Early Serum Progesterone Measurement on 9th Day after Oocyte Retrieval can be used as a Predictor of Fresh Intracytoplasmic Sperm Injection Cycle Success

BACKGROUND: In intracytoplasmic sperm injection (ICSI) infertility treatment cycles, measuring serum Progesterone level at day 9 after oocyte retrieval could be used as a predictor of success. METHODS: Sixty-nine women were prospectively included in this study, treated with fresh embryo transfer ICSI cycles. Progesterone analyses were performed on the day of oocyte pick up (day 0) at serum and follicular fluid, then re-assessment at serum on day 9 after oocyte retrieval. The data were compared to evaluate the correlation among hormones measured on day 0 and day 9 with pregnancy rate. RESULTS: Pregnancy rate of Iraqi women was 22% (n = 15), mean serum progesterone on day 9 among pregnant ladies was (mean ± SD, 39.5 ± 13.0) which was significantly higher than that who failed to get pregnant (mean 23.2 ± 11, p = 0.001), then after adjustment of the baseline readings (day 0) estimated mean = 11.1. The differences were still significant, receiver operating characteristic curve area showed that serum Progesterone on day 9 after pick up can differentiate correctly between those who will conceive and those who will not, with a sensitivity = 0.933 and specificity = 0.519, at cut off point = 22.33 and above, (Area under the curve = 0.822, p = 0.001). CONCLUSION: Serum progesterone on day 9 could be one of the predictors of endometrial receptivity and pregnancy, which is actually of great value for both doctors and patients during that stressful period till the date of confirmation, which might negatively affect treatment outcome, as well as the psychosocial and pharmacological impact of medication and limited activity for a failed one.

Safety and efficacy of repeat long-term incobotulinumtoxinA treatment for lower limb or combined upper/lower limb spasticity in children with cerebral palsy

PURPOSE: The open-label phase 3 ‘Treatment with IncobotulinumtoxinA in Movement Open-Label’ (TIMO) study investigated longer-term safety and efficacy of incobotulinumtoxin A in children/adolescents with cerebral palsy (CP). METHODS: Patients on standard treatment, with unilateral or bilateral lower limb (LL) or combined upper limb (UL)/LL spasticity received four incobotulinumtoxinA injection cycles (16 or 20 Units/kg bodyweight total [maximum 400 or 500 Units] per cycle depending on ambulatory status/clinical pattern treated), each followed by 12–16 weeks’ observation. Treatment for pes equinus was mandatory; flexed knee or adducted thigh were options for unilateral treatment and/or ULs for unilateral/bilateral treatment. The primary endpoint was safety; changes in Ashworth Scale and Gross Motor Function Measure-66 scores, and Global Impression of Change Scale scores at week 4 of each injection cycle were also evaluated. RESULTS: IncobotulinumtoxinA (≤500 Units for ≤98 weeks) was safe, well-tolerated, and effective across all endpoints for multipattern treatment of LL and combined LL/UL spasticity in ambulant/nonambulant children/adolescents with CP. Treatment effects increased with each injection cycle. No new/unexpected safety concerns were identified. CONCLUSION: IncobotulinumtoxinA showed a good safety and tolerability profile, with efficacy over multiple clinical presentations. As an adjunct treatment, it offers an effective, individualized treatment option for pediatric CP-related spasticity.

Modification of the Cavity of Plastic Injection Molds: A Brief Review of Materials and Influence on the Cooling Rates

In the 21st century, a great percentage of the plastic industry production is associated with both injection molding and extrusion processes. Manufactured plastic components/parts are used in several industry sectors, where the automotive and aeronautic stand out. In the injection process cycle, the cooling step represents 60% to 80% of the total injection process time, and it is used to estimate the production capabilities and costs. Therefore, efforts have been focused on obtaining more efficient cooling systems, seeking the best relationship between the shape, the quantity, and the distribution of the cooling channels into the injection molds. Concomitantly, the surface coating of the mold cavity also assumes great importance as it can provide increased hardness and a more straightforward demolding process. These aspects contribute to the decrease of rejected parts due to surface defects. However, the effect of the coated cavity on the heat transfer and, consequently, on the time of the injection cycle is not often addressed. This paper reviews the effects of the materials and surface coatings of molds cavity on the filling and cooling of the injection molding cycle. It shows how the design of cooling channels affects the cooling rates and warpage for molded parts. It also addresses how the surface coating influence the mold filling patterns and mold cooling. This review shows, more specifically, the influence of the coating process on the cooling step of the injection cycle and, consequently, in the productivity of the process.

Theoretical investigation on the heating performance of a recuperative heat pump water heater using CO2/HCs with large temperature glides in cold regions

Considering the issues of environmental pollution and energy efficiency, heat pumps are gradually replacing traditional coal combustion for heating at low ambient temperatures. In this paper, eco-friendly CO2/HCs with large temperature glides are applied in a single-stage recuperative heat pump water heater. Its heating performance is theoretically investigated under the working condition of producing circulating hot water in typical winter of northern China, with medium temperature difference between supply/return water and large temperature difference between air inlet and water inlet. Due to its simple structure, low initial investment and high efficiency, its potential for producing circulating hot water is demonstrated. Exergy analyses are conducted to reveal the significant influence of the exergy losses of heat exchanger on system performance. For specified CO2/HC, optimal COP is obtained through global optimization of cycle pressures and mixture concentration. The heating performances of different CO2/HCs are compared, among which CO2/R600 and CO2/R600a behave better. Meanwhile, a typical vapor-injection cycle is used to demonstrate priorities on the heating performance of this recuperative cycle, in which the COP of recuperative cycle using CO2/R600 is more than 3.4% higher than that of the vapor-injection cycle. The results obtained in this paper provide a simple and efficient solution for producing circulating hot water at low ambient temperatures.

Influence of maternal age on intracytoplasmic sperm injection outcome and global deoxyribonucleic acid methylation in women undergoing intracytoplasmic sperm injection cycle

Background: Intracytoplasmic sperm injection needs sufficient oocytes of high quality in order to increase the rate of fertilization and pregnancy. This study was designed to investigate the influence of maternal age on the ICSI outcomes in women undergoing to first ICSI cycle and to evaluate the influence of maternal age on global DNA methylation.Methods: A total of 242 females were included in this study with a mean age of 30.5±7.3 years. The participants were divided into three groups depending on women's age≤25, N=70; 26-35, N=102 and>35, N=70). The genomic DNA was isolated from the blood samples, then the global DNA methylation was evaluated using ELISA.Results: A significant reduction has been found in the level of anti-Müllerian hormone (AMH), total number of the collected oocyte, mature oocytes, fertilized oocytes and number of embryos transferred in the older females compared to the younger group (p<0.001). While a significant increase has been found in global DNA methylation level in the older females compared to the younger group (p<0.001). A positive significant correlation has been found between global DNA methylation level and maternal age (p<0.001). In contrast, a negative significant correlation has been shown between AMH level, mature oocytes and maternal age (p<0.001).Conclusions: Maternal age has a significant influence on the number of mature oocytes, number of embryos transferred and global DNA methylation. The pregnancy chance is more in the age group less than 35 years.