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Fertility and Sterility Jul 2023To date, recurrent implantation failure (RIF) has no clear definition and no clearly identified impaired function. Hence, the term RIF is currently used somewhat... (Review)
Review
IMPORTANCE
To date, recurrent implantation failure (RIF) has no clear definition and no clearly identified impaired function. Hence, the term RIF is currently used somewhat haphazardly, on the basis of clinicians' judgment.
OBJECTIVE
International experts in reproductive medicine met on July 1, 2022, in Lugano, Switzerland, to review the different facets of RIF and define the diagnosis and its appropriate management.
EVIDENCE REVIEW
A systematic review without meta-analysis of studies published in English from January 2015 to May 2022.
FINDINGS
Data indicated that RIF has been largely overevaluated, overdiagnosed, and overtreated without sufficient critical assessment of its true nature. Our analyses show that true RIF is extremely uncommon-occurring in <5% of couples with infertility-and that reassurance and continued conventional therapies are warranted in most cases of assisted reproductive technology (ART) failure. Although the true biologic determinants of RIF may exist in a small subset of people with infertility, they elude the currently available tools for assessment. Without identification of the true underlying etiology(ies), it is reasonable not to assign this diagnosis to a patient until she has failed at least 3 euploid blastocyst transfers (or the equivalent number of unscreened embryo transfers, adjusted to the patient's age and corresponding euploidy rate). In addition, other factors should be ruled out that may contribute to her reduced odds of sustained implantation. In such cases, implantation failure should not be the only issue considered in case of ART failure because this may result from multiple other factors that are not necessarily repetitive or persistent. In reality, RIF impacting the probability of further ART success is a very rare occurrence.
CONCLUSION
True RIF is extremely uncommon, occurring in <5% of couples with infertility. Reassurance and continued conventional therapies are warranted in most cases. It would seem reasonable not to assign this diagnosis to a patient until she has failed at least 3 euploid embryo transfers (or the equivalent number of unscreened embryos, adjusted to her age).
RELEVANCE
Given the number of internationally recognized experts in the field present at the Lugano meeting 2022, our publication constitutes a consensus statement.
Topics: Humans; Female; Embryo Implantation; Embryo Transfer; Infertility; Reproductive Techniques, Assisted; Aneuploidy; Retrospective Studies
PubMed: 36822566
DOI: 10.1016/j.fertnstert.2023.02.014 -
EBioMedicine Sep 2023Patients diagnosed with environmental/occupational bronchiolitis obliterans (BO) over the last 2 decades often present with an indolent evolution of respiratory symptoms... (Review)
Review
Patients diagnosed with environmental/occupational bronchiolitis obliterans (BO) over the last 2 decades often present with an indolent evolution of respiratory symptoms without a history of high-level, acute exposure to airborne toxins. Exertional dyspnea is the most common symptom and standard clinical and radiographic evaluation can be non-diagnostic. Lung biopsies often reveal pathological abnormalities affecting all distal lung compartments. These modern cases of BO typically exhibit the constrictive bronchiolitis phenotype of small airway remodeling, along with lymphocytic inflammation. In addition, hypertensive-type remodeling of intrapulmonary vasculature, diffuse fibroelastosis of alveolar tissue, and fibrous thickening of visceral pleura are frequently present. The diagnosis of environmental/occupational BO should be considered in patients who present with subacute onset of exertional dyspnea and a history compatible with prolonged or recurrent exposure to environmental toxins. Important areas for future studies include development of less invasive diagnostic approaches and testing of novel agents for disease prevention and treatment.
Topics: Humans; Bronchiolitis Obliterans; Biopsy; Dyspnea; Phenotype
PubMed: 37598462
DOI: 10.1016/j.ebiom.2023.104760 -
RSC Advances Nov 2023Recently, there has been a significant increase in academic and industrial interest in self-healing polymers (SHPs) due to their remarkable ability to regenerate... (Review)
Review
Recently, there has been a significant increase in academic and industrial interest in self-healing polymers (SHPs) due to their remarkable ability to regenerate scratched surfaces and materials of astronomical significance. Scientists have been inspired by the magical repairing mechanism of the living world. They transformed the fiction of self-healing into reality by designing engrossing polymeric materials that could self-repair mechanical abrasions repeatedly. As a result, the durability of the materials is remarkably improved. Thus, the idea of studying SHPs passively upholds economic and environmental sustainability. However, the critical areas of self-healing (including healing efficiency, healing mechanism, and thermo-mechanical property changes during healing) are under continuous scientific improvisation. This review highlights recent notable advances of SHPs for application in regenerating scratched surfaces with various distinctive underlying mechanisms. The primary focus of the work is aimed at discussing the impact of SHPs on scratch-healing technology. Beyond that, insights regarding scratch testing, methods of investigating polymer surfaces, wound depths, the addition of healing fillers, and the environmental conditions maintained during the healing process are reviewed thoroughly. Finally, broader future perspectives on the challenges and prospects of SHPs in healing surface scratches are discussed.
PubMed: 38046629
DOI: 10.1039/d3ra06676b -
Nature Communications Nov 2023Introspective agents can recognize the extent to which their internal perceptual experiences deviate from the actual states of the external world. This ability, also...
Introspective agents can recognize the extent to which their internal perceptual experiences deviate from the actual states of the external world. This ability, also known as insight, is critically required for reality testing and is impaired in psychosis, yet little is known about its cognitive underpinnings. We develop a Bayesian modeling framework and a psychophysics paradigm to quantitatively characterize this type of insight while people experience a motion after-effect illusion. People can incorporate knowledge about the illusion into their decisions when judging the actual direction of a motion stimulus, compensating for the illusion (and often overcompensating). Furthermore, confidence, reaction-time, and pupil-dilation data all show signatures consistent with inferential adjustments in the Bayesian insight model. Our results suggest that people can question the veracity of what they see by making insightful inferences that incorporate introspective knowledge about internal distortions.
Topics: Humans; Perceptual Distortion; Illusions; Bayes Theorem; Psychophysics; Psychotic Disorders; Motion Perception
PubMed: 38030601
DOI: 10.1038/s41467-023-42813-2 -
Biotechnology Advances 2024The bioprocessing industry is undergoing a significant transformation in its approach to quality assurance, shifting from the traditional Quality by Testing (QbT) to... (Review)
Review
The bioprocessing industry is undergoing a significant transformation in its approach to quality assurance, shifting from the traditional Quality by Testing (QbT) to Quality by Design (QbD). QbD, a systematic approach to quality in process development, integrates quality into process design and control, guided by regulatory frameworks. This paradigm shift enables increased operational efficiencies, reduced market time, and ensures product consistency. The implementation of QbD is framed around key elements such as defining the Quality Target Product Profile (QTPPs), identifying Critical Quality Attributes (CQAs), developing Design Spaces (DS), establishing Control Strategies (CS), and maintaining continual improvement. The present critical analysis delves into the intricacies of each element, emphasizing their role in ensuring consistent product quality and regulatory compliance. The integration of Industry 4.0 and 5.0 technologies, including Artificial Intelligence (AI), Machine Learning (ML), Internet of Things (IoT), and Digital Twins (DTs), is significantly transforming the bioprocessing industry. These innovations enable real-time data analysis, predictive modelling, and process optimization, which are crucial elements in QbD implementation. Among these, the concept of DTs is notable for its ability to facilitate bi-directional data communication and enable real-time adjustments and therefore optimize processes. DTs, however, face implementation challenges such as system integration, data security, and hardware-software compatibility. These challenges are being addressed through advancements in AI, Virtual Reality/ Augmented Reality (VR/AR), and improved communication technologies. Central to the functioning of DTs is the development and application of various models of differing types - mechanistic, empirical, and hybrid. These models serve as the intellectual backbone of DTs, providing a framework for interpreting and predicting the behaviour of their physical counterparts. The choice and development of these models are vital for the accuracy and efficacy of DTs, enabling them to mirror and predict the real-time dynamics of bioprocessing systems. Complementing these models, advancements in data collection technologies, such as free-floating wireless sensors and spectroscopic sensors, enhance the monitoring and control capabilities of DTs, providing a more comprehensive and nuanced understanding of the bioprocessing environment. This review offers a critical analysis of the prevailing trends in model-based bioprocessing development within the sector.
Topics: Biotechnology; Machine Learning; Quality Control; Artificial Intelligence; Internet of Things
PubMed: 38754797
DOI: 10.1016/j.biotechadv.2024.108378 -
Proceedings of the National Academy of... Oct 2023Houston TX experienced a widely known failure of its police forensic laboratory. This gave rise to the Houston Forensic Science Center (HFSC) as a separate entity to...
Houston TX experienced a widely known failure of its police forensic laboratory. This gave rise to the Houston Forensic Science Center (HFSC) as a separate entity to provide forensic services to the City of Houston. HFSC is a very large forensic laboratory and has made significant progress at remediating the past failures and improving public trust in forensic testing. HFSC has a large and robust blind testing program, which has provided many insights into the challenges forensic laboratories face. HFSC's journey from a notoriously failed lab to a model also gives perspective to the resource challenges faced by all labs in the country. Challenges for labs include the pervasive reality of poor-quality evidence. Also that forensic laboratories are necessarily part of a much wider system of interdependent functions in criminal justice making blind testing something in which all parts have a role. This interconnectedness also highlights the need for an array of oversight and regulatory frameworks to function properly. The major essential databases in forensics need to be a part of blind testing programs and work is needed to ensure that the results from these databases are indeed producing correct results and those results are being correctly used. Last, laboratory reports of "inconclusive" results are a significant challenge for laboratories and the system to better understand when these results are appropriate, necessary and most importantly correctly used by the rest of the system.
Topics: Humans; Crime; Forensic Medicine; Forensic Sciences; Police; Criminal Law
PubMed: 37782808
DOI: 10.1073/pnas.2303592120 -
Journal of Thoracic Oncology : Official... Sep 2023Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely... (Review)
Review
Considering the established contribution of environmental factors to the development of thoracic malignancies, the inherited susceptibility of these tumors has rarely been explored. However, the recent introduction of next-generation sequencing-based tumor molecular profiling in the real-word setting enabled us to deeply characterize the genomic background of patients with lung cancer with or without smoking-related history, increasing the likelihood of detecting germline mutations with potential prevention and treatment implications. Pathogenic germline variants have been detected in 2% to 3% of patients with NSCLC undergoing next-generation sequencing analysis, whereas the proportion of germline mutations associated with the development of pleural mesothelioma widely varies across different studies, ranging between 5% and 10%. This review provides an updated summary of emerging evidence about germline mutations in thoracic malignancies, focusing on pathogenetic mechanisms, clinical features, therapeutic implications, and screening recommendations for high-risk individuals.
Topics: Humans; Germ-Line Mutation; Lung Neoplasms; Mesothelioma, Malignant; Mesothelioma; Carcinoma, Non-Small-Cell Lung; Genetic Predisposition to Disease
PubMed: 37331604
DOI: 10.1016/j.jtho.2023.05.028 -
Micromachines Jun 2023Sustainable and safe food is an important issue worldwide, and it depends on cost-effective analysis tools with good sensitivity and reality. However, traditional... (Review)
Review
Sustainable and safe food is an important issue worldwide, and it depends on cost-effective analysis tools with good sensitivity and reality. However, traditional standard chemical methods of food safety detection, such as high-performance liquid chromatography (HPLC), gas chromatography (GC), and tandem mass spectrometry (MS), have the disadvantages of high cost and long testing time. Those disadvantages have prevented people from obtaining sufficient risk information to confirm the safety of their products. In addition, food safety testing, such as the bioassay method, often results in false positives or false negatives due to little rigor preprocessing of samples. So far, food safety analysis currently relies on the enzyme-linked immunosorbent assay (ELISA), polymerase chain reaction (PCR), HPLC, GC, UV-visible spectrophotometry, and MS, all of which require significant time to train qualified food safety testing laboratory operators. These factors have hindered the development of rapid food safety monitoring systems, especially in remote areas or areas with a relative lack of testing resources. Surface-enhanced Raman spectroscopy (SERS) has emerged as one of the tools of choice for food safety testing that can overcome these dilemmas over the past decades. SERS offers advantages over chromatographic mass spectrometry analysis due to its portability, non-destructive nature, and lower cost implications. However, as it currently stands, Raman spectroscopy is a supplemental tool in chemical analysis, reinforcing and enhancing the completeness and coverage of the food safety analysis system. SERS combines portability with non-destructive and cheaper detection costs to gain an advantage over chromatographic mass spectrometry analysis. SERS has encountered many challenges in moving toward regulatory applications in food safety, such as quantitative accuracy, poor reproducibility, and instability of large molecule detection. As a result, the reality of SERS, as a screening tool for regulatory announcements worldwide, is still uncommon. In this review article, we have compiled the current designs and fabrications of SERS substrates for food safety detection to unify all the requirements and the opportunities to overcome these challenges. This review is expected to improve the interest in the sensing field of SERS and facilitate the SERS applications in food safety detection in the future.
PubMed: 37512654
DOI: 10.3390/mi14071343 -
Frontiers in Digital Health 2024This umbrella review aims to ascertain the extent to which immersive Virtual Reality (VR) and Augmented Reality (AR) technologies improve specific competencies in...
OBJECTIVE
This umbrella review aims to ascertain the extent to which immersive Virtual Reality (VR) and Augmented Reality (AR) technologies improve specific competencies in healthcare professionals within medical education and training, in contrast to traditional educational methods or no intervention.
METHODS
Adhering to PRISMA guidelines and the PICOS approach, a systematic literature search was conducted across major databases to identify studies examining the use of VR and AR in medical education. Eligible studies were screened and categorized based on the PICOS criteria. Descriptive statistics and chi-square tests were employed to analyze the data, supplemented by the Fisher test for small sample sizes or specific conditions.
ANALYSIS
The analysis involved cross-tabulating the stages of work (Development and Testing, Results, Evaluated) and variables of interest (Performance, Engagement, Performance and Engagement, Effectiveness, no evaluated) against the types of technologies used. Chi-square tests assessed the associations between these categorical variables.
RESULTS
A total of 28 studies were included, with the majority reporting increased or positive effects from the use of immersive technologies. VR was the most frequently studied technology, particularly in the "Performance" and "Results" stages. The chi-square analysis, with a Pearson value close to significance ( = 0.052), suggested a non-significant trend toward the association of VR with improved outcomes.
CONCLUSIONS
The results indicate that VR is a prevalent tool in the research landscape of medical education technologies, with a positive trend toward enhancing educational outcomes. However, the statistical analysis did not reveal a significant association, suggesting the need for further research with larger sample sizes. This review underscores the potential of immersive technologies to enhance medical training yet calls for more rigorous studies to establish definitive evidence of their efficacy.
PubMed: 38550715
DOI: 10.3389/fdgth.2024.1365345