Following downregulated women of advanced reproductive age, superiority of HP-hMG over rFSH in live birth rate could not be concluded from this study, but noninferiority was established. Pharmacodynamic differences in follicular development, oocyte/embryo quality and endocrine response exist between HP-hMG and rFSH, which may be relevant to treatment outcome.

Background No previous study directly compares the fixed day-5 initiation versus the flexible initiation of GnRH antagonist administration in IVF/ICSI for those patients who are predicted as high ovarian responders without PCOS. To evaluate whether the number of oocytes retrieved is different by using the two GnRH antagonist protocols in Chinese women with predicted high ovarian response except PCOS. Methods A randomized controlled trial of 201 infertile women with predicted high ovarian response except PCOS undergoing in vitro fertilization. Ovary stimulation was performed using recombinant FSH and GnRH antagonists. GnRH antagonist ganirelix (0.25 mg/d) was started either on day 5 of stimulation (fixed group) or when LH was > 10 IU/L, and/or a follicle with mean diameter > 12 mm was present, and/or serum E2 was > 600 pg/ml. Patient monitoring was initiated on day 3 of stimulation in flexible group. Result(s) No significant difference was observed between the fixed and flexible groups regarding the number of oocytes retrieved (16.72 ± 7.25 vs. 17.47 ± 5.88, P = 0.421), the Gonadotropin treatment duration (9.53 ± 1.07 vs. 9.67 ± 1.03, P = 0.346) and total Gonadotropin dose (1427.75 ± 210.6 vs. 1455.94 ± 243.44, P = 0.381). GnRH antagonist treatment duration in fixed protocol was statistically longer than the flexible protocol (6.57 ± 1.17 vs 6.04 ± 1.03, P = 0.001). There was no premature LH surge in either protocol. Conclusion(s) Fixed GnRH antagonist administration on day 5 of stimulation appear to achieve a comparable oocyte retrieved compared with flexible antagonist administration. Trial registration NCT02635607 posted on December 16, 2015 in clinicaltrials.gov.

Genetic factors in endometrium are likely to be involved in the embryo implantation failure (IF), one of the major limiting factors in the success of in vitro fertilization (IVF). In this study, we aimed to identify critical genes from the transcriptional profile for the establishment of the endometrial receptivity which supporting the normal pregnancy. Three GEO datasets, including 12 samples of IF and 12 samples of controls, were used for the meta-analysis. We identified 182 different expression genes (DEGs) by comparing IF with controls and present here the successful clustering according to sample type, not by the origin. The gene ontology (GO) enriched analysis demonstrated the significant downregulation in activation and regulation of inflammatory and immune response in IF patients. Furthermore, network analysis of down-regulated genes identified the significant hub genes containing GADD45A (growth arrest and DNA damage inducible alpha, Degree = 77), GZMB (granzyme B, Degree = 38) and NLRP2 (NLR family pyrin domain containing 2, Degree = 37). The lower expression of NLRP2, related to inflammatory responses with the most degree in the network, was validatied by other GEO data. Besides, it was confirmed that the NLRP2 could act as a predictor for pregnancy after IVF (AUC = 87.93%; sensitivity, 60.00%; specificity, 91.30% ). Our meta-analysis will help us to better understand the molecular regulation of endometrial receptivity, and guiding further line of treatment for IF during IVF.

SUMMARYThe time-dependent behavior is a major consideration in the design and construction of tall buildings, especially in concrete and composite structural systems. To make an analysis of long-term effect of steel-reinforced concrete structures, the method of using master-slave constraint to deduce substructure element model of composite members was introduced, and the problem of co-work between steel and concrete was solved. The creep calculation method of combined Age-adjusted Effective Modulus Method (AEMM) and finite element method was adopted. Steel Reinforced Concrete Construction Modeling (SRCCM), a calculation program based on Visual C++ and ObjectARX, was developed for simulating the construction process of high-rise composite structures. The use of the method is illustrated through one computation example of Shanghai Center Tower, which is a super high-rise steel-reinforced concrete structures. The method provides valuable information about time effects that may be used in designing new structures or in diagnosis existing structures. The results also indicate that the vertical shortening of Shanghai Center Tower between column and core-tube is significant. Such differential length changes should be compensated during the construction process of high-rise composite structures.

Severe postoperative complications can affect cardiac surgery patients. Levosimendan is a novel calcium sensitizer commonly administered after cardiac surgery. However, the patient benefits are controversial. PubMed, Embase, and the Cochrane library were systematically searched for randomized controlled trials comparing levosimendan with control in adult cardiac surgery patients. Twenty-five studies (3247 patients) were included. Pooled data indicated that levosimendan reduced mortality after cardiac surgery [odds ratio (OR) 0.63, 95% confidence interval (CI): 0.47–0.84, P = 0.001]. However, this reduction was restricted to patients with low (<50%) left ventricular ejection fraction (OR 0.49, 95% CI: 0.35–0.70, P = 0.0001). It significantly reduced the incidence of postoperative acute kidney injury (OR 0.55, 95% CI: 0.41–0.74, P < 0.0001) and renal replacement therapy use (OR 0.56, 95% CI: 0.39–0.80, P = 0.002). Moreover, levosimendan significantly shortened the duration of the intensive care unit stay (weighted mean differences −0.49 day, 95% CI: −0.75 to −0.24, P = 0.0002) and mechanical ventilation use (weighted mean differences −2.30 hours, 95% CI: −3.76 to −0.84, P = 0.002). In conclusion, levosimendan reduced the mortality in patients with low left ventricular ejection fraction and decreased the incidence of acute renal injury and renal replacement therapy use. In addition, it shortened the duration of the intensive care unit stay and mechanical ventilation use.

Summary Typhoon In‐Fa was the strongest tropical cyclone that impacted the Shanghai Tower (ST) since the completion of the Tower, which is the tallest building in China with a height of 632 m. Wind characteristics of the Typhoon In‐Fa were described based on measured data including average wind and fluctuating wind. Structural behaviors of the main tower and the tuned mass damper (TMD) during In‐Fa were measured and analyzed based on monitoring data from the structural health monitoring (SHM) system of the ST. The peak values and root mean squares (RMS) of accelerations and displacements of the TMD and main tower were evaluated and compared with numerical results. The correlations of accelerations and displacements between the TMD and the main tower were investigated, and linear relations would be given in a certain extent. Model parameters including fundamental frequencies and damping ratios were identified by the peak picking method, and strong linear correlations were obtained between the TMD and main tower. The results showed that the actual working behavior of the TMD meets the analyzed results, and the effectiveness of the vibration control of the TMD can be verified under strong winds near a 10‐year return period.

ABSTRACT:In this paper, the effectiveness of seismic performance upgrading is studied by adoption of damping devices made of shape memory alloys (SMAs). An axial-type SMA damper is constructed and modeled on the basis of a modified multi-linear one dimensional constitutive model of SMAs. Time history analyses are carried out on typical steel frames with SMA damping devices. Performance parameters for seismic performance upgrading are investigated in consideration of four influence factors, i.e., strength ratio, martensite fraction, length ratio, and ground motion. Dynamic analyses of bare frames and frames with equivalent BRB dampers are also conducted for comparisons. Numerical investigations show that excellent re-centering ability and energy dissipation can be afforded by installing SMA damping devices in structures.

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