Recurrent miscarriage – a critical appraisal

2002 ◽  
Vol 10 (3) ◽  
pp. 165-176 ◽  
Author(s):  
R Rai
Keyword(s):  
Pregnancy Loss ◽  
Critical Appraisal ◽  
Recurrent Miscarriage ◽  
Human Reproduction ◽  
Future Research ◽  
Comparative Genomic ◽  
Significant Progress ◽  
Critical Scrutiny ◽  
The Subject ◽  
Selective Process

Only 50% of all conceptions result in a live birth (Figure 1). Human reproduction can therefore be viewed as being remarkably inefficient. However, the diametrically opposite opinion that it is in fact a very efficient and selective process, designed to optimize the outcome of pregnancy, deserves to be stated.Between 65% and 90% of clinically recognized miscarriages are due to chromosome abnormalities, the occurrence of which is more closely related to basal follicle-stimulating hormone (FSH) levels rather than to maternal age alone. In contrast to women suffering a sporadic miscarriage, women who recurrently miscarry often, but not exclusively, lose pregnancies with a normal chromosome content. Using a combination of conventional Geimsa banding and the recently introduced technique of comparative genomic hybridization it has been reported that 54% of pregnancy losses amongst women with recurrent miscarriage are euploid. The challenge we face is to identify the causes of pregnancy loss amongst those couples who recurrently lose such euploid conceptions.Whilst many conventionally held beliefs as to the aetiology and treatment of women with recurrent miscarriage have not withstood critical scrutiny, significant progress has been made. This progress is the subject of this review, which will also highlight potential areas of future research.

The current challenges of automatic recognition of facial expressions: A systematic review

2020 ◽  
Vol 33 (3-6) ◽  
pp. 113-138
Author(s):  
Audrey Masson ◽  
Guillaume Cazenave ◽  
Julien Trombini ◽  
Martine Batt
Keyword(s):  
Systematic Review ◽  
Facial Expressions ◽  
Facial Expression Recognition ◽  
Future Research ◽  
Expression Recognition ◽  
Review Of The Literature ◽  
Significant Progress ◽  
Recognition Of Facial Expressions ◽  
The Subject ◽  
Current Systems

In recent years, due to its great economic and social potential, the recognition of facial expressions linked to emotions has become one of the most flourishing applications in the field of artificial intelligence, and has been the subject of many developments. However, despite significant progress, this field is still subject to many theoretical debates and technical challenges. It therefore seems important to make a general inventory of the different lines of research and to present a synthesis of recent results in this field. To this end, we have carried out a systematic review of the literature according to the guidelines of the PRISMA method. A search of 13 documentary databases identified a total of 220 references over the period 2014–2019. After a global presentation of the current systems and their performance, we grouped and analyzed the selected articles in the light of the main problems encountered in the field of automated facial expression recognition. The conclusion of this review highlights the strengths, limitations and main directions for future research in this field.

Miscarriage and recurrent miscarriage

2020 ◽  
pp. 477-488
Author(s):  
Vikram Sinai Talaulikar ◽  
Mushi Matjila
Keyword(s):  
Early Pregnancy ◽  
Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Significant Proportion ◽  
Phenotypic Characterization ◽  
Future Research ◽  
Management Options ◽  
Global Consensus ◽  
Comprehensive Information ◽  
Definition Of

Complications of early pregnancy, including pregnancy loss and threatened miscarriage, are common. Miscarriage affects almost one in five pregnancies and accounts for utilization of a significant proportion of healthcare resources. Women presenting with miscarriage should ideally be assessed, diagnosed, and managed in early pregnancy assessment units. They should be provided with comprehensive information about expectant, medical, and surgical management options, and helped to make informed decisions about their care. Early pregnancy loss can be a source of considerable distress to women and they should be provided with appropriate support and counselling. Recurrent miscarriage (RM) remains a challenge to patients and clinicians alike. Recognition of the psychosocial impact should prompt involvement of mental health specialists, counsellors, and social workers in patient management. Inconsistencies in definition (two or three consecutive miscarriages) confound research in RM. Although endocrinological, thrombotic, autoimmune, and uterine structural perturbations have been described in association with RM, antiphospholipid syndrome and embryonic karyotype abnormalities remain the two closest conditions for which a reasonable explanation can be offered to patients along with prognostication for future pregnancies. A diagnosis of RM has additional implications, not only for previable pregnancy loss, but an association with adverse obstetric and future maternal health outcomes. A global consensus on the definition of RM, along with phenotypic characterization of this heterogeneous condition would improve interpretation of available data and future research. A thorough understanding of the underlying molecular pathophysiological mechanisms in specific phenotypic categories of RM is the fundamental requisite for the advancement of this field.

scholarly journals Runs of homozygosity in spontaneous abortions from families with recurrent pregnancy loss

2019 ◽  
Vol 23 (2) ◽  
pp. 244-249
Author(s):  
N. A. Skryabin ◽  
S. A. Vasilyev ◽  
T. V. Nikitina ◽  
D. I. Zhigalina ◽  
R. R. Savchenko ◽  
...  
Keyword(s):  
High Frequency ◽  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
De Novo ◽  
Recurrent Miscarriage ◽  
Uniparental Disomy ◽  
First Trimester ◽  
Comparative Genomic ◽  
Runs Of Homozygosity ◽  
Recessive Mutations

Recurrent pregnancy loss (RPL) is a severe reproductive pathology with a significant component of unexplained etiology. Extended homozygous regions as a possible etiological factor for RPL were sought in the genomes of embryos. Twenty-two paired first-trimester spontaneously aborted embryos from eleven women with recurrent miscarriage were analyzed. All embryos had normal karyotypes according to metaphase karyotyping and conventional comparative genomic hybridization. SurePrint G3 Human CGH + SNP 4 × 180K microarrays (Agilent Technologies) were used to search for homozygous regions. As a result, 39 runs of homozygosity (ROH) were identified in extraembryonic tissues of 15 abortuses. Verification of recurrent homozygous regions was performed by Sanger sequencing. The presence of occasional heterozygous SNPs was shown in 25 extended ROHs, which may indicate that they did not arise de novo but were inherited from parents. In the course of inheritance in a series of generations, they may accumulate mutations, leading to heterozygosity for several sites in the initially homozygous population-specific regions. Homozygotization of recessive mutations is one of the putative mechanisms of the influence of such inherited ROHs on RPL development. The high frequency of extended ROHs detected in the present study may point to a role of inbreeding in RPL etiology. Homozygous regions may also occur due to uniparental disomy, and abnormalities of genomic imprinting may be another mechanism responsible for the pathological manifestation of ROHs in embryogenesis. Indeed, five predicted imprinted genes were identified within ROHs according to the Geneimprint database: OBSCN, HIST3H2BB, LMX1B, CELF4, and FAM59A. This work reports the first finding of a high frequency of extended ROHs in spontaneously aborted embryos with normal karyotypes from families with RPL.

scholarly journals AYURVED APPROACH TO PUTRAGHNI YONIVYAPADA W.S.R. TO HABITUAL ABORTION DUE TO TORCH INFECTION: CASE STUDY

AYUSHDHARA ◽  
2020 ◽  
pp. 2776-2780
Author(s):  
Divya Pawar ◽  
Sameer Gholap
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Miscarriage ◽  
Treatment Protocol ◽  
Habitual Abortion ◽  
Consecutive Pregnancy ◽  
The Subject ◽  
Torch Infection ◽  
Antenatal Visits ◽  
Repeated Pregnancy Loss

Pregnancy is the start of an incredible journey that leads to great emotional fulfilment to woman. Pregnancy loss is a physically and emotionally demanding for couples. Recurrent Pregnancy Loss (RPL) is also called as Recurrent Miscarriage or Habitual Abortion. It is defined as three consecutive pregnancy losses prior to 20weeks of pregnancy from the last menstrual cycle (LMP). Putraghni is a condition where repeated pregnancy loss occurs because of Artava dosha, Rakta dosha, Ati raktasrava. The article is to understand the Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection and to study the effect of Ayurvedic medicines in the management of Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection. The method is the single arm, open labelled case study of the subject of 27 yrs age having repeated pregnancy loss who has been treated with Shamana Chikitsa throughout pregnancy, Matrabasti and Yonipichu in 8th and 9th months. Pregnancy continued with treatment. Antenatal visits and Ultrasonography observations gave positive outcomes with healthy foetal growth. Patient delivered a full term single live male baby vaginally on 27/10/2019 at 3:20PM with 2.8kg. No birth anomalies were detected. The selected treatment protocol i.e., Shamana Aushadha, Matrabasti and Yonipichu in 8th and 9th month are found very effective in the management of Putraghni Yonivyapada w.s.r. to habitual abortion caused due to TORCH Infection.

A Systematic Literature Review of the EFQM Excellence Model from 1991 to 2019

1970 ◽  
Vol 2 (2) ◽  
pp. 11-15
Author(s):  
Muhammad Yousaf ◽  
Petr Bris
Keyword(s):  
Quality Management ◽  
Data Collection ◽  
Literature Review ◽  
Systematic Literature Review ◽  
Quantitative Research ◽  
Web Of Science ◽  
State Of The Art ◽  
Future Research ◽  
European Foundation ◽  
The Subject

A systematic literature review (SLR) from 1991 to 2019 is carried out about EFQM (European Foundation for Quality Management) excellence model in this paper. The aim of the paper is to present state of the art in quantitative research on the EFQM excellence model that will guide future research lines in this field. The articles were searched with the help of six strings and these six strings were executed in three popular databases i.e. Scopus, Web of Science, and Science Direct. Around 584 peer-reviewed articles examined, which are directly linked with the subject of quantitative research on the EFQM excellence model. About 108 papers were chosen finally, then the purpose, data collection, conclusion, contributions, and type of quantitative of the selected papers are discussed and analyzed briefly in this study. Thus, this study identifies the focus areas of the researchers and knowledge gaps in empirical quantitative literature on the EFQM excellence model. This article also presents the lines of future research.

Improving Students’ Achievement in Reading Comprehension Through Advance Organizer Strategy

2015 ◽  
Vol 12 (1) ◽  
Author(s):  
Tuti Andriani Siregar ◽  
Didik Santoso ◽  
Anni Holila Pulungan
Keyword(s):  
Reading Comprehension ◽  
Key Words ◽  
Learning Process ◽  
Advance Organizer ◽  
Teaching Reading ◽  
Significant Progress ◽  
The Subject ◽  
Passing Grade

This study deals with the improvement of the students’ achievement in reading comprehension through advance organizer strategy. The objectives of this research were to improve the students’ achievement in reading comprehension as well as the process of learning reading comprehension by using advance organizer strategy.  The subject of the study was grade XI IPA 2 Madrasah Aliyah Negeri Binjai consisting of 33 students. The data of this study were obtained by using test, observation sheets and interview. This research was conducted in two cycles because in the pre-test (without treatment), the average of the students’ score was 59,24. In the first cycle test, it was 74,30. It is lower than the minimum passing grade, and if is viewed from the observation sheets, the situation of the learning process hasn’t met the criteria of the success. So the writer continued to the second cycle. There was a significant progress on the students’ achievement in reading comprehension in the second cycle, and the average of the students was 82,94. The students were more active and enthusiastic in following the lesson. Therefore, the teaching reading comprehension through advance organizer strategy can improve the students’ achievement in reading comprehension quantitatively and qualitatively. Key words:  improving, reading comprehension, advance organizer strategy.

scholarly journals SAT0623-HPR THE LIVED EXPERIENCES OF COGNITIVE DYSFUNCTION IN ADULTS WITH FIBROMYALGIA: A QUALITATIVE SYSTEMATIC REVIEW

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1271.1-1272
Author(s):  
S. Derham ◽  
J. Lewis ◽  
E. Dures ◽  
F. Cramp
Keyword(s):  
Clinical Practice ◽  
Cognitive Function ◽  
Cognitive Dysfunction ◽  
Lived Experiences ◽  
Critical Appraisal ◽  
Negative Impact ◽  
Practice Research ◽  
Future Research ◽  
Poor Sleep ◽  
Cognitive Changes

Background:Adults with fibromyalgia frequently report symptoms of cognitive dysfunction, often referred to as fibrofog. However primary research exploring cognitive dysfunction in the lives of adults with fibromyalgia is very limited (Kravitz and Katz, 2015).Objectives:The aim of this review was to (i) synthesise the qualitative literature on the lived experiences of cognitive dysfunction in adults with fibromyalgia, (ii) develop common themes through thematic analysis and (iii) identify knowledge gaps to inform future research and clinical practice in this area.Methods:Seven electronic databases (MEDLINE, Embase, CINAHL, PsycINFO, Amed, Scopus and OpenGrey), reference lists of key articles and two high impact qualitative journals were searched from 1990 to November 2018. Articles were eligible for inclusion if they reported primary qualitative data exploring the experiences of cognitive dysfunction in adults with fibromyalgia. Included studies were appraised using the Critical Appraisal Skills Programme (CASP) qualitative checklist and extracted data analysed using narrative synthesis. SD conducted critical appraisal and data extraction on all included studies. FC, JL and ED reviewed five papers each. All papers were reviewed by two co-authors. Of the 1413 records identified, 15 studies were selected for inclusion.Results:These studies included 208 women and 22 men with fibromyalgia, aged 18 to 72 years and representing seven different countries. Duration of diagnosis was four months to 34 years. Fourteen studies used interviews and one used focus groups. None of the included studies focussed exclusively on cognitive function in adults with fibromyalgia. Three studies identified themes specific to cognitive dysfunction and fibromyalgia symptoms. The remaining 12 studies presented relevant data intertwined with the overall lived experiences of fibromyalgia.Cognitive dysfunction, as a part of fibromyalgia, was often unpredictable. Problems with memory and concentration that were most commonly reported were emotionally distressing and affected functional and vocational activities. Participants found communication effortful, with a negative impact on work, leisure and social activities. Stress, fear and worry around perceived cognitive changes were commonly expressed. Lost employment or changed work roles and relationships, due to cognitive difficulties, had negative impacts for many participants. The terms cognitive dysfunction and fibrofog were used interchangeably within the studies, but lacked common definition. This introduced uncertainty around whether participants and authors were describing the same phenomenon.Conclusion:Adults with fibromyalgia experience unpredictable and emotionally impactful difficulties related to cognitive dysfunction. Functional impact was broad-reaching, particularly around work ability and lost employment opportunities. It is unclear how cognitive symptoms in fibromyalgia related to co-morbid symptoms such as pain, fatigue and poor sleep. Further research focusing on the full impact of cognitive function on the lives of adults with fibromyalgia is recommended to inform clinical practice. Research to establish clarity of definition of the terms cognitive dysfunction and fibrofog within fibromyalgia is highly recommended.References:[1]Kravitz H, Katz R. Fibrofog and fibromyalgia: a narrative review and implications for clinical practice. Rheumatology International. 2015;35(7):1115-25.Acknowledgments:This work is supported by the National Institute for Heath Research [ICA-PCAF-2018-01-078 to SD]Disclosure of Interests:Sandra Derham: None declared, Jenny Lewis: None declared, Emma Dures Grant/research support from: Independent Learning Grant from Pfizer, combined funding for a research fellow from Celgene, Abbvie and Novartis, Paid instructor for: A fee from Novartis to deliver training to nurses., Fiona Cramp: None declared

scholarly journals Ionic and non-ionic intravenous X-ray contrast media: antibacterial agents?

2021 ◽  
pp. 028418512110198
Author(s):  
Frank Mosler ◽  
Johannes K Richter ◽  
Marc Schindewolf ◽  
Nando Mertineit ◽  
Hendrik von Tengg-Kobligk ◽  
...  
Keyword(s):  
Contrast Media ◽  
Bactericidal Effect ◽  
Future Research ◽  
Inhibitory Effects ◽  
X Ray ◽  
Percutaneous Abscess Drainage ◽  
Ionic Contrast ◽  
Bactericidal Effects ◽  
Free Iodine ◽  
The Subject

X-ray contrast media have been reported to have inhibitory effects on bacterial growth. Despite its potentially beneficial effect on patients, these features of contrast media have received relatively little attention in the medical literature in the past decades. The aim of this review is to evaluate the literature concerning the bactericidal and bacteriostatic effects of X-ray contrast media, specifically if there is a known difference concerning these effects between ionic and non-ionic contrast media. Systematic literature review was performed for the years of publication between 1911 and 2019. Since the publication of Grossich in 1911, the effect of iodine on the treatment of superficial infections in surgical procedures has been established clinical knowledge. Bacteriostatic and bactericidal effects of ionic X-ray contrast media are well established. However, non-ionic contrast agents have been the subject of little research in this respect. In past decades, the hypothesis emerged in the literature that mainly the concentration of free iodine might be responsible for any bacteriostatic or bactericidal effect of ionic X-ray contrast media. Nowadays, however, only non-ionic contrast media are used. The question regarding the mechanism and magnitude of bacteriostatic or bactericidal effects of these, non-ionic contrast media, could not be answered conclusively from this review. Non-ionic contrast media could be used intentionally when a local antibacterial effect is intended (e.g. in percutaneous abscess drainage), as well as to reduce the overall dose of antibiotics administered to a patient. Thus, this question remains relevant and might constitute the area of future research.

scholarly journals Rational design of photocatalysts for ammonia production from water and nitrogen gas

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Seokwoo Choe ◽  
Sung Min Kim ◽  
Yeji Lee ◽  
Jin Seok ◽  
Jiyong Jung ◽  
...  
Keyword(s):  
Energy Source ◽  
Rational Design ◽  
Future Research ◽  
Ammonia Production ◽  
Significant Progress ◽  
Nitrogen Gas ◽  
Research Directions ◽  
Effective Strategies ◽  
Future Research Directions ◽  
Made In

AbstractPhotocatalytic N2 reduction has emerged as one of the most attractive routes to produce NH3 as a useful commodity for chemicals used in industries and as a carbon-free energy source. Recently, significant progress has been made in understanding, exploring, and designing efficient photocatalyst. In this review, we outline the important mechanistic and experimental procedures for photocatalytic NH3 production. In addition, we review effective strategies on development of photocatalysts. Finally, our analyses on the characteristics and modifications of photocatalysts have been summarized, based on which we discuss the possible future research directions, particularly on preparing more efficient catalysts. Overall, this review provides insights on improving photocatalytic NH3 production and designing solar-driven chemical conversions.

scholarly journals Tocopherols and Tocotrienols—Bioactive Dietary Compounds; What Is Certain, What Is Doubt?

2021 ◽  
Vol 22 (12) ◽  
pp. 6222
Author(s):  
Kacper Szewczyk ◽  
Aleksandra Chojnacka ◽  
Magdalena Górnicka
Keyword(s):  
Vitamin E ◽  
Metabolic Disorders ◽  
Tissue Concentration ◽  
Biological Properties ◽  
Biological Role ◽  
Future Research ◽  
The Past ◽  
The Subject ◽  
The Relationship

Tocopherols and tocotrienols are natural compounds of plant origin, available in the nature. They are supplied in various amounts in a diet, mainly from vegetable oils, some oilseeds, and nuts. The main forms in the diet are α- and γ-tocopherol, due to the highest content in food products. Nevertheless, α-tocopherol is the main form of vitamin E with the highest tissue concentration. The α- forms of both tocopherols and tocotrienols are considered as the most metabolically active. Currently, research results indicate also a greater antioxidant potential of tocotrienols than tocopherols. Moreover, the biological role of vitamin E metabolites have received increasing interest. The aim of this review is to update the knowledge of tocopherol and tocotrienol bioactivity, with a particular focus on their bioavailability, distribution, and metabolism determinants in humans. Almost one hundred years after the start of research on α-tocopherol, its biological properties are still under investigation. For several decades, researchers’ interest in the biological importance of other forms of vitamin E has also been growing. Some of the functions, for instance the antioxidant functions of α- and γ-tocopherols, have been confirmed in humans, while others, such as the relationship with metabolic disorders, are still under investigation. Some studies, which analyzed the biological role and mechanisms of tocopherols and tocotrienols over the past few years described new and even unexpected cellular and molecular properties that will be the subject of future research.

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