scholarly journals Does Conventional Morphological Evaluation Still Play a Role in Predicting Blastocyst Formation?

2021 ◽  
Author(s):  
Xiaoming Jiang ◽  
Jiali Cai ◽  
Lanlan Liu ◽  
Zhenfang Liu ◽  
Wenjie Wang ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Time Lapse ◽  
Cell Number ◽  
Blastocyst Transfer ◽  
Embryo Morphology ◽  
Morphological Parameters ◽  
Lasso Regression ◽  
Blastocyst Formation ◽  
Morphological Evaluation ◽  
Validation Set

Abstract BackgroundAdvanced models including time-lapse imaging and artificial intelligence technologies have been used to predict blastocyst formation. However, the conventional morphological evaluation of embryos is still widely used. The purpose of the present study was to evaluate the predictive power of conventional morphological evaluation regarding blastocyst formation.MethodsRetrospective evaluation of data from 15613 patients receiving blastocyst culture from January 2013 through December 2020 in our institution were reviewed. Generalized estimating equations (GEE) were used to establish the morphology-based model. To estimate whether including more features regarding patient characteristics and cycle parameters improve the predicting power, we also establish models including 27 more features with either LASSO regression or XGbosst. The predicted number of blastocyst were associated with the observed number of the blastocyst and were used to predict the blastocyst transfer cancellation either in fresh or frozen cycles. ResultsBased on early cleavage and routine observed morphological parameters (cell number, fragmentation, and symmetry), the GEE model predicted blastocyst formation with an AUC of 0.779(95%CI: 0.77-0.787) and an accuracy of 74.7%(95%CI: 73.9%-75.5%) in the validation set. LASSO regression model and XGboost model based on the combination of cycle characteristics and embryo morphology yielded similar predicting power with AUCs of 0.78(95%CI: 0.771-0.789) and 0.754(95%CI: 0.745-0.763), respectively. For per-cycle blastocyst yield, the predicted number of blastocysts using morphological parameters alone strongly correlated with observed blastocyst number (r=0.897, P<0.0001) and predicted blastocyst transfer cancel with an AUC of 0.926((95%CI: 0.911-0.94). ConclusionThe data suggested that routine morphology observation remained a feasible tool to support an informed decision regarding the day of transfer. However, models based on the combination of cycle characteristics and embryo morphology do not increase the predicting power significantly.

Cytoplasmic membrane activities during first cleavage of zona-free porcine embryos: description and consequences

2017 ◽  
Vol 29 (3) ◽  
pp. 557 ◽  
Author(s):  
Rong Li ◽  
Ying Liu ◽  
Hanne Skovsgaard Pedersen ◽  
Henrik Callesen
Keyword(s):  
Cytoplasmic Membrane ◽  
Membrane Surface ◽  
Time Lapse ◽  
Cell Number ◽  
Blastocyst Formation ◽  
Total Cell Number ◽  
Developmental Patterns ◽  
Developmental Potential ◽  
Surface Activities ◽  
The Relationship

Already at first embryo cleavage subsequent blastocyst formation can be predicted based on morphology but the finer morphological details can be difficult to determine due to the presence of the zona pellucida (ZP). Therefore, we monitored zona-free porcine parthenogenetically activated (PA) embryos in a time-lapse system to: (1) describe and characterise the morphological activity of the cytoplasmic membrane and the distribution to the two nuclei during first cleavage and (2) determine the relationship between specific morphological activities and subsequent embryonic development. After ZP removal the membrane surface activities were clearly visible, so all cleaved embryos could be divided into two groups depending on the surface activity during first cleavage: regular morphology (MN) or irregular morphology with ‘bumps’ (MB). The two nuclei were more unequal in MB embryos in both nucleus size and DNA quantity. After first cleavage, MB embryos could be further divided into three types of irregularities (MB1, MB2, MB3) based on their subsequent behaviour. Clear differences in developmental patterns were found between MN and MB embryos, such as delayed first cleavage, compromised blastocyst formation and total cell number. The predictive value of these new types of morphological events was comparable to the more traditionally used time of first cleavage. In conclusion, zona-free embryos allow visualisation of finer morphological details that can provide an early prediction of embryo developmental potential, but further studies are needed on other type of embryos.

scholarly journals Incidence, characteristics, determinants and prognostic impact of recurrent syncope

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Zimmermann ◽  
J Du Fay De Lavallaz ◽  
T Nestelberger ◽  
D Gualandro ◽  
P Badertscher ◽  
...  
Keyword(s):  
Patient Characteristics ◽  
Coronary Intervention ◽  
Final Diagnosis ◽  
Major Adverse Cardiovascular Events ◽  
Unknown Etiology ◽  
Funding Source ◽  
Prognostic Impact ◽  
Lasso Regression ◽  
Recurrence Rates ◽  
Increased Risk

Abstract Background The incidence, characteristics, determinants, and prognostic impact of recurrent syncope are largely unknown, causing uncertainty for both patients and physicians. Methods We characterized recurrent syncope including sex-specific aspects and its impact on death and major adverse cardiovascular events (MACE) in a large prospective international multicenter study enrolling patients ≥40 years presenting with syncope to the emergency department (ED). Syncope etiology was centrally adjudicated by two independent and blinded cardiologists using all information becoming available during syncope work-up and 12-month follow-up. MACE were defined as a composite of all-cause death, acute myocardial infarction, surgical or percutaneous coronary intervention, life-threatening arrhythmia including cardiac arrest, pacemaker or implantable cardioverter defibrillator implantation, valve intervention, heart-failure, gastrointestinal bleeding or other bleeding requiring transfusion, intracranial hemorrhage, ischemic stroke or transient ischemic attack, sepsis and pulmonary embolism. Results Incidence of recurrent syncope among 1790 patients was 20% (95%-confidence interval (CI) 18% to 22%) within 24 months. Patients with an adjudicated final diagnosis of cardiac syncope (hazard ratio (HR) 1.50, 95%-CI 1.11 to 2.01) or syncope of unknown etiology even after central adjudication (HR 2.11, 95%-CI 1.54 to 2.89) had an increased risk for syncope recurrence (Figure). LASSO regression fit on all patient information available early in the ED identified more than three previous episodes of syncope as the only independent predictor for recurrent syncope (HR 2.13, 95%-CI 1.64 to 2.75). Recurrent syncope within the first 12 months after the index event carried an increased risk for all-cause death (HR 1.59, 95%-CI 1.06 to 2.38) and MACE (HR 2.24, 95%-CI 1.67 to 3.01), whereas recurrences after 12 months did not have a significant impact on outcome measures. Conclusion Recurrence rates of syncope are substantial and vary depending on syncope etiology. There seem to be no reliable patient characteristics available early on the ED that allow for the prediction of recurrent syncope with only a history of more than three previous syncope being associated with a higher risk for future recurrences. Importantly, recurrent syncope within the first 12 months carries an increased risk for death and MACE. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): Swiss National Science Foundation, Swiss Heart Foundation

scholarly journals A role for the fusogen eff-1 in epidermal stem cell number robustness in Caenorhabditis elegans

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sneha L. Koneru ◽  
Fu Xiang Quah ◽  
Ritobrata Ghose ◽  
Mark Hintze ◽  
Nicola Gritti ◽  
...  
Keyword(s):  
Stem Cell ◽  
Caenorhabditis Elegans ◽  
Cell Fate ◽  
Single Molecule ◽  
Phenotypic Variability ◽  
Low Frequency ◽  
Time Lapse ◽  
Cell Number ◽  
Seam Cell ◽  
Neuronal Tissues

AbstractDevelopmental patterning in Caenorhabditis elegans is known to proceed in a highly stereotypical manner, which raises the question of how developmental robustness is achieved despite the inevitable stochastic noise. We focus here on a population of epidermal cells, the seam cells, which show stem cell-like behaviour and divide symmetrically and asymmetrically over post-embryonic development to generate epidermal and neuronal tissues. We have conducted a mutagenesis screen to identify mutants that introduce phenotypic variability in the normally invariant seam cell population. We report here that a null mutation in the fusogen eff-1 increases seam cell number variability. Using time-lapse microscopy and single molecule fluorescence hybridisation, we find that seam cell division and differentiation patterns are mostly unperturbed in eff-1 mutants, indicating that cell fusion is uncoupled from the cell differentiation programme. Nevertheless, seam cell losses due to the inappropriate differentiation of both daughter cells following division, as well as seam cell gains through symmetric divisions towards the seam cell fate were observed at low frequency. We show that these stochastic errors likely arise through accumulation of defects interrupting the continuity of the seam and changing seam cell shape, highlighting the role of tissue homeostasis in suppressing phenotypic variability during development.

Development and Validation of a Nomogram for Predicting Bladder Calculi Risk in Patients With Benign Prostatic Hyperplasia

2021 ◽  
Author(s):  
Euxu Xie ◽  
Xuelian Gu ◽  
Chen Ma ◽  
Li Guo ◽  
Man Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Benign Prostatic Hyperplasia ◽  
Characteristic Curve ◽  
Prostatic Hyperplasia ◽  
Calibration Plot ◽  
Lasso Regression ◽  
Net Benefit ◽  
Bladder Calculi ◽  
Validation Set ◽  
Selection Operator

Abstract Objective To develop and validate a nomogram for predicting bladder calculi risk in patients with benign prostatic hyperplasia (BPH).Methods A total of 368 patients who underwent transurethral resection of the prostate (TURP) and had histologically proven BPH from January 2018 to January 2021 were retrospectively collected. Eligible patients were randomly assigned to the training and validation datasets. Least absolute shrinkage and selection operator (LASSO) regression was used to select the optimal risk factors. A prediction model was established based on the selected characteristics. The performance of the nomogram was assessed by calibration plots and the area under the receiver operating characteristic curve (AUROC). Furthermore, decision curve analysis (DCA) was used to determine the net benefit rate of of the nomogram. Results Among 368 patients who met the inclusion criteria, older age, a history of diabetes and hyperuricemia, longer intravesical prostatic protrusion (IPP)and larger prostatic urethral angulation (PUA) were independent risk factors for bladder calculi in patients with BPH. These factors were used to develop a nomogram, which had a good identification ability in predicting the risk of bladder calculi in patients, with AUROCs of 0.911 (95% CI: 0.876–0.945) in the training set and 0.884 (95% CI: 0.820–0.948) in the validation set. The calibration plot showed that the model had good calibration. Moreover, DCA indicated that the model had a goodclinical benefit. Conclusion We developed and internally validated the first nomogram to date to help physicians assess the risk of bladder calculi in patients with BPH, which may help physicians improve individual interventions and make better clinical decisions.

scholarly journals Clinical prediction of thrombectomy eligibility: A systematic review and 4-item decision tree

2018 ◽  
Vol 14 (5) ◽  
pp. 530-539 ◽  
Author(s):  
Gaia T Koster ◽  
T Truc My Nguyen ◽  
Erik W van Zwet ◽  
Bjarty L Garcia ◽  
Hannah R Rowling ◽  
...  
Keyword(s):  
Decision Tree ◽  
Prediction Model ◽  
External Validation ◽  
Facial Asymmetry ◽  
Decision Support Tool ◽  
Patient Characteristics ◽  
Group Lasso ◽  
Lasso Regression ◽  
Vessel Occlusion ◽  
Support Tool

Background A clinical large anterior vessel occlusion (LAVO)-prediction scale could reduce treatment delays by allocating intra-arterial thrombectomy (IAT)-eligible patients directly to a comprehensive stroke center. Aim To subtract, validate and compare existing LAVO-prediction scales, and develop a straightforward decision support tool to assess IAT-eligibility. Methods We performed a systematic literature search to identify LAVO-prediction scales. Performance was compared in a prospective, multicenter validation cohort of the Dutch acute Stroke study (DUST) by calculating area under the receiver operating curves (AUROC). With group lasso regression analysis, we constructed a prediction model, incorporating patient characteristics next to National Institutes of Health Stroke Scale (NIHSS) items. Finally, we developed a decision tree algorithm based on dichotomized NIHSS items. Results We identified seven LAVO-prediction scales. From DUST, 1316 patients (35.8% LAVO-rate) from 14 centers were available for validation. FAST-ED and RACE had the highest AUROC (both >0.81, p < 0.01 for comparison with other scales). Group lasso analysis revealed a LAVO-prediction model containing seven NIHSS items (AUROC 0.84). With the GACE (Gaze, facial Asymmetry, level of Consciousness, Extinction/inattention) decision tree, LAVO is predicted (AUROC 0.76) for 61% of patients with assessment of only two dichotomized NIHSS items, and for all patients with four items. Conclusion External validation of seven LAVO-prediction scales showed AUROCs between 0.75 and 0.83. Most scales, however, appear too complex for Emergency Medical Services use with prehospital validation generally lacking. GACE is the first LAVO-prediction scale using a simple decision tree as such increasing feasibility, while maintaining high accuracy. Prehospital prospective validation is planned.

scholarly journals Embryo Morphokinetic Parameters Evaluated Using a Time-Lapse Embryo Monitoring System Can Predict the Embryo Developmental Potential in ICSI Cycles

2021 ◽  
Author(s):  
Qina He ◽  
Guidong Yao ◽  
Jiahuan He ◽  
Guang Yang ◽  
Ziwen Xu ◽  
...  
Keyword(s):  
Monitoring System ◽  
Embryo Quality ◽  
Morphological Characteristics ◽  
Time Lapse ◽  
Reproductive Technologies ◽  
Embryo Morphology ◽  
High Quality ◽  
Developmental Potential ◽  
Morphokinetic Parameters ◽  
The Mean

Abstract At present, embryo morphology assessment based on the observation of the embryonic morphological characteristics at several specific time points has been mainly used for selecting the high-quality embryo. However, we all know that embryo development is a dynamic process. Many research results on the correlation between the embryo morphokinetic parameters and embryo quality and development potential were inconsistent. With the help of time-lapse imaging, the development processes and outcomes of a total of 365 embryos were cultured and analyzed in this study. The results showed that the mean tPNf and t2 of the high-quality embryo were significantly shorter than the low-quality embryo; the mean t2PBe and tPNa of the high-quality embryo from the implantation group were significantly shorter than those from the non-implantation group. In addition, based on the quartile grouping of each morphokinetic parameter, the embryos that had 21.15≤tPNf≤25.30 value were significantly higher in embryo quality when compared with the embryos that had the tPNf values outside the range on Days 3. Similarly, the embryos that had values of t2≤25.60 were significantly higher in embryo quality than those with outside the range values on Days 3. Thus, we demonstrated that the morphokinetic parameter evaluated using a time-lapse embryo monitoring system can predict the embryo quality, and be benefit for the selection of the high-quality embryos and improvement for the implantation success of the patient in assisted reproductive technologies.

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