Cycling Protocol Research Articles

Assessing the Impact of Non-Exhaust Emissions on the Asthmatic Airway (IONA) Protocol for a Randomised Three-Exposure Crossover Study.

People living with asthma are disproportionately affected by air pollution, with increased symptoms, medication usage, hospital admissions, and the risk of death. To date, there has been a focus on exhaust emissions, but traffic-related air pollution (TRAP) can also arise from the mechanical abrasion of tyres, brakes, and road surfaces. We therefore created a study with the aim of investigating the acute impacts of non-exhaust emissions (NEEs) on the lung function and airway immune status of asthmatic adults. A randomised three-condition crossover panel design will expose adults with asthma using a 2.5 h intermittent cycling protocol in a random order at three locations in London, selected to provide the greatest contrast in the NEE components within TRAP. Lung function will be monitored using oscillometry, fractional exhaled nitric oxide, and spirometry (the primary outcome is the forced expiratory volume in one second). Biomarkers of inflammation and airborne metal exposure will be measured in the upper airway using nasal lavage. Symptom responses will be monitored using questionnaires. Sources of exhaust and non-exhaust concentrations will be established using source apportionment via the positive matrix factorisation of high-time resolution chemical measures conducted at the exposure sites. Collectively, this study will provide us with valuable information on the health effects of NEE components within ambient PM2.5 and PM10, whilst establishing a biological mechanism to help contextualise current epidemiological observations.

P-734 Low cost antagonist protocol in ivf-icsi cycles using oral ovulation induction agents in developing countries

Abstract Study question The study aimed at comparing the cost-effectiveness of a low cost antagonist protocol using oral-ovulation-induction agents with a standard long GnRH-Agonist protocol in IVF-ICSI cycles. Summary answer Low cost antagonist protocol using oral-ovulation-induction agents comparing with a standard long GnRH-Agonist protocol in IVF-ICSI cycles is cost-effectiveness in developing countries. What is known already IVF-ICSI had always been proved to be costly treatment. The additional expenditure is mainly due to use of high dose of gonadotrophins in order to get more number of eggs. To cut down the cost,low dose or mild stimulation protocol have been popularized all over the world in last few years. Use of aromatase inhibitors along with low doses of gonadotrophins have been an effective means of mild stimulation protocols for IVF cycles. Oral ovulogens, reduces the total dose of gonadotrophin required for inducing follicular maturation. We evaluated if incorporation of letrozole could be an effective alternative for low-cost IVF. Study design, size, duration A total of 304 patients under 40 years of age were studied between 2018 to 2022 Subsequently, they were randomly divided into two groups. The agonist group underwent standard long GnRH analogue protocol. The antagonist group received oral ovulation inducing drugs (CC/Letrozole) and 0.25mg antagonist injections upto the day of hCG injection, using a flexible start approach. Participants/materials, setting, methods A total of 304 patients under 40 years of age were studied between 2018 to 2022. All patients received low-dose OCP before starting treatment. Subsequently, they were randomly divided into two groups. The agonist-group underwent standard long GnRH analogue protocol. The antagonist group received oral ovulation inducing drugs (CC/Letrozole) and 0.25mg antagonist injections upto the day of hCG injection, using a flexible start approach. Follicular development was monitored by vaginal ultrasound and serum estradiol levels. Main results and the role of chance There was a significant difference in the gonadotropin usage between the two groups. As a result, the cost of the CC/Letrozole-gonadotropin-antagonist cycle was significantly lower than the long GnRH agonist-gonadotropin protocol. Though the mean number of oocytes retrieved was higher in the long protocol group, yet the clinical pregnancy rate per transfer was the same in both groups. While comparing for the primary outcomes pregnancy rate and miscarriage rate were comparable between two groups. It is of particular importance to note that despite 60%reduction of total dose of rFSH in the Let-rFSH group,which entailed significant reduction of the cost of treatment, the outcomes in all major aspects including pregnancy rate were comparable between the groups. However, numbers of matured follicles, retrieved oocytes and transferable embryos were not statistically different between study and control group in this study. This prospective study, designed to evaluate the efficacy of oral-ovulogens -FSH as a low-cost IVF protocol, involved an average number of patients; however, the results have been encouraging. We have been successful in reaching our objective to modify an expensive conventional down regulated IVF protocol into one in which the cost was reduced to a larger extent, without compromising the rate of success in developing countries. Limitations, reasons for caution Since last Cochrane review, GnRH-antagonist protocol was proved to be a short and simple protocol with good clinical outcome with significant reduction in incidence of severe OHSS and amount of gonadotrophins requirement. Although, we need more RCTs to come to a conclusion on regular use of such combined protocol. Wider implications of the findings Usage of GnRH-antagonist in combination with Oral-Ovulogens offers the advantage of a low-cost economical stimulation in IVF, as compared to an agonist-protocol, with similar pregnancy-rate in developing countries. It not only offers a cost-saving stimulation-protocol but also reduces side effects like OHSS and multiple pregnancies yet maintain a descent success-rate. Trial registration number not applicable

P-577 A randomized trial to compare the live birth rate following the progestin-primed ovarian stimulation versus the antagonist protocol in women with anticipated high ovarian responses

Abstract Study question Is there difference in the live birth rate following the progestin-primed ovarian stimulation (PPOS) versus the antagonist protocol in women with anticipated high ovarian responses? Summary answer The live birth rates of the first frozen embryo transfer following PPOS and the antagonist protocol were comparable in women with anticipated high ovarian responses. What is known already Progestin when given orally inhibits the pituitary LH surge during ovarian stimulation when taken orally i.e. progestin-primed ovarian stimulation. Two randomized trials showed similar number of oocytes for PPOS and the antagonist protocol in oocyte donation cycles. However, there is still no randomized trial to compare the live birth rate between PPOS and the antagonist protocol. Study design, size, duration This is a randomized controlled trial of 784 infertile women conducted from June 2020 and October 2021. Participants/materials, setting, methods Infertile women aged <43 years undergoing the first IVF cycle in a tertiary fertility center and having antral follicle count >15 randomly assigned in a 1:1 ratio into two groups: PPOS group and the antagonist group. Medroxyprogesterone 10 mg daily was given from the start of ovarian stimulation until the day of ovulation trigger in the PPOS group. The primary outcome was the live birth rate of the first frozen embryo transfer. Main results and the role of chance 784 women were randomly assigned into two groups: PPOS group (n = 392) and antagonist group (n = 392). Embryo transfer was either cancelled or postponed in 62 (62/392, 15.8%) women in the PPOS group and 65 (65/392, 16.6%) in the antagonist group because of no transferable embryos or no frozen embryo transfer within 6 months following randomization. The two groups were similar in demographic characteristics and number of oocytes obtained/fertilized, the number of cleaving embryos, number of good quality embryos at day 3, number of blastocysts developed and number of embryo/blastocyst frozen. There was no statistically significant difference in the live birth rate of the first frozen embryo transfer cycle between the progestin-primed ovarian stimulation and antagonist groups based on both intention to treat [37.5.0% (147/392) versus 32.7% (128/392), RR 1.148 (95% CI = 0.949–1.390), P = 0.16] and per protocol analysis [44.5% (147/330) versus 39.1.% (128/327), RR 1.138 (95%CI = 0.950–1.364), P = 0.16]. Both groups showed comparable clinical pregnancy, ongoing pregnancy, miscarriage, multiple pregnancy, ectopic pregnancy and cumulative live birth rates. Limitations, reasons for caution Women with anticipated high ovarian responses were recruited and the results may not be extrapolated to the general population seeking IVF. This is not a blind study although the live birth rate as the primary outcome is objection. The duration of the study is 6 months since randomization. Wider implications of the findings In situations in which fresh embryo transfer is not required such as oocyte/embryo freezing for fertility preservation, oocyte donation or preimplantation genetic testing, the PPOS protocol may be preferred over the antagonist protocol. Trial registration number NCT04414761

P-614 The use of home ovulation prediction kits (OPKs) in true natural cycle frozen embryo transfer (NC FET)

Abstract Study question Do urinary OPKs have inferior ability to detect the LH surge compared to daily serum monitoring among patients undergoing true NC FET? Summary answer OPKs are highly accurate and may serve as reliable tests to detect the LH surge among patients undergoing NC FET. What is known already Frozen embryo transfers continue to increase worldwide and recent evidence suggests natural cycle protocols may be superior to hormone replacement protocols because of lower risk of miscarriage and lower risk of pregnancy complications. Patients undergoing NC FET attend multiple clinic appointments which has been associated with increased patient stress levels during fertility treatment. OPKs have been found to be accurate at detecting the LH surge in the trying to conceive population and have high user acceptability. Study design, size, duration A prospective single cohort study including 139 fertility seeking participants was completed at an academic-affiliated fertility center for a duration of 12 months. Participants/materials, setting, methods Patients scheduled for NC FET (regular cycles 27-35 days, mid luteal progesterone >30 nmol/L, no luteal phase concern) with the ability to provide informed consent and access to SMS texting devices were eligible for participation. On the same day they started daily morning bloodwork as per the standard protocol (2-3 days prior to anticipated LH surge), participants began twice daily OPK testing. Upon exiting the study, patients completed a questionnaire on satisfaction with OPK use. Main results and the role of chance LH surge detection rate was 85.6% (n = 119/139) with serum monitoring and 93.5% (130/139) with OPK use (Kappa agreement 90.7%, K = 0.51, p < 0.001). Among patients with a serum-detected LH surge, OPK was positive within +/- 12 hours of the serum LH surge detection in 84.8% of patients. In 23.7% of cycles, OPK was positive the same morning as serum blood work. In 27.1% of cycles, OPK was positive 12h prior and in 33.9% of cycles, OPK was positive 12h after serum LH surge detection. Actual NC FET cycle cancellation rate was 16.6% (n = 23/139) compared to an anticipated cycle cancellation rate of 20.9% (29/139) if OPKs had been used to initiate serum monitoring. The average reduction in the number of serum monitoring visits and distance travelled in kilometers with OPK use was 3.9 visits (SD 2.1) and 155km (SD 174), respectively. The majority of participants reported satisfaction with OPK use. Of 135 patients, 110 (81.5%) strongly agreed the OPK was easy to use, 100 (74.1%) strongly agreed they would be open to using OPKs in future fertility treatments and 120 (88.9%) reported a reduction or no impact on stress levels associated with fertility treatments. Limitations, reasons for caution This study only used Clearblue Digital Ovulation Tests and the reported reliability in our study cannot be extrapolated to all OPKs. Additionally, the accuracy of the reported serum LH surge detection rate may be limited by physician specific definitions of serum LH surge. Wider implications of the findings OPKs are highly accurate and may serve as a reliable trigger for serum monitoring in NC FET. While their use would reduce the number of clinic appointments and distance travelled for patients undergoing NC FET cycles, patients should be advised OPK use may be associated with higher cycle cancellation rates. Trial registration number Not applicable

P-572 Circadian serum progesterone variations on the day of frozen embryo transfer in a modified natural cycle protocol

Abstract Study question Does a circadian variation of serum progesterone (P) on the frozen embryo transfer (FET) day in a modified natural cycle (mNC) exist? Summary answer A statistically significant diurnal variation of serum P on the day of a FET in a mNC protocol exists. What is known already In recent years, the proportion of FET cycles has increased dramatically. To further optimize pregnancy outcomes after FET, recent studies have focused on serum luteal P levels in both natural and artificially prepared FET cycles. Despite the different cut-off values proposed to define low serum P in the natural cycle, it is generally accepted that lower serum P values (<10ng/ml) around the day of FET are associated with negative reproductive outcomes. However, a single serum P measurement on the day of FET is not reliable given that P levels are prone to diurnal fluctuations and are impacted by patients’ characteristics. Study design, size, duration A prospective cohort study was conducted in a single fertility center including 22 patients performing a single blastocyst mNC-FET from August 2022 to August 2023.Serum P levels were measured on the day of transfer at 08:00h,12:00h,16:00h and 20:00h.Differences between P levels were compared using the Wilcoxon signed-rank test.The sample size was calculated to detect a difference of 15% between the first and last P measurements with a 5% false-positive rate and a 95% confidence interval. Participants/materials, setting, methods Patients with a normal BMI, between 18 and 40 years old, without uterine diseases were eligible. Patients utilizing donated oocytes were excluded. The mNC-FET protocol implied monitoring the normal ovarian cycle and triggering ovulation with an injection of 250 mcg of choriogonadotropin alfa when a pre-ovulatory follicle (16-20 mm diameter)was visualized. The blastocyst was transferred seven days later. The patients were not supplemented with exogenous P at any moment before the day of the FET. Main results and the role of chance The mean age and BMI of the study population were 33.6 ± 3.8 years and 22.7 ± 1.8 kg/m2, respectively. Mean P values at 08:00h,12:00h,16:00h, and 20:00h were 14.6 ± 4.5ng/ml, 14.7 ± 4.1ng/ml, 12.9 ± 3.5ng/ml, and 14.6 ± 4.3ng/ml, respectively. The mean P levels at 16:00h were statistically significantly lower compared to all other time points (p < 0.05:p= 0.007 between P at 8:00h and 16:00h;p = 0.003 between P at 12:00h and 16:00h;p=0.007 between P at 16:00h and 20:00h). Absence of a statistically significant fluctuation was observed between P values at the other time points (p = 0.88 between P at 8:00h and 12:00h;p=0.96 between P at 8:00h and 20:00h;p=0.83 between P at 12:00h and 20:00h). This study confirms the existence of an intra-day variation of serum P on the day of mNC-FET, with lower values at 16:00h. This highlights the importance of standardizing P measurement on the day of FET; we propose this should always be assessed in the morning to be more reliable and to allow the time to prescribe additional exogenous progesterone if lower P values (<10ng/ml) are detected. This standardization would allow fertility clinics around the world to compare their results and develop internationally recognized treatment protocols. Limitations, reasons for caution The study’s main limitation include the small sample size that may cause a bias when results are extrapolated to a larger subfertile population undergoing mNC-FET. Ideally, larger prospective trials including a more heterogeneous patient population would be necessary to validate our findings. Wider implications of the findings This study demonstrates the existence of a diurnal fluctuation of serum P on the mNC-FET day highlighting the importance of a standardized time point for its measurement.This is important when clinical actions, like additional exogenous P supplementation, are considered when encountering P values lower than 10ng/ml on the FET day. Trial registration number NCT05511272

Progesterone-modified natural cycle preparation for frozen embryo transfer

Research questionIs there any difference in clinical outcomes between the progesterone-modified natural cycle (P4mNC) and hormone replacement therapy (HRT) endometrial preparation protocols after single euploid blastocyst frozen embryo transfer (FET) cycles? DesignA retrospective cohort study was performed at a single, private, high-volume fertility centre. Patients who underwent single euploid blastocyst FET between January 2017 and December 2019 were included. A total of 1933 FET cycles were reviewed, and 723 FET cycles from 548 patients met the inclusion criteria. Two groups were compared according to endometrial preparation: 327 P4mNC-FET and 396 HRT-FET cycles. The primary outcome was the live birth rate. The secondary outcomes included the clinical pregnancy rate and the miscarriage rate. ResultsThere were no differences in the clinical pregnancy rate (50.2% versus 47.0%, P = 0.688), miscarriage rate (9.8% versus 14.5%, P = 0.115) and live birth rate (45.0% versus 39.6%, P = 0.331) between the P4mNC-FET and HRT-FET groups after covariate adjustments. ConclusionsThere were no differences in the clinical outcomes between the P4mNC-FET and HRT-FET cycles. These results indicate that P4mNC-FET cycles produce clinical outcomes comparable to those of more traditional HRT-FET while allowing greater flexibility in the timing of embryo transfer.

IMPLEMENTATION OF ENERGY EFFICIENT SECURITY MECHANISMS FOR WIRELESS SENSOR NETWORKS

Designing energy-efficient security mechanisms is critical for WSNs due to their limited power resources. Techniques like low-power cryptography, duty cycling, and energy-aware security protocols can help in achieving security without significantly impacting the energy consumption of sensor nodes. In this paper, we propose an energy aware geographical multipath routing scheme for WSNs. The distance to the destination location, remaining battery capacity, and queue size of candidate sensor nodes in the local communication range are taken into consideration for next hop relay node selection, and Analytical Hierarchy Process (AHP) and Geographical Routing Algorithm (GRA) are applied for decision making. Simulation results show that these schemes can extend the network lifetime longer than the original geographical routing scheme which only considers distance to the destination location. KEYWORDS: WSN, linear discriminate packet flow analysis system, optimized rout path switch, Analytical Hierarchy Process (AHP) and Geographical Routing Algorithms(GRA).

Reducing the Initial Capacity Loss in High-Nickel Cathodes with a Higher Upper Cut-off Voltage Formation Cycle Protocol

Reducing the Initial Capacity Loss in High-Nickel Cathodes with a Higher Upper Cut-off Voltage Formation Cycle Protocol

A gas sensor based on free-standing SWCNT film for selective recognition of toxic and flammable gases under thermal cycling protocols

The widespread adoption of e-nose devices based on chemiresistive materials has been hindered by issues related to sensor device complexity and reliability, specifically sensor drift, necessitating frequent recalibration and retraining of pattern recognition models. This study introduces a method for thermocycling a single sensor based on a free-standing network of single-walled carbon nanotubes (SWCNTs) to acquire signal patterns for selective analyte detection. Additionally, it employs a data filtering technique to compensate for the sensor drift. A free-standing SWCNT film, only a few nanometers thick, is thermally cycled via Joule heating between room temperature and 120 °C. Under these conditions, the sensitivity was tested towards NO2, H2S, and acetone vapors (10–25 ppm) in the mixture with dry air. Signal patterns produced through thermocycling were processed using CatBoost and LSTM algorithms. The accuracy of detection reached 90 % in the classification task, and the average root mean squared error of analyte concentration detection in the multioutput regression task was below 4 ppm. By combining original sensor design, thermocycling, signal filtering for drift compensation, and advanced pattern recognition models, this work contributes to overcoming the challenges in multivariate sensing systems, paving the way for practical applications of the more reliable chemiresistive sensors.

Understanding mechanical stresses upon solid-state battery electrode cycling using discrete element method

Solid-state batteries (SSBs) often fall behind conventional lithium-ion batteries (LIBs) in performance. Electrochemical cycling protocols, in particular under isostatic compression, present ample opportunities for improvement to mitigate issues like contact loss and aging among numerous other challenges. This study introduces a novel Discrete Element Method (DEM) workflow to assess the effectiveness of uniaxial and isostatic compression as proceeding electrode preparation on the conductivity and structural integrity of SSBs. Isostatic compression achieves conductivity levels comparable to uniaxial compression with significantly reduced pressure requirements. In contrast, uniaxial compression at elevated loads, while resulting in higher conductivity, subjects the particles to significant stress, increasing the risk of cracking and deformation of the SSB materials. This study shows the impact of mechanical stress during different stages of electrochemical cycling on the microstructure's integrity to provide valuable insights into electrochemistry-mechanics couplings, which can be challenging to evaluate experimentally.

Endometrial compaction to predict pregnancy outcomes in patients undergoing assisted reproductive technologies: a systematic review and meta-analysis.

Does endometrial compaction (EC) help predict pregnancy outcomes in those undergoing ART? EC is associated with a significantly higher clinical pregnancy rate (CPR) and ongoing pregnancy rate (OPR), but this does not translate to live birth rate (LBR). EC describes the progesterone-induced decrease in endometrial thickness, which may be observed following the end of the proliferative phase, prior to embryo transfer. EC is proposed as a non-invasive tool to help predict pregnancy outcome in those undergoing ART, however, published data is conflicting. A literature search was carried out by two independent authors using PubMed, Cochrane Library, MEDLINE, Embase, Science Direct, Scopus, and Web of Science from inception of databases to May 2023. All peer-reviewed studies reporting EC and pregnancy outcomes in patients undergoing IVF/ICSI treatment were included. The primary outcome is LBR. Secondary outcomes included other pregnancy metrics (positive pregnancy test (PPT), CPR, OPR, miscarriage rate (MR)) and rate of EC. Comparative meta-analyses comparing EC and no EC were conducted for each outcome using a random-effects model if I 2 > 50%. The Mantel-Haenszel method was applied for pooling dichotomous data. Results are presented as odds ratios (OR) with 95% CI. Out of 4030 screened articles, 21 cohort studies were included in the final analysis (n = 27 857). No significant difference was found between LBR in the EC versus the no EC group (OR 0.95; 95% CI 0.87-1.04). OPR was significantly higher within the EC group (OR 1.61; 95% CI 1.09-2.38), particularly when EC ≥ 15% compared to no EC (OR 3.52; 95% CI 2.36-5.23). CPR was inconsistently defined across the studies, affecting the findings. When defined as a viable intrauterine pregnancy <12 weeks, the EC group had significantly higher CPR than no EC (OR 1.83; 95% CI 1.15-2.92). No significant differences were found between EC and no EC for PPT (OR 1.54; 95% CI 0.97-2.45) or MR (OR 1.06; 95% CI 0.92-1.56). The pooled weighted incidence of EC across all studies was 32% (95% CI 26-38%). Heterogeneity due to differences between reported pregnancy outcomes, definition of EC, method of ultrasound, and cycle protocol may account for the lack of translation between CPR/OPR and LBR findings; thus, all pooled data should be viewed with an element of caution. In this dataset, the significantly higher CPR/OPR with EC does not translate to LBR. Although stratification of women according to EC cannot currently be recommended in clinical practice, a large and well-designed clinical trial to rigorously assess EC as a non-invasive predictor of a successful pregnancy is warranted. We urge for consistent outcome reporting to be mandated for ART trials so that data can be pooled, compared, and concluded on. H.A. was supported by the Hewitt Fertility Centre. S.G.P. and J.W. were supported by the Liverpool University Hospital NHS Foundation Trust. D.K.H. was supported by a Wellbeing of Women project grant (RG2137) and MRC clinical research training fellowship (MR/V007238/1). N.T. was supported by the National Institute for Health and Care Research. D.K.H. had received honoraria for consultancy for Theramex and has received payment for presentations from Theramex and Gideon Richter. The remaining authors have no conflicts of interest to report. PROSPERO CRD42022378464.

Circadian serum progesterone variations on the day of frozen embryo transfer in a modified natural cycle protocol.

Is there a circadian variation of serum progesterone (P) on the day of frozen embryo transfer (FET) in a modified natural cycle (mNC)? There is a statistically significant diurnal variation of serum P on the day of a FET in an mNC protocol. In recent years, the proportion of FET cycles has increased dramatically. To further optimize pregnancy outcomes after FET, recent studies have focused on serum luteal P levels in both natural and artificially prepared FET cycles. Despite the different cut-off values proposed to define low serum P in the NC, it is generally accepted that lower serum P values (<10 ng/ml) around the day of FET are associated with negative reproductive outcomes. However, a single serum P measurement is not reliable given that P levels are prone to diurnal fluctuations and are impacted by patients' characteristics. A prospective cohort study was conducted in a single university-affiliated fertility center, including 22 patients performing a single blastocyst mNC-FET from August 2022 to August 2023. Serum P levels were measured on the day of transfer at 08:00h, 12:00h, 16:00h, and 20:00h. Differences between P levels were compared using the Wilcoxon signed-rank test. The sample size was calculated to detect a difference of 15% between the first and last P measurements with a 5% false-positive rate and a 95% CI. Patients with a normal BMI, between 18 and 40 years old, without uterine diseases were eligible. Patients utilizing donated oocytes were excluded. The mNC-FET protocol involved monitoring the normal ovarian cycle and triggering ovulation with an injection of 250 μg of choriogonadotropin alfa when a pre-ovulatory follicle (16-20 mm diameter) was visualized. The blastocyst was transferred seven days later. The patients were not supplemented with exogenous P at any time before the day of the FET. The mean age and BMI of the study population were 33.6 ± 3.8 years and 22.7 ± 1.8 kg/m2, respectively. Mean P values at 08:00h, 12:00h, 16:00h, and 20:00h were 14.6 ± 4.5, 14.7 ± 4.1, 12.9 ± 3.5, and 14.6 ± 4.3 ng/ml, respectively. The mean P levels at 16:00h were significantly lower compared to all other time points (P < 0.05: P = 0.007 between P at 8:00h and 16:00h; P = 0.003 between P at 12:00h and 16:00h; P = 0.007 between P at 16:00h and 20:00h). No statistically significant difference was observed between P values at the other time points (P > 0.05: P = 0.88 between P at 8:00h and 12:00h; P = 0.96 between P at 8:00h and 20:00h; P = 0.83 between P at 12:00h and 20:00h). The study's limitations include the small sample size that may cause a bias when the results are extrapolated to a larger subfertile population undergoing mNC-FET. Ideally, larger prospective trials including a more heterogeneous patient population would be necessary to validate our findings. The current study demonstrates the existence of a diurnal fluctuation of serum P on the day of mNC-FET highlighting the importance of a standardized time point for its measurement. This is especially important for considering clinical actions, such as additional exogenous P supplementation, when encountering P values lower than 10 ng/ml on the day of FET. No funding was obtained for the study. The authors have no conflicts of interest to declare regarding the content of the study. NCT05511272.

Attention towards chemistry agnostic and explainable battery lifetime prediction

Predicting and monitoring battery life early and across chemistries is a significant challenge due to the plethora of degradation paths, form factors, and electrochemical testing protocols. Existing models typically translate poorly across different electrode, electrolyte, and additive materials, mostly require a fixed number of cycles, and are limited to a single discharge protocol. Here, an attention-based recurrent algorithm for neural analysis (ARCANA) architecture is developed and trained on an ultra-large, proprietary dataset from BASF and a large Li-ion dataset gathered from literature across the globe. ARCANA generalizes well across this diverse set of chemistries, electrolyte formulations, battery designs, and cycling protocols and thus allows for an extraction of data-driven knowledge of the degradation mechanisms. The model’s adaptability is further demonstrated through fine-tuning on Na-ion batteries. ARCANA advances the frontier of large-scale time series models in analytical chemistry beyond textual data and holds the potential to significantly accelerate discovery-oriented battery research endeavors.

Carbon Corrosion Induced by Surface Defects Accelerates Degradation of Platinum/Graphene Catalysts in Oxygen Reduction Reaction.

Graphene supported electrocatalysts have demonstrated remarkable catalytic performance for oxygen reduction reaction (ORR). However, their durability and cycling performance are greatly limited by Oswald ripening of platinum (Pt) and graphene support corrosion. Moreover, comprehensive studies on the mechanisms of catalysts degradation under 0.6-1.6V versus RHE (Reversible Hydrogen Electrode) is still lacking. Herein, degradation mechanisms triggered by different defects on graphene supports are investigated by two cycling protocols. In the start-up/shutdown cycling (1.0-1.6V vs.RHE), carbon oxidation reaction (COR) leads to shedding or swarm-like aggregation of Pt nanoparticles (NPs). Theoretical simulation results show that the expansion of vacancy defects promotes reaction kinetics of the decisive step in COR, reducing its reaction overpotential. While under the load cycling (0.6-1.0V vs.RHE), oxygen containing defects lead to an elevated content of Pt in its oxidation state which intensifies Oswald ripening of Pt. The presence of vacancy defects can enhance the transfer of electrons from graphene to the Pt surface, reducing the d-band center of Pt and making it more difficult for the oxidation state of platinum to form in the cycling. This work will provide comprehensive understanding on Pt/Graphene catalysts degradation mechanisms.

ACUTE INTERMITTENT HEAT EXPOSURE WITH MORE FREQUENT AND SHORTER COOLING BREAKS ENHANCES PERFORMANCE AND ELICITS COMPARABLE PHYSIOLOGICAL RESPONSES TO CONTINUOUS HEAT EXPOSURE

INTRODUCTION &amp; AIMS Heat acclimation (HA) is critical to mitigate the adverse effects of heat on exercise performance. While these methods yield physiological adaptations to heat, it also results in greater internal training load. This can potentially compromise training quality and lead to overreaching. Therefore, there is a need for HA protocols that address situations where training quality is crucial, yet the heat stimulus is necessary. The aim of this study was to investigate the influence of shorter, more frequent rest breaks with per-cooling (PerC) as an alternative HA session on physiological, perceptual, and self-paced maximal cycling performance, compared to continuous heat exposure. METHODS Thirteen participants completed one continuous and three intermittent heat exposure (IHE) maximal self-paced cycling protocols matched for total exercise and rest duration, in a random order in heat (36°C, 80% relative humidity): 1 x 60-min exercise (CON), 3 x 20-min exercise with 7.5-min rest between sets (IHE-20), 4 x 15-min exercise with 5-min rest between sets (IHE-15), 6 x 10-min exercise with 3-min rest between sets (IHE-10). Mixed-method PerC (crushed-ice ingestion and cooling vest) was applied during rest periods of all IHE protocols. RESULTS Total distance completed was greater in IHE-10, IHE-15, and IHE-20 compared to CON (+11%, +9%, and +8%, respectively), with no difference observed between IHE protocols. Total time spent above 38.5°C core temperature (Tc) was longer in CON compared to IHE-15 and IHE-20 (+62% and +78%, respectively), but similar to IHE-10 (+5%). Furthermore, a longer time above 38.5°C Tc occurred in IHE-10 versus IHE-15 and IHE-20 (+54% and +69%, respectively). Sweat loss did not differ between conditions. CONCLUSION Intermittent heat exposure with PerC may be a viable alternative HA protocol in situations where training quality takes precedence over thermal stimulus, or when both factors hold equal priority.

Comparison of four in vitro test methods to assess nucleus pulposus replacement device expulsion risk.

Nucleus replacement devices (NRDs) are not routinely used in clinic, predominantly due to the risk of device expulsion. Rigorous in vitro testing may enable failure mechanisms to be identified prior to clinical trials; however, current testing standards do not specify a particular expulsion test. Multiple methods have therefore been developed, complicating comparisons between NRD designs. Thus, this study assessed the effectiveness of four previously reported expulsion testing protocols; hula-hoop (Protocol 1), adapted hula-hoop (Protocol 2), eccentric cycling (Protocol 3), and ramp to failure (Protocol 4), applied to two NRDs, one preformed and one in situ curing. Nucleus material was removed from 40 bovine tail intervertebral disks. A NRD was inserted posteriorly into each cavity and the disks were subjected to one of four expulsion protocols. NRD response was dependent on both the NRD design and the loading protocol. Protocol 1 resulted in higher migration and earlier failure rates compared to Protocol 2 in both NRDs. The preformed NRD was more likely to migrate when protocols incorporated rotation. The NRDs had equal migration (60%) and expulsion (60%) rates when using unilateral bending and ramp testing. Combining the results of multiple tests revealed complimentary information regarding the NRD response. Adapted hula-hoop (Protocol 2) and ramp to failure (Protocol 4), combined with fluoroscopic analysis, revealed complimentary insights regarding migration and failure risk. Therefore, when adopting the surgical approach and animal model used in this study, it is recommended that NRD performance be assessed using both a cyclic and ramp loading protocol.

Uniform and local degradation of epoxy-based powder coatings: Salt transport and accelerated exposure analysis

The barrier performance of epoxy-based powder coatings for pipelines was evaluated through salt transport measurements through free-standing coating films and via cyclic testing of coated steel panels. The permeability of salt through the free-standing coating films was measured using reverse osmosis techniques under hydraulic pressures relevant to industrial use. These tests showed that fusion bonded epoxy (FBE) and high-performance powder coating (HPPC) have low salt permeability. Accelerated exposure tests were then conducted on the coated steel panels, subjecting them to humidified environments, ultraviolet (UV) light, and salt/fog conditions, all in accordance with ASTM D5894. Some of the exposure conditions (e.g., intensity of UV light and humidity) were modified to examine the impact of each parameter on the relative performance of these coating systems. The reversibility of the coating properties was characterized by a thermal cycling protocol and adhesion performance analysis. Alternative exposure to dry- and wet-cycles (at 60 °C and 50 °C, respectively), salt/fog conditions and UV light results in irreversible damage to the coatings as early as two weeks. However, coated panels exposed to a lower UV intensity (one tenth of the value defined by the standard) showed minimal degradation of FBE, meaning that the most critical parameter was the UV radiation exposure. For one 336-h ageing sequence under UV exposure, the HPPC exhibited superior performance compared to FBE. More importantly, our extended exposure sequences showed that while the FBE coating structure undergoes a slow ablation process, indicating significant surface damage, it still retains its effectiveness as a barrier. However, the osmotic pressures around coated pipes and the pre-existing, unavoidable, porosity throughout the coating thickness can facilitate local through-thickness pinholes, which could potentially serve as areas susceptible to cathodic disbondment.

In vitro fertilization practice in patients with absolute uterine factor undergoing uterus transplant in the United States

ObjectiveReport detailed, pooled multicenter experiences and outcomes after IVF among patients undergoing uterus transplantation in the United States. DesignCohort study SubjectsPatients undergoing uterus transplant from the three longest running uterus transplant clinical trials in the United States. InterventionIn vitro fertilization among uterus transplant patients Main Outcome MeasuresReproductive outcomes pre- and post-transplant ovarian stimulation Results31 uterus transplant recipients were included in this cohort (mean age at transplant was 31 years, standard deviation 4.7). Prior to transplant, recipients completed a mean of 2 oocyte retrievals (range 1-4), banking a mean of 8 untested embryos (range 3-24) or 6 euploid embryos (range 2-10). Post-transplant retrieval cycles were required in 19% of recipients (n=6/31): a total of 16 cycles (range 2-4 cycles per recipient). All post-transplant retrievals were performed vaginally without complication. Preimplantation genetic testing was used by 74% of subjects (n=23/31). 72 autologous single embryo transfers occurred in 23 patients who completed at least one embryo transfer. Two embryo transfers followed a fresh IVF cycle and the remainder were frozen embryo transfers (n=70). Endometrial preparation during was more commonly performed with programmed protocols (n=61) (exogenous administration of estrogen/progesterone) compared to natural cycle protocols (n=9). The overall live birth rate for this cohort was 35% (n=25/72) per embryo transfer. Among those patients who had an embryo transfer leading to a live birth (n=21), a mean of 2.2 embryo transfers was performed. The overall live birth rate after the first embryo transfer was 57% (n=13/23) and rose to 74% after a second embryo transfer (n=17/23). There was no difference in rate of preeclampsia, live birth, neonatal birth, or placental weights among programmed versus natural cycle frozen embryo transfers. There were no differences in the live birth rate between living or deceased donor uteri (37% versus 32%, p=0.6). ConclusionsPost-transplant ovarian stimulation was required in 26% (n=6/23) of recipients undergoing at least one embryo transfer despite high rates of preimplantation genetic testing and pre-transplant embryo cryopreservation. Post-transplant retrievals were performed transvaginally, without complication. Future reporting of IVF experience will be essential to optimize reproductive outcomes after uterus transplant.

Relating Chemo-Mechanical Hysteresis and Formation Protocols for Anode-Free Lithium Metal Batteries

Cell formation is an energy and time-intensive empirically-guided process crucial to manufacturing secondary lithium-ion batteries. As the rechargeable battery industry moves towards manufacturing lithium metal batteries—where a metallic lithium negative electrode is used instead of a porous graphite composite—the cell formation process may need reconsidering. The effects of formation rate and cycling protocol on lithium metal battery performance are poorly understood. In this work, we used operando acoustic transmission to measure physical changes during the formation cycles and the effect of formation cycling protocols on the long-term cycling of anode-free lithium metal pouch cells—where all the lithium inventory comes from the positive electrode and is deposited as metallic lithium on copper foil during initial charge. We show that a faster C/3 formation protocol results in comparable cycling performance and cell stiffness change to a slower C/10 formation step. Variations in acoustic metrics across different electrolytes tested are attributed to differences in gas formation, cell swelling, and lithium deposition morphology. NMC811 cathodes paired with a high-concentration ether electrolyte are shown to be particularly prone to gas formation, which is mitigated by using a localized high-concentration ether electrolyte and single-crystal NMC532. The results highlight differences in formation behavior between anode-free lithium metal cells and lithium-ion cells. These are important to consider when bringing new manufacturing plants online for lithium metal batteries.

Unravelling the Mechanism of Pulse Current Charging for Enhancing the Stability of Commercial LiNi0.5Mn0.3Co0.2O2/Graphite Lithium‐Ion Batteries

AbstractThe key to advancing lithium‐ion battery (LIB) technology, particularly with respect to the optimization of cycling protocols, is to obtain comprehensive and in‐depth understanding of the dynamic electrochemical processes during battery operation. This work shows that pulse current (PC) charging substantially enhances the cycle stability of commercial LiNi0.5Mn0.3Co0.2O2 (NMC532)/graphite LIBs. Electrochemical diagnosis unveils that pulsed current effectively mitigates the rise of battery impedance and minimizes the loss of electrode materials. Operando and ex situ Raman and X‐ray absorption spectroscopy reveal the chemical and structural changes of the negative and positive electrode materials during PC and constant current (CC) charging. Specifically, Li‐ions are more uniformly intercalated into graphite and the Ni element of NMC532 achieves a higher energy state with less Ni─O bond length variation under PC charging. Besides, PC charging suppresses the electrolyte decomposition and continuous thickening of the solid‐electrolyte‐interphase (SEI) layer on graphite anode. These findings offer mechanistic insights into Li‐ion storage in graphite and NMC532 and, more importantly, the role of PC charging in enhancing the battery cycling stability, which will be beneficial for advancing the cycling protocols for future LIBs and beyond.