Explore the vast range of titles available.

Background To investigate the obstetrical and perinatal impact of oocyte donation, a cohort of women who conceived after OD was compared with a matched control group of women who became pregnant through in vitro fertilisation with autologous oocytes (AO). Methods A matched-pair analysis has been performed at the Centre for Reproductive Medicine of the UZ Brussel, Dutch speaking Free University of Brussel. A total of 410 pregnancies resulted in birth beyond 20 weeks of gestation occurring over a period of 10 years, including 205 oocyte donation pregnancies and 205 ICSI pregnancies with autologous oocytes (AO). Patients in the OD group were matched on a one-to-one basis with the AO group in terms of age, ethnicity, parity and plurality. Matched groups were compared using paired t-tests for continuous variables and McNemar test for categorical variables. A conditional logistic regression analyses was performed adjusting for paternal age, age of the oocyte donor, number of embryos transferred, and singleton/twin pregnancy. Results Oocyte donation was associated with an increased risk of pregnancy induced hypertension (PIH) (matched OR: 1.502 CI: 1.024-2.204), and first trimester bleeding (matched OR: 1.493 CI: 1.036-2.15). No differences were observed between the two matched groups with regard to gestational age, mean birth weight and length, head circumference and Apgar scores. Conclusions Oocyte donation is associated with an increased risk for PIH and first trimester bleeding independent of the recipients’ age, parity and plurality, and independent of the age of the donor or the partner. However, oocyte donation has no impact on the overall perinatal outcome.

Almost all fertility treatment involves ovarian stimulation. This can be in the form of ovulation induction in women with anovulation or controlled ovarian stimulation for in vitro fertilisation treatment. The stepwise approach to fertility treatment in most cases it will be safe and successful. In certain cases, it might be however ineffective or related with adverse health outcomes for the woman causing significant distress for the couple and the treating clinicians. Fertility treatment could be perceived as a paradox, as healthy women undergo treatment 'willingly', with often no cause identified of their failed conceptions. Exposure to assisted reproduction can therefore result in these healthy women being admitted to hospital suffering from complications of fertility treatment. In this thesis of the genetic make-up of women, who had ovulation induction with or without success, is evaluated. Aiming for potential prediction of response for future patients. In order to gain more insight in the pathophysiology of ovarian overresponse, the ovarian renin angiotensin system was assessed during stimulation for IVF. The use of a dopamine agonist to alleviate or prevent OHSS was studied. And any assisted reproductive treatment adverse outcome rates after a salpingectomy prior to treatment were investigated. The studies presented in this thesis utilized various research modalities, including systematic literature reviews, three-dimensional ultrasound, single nucleotide polymorphism analysis and polymerase chain reactions. When OHSS develops dopamine agonists provide limited symptomatic relieve, but causes no harm. Salpingectomy prior to ovarian stimulation with potential harm to the ovarian blood supply does not influence the overall treatment outcome. Serum renin levels during ovarian stimulation might be able to differentiate which women become symptomatic of OHSS, but is a difficult test to implement in daily practice. For ovulation induction the use of genotyping of CYP450 might allow adjusting the dose needed to prevent unwanted response. We need to remain critical of our practise. Registration and evaluation of complications will allow achievement of safer and better fertility treatment in the future. The overall conclusion is that the next trial should focus on the patient group found to be at risk of overresponse and randomise them to an antagonist protocol with agonist trigger and modified luteal support. Controlled ovarian stimulation should be in conjunction with a national complication registration to have a real picture of the risks associated with fertility treatment.

We report the isolation and characterization of the Hirudo medicinalis homoeobox gene Lox2. Sequence analysis shows that it contains a region that has homology to Drosophila and vertebrate homoeodomains of the Antennapedia class. In addition, Lox2 shares homology with sequences in the bithorax complex Ultra-bithorax (Ubx) and abdominal A (abdA) genes in a region adjacent to the C-terminus of the homoeodomain. Whole mount in situ hybridization of embryos of various ages demonstrates that during early development this gene has temporally and spatially restricted patterns of expression that resemble those of the homoeotic genes of the Drosophila bithorax complex and of many vertebrate homoeobox genes. The largest accumulation of transcripts was seen in the posterior two-thirds of the developing leech central nervous system in 7-14-day-old embryos. Adult leeches also express Lox2. We propose that in Hirudo, Lox2 represents the ancestral gene of the Ubx and abdA genes of the bithorax complex of Drosophila.

This study aimed to discover whether students in upper grade elementary school produced more creative art projects when they were working in a setting with significant constraints on their choices and behaviors as opposed to when they were working in a self-directed setting with few if any constraints. Participants for this study consisted of 220 students in grades 3, 4 and 5 at two Los Angeles area schools. All subjects made a found-object collage working in one of the four experimental conditions: Self-direction, procedural constraint, time constraint, or a combination of procedural and time constraint. Collages were rated for creativity, aesthetic quality and technical quality by three artist judges using the Consensual Assessment Technique developed by Teresa Amabile. Intraclass correlations for judges were calculated to obtain a measure of interrater agreement. A one-way multivariate analysis of variance followed by Tukey post hoc analysis was used to test for a significant main effect for each of the three hypotheses. Hierarchical regression analyses were done to discover whether working condition added significantly to the explanation of the judges' scores after controlling for innate variables. It was found that students produced more creative art projects when working in a self-directed setting with minimal procedural and time constraints on their choices and behaviors. The study also found that students produced art projects with higher aesthetic quality when working in a self-directed setting, and higher technical quality when working in a setting with procedural constraint, but with a minimal combination of time and procedural constraints. These results were largely as expected and hypothesized. Creative production is a meaningful goal in the school and workplace, and in the arts and sciences. The empirical base in the area of creativity, nevertheless, is both scanty and fraught with definitional and methodological problems. This study fulfilled its overriding goal of examining one aspect of creativity in order to provide a basis for future research aimed at better understanding creativity enhancement and creativity in general.

About 21 Drosophila genes contain a 180 base pair motif encoding a DNA-binding region called the homeobox. These genes regulate either the specification or the transduction of polyclonal positional information required for the fruitfly's metameric anatomical architecture (polarity, segmentation, and homeotic genes). According to the Lewis model of Drosophila development, the successive and overlapping expression of homeotic genes along the length of the organism uniquely defines each metameric phenotype. Furthermore, the chromosomal organization of homeotic genes corresponds to that of the metamers whose phenotypes they regulate (the co-linearity principle). The model also suggests that homeotic genes evolved by duplication and divergence of an archetypal gene. I examined homeobox evolution and possible origins of the Drosophila developmental paradigm in an annelid, the leech. Being segmented, annelids have been presumed progenitors of arthropods, but their embryogenic strategy includes processes (e.g., linear proliferation of germinal bands, intersegmental migration of germinal derivatives) different from that of Drosophila with its syncitial blastoderm and comparmentalized polyclonal developmental units. I probed Hirudo medicinalis and Haemopis marmorata total genomic DNA on southern blots with fruitfly homeobox-containing fragments, constructed a $\\lambda$EMBL3 Hirudo genomic library, screened it with the Scr homeobox, and identified, subcloned, and sequenced several clones. I ascertained that clones pH1, pH4, and pH5 contain regions whose predicted translation products are 82%, 68%, and 87% identical to the Scr, Dfd, and Antp homeoboxes, respectively. Similarity to the fruitfly stabilization-recognition helices and the upstream protein interaction helix suggests conservation of DNA-binding function and target sites as well as multiprotein regulatory activities. I showed expression at low levels in the adult of the pH1 and pH5 genes by northern blot. My plasmid constructs were used by others in my lab to show expression of the pH4 gene by northern blot and of the pH5 gene in embryonic posterior segmental ganglia by in situ hybridization.

ObjectiveThe aim of this work is to define competencies and entrustable professional activities (EPAs) to be imparted within the framework of surgical neuro-oncological residency and fellowship training as well as the education of medical students. Improved and specific training in surgical neuro-oncology promotes neuro-oncological expertise, quality of surgical neuro-oncological treatment and may also contribute to further development of neuro-oncological techniques and treatment protocols. Specific curricula for a surgical neuro-oncologic education have not yet been established.MethodsWe used a consensus-building approach to propose skills, competencies and EPAs to be imparted within the framework of surgical neuro-oncological training. We developed competencies and EPAs suitable for training in surgical neuro-oncology.ResultIn total, 70 competencies and 8 EPAs for training in surgical neuro-oncology were proposed. EPAs were defined for the management of the deteriorating patient, the management of patients with the diagnosis of a brain tumour, tumour-based resections, function-based surgical resections of brain tumours, the postoperative management of patients, the collaboration as a member of an interdisciplinary and/or -professional team and finally for the care of palliative and dying patients and their families.Conclusions and RelevanceThe present work should subsequently initiate a discussion about the proposed competencies and EPAs and, together with the following discussion, contribute to the creation of new training concepts in surgical neuro-oncology.

Since the report of the initial outbreak of Porcine rubulavirus (PorPV) infection in pigs, only one full-length genome from 1984 (PorPV-LPMV/1984) has been characterised. To investigate the overall genetic variation, full-length gene nucleotide sequences of current PorPV isolates were obtained from different clinical cases of infected swine. Genome organisation and sequence analysis of the encoded proteins (NP, P, F, M, HN and L) revealed high sequence conservation of the NP protein and the expression of the P and V proteins in all PorPV isolates. The V protein of one isolate displayed a mutation that has been implicated to antagonise the antiviral immune responses of the host. The M protein indicated a variation in a short region that could affect the electrostatic charge and the interaction with the membrane. One PorPV isolate recovered from the lungs showed a mutation at the cleavage site (HRKKR) of the F protein that could represent an important factor to determine the tissue tropism and pathogenicity of this virus. The HN protein showed high sequence identity through the years (up to 2013). Additionally, a number of sequence motifs of very high amino acid conservation among the PorPV isolates important for polymerase activity of the L protein have been identified. In summary, genetic comparisons and phylogenetic analyses indicated that three different genetic variants of PorPV are currently spreading within the swine population, and a new generation of circulating virus with different characteristics has begun to emerge.

Although the risk of Down's syndrome increases with maternal age, women under 35 bear about 80 percent of the infants born with this condition. We prospectively investigated the utility of measuring maternal serum alpha-fetoprotein during the second trimester in women under 35 in order to identify pregnancies in which the fetus was affected with Down's syndrome. Over a two-year period, 34,354 women in this age group were screened. Amniocentesis was offered when the risk of Down's syndrome, calculated as a function of maternal age and maternal serum alpha-fetoprotein concentration adjusted for maternal weight and race, was 1:270 or higher, the risk for a 35-year-old woman. This threshold was exceeded in 1451 women in whom gestational age was confirmed by ultrasound; 9 women in this group had a fetus with the syndrome. In three women whose fetuses had trisomy 18 and one whose fetus had trisomy 13, the calculated risk of Down's syndrome was 1:270 or higher. Thus, among women in whom the risk exceeded our cutoff point, 1 in 161 were found to have a pregnancy in which the fetus was affected with Down's syndrome; the figure was 1 in 112 for all autosomal trisomies. Eighteen pregnancies involving Down's syndrome, three involving trisomy 18, and two involving trisomy 13 were not associated with a calculated risk above the cutoff point. The available data indicate that In our population, using a cutoff for risk at which 5 percent of women under 35 are offered amniocentesis, we will detect one quarter to one third of pregnancies in which the fetus has Down's syndrome. (N Engl J Med 1987; 317:3426.) THE risk of fetal aneuploidy due to an extra chromosome increases significantly with maternal age, but since approximately 95 percent of children are born to women under 35 years old, 1 so are the majority of babies with a trisomy. For example, about 80 percent of infants with Down's syndrome are born to women under 35, even though the risk of the syndrome is considerably higher among women in their late 30s or 40s. 2 Until recently, the use of amniocentesis to detect Down's syndrome has usually been restricted to women 35 years old or older, because of limited laboratory facilities, the . . .

To the Editor: We wish to respond to the editorial of August 6. 1 Calculation of a risk–benefit ratio for Down's syndrome screening with use of maternal age and values for maternal serum alpha-fetoprotein should take into consideration the following points. First, the benefit of such screening includes not only the diagnosis of Down's syndrome, but also that of trisomy 18. These chromosome errors can result in seriously affected living infants, and the benefit of prenatal diagnosis should not be disregarded. The author notes that the predictive value of such testing (for Down's syndrome only) was 0.6 percent and suggests that . . .