A Clinical Nomogram For Predicting Preterm Birth in Women Who Conceived Through Assisted Reproductive Technology

2021 ◽  
Author(s):  
Yaduan Lin ◽  
Fanchen He ◽  
Rui Gao ◽  
Ting Liu ◽  
Ke Zhao ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Assisted Reproductive Technology ◽  
Risk Model ◽  
Cox Regression ◽  
Early Stage ◽  
Statistical Significance ◽  
Reproductive Technology ◽  
Brier Score ◽  
Chronic Hypertension ◽  
Singleton Pregnancy

Abstract Background: We used prepregnant and gestational characteristics as predictors to develop and validated a nomogram predicting the risk of preterm birth (PTB) in assisted reproductive technology (ART) treated women. Methods: The National Vital Statistics System (NVSS) was queried for singleton ART-treated pregnant women from 2015 to 2019. Multivariable cox regression was used to develop the early (< 32 weeks) or late (< 37 weeks) PTB risk model using both statistical significance and clinical importance criteria for variable selection. The predictive accuracy was assessed, and bootstrapping was used for validation. A nomogram was constructed for the presentation of the final model. Results: ART-treated women who were over 45 years old, black, obese, had a history of cesarean section and PTB, restarting ART within 3 months, prepregnant diabetes, chronic hypertension, gestational diabetes, gestational hypertension, and eclampsia, had the highest risk for late and early-stage PTB. The nomogram with these variables accurately predicted PTB in ART women with a singleton pregnancy. (Brier score:0.121, calibration slope: 0.99, c-index: 0.684). Conclusion: We created a nomogram predicting the risk of early or late PTB in ART women with a singleton pregnancy, which could identify potentially at-risk women who seeking ART treatment and inform appropriate preterm care.

Singleton Preterm Birth: Risk Factors and Association with Assisted Reproductive Technology

2011 ◽  
Vol 16 (4) ◽  
pp. 807-813 ◽  
Author(s):  
Naomi K. Tepper ◽  
Sherry L. Farr ◽  
Bruce B. Cohen ◽  
Angela Nannini ◽  
Zi Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Assisted Reproductive Technology ◽  
Reproductive Technology

Male breast cancer (MBC) in the VA population: A gender issue?

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 587-587 ◽  
Author(s):  
Z. Nahleh ◽  
R. Srikantiah ◽  
R. Komrokji ◽  
M. Safa ◽  
J. Pancoast ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cox Regression ◽  
Ductal Carcinoma ◽  
Early Stage ◽  
Statistical Significance ◽  
Clinical Stage ◽  
Hormonal Treatment ◽  
Cancer Site ◽  
Early Stage Disease ◽  
Cox Regression Analysis

587 Background: The incidence of MBC continues to rise. Few studies have addressed the differences between MBC and female breast cancer (FBC). Treatment for MBC has ben extrapolated from FBC regimens. The VA cancer registry (VACCR) provides a unique source to study MBC. This retrospective analysis aims at comparing the characteristics and outcome of MBC and FBC in the VA population. Methods: We reviewed the VACCR database between 1995 and 2005, for 120 VA medical centers. Primary breast cancer site codes were identified (500–508). Data was entered and analyzed using bio-statistical software SPSS. Results: A total of 3025 patients :612 MBC and 2413 FBC were compared. Mean age at diagnosis was 67 for MBC and 57 for FBC (p <0.005). More MBC patients were black. MBC patients presented with a significantly higher stage of disease, more node positive(N+) and larger tumor size. In MBC, ductal histology was more common while lobular and ductal carcinoma in situ were less common than in FBC. ER + and PR + tumors were significantly more common in MBC (60% vs 52% and 53% vs 47%, P< 0.005). MBC patients received less chemotherapy while no statistical difference in hormonal treatment was observed. The median overall survival (OS) was lower for MBC (7 years vs 9.8 years, p<0.005). OS was not significantly different for stage III and IV while OS was inferior for MBC in stage I (7 yr vs not reached, p 0.005) and stage II (6 vs 8.6yr, p 0.001). In N- tumors, OS was inferior in MBC (6.1 vs 14.6 yr, p<0.005) but not statistically different for N+ tumors . In ER + and PR + tumors, OS was inferior in MBC (7yr vs 8yr and 7.3 yr vs 9.8 yr p<0.005); however, no statistical significance was observed in ER - or PR - tumors. Using Cox regression analysis age, sex, clinical stage, nodal status were statistically independent prognostic factors while race, histology and grade were not. Conclusion: This study suggests differences in the biology, pathology, presentation, and survival between male and female VA breast cancer patients. Survival of MBC patients appears inferior in early stage disease and N- tumors suggesting gender differences in the tumor pathogenesis and biology. In hormone receptor + MBC, survival was also inferior despite similar hormonal treatment practices. This observational study calls for different approach and treatment strategies in MBC. No significant financial relationships to disclose.

scholarly journals Risk factors vary early preterm birth and perinatal complications after assisted reproductive technology

2016 ◽  
Vol 32 (sup2) ◽  
pp. 56-61 ◽  
Author(s):  
G. Chistyakova ◽  
I. Gazieva ◽  
I. Remizova ◽  
L. Ustyantseva ◽  
V. Lyapunov ◽  
...  
Keyword(s):  
Risk Factors ◽  
Preterm Birth ◽  
Assisted Reproductive Technology ◽  
Reproductive Technology ◽  
Perinatal Complications ◽  
Early Preterm Birth

scholarly journals Lymph Node Maximum Uptake of 18F-ALF-NOTA-PRGD2 II PET/CT Predicts Lung Cancer Survival

2020 ◽  
Author(s):  
Yuchun Wei ◽  
Li Ma ◽  
Jinsong Zheng ◽  
Yanqing Pei ◽  
Xueting Qin ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Cox Regression ◽  
Early Stage ◽  
Statistical Significance ◽  
Tnm Staging ◽  
Tnm Stage ◽  
Receiver Operating Curve ◽  
Cox Regression Analysis ◽  
Pet Ct

Abstract Background:Tumor angiogenesis plays a key role in tumor growth, development, and metastasis, so the exploratory study of tumor neovascularization imaging is one of the potential methods to predict survival. This study aims to examine the predictive capacity of 18F-ALF-NOTA-PRGD2 II (denoted 18F-Alfatide II) positron emission tomography (PET)/computed tomography (CT) before antitumor therapy (ATR) in patients with lung cancer.Results The median follow-up was 31 (1.3~57.0) months. Among the patients, 6 were lost to follow-up. The overall survival (OS) and progression-free survival (PFS) were 40.0 (3.50~57.0) months and 21.30 (2.0~56.0) months, respectively. The maximum uptake values (SUVmax) of the metastatic lymph nodes (SUVLN) and tumor node metastasis (TNM) staging were significant predictors of PFS and OS (all P<0.05) in a multivariate Cox regression analysis. Statistical significance was not reached by any other variable in the multivariate analysis. Receiver operating curve (ROC) analysis for survival revealed an area under the curve of 0.93 (P<0.001) for SUVLN and 0.96 for the TNM stage (P<0.001). The SUVLN and TNM stage cutoff values were 2.50 and II, and their sensitivity, specificity and positive and negative prediction were 77.42%, 80.0% and 82.76% and 74.07%; and 87.10%, 60.0% and 72.97% and 78.95%, respectively. Patients with a lower SUVLN and early stage had a longer PFS and OS (all P<0.05).Conclusions For lung cancer, low SUVLN and an early TNM stage (≤stage II) as assessed before ATR by 18F-alfatide II PET/CT represents a favorable subgroup with increased PFS and OS.

scholarly journals Towards the automation of early-stage human embryo development detection

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Vidas Raudonis ◽  
Agne Paulauskaite-Taraseviciene ◽  
Kristina Sutiene ◽  
Domas Jonaitis
Keyword(s):  
Deep Learning ◽  
Assisted Reproductive Technology ◽  
Embryo Development ◽  
Human Embryo ◽  
Early Stage ◽  
Significant Proportion ◽  
Time Lapse ◽  
Reproductive Technology ◽  
In Vitro Fertilisation ◽  
Human Embryo Development

Abstract Background Infertility and subfertility affect a significant proportion of humanity. Assisted reproductive technology has been proven capable of alleviating infertility issues. In vitro fertilisation is one such option whose success is highly dependent on the selection of a high-quality embryo for transfer. This is typically done manually by analysing embryos under a microscope. However, evidence has shown that the success rate of manual selection remains low. The use of new incubators with integrated time-lapse imaging system is providing new possibilities for embryo assessment. As such, we address this problem by proposing an approach based on deep learning for automated embryo quality evaluation through the analysis of time-lapse images. Automatic embryo detection is complicated by the topological changes of a tracked object. Moreover, the algorithm should process a large number of image files of different qualities in a reasonable amount of time. Methods We propose an automated approach to detect human embryo development stages during incubation and to highlight embryos with abnormal behaviour by focusing on five different stages. This method encompasses two major steps. First, the location of an embryo in the image is detected by employing a Haar feature-based cascade classifier and leveraging the radiating lines. Then, a multi-class prediction model is developed to identify a total cell number in the embryo using the technique of deep learning. Results The experimental results demonstrate that the proposed method achieves an accuracy of at least 90% in the detection of embryo location. The implemented deep learning approach to identify the early stages of embryo development resulted in an overall accuracy of over 92% using the selected architectures of convolutional neural networks. The most problematic stage was the 3-cell stage, presumably due to its short duration during development. Conclusion This research contributes to the field by proposing a model to automate the monitoring of early-stage human embryo development. Unlike in other imaging fields, only a few published attempts have involved leveraging deep learning in this field. Therefore, the approach presented in this study could be used in the creation of novel algorithms integrated into the assisted reproductive technology used by embryologists.

Obesity, Assisted Reproductive Technology, and Early Preterm Birth--Florida, 2004-2006

2012 ◽  
Vol 176 (10) ◽  
pp. 886-896 ◽  
Author(s):  
E. K. Sauber-Schatz ◽  
W. Sappenfield ◽  
V. Grigorescu ◽  
A. Kulkarni ◽  
Y. Zhang ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Assisted Reproductive Technology ◽  
Reproductive Technology ◽  
Early Preterm Birth

scholarly journals Embryo manipulation via assisted reproductive technology and epigenetic asymmetry in mammalian early development

2013 ◽  
Vol 368 (1609) ◽  
pp. 20120353 ◽  
Author(s):  
Takashi Kohda ◽  
Fumitoshi Ishino
Keyword(s):  
Assisted Reproductive Technology ◽  
Early Stage ◽  
Gene Activation ◽  
Reproductive Technology ◽  
Blastocyst Stage ◽  
Mammalian Development ◽  
Cell Stage ◽  
Genome Wide ◽  
Zygotic Gene ◽  
Developmental Risks

The early stage of mammalian development from fertilization to implantation is a period when global and differential changes in the epigenetic landscape occur in paternally and maternally derived genomes, respectively. The sperm and egg DNA methylation profiles are very different from each other, and just after fertilization, only the paternally derived genome is subjected to genome-wide hydroxylation of 5-methylcytosine, resulting in an epigenetic asymmetry in parentally derived genomes. Although most of these differences are not present by the blastocyst stage, presumably due to passive demethylation, the maintenance of genomic imprinting memory and X chromosome inactivation in this stage are of critical importance for post-implantation development. Zygotic gene activation from paternally or maternally derived genomes also starts around the two-cell stage, presumably in a different manner in each of them. It is during this period that embryo manipulation, including assisted reproductive technology, is normally performed; so it is critically important to determine whether embryo manipulation procedures increase developmental risks by disturbing subsequent gene expression during the embryonic and/or neonatal development stages. In this review, we discuss the effects of various embryo manipulation procedures applied at the fertilization stage in relation to the epigenetic asymmetry in pre-implantation development. In particular, we focus on the effects of intracytoplasmic sperm injection that can result in long-lasting transcriptome disturbances, at least in mice.

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