) were systematically searched from 1992 to December 2020. Search terms referred to “cumulative live birth” AND “ART/IVF/ICSI”. No restrictions were made on the type or language of publication. Studies were included if they reported absolute numbers of patients and live births per consecutive complete IVF/ICSI cycle or per consecutive embryo transfer cycle, starting from the first IVF/ICSI cycle for each patient. Participants/materials, setting, methods Dropout-rates per cycle were calculated in two manners: “intrinsic dropout-rate” with all patients that started the particular IVF/ICSI cycle in the denominator, and “potential dropout-rate” with all patients who did not achieve a live birth after IVF/ICSI (and potentially could have started a consecutive cycle) in the denominator. Dropout-rates were analysed for consecutive complete cycles and consecutive embryo transfer cycles, because these two manners are used in reporting CLBRs, often related to the reimbursement policy. Main results and the role of chance This review included 29 studies and almost 800,000 patients from different countries and registries. Regarding the patients who started their first IVF/ICSI cycle, trying to conceive their first child by IVF/ICSI, intrinsic dropout-rate was 33% (weighted average) after the first complete cycle, meaning they did not return for their second oocyte retrieval cycle. After the first embryo transfer cycle, intrinsic dropout-rate was 27% (weighted average), meaning those patients did not return for their next frozen-thawed embryo transfer cycle or for the next oocyte retrieval cycle. Regarding the patients who did not achieve a live birth after the first complete cycle, potential dropout-rate was 48% (weighted average), and 37% (weighted average) after the first embryo transfer cycle. Both potential and intrinsic dropout-rates for both consecutive complete and embryo transfer cycles tended to increase with cycle number. One study on second IVF/ICSI conceived children showed a potential dropout-rate after the first complete cycle of 29%. From studies on women >40 years of age, the potential dropout-rate after the first complete cycle was 45% (weighted average) and from studies with the uses of testicular sperm extraction, the potential dropout-rate after the first complete cycle was 34% (weighted average). Limitations, reasons for caution Our analysis was hampered by the different ways of reporting on CLBRs (complete cycles versus embryo transfer cycles), informative censoring, patients changing clinics and spontaneous pregnancies. Dropout-rates were potentially overestimated given that spontaneous pregnancies were not taken into account. Wider implications of the findings: The extent of dropout in IVF/ICSI treatment is substantial and has an important impact on its effectiveness. Therefore, it is a challenge for fertility centers to try to keep patients longer on board, by taking into account the patients’ preferences and managing their expectations. Trial registration number PROSPERO Registration number: CRD42020223512

Stiffness and Damping Forces in the Intervertebral Joints of Blue Marlin (Makaira Nigricans)

1992 ◽  
Vol 162 (1) ◽  
pp. 131-155 ◽  
Author(s):  
JOHN H. LONG
Keyword(s):  
Regional Variation ◽  
Vertebral Column ◽  
Damping Coefficient ◽  
Complete Cycle ◽  
Blue Marlin ◽  
Makaira Nigricans ◽  
External Moment ◽  
Order Of Magnitude ◽  
Dynamic Bending ◽  
Stiffness And Damping

The stiffness and damping moments that are transmitted by intervertebral joints during sinusoidal bending were determined in the blue marlin, Makaira nigricans Lacépède. Using a dynamic bending machine, the angular stiffness (N m rad−1) and damping coefficient (kg m2 rad−2 s−1) of the intervertebral joints were measured over a range of bending frequencies, amplitudes and positions along the backbone. Angular stiffness increases with increasing bending amplitude, but, for some joints, the rate at which it changes with increasing bending frequency is negative. The precaudal intervertebral joints are less stiff than the caudal joints. The damping coefficient, which also shows regional variation, does not change with amplitude but does decrease with increasing bending frequency in joint positions three and five. Stiffness moments along the vertebral column, given the same amount of bending at each joint, are always greater than the damping moments. However, damping moments increase by an order of magnitude with an increase in bending frequency from 0.5 to 5.0Hz. The stiffness and damping moments determine the work that an external moment, such as muscle, must do over a complete cycle of bending. The external moments and work needed to bend an intervertebral joint are determined largely by the stiffness moments of the intervertebral joints.

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