[Determinants of pregnancy rate in the donor oocyte model: a multivariate analysis of frozen-thawed embryo transfers]

Objective: To determine independent factors of pregnancy in the recipient after frozen-thawed embryo transfer (FTET). Methods: We performed a retrospective study of 431 patients who had undergone embryo transfer after oocyte donation (OD), in vitro fertilization and embryo cryopreservation between April 2009 and December 2018 at our Reproductive Center. Comparison of general data between clinical pregnant group and non-pregnant group; Logistic regression were used to identify independent factors of pregnancy. The ability of independent factors of pregnancy was assessed by receiver operating characteristics (ROC). Results: ①Pregnancy rates were significantly higher in women with more embryos, more high-quality embryos, more transferred embryos and higher basalfollicular stimulation hormone(FSH) (P<0.05). Pregnancy rate of premature ovarian insufficiency (POI) (75.00%) was higher than advanced age (55.83%,P=0.005) and chromosome abnormality (56.86%,P=0.021). ②Using logistic regression analysis, the POI (OR=2.065, 95%CI=1.026-4.156), basal FSH(OR=1.499, 95%CI=1.072-1.959), high-quality embryos (OR=1.449, 95%CI=1.072-1.959) and transferred embryos (OR=2.583, 95%CI=1.519-4.391)were independent predictors of pregnancy (P<0.05). ③The ROC curves revealed the cut-off points of basal FSH was 19.28U/L for pregnancy, the areas under the curve of basal FSH was 0.627, 95%CI=0.572-0.680. According basal FSH and age, all patients were further divided into four groups, pregnancy rates were significantly higher in ≤40 years and FSH>19U/L group (P<0.05). We contain pregnancy rates and multiple pregnancy rates of two transferred embryos were higher than one (P<0.01). Conclusions: This study supports that pregnancy rates of POI was higher than other infertility diagnosis needed OD. Pregnancy rates of two transferred embryos were higher than one, but multiple pregnancy rates was also higher than one.

Genotyping and pathogenic characterization of canine distemper virus based on mutations in the hemagglutinin gene in Chinese domestic dogs

Canine distemper virus (CDV) infects wild and domestic Canidae worldwide. The hemag- glutinin (H) gene has the highest genetic variation in the genome of this virus. Thus, the H gene is commonly used for lineage identification and genetic analyses. In order to study the genetic characteristics and pathogenicity of CDV strains prevalent in China, 132 samples were collected from domestic dogs with suspected CDV infection, 58 samples were confirmed to be positive, and the H gene was successfully amplified from 15 samples. The epidemic strain was identified as type Asia-1 and the novel mutations, A51T, V58I, R179K and D262N, were detected in this strain. Isolated strains, BJ16B53, BJ16B14, and BJ17B8, were used for an animal infection experiment in raccoon dogs. BJ16B53 and BJ16B14 were found to cause clinical symptoms, death, and exten- sive lesions in various organs. These results are expected to facilitate the development of effective strategies to monitor and control CDV infection in China.

Smart identification of psoriasis by images using convolutional neural networks: a case study in China

BACKGROUND

Psoriasis is a chronic inflammatory skin disease, which holds a high incidence in China. However, professional dermatologists who can diagnose psoriasis early and correctly are insufficient in China, especially in the rural areas. A smart approach to identify psoriasis by pictures would be highly adaptable countrywide and could play a useful role in early diagnosis and regular treatment of psoriasis.

OBJECTIVES

Design and evaluation of a smart psoriasis identification system based on clinical images (without relying on a dermatoscope) that works effectively similar to a dermatologist.

METHODS

A set of deep learning models using convolutional neural networks (CNNs) was explored and compared in the system for automatic identification of psoriasis. The work was carried out on a standardized dermatological dataset with 8021 clinical images of 9 common disorders including psoriasis along with full electronic medical records of patients built over the last 9 years in China. A two-stage deep neural network was designed and developed to identify psoriasis. In the first stage, a multilabel classifier was trained to learn the visual patterns for each individual skin disease. In the second stage, the output of the first stage was utilized to distinguish psoriasis from other skin diseases.

RESULTS

The area under the curve (AUC) of the two-stage model reached 0.981 ± 0.015, which outperforms a single-stage model. And, the classifier showed superior performance (missed diagnosis rate: 0.03, misdiagnosis rate: 0.04) than 25 Chinese dermatologists (missed diagnosis rate: 0.19, misdiagnosis rate: 0.10) in the diagnosis of psoriasis on 100 clinical images.

CONCLUSIONS

Using clinical images to identify psoriasis is feasible and effective based on CNNs, which also builds a solid technical base for smart care of skin diseases especially psoriasis using mobile/tablet applications for teledermatology in China.

P1499Data-driven clustering unveils the adaptive remodeling of athlete heart: an echocardiographic study from 2017 Taipei summer universiade

Background

Sport-specific adaptations of the athlete's heart are still under investigation. This study sought to provide a proof-of-concept for hierarchical clustering of echocardiography-derived parameters in unfolding the adaptations and to make a comparison between hypothesis-driven and data-driven approaches for characterizing the athlete's heart.

Methods

Anthropometric, echocardiographic and electrocardiographic assessments were collected during the peri-participation cardiovascular examination of 2017 Summer Universiade. Besides standard echocardiography and strain measurements, ventricular-arterial coupling was assessed by the ratio of effective arterial elastance (Ea) to left ventricular end-systolic elastance (Ees), using a modified single-beat algorithm to calculate Ees.

Results

A total of 598 elite athletes (348 male, mean age 23±2.5 years) engaged 24 disciplines were grouped by Mitchell's classification. The hypothesis-driven approach showed significant differences in heart rate, ventricular size, and stroke volume when classified by dynamic levels. Adaptations of ventricular function were not found. Contrarily, the data-driven approach not only hierarchically clustered athletes with more manifest morphologic remodeling, more proportions playing high dynamic sports but also showed a functional propensity of lower Ea and Ees, supranormal diastolic function and preserved ventricular-arterial coupling with ample pumping reserve.

Phenotype heatmaps of athletes

Conclusions

The hierarchical clustering can analyze numerous echocardiography-derived phenotypes pertaining to an individual athlete as well as discern an adaptive propensity of the athlete's heart to be the resting status of a reservoir-rich pump. This pilot demonstration of the data-driven approach in figuring out integrated physiologic adaptations with remodeling-relevant geometry and function leads to a fundamentally improved understanding of the athlete's heart and then will be applicable to various domains.

Successful implementation of bedaquiline for multidrug-resistant TB treatment in remote Papua New Guinea

SETTING

Bedaquiline (BDQ) was introduced in the multi-drug-resistant tuberculosis (MDR-TB) programme in Daru in remote Papua New Guinea in 2015, along with a core package of active drug-safety monitoring (aDSM).

OBJECTIVE

To assess interim results and safety of BDQ for the treatment of MDR-TB from 1 July 2015 to 31 December 2017.

DESIGN

A retrospective cohort analysis of routine programme data.

RESULTS

Of 277 MDR-TB patients, 77 (39%) received BDQ with a total of 8 serious adverse events including 5 (6.5%) deaths, of which 1 (1.3% QTcF prolongation, grade 3) was attributable to BDQ. Of 200 (61%) patients who did not receive BDQ, there were 17 (9%) deaths. Completeness of monitoring for the BDQ group was 90% for >5 electrocardiograms and 79% for ⩾2 cultures. In the interim result indicator analysis at month 6 in the BDQ and non-BDQ groups, there were respectively 0% and 1% lost to follow-up; 6.5% and 8.5% who died; 94% and 91% in care; and 92% and 96% with negative culture among those monitored.

CONCLUSION

Early experience in Daru shows BDQ is safe and feasible to implement with aDSM with good interim effectiveness supporting the rapid adoption and scale-up of the 2019 WHO MDR-TB treatment guidelines in the programme and in similar remote settings.

[Association between elective cesarean delivery and duration of breastfeeding in Ma'anshan City from 2013 to 2014]

Objective: To analyze the correlation between elective cesarean delivery and duration of breastfeeding in Ma'anshan city from 2013 to 2014. Methods: From May 2013 to September 2014, a total of 3 474 pregnant women with the first prenatal checkup were recruited from Ma'anshan maternal and child health care hospital. Finally, 3 109 pregnant women were included after exclusion of those with terminated pregnancies, adverse birth outcomes, twin or multiple pregnancies, breech traction, breech midwifery and loss of delivery information. Demographic data of pregnant women, mode of delivery and breast feeding of children were collected through questionnaires and hospital records. Logistic regression model was used to analyze the relationship between elective cesarean delivery and duration of breastfeeding in children, with the mode of delivery as independent variable and the duration of breastfeeding as dependent variable. Results: The age of 3 109 subjects was (26.6±3.6) years old, the rate of vaginal delivery was 51.1% (1 589), and the rate of elective cesarean delivery was 46.4% (1 443), among which the rate of non-indicative elective cesarean delivery was 26.4% (820), the rate of indicative elective cesarean delivery was 20.0% (623), and the rate of emergency cesarean delivery was 2.5% (77). The proportion of breastfeeding lasting until 4, 12 and 18 months was 45.0% (1 348/2 998), 23.7% (702/2 962) and 5.2% (154/2 944), respectively. After adjusting the confounding factors, compared with vaginal delivery, the OR (95%CI) values of breastfeeding for 4 months in indicative elective cesarean delivery and non-indicative elective cesarean delivery women were 0.870(0.714-1.059), 0.795(0.665-0.949), and the OR (95%CI) values of breastfeeding for 12 months were 0.772(0.611-0.975), 0.755(0.610-0.934), respectively. Conclusion: Elective cesarean delivery may result in shorter duration of breastfeeding in children.

[Placental microbiota and pregnancy]

The role of microbes in regulating the metabolism and immune function of the body has been highlighted. The interactions of host-microbe and microbial-microbe have existed before the birth. However, the existence of placental microbiota and their regulatory effects on pregnancy are still controversial. It was found that placental microbes might be implanted into the placenta via urogenital-placental, gastrointestinal-placental, and oral-placental routes. Microbiome may play a role in promoting the outcome of benign pregnancy, and the placental microbiota in pathological pregnancy may be associated to adverse pregnancy outcome. Placenta and amniotic fluid microbes have been linked to abortion, chorioamnionitis, premature rupture of membranes, premature delivery and stillbirth in Cultivation-dependent and Cultivation-independent studies. Obesity, gestational diabetes mellitus, probiotics and antibiotics during pregnancy may be the main factors affecting placenta microbiology.

[Cumulative risk assessment of phthalates exposure in preschool children]

Objective: The urine concentrations of phthalate metabolites were used to estimate the cumulative risk assessment in preschool children in Ma'anshan of Anhui province. Methods: Based on the China-Anhui Birth Cohort, the demographic information and urine samples of 3 743 children were collected in Ma'anshan from April 2014 to April 2015. The concentrations of 7 metabolites' [monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), mono (2-ethylhexyl) phthalate (MEHP), mono (2-ethyl- 5-oxohexyl) phthalate (MEOHP) and mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP)] of 5 phthalates [dimethyl phthalate (DMP), diethyl phthalate (DEP), dibutyl phthalate (DBP), butyl benzyl phthalate (BBzP), and di (2-ethylhexyl) phthalate (DEHP)] in the urine samples of the children were measured by solid-phase extration-triple quadrupole high performance liquid chromatography-tandem mass spectrometry-isotope method. In addition, the estimated daily intakes (EDIs) of 5 phthalates were calculated according to the metabolites' concentrations. Cumulative risk assessment was performed using hazard quotient (HQ) and hazard index (HI) methods. Results: The M (Q(R)) of seven metabolite concentrations were 29.58 (18.69-48.26), 26.65 (13.44-56.09), 256.86 (150.99-438.51), 0.12 (0.04-0.32), 6.27 (3.71-11.13), 17.94 (11.94-28.42) and 24.80 (16.05-40.32) μg/g creatinine, respectively. For the EDIs of 5 phthalates, DBP ranked first, followed by DEHP, DMP, DEP and BBzP with the M (Q(R)) of 7.54 (4.41-12.85), 3.35 (2.20-5.42), 0.75 (0.47-1.24), 0.71 (0.36-1.52) and 0.003 (0.001-0.009) μg/(kg·d), respectively. The HQ and HI varied with age, gender and sampling season, the differences were significant (P<0.05). Conclusions: These results indicated that risk of cumulative exposure to phthalates was high in preschool children aged 3-6 years in Ma'anshan. Age, gender and sampling season were influencing factors.

A novel cage for actinides: A 6W4Al43 (A = U and Pu)

We report on synthesis and characterization of the compounds A ₆W₄Al₄₃ (A  =  U and Pu), that form in the hexagonal Ho₆Mo₄Al₄₃ caged-structure family. The A ions reside within W/Al cages where the A-A nearest neighbors form dimers between adjacent W/Al cages, with U-U and Pu-Pu distances of 3.3892 [Formula: see text] and 3.4080 [Formula: see text], respectively. While the W/Al networks provide environments similar to those of other cage-like materials (e.g. filled skutterudites), the atomic displacement parameters from single crystal x-ray diffraction measurements show that the A-ions do not exhibit rattling behavior. We find that there is site interchange disorder on one of the W/Al sites. Magnetic susceptibility measurements show that U₆W₄Al₄₃ displays anisotropic Curie-Weiss behavior where it fits to the data yield an effective magnetic moment near 2.0 [Formula: see text]/U. At low temperatures the magnetic susceptibility deviates from the Curie-Weiss temperature dependence and eventually saturates to a constant value. In contrast, Pu₆W₄Al₄₃ displays nearly temperature independent Pauli paramagnetism for all temperatures, as would be expected if the 5f -electrons are delocalized. The electrical resistivity for U₆W₄Al₄₃ increases slightly with the decreasing temperature, suggesting that it is dominated by f -electronic hybridization effects and disorder scattering that originates from the W/Al site interchange. Specific heat measurements for U₆W₄Al₄₃ further reveal an enhanced electronic Sommerfeld coefficient that is consistent with a moderately enhanced charge carrier effective mass. Together these measurements expose these materials as hosts for unstable f -electron magnetism, where the novel cage-like structures control the phenomena through the spacing between the A ions. Through this combination of mild magnetism, the low cost elements of the Al-W cages, and chemical tunability that has been shown for related materials in the same structure, the A ₆W₄Al₄₃ compounds emerge as promising nuclear waste-forms for transuranics, while the wider family of materials makes an appealing environment for studying f -electron physics in a novel structure.

[The relationship of maternal and umbilical cord blood zinc level associated with newborn birth weight: a birth cohort study]

Objective: To study serum zinc level in pregnancy and umbilical cord blood and their association with newborn birth weight. Methods: Pregnant women accepting obstetric examination in Ma'anshan Maternal and Child Care Center were recruited from May 2013 to September 2014. The follow up was conducted during their first, second and third trimesters of pregnancy and the self-designed questionnaire was used to collect information of social and demographic characteristics. Blood samples in the first, second pregnancy period and umbilical cord blood samples were collected and serum concentrations of zinc were assayed. 3 239 mother-infant entered the final analysis. We divided serum zinc level into low (<P(25)), medium (P(25)-P(75)) and high (>P(75)) groups according to their exposure concentrations at each trimesters. Non-conditional multivariate logistic regression model was conducted to evaluate the association between serum zinc level in first, second trimesters of pregnancy and umbilical cord blood with small for gestational age (SGA) and large for gestational age (LGA). Results: Serum zinc level in P(50) (P(25)-P(75)) during the first, second trimesters and cord blood were 1 016.18 (907.09-1 145.60), 813.36 (732.47-897.89) and 903.44 (808.71-1 015.64) μg/L, respectively. The prevalence of zinc deficiency during the first, second trimesters and cord blood were 1.5% (44/2 957), 15.9% (492/3 087) and 6.5% (176/2 707), respectively. The prevalence of total SGA and LGA were 9.7% (313/3 239) and 16.5% (536/3 239), respectively. Compared to high-level serum zinc group, the risk of SGA (OR (95%CI) in low-level serum zinc group during first trimesters was 1.51 (1.05-2.19)). Serum zinc level among second pregnancy period and umbilical cord blood had no statistically significant effect on SGA and LGA (both P values >0.05). Conclusion: Zinc nutritional status of pregnant women in Ma'anshan city was at a good level. The low serum zinc level in first trimester increased the risk of SGA.

[The associations between nighttime sleep duration, bedtime and preschool children's obesity]

Objective: To examine the relationship of nighttime sleep duration and bedtime with preschool children's obesity, and to explore possible early life risk factors for childhood obesity. Methods: A total of 14 946 valid children from 16 439 pre-school children aged 3-6 years in 91 kindergartens in Ma'anshan city participated in the study. The body mass index cut-offs for overweight and obesity in Chinese children and adolescents aged 2-18 years was used as the criterion for judging overweight and obesity, and pathological and secondary causes of obesity were excluded. The associations of nighttime sleep duration and bedtime with preschool children's obesity was analyzed by using non-conditional multivariate binary logistic regression model. Results: Among the preschool children, 22.4% (n=3 345) had shorter sleep duration. 9.5% (n=1 415) had bedtimes after 22:00 on weekdays and 21.8% (n=3 260) had bedtimes after 22:00 on weekends. The prevalence of overweight and obesity were 16.5% (n=2 466) and 10.5% (n=1 562), respectively. After the adjustent of age, gender, whether or not only child, residence in the last six months, parents' body mass index parents' educational level, diet preference, outdoor activities, TV viewing duration, sleep duration, bedtime on weekdays and weekends, only the shorter sleep duration (OR=1.25, 95%CI: 1.03-1.51) was still positively associated with the prevalence of obesity in preschool children. Conclusion: Shorter sleep duration was positively associated with the prevalence of obesity among preschool children.

[Effect of breastfeeding on the behavioral development of infants and children: a birth cohort study in Ma'anshan]

Objective: To discuss the relationship between breastfeeding and the behavioral development of infants and children. Methods: Based on the Ma'anshan Birth Cohort Study, there were 3 474 pregnant women recruited from Ma'anshan Maternal and Child Care Center between May 2013 and September 2014, including 3 273 singleton live births. Follow up the infants to the age of 18 months old. Excluded the infants with incomplete information of breastfeeding and who did not finish the ASQ-3 evaluation in 6 months old and 18 months old, 2 404 valid subjects were included in the study. The information of demographic characteristics, deliver, infants and breastfeeding was collected. The behavioral development were evaluated by the third edition of Ages and Stages Questionnaire (ASQ-3) at 6 months old and 18 months old, and the effect of breastfeeding on behavioral development among infants and children were analyzed by multivariable logistic regression model. Results: The intensity of breastfeeding of infants within 6 months old was (26.56±10.56). The rate of breastfeeding as pure or major intake for infants between 0-5 months old were separately 54.2% (1 303), 54.0% (1 298). 54.0% (1 297), 50.5% (1 213), 34.4% (827) and 9.9% (237). After age, pre-pregnant BMI, intelligence, delivery mode, gender, gestational age, birth weight and family economic status adjusted, compared to never-breastfeeding, continuous breastfeeding for 1-3 months could protect children from severe developmental delay in fine motor domain aged 6 months old (RR=0.36, 95%CI: 0.17-0.79), communication domain aged 18 months old (RR=0.27, 95%CI: 0.08-0.88), and social domain aged 18 months old (RR=0.36, 95%CI: 0.21-0.63). Compared to never-breastfeeding, continuous breastfeeding for more than 4 months could protect children from severe developmental delay in fine motor domain aged 6 months old (RR=0.58, 95%CI: 0.34-0.97), communication domain (RR=0.57, 95%CI: 0.39-0.83) and mild developmental delay (RR=0.65, 95%CI: 0.48-0.87) aged 18 months old and fine motor domain (RR=0.57, 95%CI: 0.39-0.83) aged 18 months old and social domain aged 18 months old (RR=0.57, 95%CI: 0.39-0.83). With the breastfeeding intensity rising, there were less children evaluated as severe development delay in communication domain aged 6 months old, communication, fine motor and problem-solving domains aged 18 months old, with RR (95%CI) at 0.98 (0.96-1.00), 0.96 (0.93-0.99), 0.98 (0.97-1.00) and 0.98 (0.96-1.00); and less children evaluated as mild development delay in communication domain aged 18 months old with RR (95%CI) at 0.99 (0.98-1.00). Conclusion: Breastfeeding with longer duration and increased intensity could promote better development in children.

Search for a Light CP-odd Higgs Boson and Low-Mass Dark Matter at the Belle Experiment

We report on the first Belle search for a light CP-odd Higgs boson, A^{0}, that decays into low mass dark matter, χ, in final states with a single photon and missing energy. We search for events produced via the dipion transition ϒ(2S)→ϒ(1S)π^{+}π^{-}, followed by the on-shell process ϒ(1S)→γA^{0} with A^{0}→χχ, or by the off-shell process ϒ(1S)→γχχ. Utilizing a data sample of 157.3×10^{6} ϒ(2S) decays, we find no evidence for a signal. We set limits on the branching fractions of such processes in the mass ranges M_{A^{0}}<8.97  GeV/c^{2} and M_{χ}<4.44  GeV/c^{2}. We then use the limits on the off-shell process to set competitive limits on WIMP-nucleon scattering in the WIMP mass range below 5  GeV/c^{2}.

Determination of 23 perfluorinated alkylated substances in water and suspended particles by ultra-performance liquid chromatography/tandem mass spectrometry

A practical multi-residue method based on ultra-performance liquid chromatography/tandem mass spectrometry was developed for the simultaneous determination of 23 perfluorinated alkylated substances (PFASs) in water and suspended particles. Suspended particle samples were extracted with 1% formic acid-acetonitrile and cleaned by matrix solid phase dispersion extraction using a C₁₈ sorbent and graphitized carbon black. Water samples were filtered through 0.7-μm glass fiber membranes and enriched utilizing weak anion exchange cartridges. The eluent was dried under a gentle stream of N₂ at 45°C and suspended in 1 mL acetonitrile-5 mM ammonium acetate (1:1, vol:vol). Gradient elution for chromatographic separation utilized acetonitrile and 5 mM ammonium acetate as mobile phases on a reverse phase C₁₈ column. The compounds were quantified using an internal standard method in multiple reaction-monitoring mode. Limits of detection and quantitation of the 23 PFAS test compounds in water samples were 0.5-10 ng L^-1 and 2-20 ng L^-1, respectively. Recoveries at three fortified levels of 20, 50, and 200 ng L^-1 ranged from 68.5% to 118% with relative standard deviations below 9.6%. We used this method to determine PFAS levels in real water and suspended particle samples and found high sensitivity and good reproducibility.

Radiotherapy improves the survival of patients with metastatic esophageal squamous cell carcinoma: a propensity score matched analysis of Surveillance, Epidemiology, and End Results database

The survival advantage of radiotherapy (RT) for patients with metastatic esophagus cancer has not been adequately evaluated. This study aims to find out the role of RT for metastatic esophagus cancer and to find the different effect for RT to esophageal adenocarcinoma (EAC) and esophageal squamous cell carcinoma (ESCC). This study included 5,970 metastatic esophagus cancer patients from the Surveillance, Epidemiology, and End Results (SEER) database, registered from January 2004 to December 2013. Propensity score (PS) analysis with 1:1 nearest neighbor matching method was used to ensure well-balanced characteristics of all comparison groups by histological types. The Kaplan-Meier and Cox proportional hazardous models were used to evaluate the overall survival (OS), cancer-specific survival (CSS), and corresponding 95% confidence interval (CI). Generally speaking, EAC did not get survival benefit from RT (median OS for RT group vs. no-RT group-8.0, 7.6-8.4 vs. 9.0, 8.5-9.5, P = 0.073), whereas RT for metastatic ESCC did significantly improve OS (median OS for RT group vs. no-RT group-8.0, 7.4-8.6 vs. 7.0, 6.4-7.6, P = 0.044). Therefore, compared with adenocarcinoma, ESCC could get more survival benefit from RT.