MAR

原发性干燥综合征
  • 文章类型: Case Reports
    描述由nivolumab治疗引发的抗TRPM1自身抗体阳性单侧黑色素瘤相关视网膜病变(MAR)的不寻常病例的视网膜表型,并与TRPM1相关的先天性固定夜盲症(TRPM1-CSNB)的表型进行比较。
    在开始nivolumab治疗合并成功治疗的黑色素瘤后3个月诊断为单侧MAR。鉴定了针对TRPM1的视网膜自身抗体。ffERG,显微视野和静态色度视野检查证实左眼单侧双极型细胞(ON-BPC)功能障碍和中央棒敏感性丧失;对侧眼睛正常。有交界神经节细胞(GCL)和内核层(INL)变薄,但与未受影响的眼睛相比,受影响的内部丛状层(IPL)明显更薄。纵向反射率分布(LRP)表明受累眼睛中存在异常的内部丛状层(IPL)层压。在两例TRMP1-cCSNB和一例抗TRPM1自身抗体阴性MAR中记录了几乎相同的变化。在不增加免疫抑制的情况下,停止药物治疗后,功能变化部分恢复。
    在这个单侧MAR病例中,受影响和未受影响的眼睛之间的比较显示,内部视网膜异常和与经典视网膜宽的ON-BPC功能障碍相关的IPL异常分层,和局部中央杆介导的敏感性损失。在两个cCSNB病例和一个抗TRPM1自身抗体阴性MAR病例中,几乎相同的结构表型支持这些具有ON-BPC功能障碍的病症的特定结构功能表型。
    UNASSIGNED: To describe the retinal phenotype of an unusual case of anti-TRPM1 autoantibody-positive unilateral melanoma-associated retinopathy (MAR) triggered by nivolumab therapy and compare with the phenotype of TRPM1-associated Congenital Stationary Night Blindness (TRPM1-CSNB).
    UNASSIGNED: Unilateral MAR was diagnosed 3 months after starting nivolumab therapy for consolidation of a successfully treated melanoma. Retinal autoantibodies against TRPM1 were identified. ffERG, microperimetry and static chromatic perimetry confirmed unilateral ON-Bipolar Cell (ON-BPC) dysfunction and central rod sensitivity losses in the left eye; the contralateral eye was normal. There was borderline ganglion cell (GCL) and inner nuclear layer (INL) thinning, but a significantly thinner inner plexiform layer (IPL) in the affected compared to the unaffected eye. Longitudinal reflectivity profiles (LRPs) demonstrated an abnormal inner plexiform layer (IPL) lamination in the involved eye. Nearly identical changes were documented in two cases of TRMP1-cCSNB and in a case of anti-TRPM1 autoantibody-negative MAR. The functional changes partially recovered with discontinuation of the medication without added immunosuppression.
    UNASSIGNED: Comparisons between the affected and unaffected eye in this unilateral MAR case revealed inner retinal abnormalities and abnormal lamination of the IPL associated with the classical retina-wide ON-BPC dysfunction, and localized central rod-mediated sensitivity losses. A nearly identical structural phenotype in two cases of cCSNB and a case of anti-TRPM1 autoantibody-negative MAR supports a specific structural-functional phenotype for these conditions with ON-BPC dysfunction.
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  • 文章类型: Journal Article
    黑色素瘤相关视网膜病变(MAR)是一种与皮肤转移性黑色素瘤相关的副肿瘤综合征,患者出现视力缺陷,包括夜视功能下降,对比敏感度差,和光视。MAR是由靶向TRPM1的自身抗体引起的,TRPM1是在黑素细胞和视网膜ON双极细胞(ON-BC)中发现的离子通道。当TRPM1自身抗体进入ON-BCs并阻断TRPM1的功能时出现视觉症状,因此在患者血清中检测TRPM1自身抗体是诊断MAR的关键标准。视网膜电图用于测量TRPM1自身抗体对ON-BC功能的影响,并代表MAR的另一个重要诊断工具。迄今为止,MAR病例报告包括一个或两个诊断组件,但只针对患者疾病过程中的单个时间点。这里,我们报告了一例由血清自身抗体检测的纵向分析支持的MAR,视觉功能,眼部炎症,血管完整性,以及对缓释眼内皮质类固醇的反应。将这些数据与患者的肿瘤和眼科记录相结合,揭示了有关MAR发病机制的新见解。programming,和治疗,这可能为新的研究提供信息,扩大我们对这种疾病的集体理解。简而言之,我们发现TRPM1自身抗体即使在westernblot和免疫组织化学几乎检测不到血清水平时也能破坏视力;尽管循环中的TRPM1自身抗体水平很高,但眼内地塞米松治疗可缓解MAR视觉症状,提示抗体进入视网膜是MAR发病机制的关键因素。患者眼睛中炎性细胞因子水平升高可能是观察到的血-视网膜屏障损伤以及随后自身抗体进入视网膜的原因。
    Melanoma-associated retinopathy (MAR) is a paraneoplastic syndrome associated with cutaneous metastatic melanoma in which patients develop vision deficits that include reduced night vision, poor contrast sensitivity, and photopsia. MAR is caused by autoantibodies targeting TRPM1, an ion channel found in melanocytes and retinal ON-bipolar cells (ON-BCs). The visual symptoms arise when TRPM1 autoantibodies enter ON-BCs and block the function of TRPM1, thus detection of TRPM1 autoantibodies in patient serum is a key criterion in diagnosing MAR. Electroretinograms are used to measure the impact of TRPM1 autoantibodies on ON-BC function and represent another important diagnostic tool for MAR. To date, MAR case reports have included one or both diagnostic components, but only for a single time point in the course of a patient\'s disease. Here, we report a case of MAR supported by longitudinal analysis of serum autoantibody detection, visual function, ocular inflammation, vascular integrity, and response to slow-release intraocular corticosteroids. Integrating these data with the patient\'s oncological and ophthalmological records reveals novel insights regarding MAR pathogenesis, progression, and treatment, which may inform new research and expand our collective understanding of the disease. In brief, we find TRPM1 autoantibodies can disrupt vision even when serum levels are barely detectable by western blot and immunohistochemistry; intraocular dexamethasone treatment alleviates MAR visual symptoms despite high levels of circulating TRPM1 autoantibodies, implicating antibody access to the retina as a key factor in MAR pathogenesis. Elevated inflammatory cytokine levels in the patient\'s eyes may be responsible for the observed damage to the blood-retinal barrier and subsequent entry of autoantibodies into the retina.
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  • 文章类型: Journal Article
    目标:不孕症的身心计划(MBPI)是否表现更好,由于某些独特的元素,在改善临床环境中痛苦水平升高的女性的健康和医学辅助生殖(MAR)结局方面,比部分匹配的支持小组要好吗?
    结论:虽然总体上改善了健康,MBPI的认知行为和形式化的压力管理元素使特质焦虑的改善显着增强,但在其他心理健康和MAR结果中却没有,与支持小组相比。
    背景:已发现与MAR相邻的身心心理计划可以改善女性的精神状态,并可能增加怀孕的机会。然而,在常规临床环境中,对该计划在痛苦水平升高的患者中的有效性知之甚少,也不清楚它的特定成分是特别有效的。
    方法:pre-post设计,单中心,随机对照试验于2019年12月至2022年10月进行(招募开始和结束,分别)。计算样本量(n=168)以检测MBPI在改善与生育相关的生活质量方面的优越性。随机化是基于计算机的,随机数字隐藏患者的身份,直到分配后。
    方法:该试验在一家大型大学教学医院进行。将168例患者随机分为身心(MBPI)组(n=84)和生育支持(FS)对照组(n=84)。患者接受了10周的治疗,135分钟/周的组干预,FS组的格式与MBPI组相同,但是内容限制和系统较少,没有假定的有效因素。干预后心理结局分析的患者人数为n=74(MBPI)和n=68(FS),在30个月的随访中,妊娠结局n=54(MBPI)和n=56(FS)。
    结果:两组在所有心理领域均有显着改善(调整后P<0.001),除了与治疗相关的生活质量。线性混合模型回归分析未显示MBPI组在生育相关生活质量方面的前后改善显着大于FS组(差异差异(DD)=4.11[0.42,7.80],d=0.32,调整后的P=0.124),治疗相关生活质量(DD=-3.08[-7.72,1.55],d=-0.20,调整后P=0.582),不孕症特异性应激(DD=-2.54[-4.68,0.41],d=-0.36,调整后P=0.105),抑郁症(DD=-1.16[3.61,1.29],d=-0.13,调整后的P=0.708),和一般应力(DD=-0.62[-1.91,0.68],d=-0.13,调整后的P=0.708),但它确实显示了特质焦虑的显着较大改善(DD=-3.60[-6.16,-1.04],d=-0.32,调整后P=0.042)。Logistic回归显示对MAR妊娠无群体效应,自发怀孕,或活产。
    结论:随访仅涵盖与MAR相关的医疗结果,没有心理变量,两组的比率不相等。年龄以外的生物因素,病因学,和不孕症的持续时间可能混淆了研究结果。随访损失在5%到10%之间,这可能导致了一些偏见。
    结论:心理和医学上的异质性样本,正常的临床环境和较低的流失率都提高了我们研究的外部有效性和普遍性。MBPI不仅在受控条件下工作,而且在常规的MAR练习中,在那里它可以作为一个具有成本效益的引入,低强度心理干预,在阶梯式护理的框架内。需要更多的研究来进一步确定其活性成分。
    背景:作者没有获得资助,作者身份,和/或本文的出版。作者没有利益冲突要披露。
    背景:ClinicalTrials.govNCT04151485。
    2019年11月5日。
    2019年12月15日。
    OBJECTIVE: Does the Mind/Body Program for Infertility (MBPI) perform better, due to certain distinctive elements, than a partly matched support group in improving the wellbeing and medically assisted reproduction (MAR) outcomes of women with elevated distress levels in a clinical setting?
    CONCLUSIONS: While robust enhancements occurred in the wellbeing overall, the cognitive behavioural and formalized stress management elements of the MBPI allowed a significantly stronger improvement in trait anxiety, but not in other mental health and MAR outcomes, compared with a support group.
    BACKGROUND: Mind-body psychological programmes adjacent to MAR have been found to improve women\'s mental states and possibly increase chances of pregnancy. However, not enough is known about the programme\'s effectiveness among patients with elevated distress levels in routine clinical settings, nor is it clear which of its particular ingredients are specifically effective.
    METHODS: A pre-post design, single-centre, randomized controlled trial was performed between December 2019 and October 2022 (start and end of recruitment, respectively). The sample size (n = 168) was calculated to detect superiority of the MBPI in improving fertility-related quality of life. Randomization was computer-based, with random numbers concealing identities of patients until after allocation.
    METHODS: The trial was conducted at a large university teaching hospital. A total of 168 patients were randomly assigned to the mind-body (MBPI) group (n = 84) and the fertility support (FS) control group (n = 84). Patients received a 10-week, 135-min/week group intervention, with the FS group following the same format as the MBPI group, but with a less restricted and systematic content, and without the presumed effective factors. The number of patients analysed was n = 74 (MBPI) and n = 68 (FS) for post-intervention psychological outcomes, and n = 54 (MBPI) and n = 56 (FS) for pregnancy outcomes at a 30-month follow-up.
    RESULTS: Significant improvements occurred in both groups in all psychological domains (adjusted P < 0.001), except for treatment-related quality of life. Linear mixed-model regression analysis did not reveal significantly greater pre-post improvements in the MBPI group than in the FS group in fertility-related quality of life (difference in differences (DD) = 4.11 [0.42, 7.80], d = 0.32, adjusted P = 0.124), treatment-related quality of life (DD = -3.08 [-7.72, 1.55], d = -0.20, adjusted P = 0.582), infertility-specific stress (DD = -2.54 [-4.68, 0.41], d = -0.36, adjusted P = 0.105), depression (DD = -1.16 [3.61, 1.29], d = -0.13, adjusted P = 0.708), and general stress (DD = -0.62 [-1.91, 0.68], d = -0.13, adjusted P = 0.708), but it did show a significantly larger improvement in trait anxiety (DD = -3.60 [-6.16, -1.04], d = -0.32, adjusted P = 0.042). Logistic regression showed no group effect on MAR pregnancies, spontaneous pregnancies, or live births.
    CONCLUSIONS: The follow-up only covered MAR-related medical outcomes and no psychological variables, and their rates were not equal in the two groups. Biological factors other than age, aetiology, and duration of infertility may have confounded the study results. Loss to follow-up was between 5% and 10%, which may have led to some bias.
    CONCLUSIONS: The psychologically and medically heterogeneous sample, the normal clinical setting and the low attrition rate all raise the external validity and generalizability of our study. The MBPI works not only in controlled conditions, but also in routine MAR practice, where it can be introduced as a cost-effective, low-intensity psychological intervention, within the framework of stepped care. More studies are needed to further identify its active ingredients.
    BACKGROUND: The authors received no financial support for the research, authorship, and/or publication of this article. The authors have no conflict of interest to disclose.
    BACKGROUND: ClinicalTrials.gov NCT04151485.
    UNASSIGNED: 5 November 2019.
    UNASSIGNED: 15 December 2019.
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  • 文章类型: Journal Article
    长期以来,了解兽医和医学重要性寄生虫中宿主和组织嗜性的决定因素一直构成重大挑战。在已知寄生鸡肠的七种艾美球虫中,已观察到组织嗜性的广泛变化。先前的研究表明,由负责初始宿主细胞识别和附着的微丝粘附重复(MAR)结构域组成的微丝蛋白(MIC)可能决定了艾美球虫寄生虫的组织嗜性。本研究旨在探讨MIC及其相关的MARs在赋予E.acervuline位点特异性发育中的作用,E.最大值,和宿主内的E.mitis。免疫荧光分析显示,E.acervuline(EaMIC3)的MIC3,E.maxima的MIC3(EmMIC3),E.mitis的MIC3(EmiMIC3),EaMIC3的MAR3(EaMIC3-MAR3),EmMIC3的MAR2(EmMIC3-MAR2),和EmiMIC3的MAR4(EmiMIC3-MAR4),表现出与这些寄生虫感染的特定肠道的结合能力。相比之下,针对EaMIC3,EmMIC3,EmiMIC3,EaMIC3-MAR3,EmMIC3-MAR2和EmiMIC3-MAR4的抗体可以显着抑制子孢子对宿主肠细胞的侵袭。涉及MAR结构域的取代实验强调了EaMIC3-MAR3,EmMIC3-MAR2和EmiMIC3-MAR4在控制与宿主配体的相互作用中的关键作用。此外,动物实验证实了EmiMIC3,EmiMIC3-MAR4及其多克隆抗体在赋予艾美球虫附属鸟类保护性免疫方面的重要贡献。总之,EaMIC3,EmMIC3和EmiMIC3是E.acervuline表现出的各种组织嗜性背后的潜在因素,E.最大值,还有E.Mitis,EaMIC3-MAR3,EmMIC3-MAR2和EmiMIC3-MAR4是每种寄生虫MIC介导的组织嗜性的主要决定因素。结果阐明了艾美球虫MIC作用方式的分子基础,从而促进对E.acervuline之间组织嗜性的明显差异的理解和合理化,E.最大值,还有E.米蒂斯.
    Understanding the determinants of host and tissue tropisms among parasites of veterinary and medical importance has long posed a substantial challenge. Among the seven species of Eimeria known to parasitize the chicken intestine, a wide variation in tissue tropisms has been observed. Prior research suggested that microneme protein (MIC) composed of microneme adhesive repeat (MAR) domain responsible for initial host cell recognition and attachment likely dictated the tissue tropism of Eimeria parasites. This study aimed to explore the roles of MICs and their associated MARs in conferring site-specific development of E. acervuline, E. maxima, and E. mitis within the host. Immunofluorescence assays revealed that MIC3 of E. acervuline (EaMIC3), MIC3 of E. maxima (EmMIC3), MIC3 of E. mitis (EmiMIC3), MAR3 of EaMIC3 (EaMIC3-MAR3), MAR2 of EmMIC3 (EmMIC3-MAR2), and MAR4 of EmiMIC3 (EmiMIC3-MAR4), exhibited binding capabilities to the specific intestinal tract where these parasites infect. In contrast, the invasion of sporozoites into host intestinal cells could be significantly inhibited by antibodies targeting EaMIC3, EmMIC3, EmiMIC3, EaMIC3-MAR3, EmMIC3-MAR2, and EmiMIC3-MAR4. Substitution experiments involving MAR domains highlighted the crucial roles of EaMIC3-MAR3, EmMIC3-MAR2, and EmiMIC3-MAR4 in governing interactions with host ligands. Furthermore, animal experiments substantiated the significant contribution of EmiMIC3, EmiMIC3-MAR4, and their polyclonal antibodies in conferring protective immunity to Eimeria-affiliated birds. In summary, EaMIC3, EmMIC3, and EmiMIC3 are the underlying factors behind the diverse tissue tropisms exhibited by E. acervuline, E. maxima, and E. mitis, and EaMIC3-MAR3, EmMIC3-MAR2, and EmiMIC3-MAR4 are the major determinants of MIC-mediated tissue tropism of each parasite. The results illuminated the molecular basis of the modes of action of Eimeria MICs, thereby facilitating an understanding and rationalization of the marked differences in tissue tropisms among E. acervuline, E. maxima, and E. mitis.
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  • 文章类型: Journal Article
    目的:本研究调查了社会经济因素之间的关系,饮食摄入量,韩国老年人的节肉性肥胖。
    方法:分析了第七次韩国国家健康和营养检查调查(2016-2018)的数据。该研究包括3,690名65岁及以上的参与者(1,645名男性和2,045名女性)。肌肉减少性肥胖定义为低肌肉力量(男性握力<28kg,女性<18kg)和腹部肥胖(男性腰围>90cm,女性>85cm)并存。评估的社会经济因素包括年龄,生活状态,住宅区,employment,教育,和家庭收入水平。使用从24小时饮食召回数据得出的营养充足率和平均充足率评估饮食摄入量。采用多因素logistic回归分析确定与减少肌肉性肥胖相关的因素。
    结果:男性和女性分别为17.4%和6.5%。低教育水平与女性少肌症性肥胖的患病率显着相关,而较低的家庭收入水平与男性减少肌肉肥胖的风险增加有关.在女性中,较低的平均充足率与较高的少节性肥胖风险显著相关.
    结论:较低的家庭收入和教育水平与较高的少肌症性肥胖患病率相关。广告上,总体营养充足性与少肌症性肥胖的患病率成反比,尤其是女性。
    OBJECTIVE: This study investigated the relationship between socioeconomic factors, dietary intake, and sarcopenic obesity among older adults in Korea.
    METHODS: Data from the seventh Korean National Health and Nutrition Examination Survey (2016-2018) were analyzed. The study included 3,690 participants (1,645 men and 2,045 women) aged 65 years and older. Sarcopenic obesity was defined as the coexistence of low muscle strength (handgrip strength <28 kg in men and <18 kg in women) and abdominal obesity (waist circumference >90 cm in men and >85 cm in women). Socioeconomic factors assessed included age, living status, residential area, employment, education, and family income level. Dietary intake was evaluated using the nutrient adequacy ratio and mean adequacy ratio derived from 24-h dietary recall data. Multiple logistic regression was used to identify factors associated with sarcopenic obesity.
    RESULTS: The prevalence rates of sarcopenic obesity were 6.5% in men and 17.4% in women. Low education levels were significantly associated with a higher prevalence of sarcopenic obesity in women, whereas lower family income levels were associated with an increased risk of sarcopenic obesity in men. In women, a lower mean adequacy ratio was significantly associated with a higher risk of sarcopenic obesity.
    CONCLUSIONS: Lower family income and education level are associated with a higher prevalence of sarcopenic obesity. Ad-ditionally, overall nutritional adequacy is inversely related to the prevalence of sarcopenic obesity, particularly in women.
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  • 文章类型: Journal Article
    收缩是科学研究的重要结果,从无意的错误到故意的不当行为等各种因素造成的。以前对妇产科撤回出版物的评论已经确定了“文章重复,\"\"剽窃,\"和\"捏造的结果\"作为撤回的主要原因。然而,关于医学辅助生殖(MAR)文献中撤回文章的范围尚不清楚.本系统综述旨在评估MAR领域撤回文章的数量和特征。
    本研究遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。从1993年到2023年2月,在PubMed数据库上进行了全面的文献检索,仅限于英文文章,包括国际不育和生育护理词汇表中的所有283个术语。为了识别撤回的研究,使用了将词汇表中的283个术语与撤回相关关键字相结合的特定查询。仅包括针对MAR和涉及人类受试者的研究。
    电子搜索在不孕症和生育护理领域总共产生了523,067条记录。其中,共有2,458条记录被确认为收回。引文回撤率为0.47%(2,458/523,067;95CI0.45-0.49),随机对照试验(RCT)的引文撤回率为0.20%(93/45,616;95CI0.16~0.25).总共确定了39篇与MAR特别相关的撤回文章。其中,RCT占41.0%(n=16),15.4%是评论(n=6),10.3%为回顾性研究(n=4)或前瞻性研究(n=4).大多数撤回发生在发布后不久,“抄袭”是撤回的最常见原因,后跟“重复发布”。\"
    在不孕症和生育护理领域存在撤回问题,包括3月。我们的研究结果表明,科学不端行为,特别是抄袭和重复出版,是MAR中收缩的主要原因。尽管发现撤回引文的比例很低,促进科学诚信应该是一个优先事项。文章撤回的后果对患者护理和科学界具有重大影响。因此,至关重要的是,在出版前优先对手稿进行彻底的筛选,以保持研究的完整性。
    https://www.crd.约克。AC.uk/prospro/display_record.php?RecordID=185769,PROSPERO,标识符:CRD42020185769。
    Retraction is a significant consequence of scientific research, resulting from various factors ranging from unintentional errors to intentional misconduct. Previous reviews on retracted publications in obstetrics and gynecology have identified \"article duplication,\" \"plagiarism,\" and \"fabricated results\" as the main reasons for retraction. However, the extent of retracted articles in the literature on medically assisted reproduction (MAR) remains unclear. This systematic review aimed to assess the number and characteristics of retracted articles in the field of MAR.
    The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this study. A comprehensive literature search was conducted on the PubMed database from 1993 to February 2023, limited to English articles and including all 283 terms from the International Glossary on Infertility and Fertility Care. To identify retracted studies, a specific query combining the 283 terms from the glossary with a retraction-related keyword was used. Only studies focused on MAR and involving human subjects were included.
    The electronic search yielded a total of 523,067 records in the field of infertility and fertility care. Among these, a total of 2,458 records were identified as retracted. The citation retraction rate was found to be 0.47% (2,458/523,067; 95%CI 0.45-0.49), and the citation retraction rate for randomized controlled trials (RCTs) was 0.20% (93/45,616; 95%CI 0.16-0.25). A total of 39 retracted articles specifically related to MAR were identified. Among these, 41.0% were RCTs (n = 16), 15.4% were reviews (n = 6), and 10.3% were retrospective studies (n = 4) or prospective studies (n = 4). Most of the retractions occurred shortly after publication, with \"plagiarism\" being the most common reason for retraction, followed by \"duplicate publication.\"
    The issue of retraction exists within the field of infertility and fertility care, including MAR. Our findings indicate that scientific misconduct, particularly plagiarism and duplicate publication, are the primary causes of retraction in MAR. Despite finding that the proportion of retracted citations is low, promoting scientific integrity should be a priority. The consequences of article retractions have significant implications for patient care and the scientific community. Hence, it is crucial to prioritize thorough screening of manuscripts before publication to maintain research integrity.
    https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=185769, PROSPERO, identifier: CRD42020185769.
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  • 文章类型: Journal Article
    一对夫妇在第一次不孕症预约时的主要目的是尽快得到一个健康的婴儿。从诊断和决定辅助生殖技术(ART)和控制性卵巢刺激,选择移植哪个胚胎,专门的医生和胚胎学家团队竭尽全力缩短怀孕和活产的时间。因此,时间似乎是辅助生殖的核心,我们可以方便地使用它作为治疗效率的衡量标准。我们如何衡量活产的时间?我们需要考虑什么时间表来评估效率?在本文中,我们将讨论“时间”作为衡量ART成功的基本参数的重要性。
    The major purpose of a couple at the first infertility appointment is to get a healthy baby as soon as possible. From diagnosis and decision on which assisted reproduction technique (ART) and controlled ovarian stimulation, to the selection of which embryo to transfer, the dedicated team of physicians and embryologists puts all efforts to shorten the time to pregnancy and live birth. Time seems thus central in assisted reproduction, and we can conveniently use it as a measure of treatment efficiency. How can we measure time to live birth? What timelines do we need to consider to evaluate efficiency? In this paper, we will discuss the importance of \"Time\" as a fundamental parameter for measuring ART success.
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  • 文章类型: Journal Article
    背景:2019年冠状病毒病(COVID-19)大流行正在影响患者的心理和情绪健康,家庭成员,和医护人员。隔离病房的病人可能因长期住院而出现心理问题,流行病的发展,以及无法与家人见面。医疗辅助机器人(MAR)作为沟通的中介,可以用来解决精神压力。
    目标:CareDo,具有远程呈现和远程操作功能的MAR,是在这项工作中为远程医疗保健开发的。这项研究旨在调查其在大流行期间在隔离病房的实际表现。
    方法:将两个系统集成到CareDo机器人中。对于远程呈现系统,网络实时通信解决方案用于多用户聊天系统,卷积神经网络用于表情识别。对于远程操作系统,增量运动映射方法用于远程操作机器人。这项研究最终在第一附属医院进行,浙江大学临床试验。
    结果:在第一附属医院的临床试验中,浙江大学,任务,如视频聊天,情绪检测,医疗用品的运送是通过这个机器人进行的。设置了七个语音命令以执行系统唤醒,视频聊天,系统退出。公共命令的统计持续时间从1秒到3秒被设置以改进语音命令检测。在一天内记录患者的面部表情152次,以进行心理干预。快乐表情和中性表情的识别准确率分别达到95%和92.8%。
    结论:在COVID-19大流行期间,患者和医护人员可以在隔离病房使用该MAR进行远程医疗。它可以是打破病毒传播链的有用方法,也是远程心理干预的有效途径。
    BACKGROUND: The COVID-19 pandemic is affecting the mental and emotional well-being of patients, family members, and health care workers. Patients in the isolation ward may have psychological problems due to long-term hospitalization, the development of the epidemic, and the inability to see their families. A medical assistive robot (MAR), acting as an intermediary of communication, can be deployed to address these mental pressures.
    OBJECTIVE: CareDo, a MAR with telepresence and teleoperation functions, was developed in this work for remote health care. The aim of this study was to investigate its practical performance in the isolation ward during the pandemic.
    METHODS: Two systems were integrated into the CareDo robot. For the telepresence system, a web real-time communications solution is used for the multiuser chat system and a convolutional neural network is used for expression recognition. For the teleoperation system, an incremental motion mapping method is used for operating the robot remotely. A clinical trial of this system was conducted at First Affiliated Hospital, Zhejiang University.
    RESULTS: During the clinical trials, tasks such as video chatting, emotion detection, and medical supplies delivery were performed via the CareDo robot. Seven voice commands were set for performing system wakeup, video chatting, and system exiting. Durations from 1 to 3 seconds of common commands were set to improve voice command detection. The facial expression was recorded 152 times for a patient in 1 day for the psychological intervention. The recognition accuracy reached 95% and 92.8% for happy and neutral expressions, respectively.
    CONCLUSIONS: Patients and health care workers can use this MAR in the isolation ward for telehealth care during the COVID-19 pandemic. This can be a useful approach to break the chains of virus transmission and can also be an effective way to conduct remote psychological intervention.
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  • 文章类型: Journal Article
    在估计多变量模型时,可忽略似然(IL)方法通常用于处理缺失数据,比如结构方程模型。在这种情况下,可能性是基于所有可用的数据,并且没有为缺少的数据机制指定模型。推理通过最大似然或贝叶斯方法进行,包括没有辅助变量的多个插补。这种IL方法在随机缺失(MAR)假设下是有效的。Rabe-Hesketh和Skrondal(忽略不可忽视的痛苦。在心理测量学会国际会议上的总统讲话,北京,中国,2015;Psychometrika,2023)考虑MAR的违反,其中变量A可以影响另一个变量B的错误,当A未被观察到时。他们表明,这种情况可以通过在进行IL方法之前丢弃更多数据来处理。这种数据删除方法类似于Mohan等人的顺序估计。(in:神经信息处理系统的进展,2013)基于他们的有序因式分解定理,但更适合参数模型。采用哪种类型的数据删除或有序因式分解取决于MAR违规的性质。在这篇文章中,因此,我们提出了两种诊断测试,异方差回归模型的似然比检验和核条件独立性检验。我们还开发了一种基于测试的估计器,该估计器首先使用诊断测试来确定似乎存在哪些MAR违规,然后进行相应的数据删除估计器。仿真表明,当缺失数据问题严重时,基于测试的估计器的性能优于IL,否则执行类似。
    Ignorable likelihood (IL) approaches are often used to handle missing data when estimating a multivariate model, such as a structural equation model. In this case, the likelihood is based on all available data, and no model is specified for the missing data mechanism. Inference proceeds via maximum likelihood or Bayesian methods, including multiple imputation without auxiliary variables. Such IL approaches are valid under a missing at random (MAR) assumption. Rabe-Hesketh and Skrondal (Ignoring non-ignorable missingness. Presidential Address at the International Meeting of the Psychometric Society, Beijing, China, 2015; Psychometrika, 2023) consider a violation of MAR where a variable A can affect missingness of another variable B also when A is not observed. They show that this case can be handled by discarding more data before proceeding with IL approaches. This data-deletion approach is similar to the sequential estimation of Mohan et al. (in: Advances in neural information processing systems, 2013) based on their ordered factorization theorem but is preferable for parametric models. Which kind of data-deletion or ordered factorization to employ depends on the nature of the MAR violation. In this article, we therefore propose two diagnostic tests, a likelihood-ratio test for a heteroscedastic regression model and a kernel conditional independence test. We also develop a test-based estimator that first uses diagnostic tests to determine which MAR violation appears to be present and then proceeds with the corresponding data-deletion estimator. Simulations show that the test-based estimator outperforms IL when the missing data problem is severe and performs similarly otherwise.
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  • 文章类型: Journal Article
    在这篇文章中,年龄深度建模数据的数据集,介绍了喀尔巴厘盆地四个黄土-古土壤序列的沉积速率和尘埃质量积累速率(MAR)。该数据集与“伊里格黄土-古土壤序列的最后两个冰川-间冰期循环中尘埃质量积累速率的详细发光年代”一文有关,喀尔巴厘盆地\“,发表在Perić等人的《全球与行星变化》杂志上。[1].在数据集中,来自黄土遗址Irig的发光年龄,Nosak,使用r.bacon软件对StariSlankamen和Crvenka进行建模,然后计算粉尘质量累积率。对于更真实的表示,随后使用SigmaPlot软件平滑MAR。对于所有网站,minimum,最大值,计算并给出了建模年龄和累积率的中值和平均值。
    In this article, a dataset of age-depth modelling data, sedimentation rates and dust mass accumulation rates (MAR) from four loess-palaeosol sequences from the Carpathian Basin is presented. The dataset is related to the article \"Detailed luminescence dating of dust mass accumulation rates over the last two glacial-interglacial cycles from the Irig loess-palaeosol sequence, Carpathian Basin\", published in the journal Global and Planetary Change by Perić et al. [1]. In the dataset, luminescence ages from the loess sites Irig, Nosak, Stari Slankamen and Crvenka were modeled using the r.bacon software after which the dust mass accumulation rates were calculated. For a more realistic representation the MARs were subsequently smoothed using the SigmaPlot software. For all sites, minimum, maximum, median and mean values for the modelled ages and accumulation rates are calculated and presented.
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