scholarly journals Measuring embryo metabolism to predict embryo quality

2016 ◽  
Vol 28 (2) ◽  
pp. 41 ◽  
Author(s):  
Jeremy G. Thompson ◽  
Hannah M. Brown ◽  
Melanie L. Sutton-McDowall

Measuring the metabolism of early embryos has the potential to be used as a prospective marker for post-transfer development, either alone or in conjunction with other embryo quality assessment tools. This is necessary to maximise the opportunity of couples to have a healthy child from assisted reproduction technology (ART) and for livestock breeders to efficiently improve the genetics of their animals. Nevertheless, although many promising candidate substrates (e.g. glucose uptake) and methods (e.g. metabolomics using different spectroscopic techniques) have been promoted as viability markers, none has yet been widely used clinically or in livestock production. Herein we review the major techniques that have been reported; these are divided into indirect techniques, where measurements are made from the embryo’s immediate microenvironment, or direct techniques that measure intracellular metabolic activity. Both have strengths and weaknesses, the latter ruling out some from contention for use in human ART, but not necessarily for use in livestock embryo assessment. We also introduce a new method, namely multi- (or hyper-) spectral analysis, which measures naturally occurring autofluorescence. Several metabolically important molecules have fluorescent properties, which we are pursuing in conjunction with improved image analysis as a viable embryo quality assessment methodology.

Author(s):  
Jacob Stegenga

Medical scientists employ ‘quality assessment tools’ to assess evidence from medical research, especially from randomized trials. These tools are designed to take into account methodological details of studies, including randomization, subject allocation concealment, and other features of studies deemed relevant to minimizing bias. There are dozens of such tools available. They differ widely from each other, and empirical studies show that they have low inter-rater reliability and low inter-tool reliability. This is an instance of a more general problem called here the underdetermination of evidential significance. Disagreements about the quality of evidence can be due to different—but in principle equally good—weightings of the methodological features that constitute quality assessment tools. Thus, the malleability of empirical research in medicine is deep: in addition to the malleability of first-order empirical methods, such as randomized trials, there is malleability in the tools used to evaluate first-order methods.


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 607.2-608
Author(s):  
S. Giambalvo ◽  
C. Garaffoni ◽  
E. Silvagni ◽  
F. Furini ◽  
M. Govoni ◽  
...  

Background:Fertility is thought to be not reduced in women affected by systemic lupus erythematosus (SLE), however disease-related factors, psychosocial effects of chronic disease as well as medication exposure might impair gonadal function.Objectives:The aim of this systematic review was to explore clinical, hormonal, serological, instrumental and management factors associated with fertility outcomes in women of childbearing age with SLE.Methods:This systematic review was conducted following the Preferred Reporting Items for systematic reviews and Meta-analysis (PRISMA) statement. All articles available in English, published from 1972 to 15th August 2020 in Pubmed, EMBASE, Scopus and Cochrane Library. Study selection and data collection were performed by two independent reviewers. All data were extracted using a standardized template. Risk of bias of the included studies was assessed by using the NIH risk-of-bias tool [1].Results:Of 788 abstracts, we included in the review 45 studies of which 1 systematic literature reviews, 16 cross-sectional studies, 15 cohort studies, 12 observational studies and 1 case-series study, with a total of 4656 patients. The mean age was 33.5 ± 5.4 years, while the mean disease duration was 97.4 ± 65.2 months. Figure 1 illustrates the quality of the included studies. Definitions of fertility/premature ovarian failure (POF) adopted in the studies varied in terms of the number of months of amenorrhea considered. Most studies did not use a hormonally based definition of fertility. Clinical factors associated with the development of POF were older age at the time initiation of therapy and older age at the onset of SLE disease. Cyclophosphamide exposure (CYC) and its cumulative dose influenced gonadal function in SLE women, leading to amenorrhoea and ovarian failure, as reported in 19 studies. Mycophenolate, azathioprine, calcineurin inhibitors and steroids seem to be associated with a lower risk of ovarian failure compared to CYC. 3 studies demonstrated that POF was more frequent in patients treated with CYC not receiving gonadotropin-releasing hormone analogues (GnRH) in comparison to those co-treated with GnRH. 11 studies evaluated the impact of damage and disease activity on ovarian reserve in patients with SLE with conflicting evidence. Finally, 18 studies investigated exposure to hormonal and serological factors able to influence fertility outcomes; among others nor Anti-Müllerian Hormone, neither anti-corpus luteum antibodies were associated with POF.Conclusion:The role of disease activity on fertility in SLE patients is contradictory. Regarding management factors associated with fertility in SLE women of childbearing age, the strongest evidence is about the treatment with CYC and its cumulative dose. Hormonal and serological factors did not impact on fertility outcome but might be used as a surrogate of fertility, especially after treatment with disease-specific drugs.References:[1]Study Quality Assessment Tools NIH. https://www.nhlbi.nih.gov/health-topics/study-quality-assessment-tools.[2]Andreoli L. et al. EULAR recommendations for women’s health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017; 76: 476–485.Disclosure of Interests:None declared


2013 ◽  
Vol 39 (7) ◽  
pp. 745-754 ◽  
Author(s):  
A. Bentohami ◽  
K. de Burlet ◽  
N. de Korte ◽  
M. P. J. van den Bekerom ◽  
J. C. Goslings ◽  
...  

The purpose of this systematic review is to assess the prevalence of complications following volar locking plate fixation of distal radial fractures. A computer-based search was carried out using EMBASE and PUBMED/MEDLINE. Only prospective comparative and prospective cohort studies that presented data concerning complications after treatment of distal radial fractures with a volar locking plate in human adults with a minimal follow-up of 6 months were included. Two quality assessment tools were used to assess the methodological quality of the studies (level of evidence rating according to the Oxford Centre of Evidence Based Medicine and the modified version of the Cochrane Bone, Joint and Muscle Trauma Group’s former quality assessment tool). Thirty three studies were eligible for final assessment. Most complications were problems with nerve and tendon function as well as complex regional pain syndrome. With an overall complication rate of 16.5%, most of which were ‘minor’ complications and low rates of nonunion and malunion, volar locking plate fixation can be considered a reasonably safe treatment option for patients with distal radial fractures.


2021 ◽  
Author(s):  
Laura Jefferson ◽  
Su Golder ◽  
Veronica Dale ◽  
Holly Essex ◽  
Elizabeth McHugh ◽  
...  

Background Over recent years chronic stress and burnout have been reported by doctors working in general practice in the UK NHS and internationally. The COVID-19 pandemic has changed general practitioners working lives; adding potential pressures from avoiding infection and addressing pent-up demand for care, but also changing processes such as rapidly taking up remote consultations. To date, there has been a focus on exploring the impact of the pandemic on the wellbeing of hospital clinicians. No registered systematic reviews currently focus on exploring the impact of the pandemic on the mental health and wellbeing of general practitioners. Aims and objectives To synthesise the current international evidence base exploring the impact of COVID-19 on the mental health and wellbeing of general practitioners, and which factors are associated with their reported mental health and wellbeing during the pandemic. Methods In this paper we report a systematic review protocol, following PRISMA guidance. In our search strategy we will identify primary research studies or systematic reviews exploring the mental health and wellbeing of general practitioners during the COVID-19 pandemic in four databases (MEDLINE, Embase, PsychInfo and Medrxiv) and Google Scholar. We will hand-search reference lists and grey literature. Two reviewers will undertake all stages including study selection, data extraction and quality assessment, with arbitration by a third reviewer where necessary. We will use standardised quality assessment tools to ensure transparency and reduce bias in quality assessment. Depending on the quality of included studies, we may undertake a sensitivity analysis by excluding studies from narrative synthesis that are rated as low quality using the checklists. We will describe the findings across studies using narrative thematic data synthesis, and if sufficiently homogenous data are identified, we will pool quantitative findings through meta-analysis.


2015 ◽  
Vol 12 (1) ◽  
pp. 131 ◽  
Author(s):  
Miguel Baldomero Ramirez Fernandez ◽  
Jose Luis Salmeron Silvera ◽  
Eloy López Meneses

2012 ◽  
Vol 108 (11) ◽  
pp. 1948-1961 ◽  
Author(s):  
Fiona O'Leary ◽  
Margaret Allman-Farinelli ◽  
Samir Samman

Poor vitamin B12 status may lead to the development of cognitive decline and dementia but there is a large variation in the quality, design of and results reported from these investigations. We have undertaken a systematic review of the evidence for the association between vitamin B12 status and cognitive decline in older adults. A database search of the literature to 2011 was undertaken, using keywords related to vitamin B12 and cognition. All prospective cohort studies assessing the association of serum vitamin B12 or biomarkers were included. Quality assessment and extraction of the data were undertaken by two researchers. The quality assessment tool assigns a positive, neutral or negative rating. Of 3772 published articles, thirty-five cohort studies (n 14 325 subjects) were identified and evaluated. No association between serum vitamin B12 concentrations and cognitive decline or dementia was found. However, four studies that used newer biomarkers of vitamin B12 status (methylmalonic acid and holotranscobalamin (holoTC)) showed associations between poor vitamin B12 status and the increased risk of cognitive decline or dementia diagnosis. In general, the studies were of reasonable quality (twenty-one positive, ten neutral and four negative quality) but of short duration and inadequate subject numbers to determine whether an effect exists. Future studies should be of adequate duration (at least 6 years), recruit subjects from the seventh decade, choose markers of vitamin B12 status with adequate specificity such as holoTC and/or methylmalonic acid and employ standardised neurocognitive assessment tools and not screening tests in order to ascertain any relationship between vitamin B12 status and cognitive decline.


2019 ◽  
Vol 214 ◽  
pp. 01030
Author(s):  
Juraj Smiesko

An integrated system for data quality and conditions assessment for the ATLAS Tile Calorimeter is known amongst the ATLAS Tile Calorimeter as the Tile-in-One. It is a platform for combining all of the ATLAS Tile Calorimeter offline data quality tools in one unified web interface. It achieves this by using simple main web server to serve as central hub and group of small web applications called plugins, which provide the data quality assessment tools. Every plugin runs in its own virtual machine in order to prevent interference between the plugins and also to increase stability of the platform.


2017 ◽  
Vol 29 (1) ◽  
pp. 115-118
Author(s):  
Uma Krishnakumar ◽  
V. Sivasubramanian

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