P–774 Clinical effectiveness of elective single versus double blastocyst transfer in women aged 36 years or older

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
H Cai ◽  
B W Mol ◽  
S Gordts ◽  
H Wang ◽  
J Shi
Keyword(s):  
Statistical Significance ◽  
Age Groups ◽  
Clinical Effectiveness ◽  
Blastocyst Transfer ◽  
P Value ◽  
Multiple Gestation ◽  
Multiple Pregnancies ◽  
Morphological Examination ◽  
Female Age

Abstract Study question If the elective single-blastocyst transfer (eSBT) strategy can be applied to women aged 36 or older. Summary answer In women ≥36 years old with at least two blastocysts, eSBT increased cumulative livebirth rate (LBR) while minimizing twins compared with double blastocyst transfer (DBT). What is known already: In young women with a good prognosis, eSBT policy is an accepted strategy to maintain LBR while decreasing multiple gestation. However, in many areas of the world DBT is still applied in older women. Study design, size, duration We performed a retrospective cohort study of 429 women aged ≥36 years or older who received IVF ovarian stimulation cycles between Jan 2015 and Oct 2018 and who had at least two blastocysts. Women were followed up until Oct 2020 for their fertility outcomes including cumulative live birth and multiple pregnancies. The study was performed at the Northwest Women and Children’s Hospital, Xi’an, China. Participants/materials, setting, methods Out of 429 women, 240 underwent a fresh cycle of eSBT and 189 DBT. The subsequent frozen-thawed embryo transfer cycles were a combination of single- and double- blastocyst transfers, more commonly the latter. Analysis was stratified for patients in age groups 36–37, 38–39 and ≥40 and quality of the blastocyst transferred, as graded by morphological examination. Outcomes were the LBR in the fresh cycle, cumulative LBR and multiple rate after fresh and frozen embryo transfers. Main results and the role of chance The cumulative LBR was 74.2% (178/240) for eSBT versus 63.0% (119/189) for DBT (OR = 1.69, 95%CI 1.12–2.56), irrespective of female age. The multiple rate was 9% (16/178) after eSBT versus 29.4% (35/119) after DBT (P- value < .001). The total number of children born was 194 after eSBT versus 154 after DBT. Stratified by female age, the cumulative LBRs in women aged 36–37 (78.9 vs 70.5%), 38–39 (68.9 and 61.1%) and ≥ 40 years (59.3 and 47.5%), were higher after eSBT compared with DBT, however, the differences did not reach statistical significance in each subgroups. LBRs in the fresh cycles were comparable for patients with eSBT compared with DBT (52.1% vs. 52.4%, OR = 0.99, 95%CI 0.68–1.45). In women < 40 years, DBT resulted in a small non-significant increase in LBR in the fresh transfer (63.2% vs. 61.2%, 95%CI=0.64–1.85, 36–37 years; 48.1% vs. 41.0%, 95%CI=0.64–2.80, 38–39 years) at the expense of a marked increase in twinning rate (0–5.4% vs. 31.7–34.6%). For women ≥40 years, no significant differences were observed in the LBR (37.0% vs 45%, 95%CI 0.47–4.07) or twinning rate (0 vs 7.7%) between eSBT and DBT group. The findings persisted with and without accounting for quality of the blastocyst transferred. Limitations, reasons for caution This study is limited by its observational character. Wider implications of the findings: In women ≥36 years with two blastocysts, eSBT should be the preferred treatment which maximizes the cumulative LBR for a decrease in the rate of multiple pregnancies. Trial registration number Not applicable

ASSECSSING MOCA TEST IN SUBACUTE STROKE PATIENTS AND COMPARE MOCA VERSUS MMSE

2016 ◽  
pp. 120-127
Author(s):  
Dinh Toan Nguyen
Keyword(s):  
Human Life ◽  
Statistical Significance ◽  
High Sensitivity ◽  
Stroke Patients ◽  
Cross Sectional ◽  
Female Age ◽  
Subacute Stroke ◽  
Duration Of Illness ◽  
Dsm Iv

Background: Dementia after stroke, particularly subacute period is often overlooked. Today the quality of human life is increasingly high, finding scales that have high value for detection of dementia in patients with stroke is increasingly interested. MoCA test is high sensitivity with mild dementia and identify more abnormalities of awareness caused by vascular, but MoCA have not been studied much in Vietnam. Objective: Assessing MoCA test in subacute stroke patients and compare MoCA versus MMSE in these patients. Subjects: 90 patients with subacute stroke period, these people are being treated at Department of cardiovascular internal medicine at Hue Central Hospital, from 7/2014 - 7/2015. Methods: cross-sectional description and analysis. Results: The mean age is 65.57 ± 13.38, accounting for 54.4% male and 45.6% female. Age, duration of illness has weak correlation with MoCA. The risk factors: hypertension, stroke ischemic transient, alcoholism, smoking, heart disease, diabetes, dyslipidemia related no statistical significance with MoCA. The proportion of dementia in subacute stroke according MoCA is 82.2%. The concordance between MoCA and MMSE was good (kappa = 0.684). Using DSM-IV criteria as the gold standard we found MoCA more valuable in the dementia diagnosis than MMSE (AUC 0.864 versus 0.774, p <0.05). Conclusion: The rate of dementia in stroke subacute period according MoCA is quite high. MoCA is valuable than MMSE in detecting dementia in patients with stroke subacute period, this scale is short, easy to implement so should put into using widely in clinical practice. Key words: MoCA test, subacute stroke, dementia

scholarly journals Economic implications of polypharmacy in Nepal: Multicenter community-based study

2020 ◽  
Author(s):  
Binaya Sapkota ◽  
Suraj Shakya ◽  
Saroj Sah ◽  
Narendra Chaudhary ◽  
Bijendra Tamang ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Multinomial Logistic Regression ◽  
Statistical Significance ◽  
Age Groups ◽  
Pharmacoeconomic Evaluation ◽  
Secondary Outcome ◽  
P Value ◽  
Cross Sectional ◽  
Economic Implications ◽  
Total Cost

Objective:Improper management of polypharmacy in community and hospital pharmacies may lead to adverse effects and drug interactions in patients of all age groups, especially children and the elderly. This study aimed to determine the scenario of polypharmacy in multiple communities in Nepal and the costs associated with them. Design: Cross-sectional study Setting:Local communities of nine districts in Nepal Participants:Total 400 patients of all age groups, who were consuming medicines and who fulfilled inclusion criteria from May 2017 to August 2018 Primary and secondary outcome measures:A semi-structured questionnaire, based on the prescription optimization method, was used for data collection. Multinomial logistic regression was performed to analyze the statistical significance of polypharmacy with the predictor variables (e.g., age, education level, occupation, diagnosis, total cost of medicines). The p-value <0.05 was considered statistically significant at 95% confidence interval. Polypharmacy cases and their economic implications were reported. Results:Eighty-one patients (20.3%) with an age group of 22-31 years with female patients (219, 54.8%) reported more polypharmacy events. There were 216 patients (54%) with prescriptions of five medicines i.e., moderate polypharmacy. Total number of medicines consumed by all 400 patients was 2269, with a mean, SD 5.67, 1.08. Total expenditure by all 400 patients was USD 3409.54 during the study period, with a mean, SD 8.66, 6.04. Both moderate and severe polypharmacy cases were non-significantly related with age, gender and total cost of medications. They had significant relationship in almost all levels of education and occupation and showed mixed type of significance and non-significance with the diagnosis of the respondents. Conclusion: Polypharmacy cases can be minimized, considering adverse drug reactions and drug interactions. Further studies are warranted in medication utilization and avoidable polypharmacy along with detailed pharmacoeconomic evaluation.

scholarly journals Population-based survey of HIV sero-status and vertical transmission among naive pregnant women in Sokoto, Nigeria

2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo
Keyword(s):  
Antiretroviral Therapy ◽  
Pregnant Women ◽  
Vertical Transmission ◽  
Statistical Significance ◽  
Demographic Data ◽  
Age Groups ◽  
P Value ◽  
Full Time ◽  
Cross Sectional ◽  
Significant Difference

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  

scholarly journals Spatiotemporal Characteristics of Bacillary Dysentery from 2005 to 2017 in Zhejiang Province, China

2018 ◽  
Vol 15 (9) ◽  
pp. 1826 ◽  
Author(s):  
Congcong Yan ◽  
Yijuan Chen ◽  
Ziping Miao ◽  
Shuwen Qin ◽  
Hua Gu ◽  
...  
Keyword(s):  
High Risk ◽  
Bacillary Dysentery ◽  
Health Planning ◽  
Statistical Significance ◽  
Age Groups ◽  
Zhejiang Province ◽  
P Value ◽  
High Risk Population ◽  
Circular Distribution ◽  
Spatiotemporal Characteristics

Background: This study aimed to analyze the epidemiological and spatiotemporal characteristics of bacillary dysentery in Zhejiang Province and to provide the basis for its monitoring, prevention and control. Methods: This study included cases registered in China Information System for Diseases Control and Prevention from 1 January 2005 to 31 December 2017 in Zhejiang. Descriptive methods were employed to investigate the long trend of this disease: gender distribution, high-risk population, seasonality, and circular distribution was explored to detect the peak period; incidence maps were made to show the incidence trend of disease at county level; spatial autocorrelation was explored and the regions with autocorrelation were detected; and spatiotemporal scan was conducted to map out the high-risk regions of disease and how long they lasted. Statistical significance was assumed at p value of <0.05. Results: A total of 105,577 cases of bacillary dysentery were included, the incidence declining sharply from 45.84/100,000 to 3.44/100,000 with an obvious seasonal peak from July to October. Males were more predisposed to the infection than females. Pre-education children had the highest proportion among all occupation categories. Incidence in all age groups were negatively correlated with the year (p < 0.001), and the incidences were negatively correlated with the age groups in 2005–2008 (p = 0.022, 0.025, 0.044, and 0.047, respectively). Local autocorrelation showed that counties in Hangzhou were high-risk regions of bacillary dysentery. The spatiotemporal scan indicated that all clusters occurred before 2011, and the most likely cluster for disease was found in Hangzhou, Jiaxing and Huzhou. Conclusions: The incidence of bacillary dysentery in Zhejiang from 2005 to 2017 featured spatiotemporal clustering, and remained high in some areas and among the young population. Findings in this study serve as a panorama of bacillary dysentery in Zhejiang and provide useful information for better interventions and public health planning.

scholarly journals Age-Related Success with Elective Single versus Double Blastocyst Transfer

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Brooke E. Friedman ◽  
Lynn B. Davis ◽  
Ruth B. Lathi ◽  
Lynn M. Westphal ◽  
Valerie L. Baker ◽  
...  
Keyword(s):  
Age Groups ◽  
Blastocyst Transfer ◽  
Multiple Gestation ◽  
Optimal Outcome ◽  
Singleton Pregnancy ◽  
Multiple Gestations ◽  
Age Related ◽  
Single Blastocyst Transfer ◽  
Significant Difference ◽  
Single Versus

Background. Although the optimal outcome of assisted reproductive technology (ART) is a healthy singleton pregnancy, the rate of twin gestation from ART in women over the age of 35 is persistently high. Methods/Findings. We compared clinical pregnancy rates (PRs), ongoing pregnancy/live birth rates, and multiple gestation rates (MGRs) in 108 women who chose elective single blastocyst transfer (eSBT) to 415 women who chose elective double blastocyst transfer (eDBT) at a hospital-based IVF center. There was no significant difference in PR between eSBT and eDBT (57.4% versus 50.2%, ) nor between eSBT and eDBT within each age group: <35, 35–37, 38–40, and >40. The risk of multiple gestations, however, was greatly increased between eSBT and eDBT (1.6 versus 32.4%, ), and this difference did not vary across age groups. Conclusion(s). Women undergoing eDBT are at uniformly high risk of multiple gestation regardless of age. eSBT appears to significantly lower the risk of multiple gestation without compromising PR.

scholarly journals Factors Related to the Quality of Antenatal Care Based on The Complete Scope of the Examination of Pregnant Women in the Health Center at Palopo City

2019 ◽  
Vol 3 (3S) ◽  
pp. 84-89
Author(s):  
Dian Furqani ◽  
Nuraerni Semagga
Keyword(s):  
Antenatal Care ◽  
Pregnant Women ◽  
Gestational Age ◽  
Statistical Significance ◽  
P Value ◽  
Service Access ◽  
Maternal Knowledge ◽  
Cross Sectional ◽  
Maternal Characteristics

This study aims to see the factors that influence the quality of Antenatal Care in the City of Palopo; the type of design used is analytical descriptive with the Cross-Sectional Study approach. Samples from this study were all pregnant women based on 1, 2 and 3th-trimester pregnancy age, and 3 who were lived at the research location as many as 154 people who conducted inspection visits from January to March 2018. The results showed that the average age of the mother was 20 years. In the research statisticallly interconnected variables are maternal knowledge showed p-value (0.000). There are several variables have statistical significance, but there are differences in the percentage between the classification of each variabels as for the quality of Antenatal care associated with parity, maternal characteristics (age, education and occupation), antenatal care in each of the 1.2 trimester, and 3. Service access and economic welfare status, where each variable has a p-value> 0.005. The study expects that a health program should not look the quantity of maternal pregnancy visits, but pay attention to the examination checks received at each gestational age. We hope to encourage mothers to be more active in paying attention to the examinations that will be accepted based on their gestational age so that good health services and of recipients of services occur.

scholarly journals Women’s perception and satisfaction with the quality of antenatal care services in mission hospitals in Benin City, Nigeria

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Collins Ejakhianghe Maximilian Okoror ◽  
Ehigha Jude Enabudoso ◽  
Maryjane Ifeyinwa Okoroh
Keyword(s):  
Antenatal Care ◽  
Statistical Significance ◽  
Vital Role ◽  
P Value ◽  
Cross Sectional ◽  
Nigerian Women ◽  
Benin City ◽  
Delivery Services ◽  
High Level

Despite the vital role and availability of antenatal care, only a small proportion of Nigerian women utilise it. Women’s perception and satisfaction with antenatal care is believed to improve health outcomes, continuity of care, adherence to treatment, and the relationship with the provider. The aim is to ascertain the women’s perception and satisfaction with the quality of ANC services in mission hospitals in Benin City, Nigeria. This cross-sectional descriptive study was carried out among 405 pregnant women in their third trimester. Data collection was with a pretested interviewer-administered questionnaire and analysis with IBM SPSS Statistics version 21.0. Statistical significance was taken as P value <0.05. The women’s perception of doctors and nurses was good for all domains assessed. Their satisfaction was highest for cleanliness of the facility 336 (83.0%) and lowest for amount paid for delivery services 168 (41.5%). The overall satisfaction for services received was high 337 (83.2%). The religion of the respondents, gestational age at ANC booking, payment for booking, the delivery fee and availability of requisite resources to cater for the women showed statistically significance with the overall satisfaction. However, only religion (AOR = 17.450, 95% CI = 3.364-90.508) and availability of requisite resources (AOR = 4.629, 95% CI = 2.426-8.832) independently influenced their satisfaction. This study showed a high level of satisfaction with the services rendered. However, making services more affordable as well as improving their quality through investment in both human and material resources to deliver essential care to all clients will drive better satisfaction among them.

scholarly journals Prioritizing COVID-19 tests based in Participatory Surveillance and Spatial Scanning

2020 ◽  
Author(s):  
OB Leal-Neto ◽  
FAS Santos ◽  
JY Lee ◽  
JO Albuquerque ◽  
WV Souza
Keyword(s):  
Spatial Data ◽  
Surveillance System ◽  
Statistical Significance ◽  
Health Department ◽  
P Value ◽  
Priority Areas ◽  
Participatory Surveillance ◽  
The City ◽  
Traditional Surveillance

AbstractObjectivesThis study aimed to identify, describe and analyze priority areas for Covid-19 testing combining participatory surveillance and traditional surveillance.DesignIt was carried out a descriptive transversal study in the city of Caruaru, Pernambuco state, Brazil, within the period of 20/02/2020 to 05/05/2020. Data included all official reports for influenza-like illness notified by the municipality health department and the self-reports collected through the participatory surveillance platform Brasil Sem Corona.MethodsWe used linear regression and loess regression to verify a correlation between Participatory Surveillance (PS) and Traditional Surveillance (TS). Also a spatial scanning approach was deployed in order to identify risk clusters for Covid-19.ResultsIn Caruaru, the PS had 861 active users, presenting an average of 1.2 reports per user per week. The platform Brasil Sem Corona started on March 20th and since then, has been officially used by the Caruaru health authority to improve the quality of information from the traditional surveillance system. Regarding the respiratory syndrome cases from TS, 1,588 individuals were positive for this clinical outcome. The spatial scanning analysis detected 18 clusters and 6 of them presented statistical significance (p-value < 0.1). Clusters 3 and 4 presented an overlapping area that was chosen by the local authority to deploy the Covid-19 serology, where 50 individuals were tested. From there, 32% (n=16) presented reagent results for antibodies related to Covid-19.ConclusionParticipatory surveillance is an effective epidemiological method to complement the traditional surveillance system in response to the COVID-19 pandemic by adding real-time spatial data to detect priority areas for Covid-19 testing.

scholarly journals From Introduction to Integration: Providing Community-Engaged Structure for Interprofessional Education

2016 ◽  
Vol 3 ◽  
pp. JMECD.S30368 ◽  
Author(s):  
Daniel P. Griffin ◽  
Marie C. Matte ◽  
John M. Clements ◽  
Elizabeth A. Palmer ◽  
Laurie A. Bahlke ◽  
...  
Keyword(s):  
Student Satisfaction ◽  
Athletic Training ◽  
Interprofessional Education ◽  
Statistical Significance ◽  
P Value ◽  
Speech Language Pathology ◽  
Healthcare Profession ◽  
Clinical Scenarios ◽  
Language Pathology

Background Training future healthcare profession students using interprofessional education (IPE) is critical to improve quality of health care and patient safety. Objective The objective of this study was to implement an IPE program and determine student satisfaction with each session, including a clinical case requiring teams with members from each profession addressing clinical scenarios. Subjects The subjects of this study were students from Athletic Training, Medicine, Nursing, Pharmacy, Physical Therapy, Physician Assistant, Social Work, and Speech-Language Pathology. Methods Evaluations, administered to all participating students, consisted of Likert-style responses, rating agreement with a series of questions, and space for descriptive comments. Score differences for each question were compared using independent group t-tests with a P-value of 0.05 to determine statistical significance. Results There were statistically higher satisfaction ratings for the problem-based learning case when compared to less interactive sessions ( P < 0.0001). Conclusion Students perceived benefits of the IPE program. Perceptions improved when various students had the opportunity to work together on clinically relevant problems.

The Impact of Milieu Nurse–Client Shift Assignments on Monthly Restraint Rates on an Inpatient Child/Adolescent Psychiatric Unit

2019 ◽  
Vol 26 (1) ◽  
pp. 86-91 ◽  
Author(s):  
Stefani Rae Magnowski ◽  
Sandra Cleveland
Keyword(s):  
Statistical Significance ◽  
Nurse Staffing ◽  
P Value ◽  
Chart Audit ◽  
Psychiatric Unit ◽  
Chart Audits ◽  
Evidenced Based ◽  
The Individual ◽  
The Impact

INTRODUCTION: Restraints in the inpatient child/adolescent psychiatric population pose a threat to client safety and quality of care. Nurses are key in reducing restraints through implementation of evidenced-based interventions to improve quality and safety. AIM: To identify the impact of milieu nurse–client shift assignments on monthly restraint rates when compared with individual nurse–client shift assignments on an inpatient child/adolescent psychiatric unit. METHODS: A quantitative, retrospective, comparative project design was used. The sample included all inpatient child/adolescent clients admitted to the child/adolescent psychiatric unit between the months of January–May 2016 and 2017 who were physically or mechanically restrained. Retrospective chart audits were conducted, and information transcribed onto an adapted chart audit tool by Edwards et al. (2006). Monthly restraint rates were compared using the Mann–Whitney U test. A p value of <.05 was used to determine statistical significance. RESULTS: The Mann–Whitney U test revealed statistical significance between the impact that the individual nurse–client shift assignments ( Mdn = 61.2, n = 6) and the milieu nurse–client shift assignments ( Mdn = 6.8, n = 6) had on monthly restraint rates, U = .000, z = −2.88, p = .004, r = .83. CONCLUSION: Use of milieu nurse–client shift assignments are associated with lower monthly restraint rates when compared to individual nurse–client shift assignments. Milieu nurses provide structure, safety, consistency, and security, leading to early intervention and de-escalation of clients who display aggressive behaviors. Nurse staffing structures also need to be optimized to meet the needs of this population.

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