Twin Group Research Articles

THE RISKS OF BEING A PRETERM TWIN

Aim: Twins may have additional clinical problems compared to singletons, but there is insufficient information about whether preterm twins (especially those born before 32 weeks of gestation) are at greater risk than singletons. This study aimed to compare morbidity and mortality in twins and singletons born before 32 weeks of gestation. Materials and Methods: Infants with a gestational age (GA) < 32 weeks who were followed in our unit between July 2019 and December 2020 were examined retrospectively. The demographic and clinical characteristics of the infants were recorded and compared between twins and singletons. Results: A total of 770 preterm infants were included in the study, 584 singletons and 186 twins. The singleton group had higher rates of maternal hypertension and small for GA status, while the rate of cesarean delivery was higher in the twins group (p<0.05). Other demographic characteristics and clinical outcomes were similar in the singleton and twin groups (p<0.05). Conclusion: Preterm morbidity and mortality were similar in the twin and singleton groups in this study. This can be attributed to the similar GA and birth weight (BW) in both groups. Therefore, our results suggest that the main determinants of mortality and morbidity in preterm infants are GA and BW rather than twin pregnancy.

Hollywood Baby

What is the essence of parenting? Can a company, or the state, ever fulfill this essence and be a good parent to children? In this work of philosophical short story fiction, Araminta Fox and her twin sister, Anastasia Fox, were conceived and brought into the world by Fox Television. They are the property of Fox and, while they have surrogates, they are not the legal parents of the children, the Fox entity is. The children are raised by a casting director, Beth, who receives direction and funding from the Fox board of directors. Araminta and Anastasia continue to work and grow in television and movies. Araminta enjoys the work, her sister does not. They are both emancipated at eighteen years old. Araminta continues to work in theatre while her sister goes to school, meets a boy, and gets married. Eventually, Fox reaches out to Araminta for a new TV show and asks her to be the “mother” to a new group of twins they are ready to birth and raise within the Hollywood system. Araminta is thrilled to do until she reads a clause in the contract stating that the caretaker for the twins will be rotated every five years; these twins will not have a “Beth” of their own.

Day-3 vs. Day-5 fresh embryo transfer.

Embryo transfer on day-5 has been associated with higher success rates, therefore our IVF clinics started to extend embryo culture until blastocyst stage. This study aimed to compare the success rates of day-3 vs. day-5 embryo transfers. We had 266 patients included, all having undergone ICSI, with 221 patients having undergone day-3 embryo transfers, and 45 patients having undergone day-5 embryo transfers. Patients with more than five good quality embryos on day-3 were chosen to prolong the culture of embryos into day-5. There were no significant differences in patient characteristics, including baseline LH, FSH, Prolactin and Estradiol hormone levels. In addition, there were also no significant differences in rFSH total dosage and duration of stimulation day. Final estradiol levels, number of follicles, retrieved oocytes, matured oocytes, fertilized oocytes and number of embryos were significantly higher in day-5 compared to day-3 embryo transfer groups. Number of embryos transferred on day-3, were significantly higher compared to day-5. Neither group showed any significant differences in clinical pregnancy, implantation, multiple pregnancy or living birth rates. There were no differences in birth weights and lengths, head circumstances and Apgar Scores between both groups either in singleton or twin group. Transferring embryos at day-3 may provide the same benefits as day-5 embryo transfers to patients. However, more embryos were required to be transferred to achieve these comparable results.

Perinatal Outcomes of Using Ursodeoxycholic Acid to Treat Monochorionic and Dichorionic Twin Pregnancy Complicated by Intrahepatic Cholestasis of Pregnancy

To study the effect of using ursodeoxycholic acid (UDCA) to treat monochorionic and dichorionic twin pregnancies complicated by intrahepatic cholestasis of pregnancy (ICP) and to examine the differences in perinatal outcomes. A total of 406 twin-carrying pregnant women who had ICP and received care at West China Second Hospital, Sichuan University between January 1, 2015 and November 1, 2018 were included in the study. The clinical data of monochorionic diamniotic (MCDA) and dichorionic diamniotic (DCDA) twins with ICP were analyzed. Analysis was done to compare the treatment effect for lowering serum total bile acid (TBA) and the perinatal outcomes with simple UDCA medication or combination medication. There were no statistically significant differences in TBA levels, early-onset ICP, simple UDCA medication or combination medication, neonatal Apgar score, birth weight, length of hospital stay, C-section rate, and perinatal mortality between the MCDA and the DCDA twin groups with ICP. However, maternal age, BMI, scarred uterus, in vitro fertilization-embryo transfer, preeclampsia, twin comorbidity rate of the two groups showed statistical differences. Further comparison between twin pregnancies with mildly-elevated TBA and those with severely-elevated TBA showed significant difference in preterm birth rate ( P<0.05). Simple UDCA medication or combination medication may have the same therapeutic effect on MCDA and DCDA twin pregnancies with ICP. Monochorionic twin pregnancy, twin comorbidities and pregnancy complications were still important factors affecting pregnancy outcomes of twin pregnancies with ICP. Twin pregnancies with slightly elevated TBA have been managed as severe ICP, which may be associated with increased iatrogenic preterm births.

Latency to delivery in physical examination-indicated cerclage in twins is similar to that in singleton pregnancies.

To compare latency to delivery and perinatal outcomes between twin and singleton pregnancies undergoing physical examination-indicated cerclage. Retrospective observational study (2007-2017) of women who underwent physical examination-indicated cerclage at the Hospital Clinic of Barcelona. Primary outcomes were latency from cerclage to delivery and gestational age at delivery. Secondary outcomes included: neonatal morbidity and mortality, preterm prelabor rupture of membranes, clinical chorioamnionitis and cerclage displacement. Wilcoxon-test and χ2 test were used to compare continuous and categorical variables. Sixty women were included (17 twins and 43singletons). There were no differences in gestational age at cerclage or presence of bulging membranes between groups. Median (25th;75th percentile) gestational age at delivery was 27.1 (24.5;32.3) weeks in the twin group and 27.6 (25.3;35.3) weeks in the singleton group (P=0.594). There were no statistically significant differences in latency from cervical cerclage to delivery between the two groups (43days [21;64] vs. 29days [16;76], respectively; P=0.938). There were no differences in neonatal mortality (2/26 [7.7%] vs. 1/33 [3.1%]; P=0.578) or in composite neonatal morbidity (14 [53.9%] vs. 14 [42.4%]; P=0.283) between groups, respectively. These results suggest that physical examination-indicated cerclage placement in twins could prolong latency to delivery similarly to singleton pregnancies.

Dental age estimation using three different methods in monozygotic and dizygotic twins

ABSTRACT Dental development, one of the most reliable indicators of chronological age (CA), has been believed to be fundamentally influenced by genetics rather than environmental factors. The study aims (i) to compare dental ages (DAs) in monozygotic (MZ) and dizygotic (DZ) twins using three different DA methods and determining the most appropriate method, and (ii) to determine the possible effects of genetics on DA by evaluating the differences in the estimated DAs of MZ and DZ twins. The study sample consisted of 171 twin pairs (47 monozygotic, 124 dizygotic) between the ages of 5.0 and 12.9. In order to estimate DA, Demirjian, Willems and Nolla methods were used. The mean CA of group was 8.42 (2.05) years. The Demirjian, Willems and Nolla methods overestimated the DAs by 0.69, 0.60 and 0.56 years, respectively. The estimated DAs in age groups were similar, and differences were not statistically significant for intrapair DZ and MZ twins. As a result, it was not correct to state that any method was more appropriate and better than others for studies of twins. All methods’ standards were not suitable for any age groups of MZ and DZ twins, except for twins aged 12–12.9 years. Country-wide samples are needed to gather enough data to create valuable results and to establish the applicability of methods used.

Experience with different techniques of laser coagulation of placental anastomoses to relieve feto-fetal transfusion syndrome in monochorionic diamniotic twins

Introduction. In recent years, the problem of multiple fetuses has become particularly important, which is associated with a steady increase in the frequency of multiple pregnancies worldwide. The feto-fetal transfusion syndrome (FFTS) is a classic example of unbalanced functioning of placental anastomoses, which leads to transfusion between fetuses. The incidence of this syndrome in a group of monochorionic diamniotic twins ranges from 8% to 15% and, in the absence of timely diagnosis and intrauterine correction, leads to death of one or both fetuses in 70-100% of cases. The effect of different methods of intrauterine surgical correction of FFTS in monochorionic diamniotic multiple fetuses on perinatal outcomes is of scientific interest. Purpose of the study — to investigate the effect of different types of laser coagulation of placental anastomosis (LCPA) on perinatal outcomes in intrauterine surgical correction of FFTS. Materials and methods. Depending on the surgical technique used, women were divided into three groups: the total placental anastomosis coagulation method, Group 1 (58 pregnant women); the selective placental anastomosis coagulation method, Group 2 (67 pregnant women); the sequential selective laser coagulation of placental anastomoses, Group 3 (62 pregnant women). Results. We analyzed the results of intrauterine surgical correction of FFTS by different methods of laser coagulation of placental anastomoses in 187 women with monochorionic diamniotic type of placentation of II-IV degrees according to Quintero. We obtained statistically significant differences in many perinatal period indices depending on the LCPA method used. Discussion. Sequential selective LCPA has proven to be the most effective, safe, and promising technique for correction of FFTS. The data obtained indicate possible ways to improve pregnancy prolongation and fetal survival rates after the use of intrauterine surgical correction of placental vascular anastomoses. Conclusion. Sequential selective LCPA has proven to be the best technique to correct FFTS with the least perinatal losses and postoperative complications, as well as the highest efficacy.

The Effects of Different Post-thawed Culture Periods on Clinical Outcomes in Frozen Embryo Transfer Cycle.

The purpose of this study is to evaluate the effects of different post-thawed culture periods on the clinical outcomes. 9381 frozen embryo transfer (FET) cycles were divided into three groups according to female age: < 35, 35-39, and > 39years, and two groups depending on post-thawed culture period before transfer: short culture (2-3h) group (S) and long culture (18-20h) group (L). According to the increment number of post-thawed embryos, the L group divided into three groups: ≤ 2, one ≤ 2 and the other > 2, and > 2 groups. Pregnancy outcomes included the implantation rate (IR), clinical pregnancy rate (CPR), multiple pregnancy rate (MPR), live birth rate (LBR), and neonatal characteristics. Long post-thawed culture caused a significant increase in the IR, CPR, MPR, and LBR (p = 0.000, 0.004, 0.037, and 0.001; CI = 1.06-1.194, 1.042-1.237, 1.008-1.254, and 1.054-1.245, respectively), and blastomere increment number also had a significant effect on IR, CPR, MPR, and LBR (p = 0.000, 0.000, 0.000, and 0.000, respectively). No significant differences were present in neonatal characteristics between the two post-thawed culture groups. Singleton group had a higher average gestational age and birthweight as well as a lower cesarean section rate, preterm labor rate, and low birthweight rate than twins group. Long post-thawed culture was associated with higher IR, CPR, MPR, and LBR, and transferring a well-developed embryo after long post-thawed culture might be a viable embryo transfer strategy to decrease MPR while maintaining CPR and LBR.

Functional development of preterm children born from singleton and multiple pregnancies: Preliminary study.

BackgroundIn recent years an increasing number of multiple pregnancies have been observed, which is a result of advancements made in reproductive technologies for infertility treatments as well as a tendency for women to delay childbearing until later in life. The risk of preterm birth in the case of a twin pregnancy is five to seven times higher than that of a singleton pregnancy, and in the case of triplet pregnancy, the risk is even 10 times higher. The objective of the study was to assess and compare the functional development of children aged between 2 and 2.5 who were prematurely born from singleton, twin and triplet pregnancies.Material and methodsThe study was carried out in a group of 43 children aged between 2 and 2.5 who were born prematurely (between the 32nd and 36th week of pregnancy) in 2017 and 2018. Group I was made up of 10 children born from singleton pregnancies, group II included 12 children born from six twin pregnancies and group III consisted of 21 children born from seven triplet pregnancies. The evaluation of functional development was conducted using the Munich Functional Developmental Diagnostics.ResultsThere were no statistically significant differences in functional development between the studied singletons, twins and triplets. In the examined groups of singletons, twins and triplets, the calculated quotient medians for the 50th percentile approximated 1, which means that development was typical and did not differ from the development of the general population. In turn, for the 95th percentile, the median scores usually approximated 0.8, which also indicated that there was no significant delay in development. Had scores been higher than 1, this might have indicated a delay.ConclusionsOn the basis of the study group, no relationship was found between the multiplicity of pregnancies and the functional development of premature babies born between the 32nd and 36th weeks of gestation.

Metabolites of gut microbiome are associated with glucose metabolism in non-diabetic obese adults: a Chinese monozygotic twin study

BackgroundEvidence suggests gut microbiome is associated with diabetes. However, it’s unclear whether the association remains in non-diabetic participants. A Chinese monozygotic twin study, in which the participants are without diabetes, and are not taking any medications, was conducted to explore the potential association.MethodsNine pairs of adult monozygotic twins were enrolled and divided into two twin-pair groups (a and b). Clinical and laboratory measurements were conducted. Visceral adipose tissue (VAT) was assessed. Fecal samples were collected to analyze the microbiome composition by 16S rDNA gene amplicon sequencing. Liquid chromatography mass spectrometry was performed to detect the metabolites.ResultsThe participants aged 53 years old averagely, with 8 (88.9%) pairs were women. All the participants were obese with VAT higher than 100 cm2 (152.2 ± 31.6). There was no significant difference of VAT between the twin groups (153.6 ± 30.4 cm2 vs. 150.8 ± 29.5 cm2, p = 0.54). Other clinical measurements, including BMI, lipid profiles, fasting insulin and blood glucose, were also not significantly different between groups (p ≥ 0.056), whereas HbA1c level of group a is significantly higher than group b (5.8 ± 0.3% vs. 5.6 ± 0.2%, p = 0.008). The number and richness of OTUs are relatively higher in group a, and 13 metabolites were significantly different between two groups. Furthermore, several of the 13 metabolites could be significantly linked to special taxons. The potential pathway involved drug metabolism-other enzymes, Tryptophan metabolism and Citrate cycle.ConclusionsGut microbiome composition and their metabolites may modulate glucose metabolism in obese adults without diabetes, through Tryptophan metabolism, Citrate cycle and other pathways.

Analysis of the effect of modified cervical cerclage in the treatment of cervical insufficiency

Objective: To discuss the surgical effect of modified cervical cerclage for the treatment of pregnant women with cervical insufficiency. Methods: The clinical data of 225 pregnant women who underwent modified cervical cerclage in Qilu Hospital (Qingdao) were selected for retrospective analysis from April 2014 to June 2020. Surgical success rate, full-term birth rate, preterm birth rate, prolonged pregnancy weeks and newborn birth weight were compared between singleton and twin pregnancies, preventive cerclage and emergency cerclage, surgery before and after 18 weeks, naturally and in vitro fertilization and embryo transfer (IVF-ET) conceived pregnant women respectively. Results: Among the 225 pregnant women, the gestational weeks of surgery were 14-24+5 weeks, mean gestational weeks of delivery were 38+2 weeks (35+5-39+3 weeks), the number of prolonged gestation were (20.3±5.2) weeks, and the newborn birth weight was (3 065±735) g; the overall surgical success rate was 92.9% (209/225), and the miscarriage rate was 7.1% (16/225); among the surviving newborns, the full-term birth rate was 73.7% (154/209), and the preterm birth rate was 26.3% (55/209). All cases had no intraoperative complications. Among the 225 pregnant women, 202 (89.8%, 202/225) cases were singleton pregnancies, and 23 (10.2%, 23/225) cases were twin pregnancies; 201 (89.3%, 201/225) cases underwent preventive cervical cerclage, and 24 (10.7%, 24/225) cases underwent emergency cervical cerclage; 190 (84.4%, 190/225) cases underwent the surgery before 18 weeks, and 35 (15.6%, 35/225) cases underwent the surgery after 18 weeks; 49 (21.8%, 49/225) cases were conceived by IVF-ET. There was no statistically significant difference in the overall surgical success rate of single and twin group (P>0.05). The full-term birth rate, newborn birth weight and prolonged pregnancy weeks of single group were higher than those of twin group (P<0.05). There were no statistical differences between preventive and emergency cerclage in overall surgical success rate, full-term birth rate, preterm birth rate, and newborn birth weight (all P>0.05). The pregnancy prolonged weeks of preventive cerclage was higher than that of emergency cerclage (P<0.05). There were no statistically significant differences in the overall surgical success rate, full-term birth rate, preterm birth rate and birth weight of newborns at different surgical timings (all P>0.05). The pregnancy prolonged week for those who underwent surgery before 18 weeks was higher than that of surgery after 18 weeks (P<0.05). The premature birth rate of IVF-ET was higher than that of naturally conceived pregnant women (P<0.05). Conclusion: The modified cervical cerclage could effectively prolong the gestational weeks of delivery, reduce the rate of preterm birth, and the operation is simple and easy to promote. It could be used as a surgical option for patients with cervical insufficiency.

Gestational diabetes and fetal growth in twin compared with singleton pregnancies

Gestational diabetes mellitus is associated with accelerated fetal growth in singleton pregnancies but may affect twin pregnancies differently because of the slower growth of twin fetuses during the third trimester of pregnancy and their greater predisposition to fetal growth restriction. This study aimed to evaluate the association of gestational diabetes mellitus with longitudinal fetal growth in twin pregnancies and to compare this association with that observed in singleton pregnancies. This was a retrospective cohort study of all women with a singleton or twin pregnancy who were followed up at a single tertiary referral center between January 2011 and April 2020. Data on estimated fetal weight and individual fetal biometric indices were extracted from ultrasound examinations of eligible women. Generalized linear models were used to model and compare the change in fetal weight and individual biometric indices as a function of gestational age between women with and without gestational diabetes mellitus in twin pregnancies and between women with and without gestational diabetes mellitus in singleton pregnancies. The primary outcome was estimated fetal weight as a function of gestational age. The secondary outcomes were longitudinal growth of individual fetal biometric indices and the rate of small for gestational age and large for gestational age at birth. A total of 26,651 women (94,437 ultrasound examinations) were included in the analysis: 1881 with a twin pregnancy and 24,770 with a singleton pregnancy. The rate of gestational diabetes mellitus in the twin and singleton groups was 9.6% (n=180) and 7.6% (n=1893), respectively. The estimated fetal weight in singleton pregnancies with gestational diabetes mellitus was significantly higher than that in pregnancies without gestational diabetes mellitus (P<.001) starting at approximately 30 weeks of gestation. The differences remained similar after adjusting for maternal age, chronic hypertension, nulliparity, and neonatal sex (P<.001). In twin pregnancies, fetal growth was similar between pregnancies with and without gestational diabetes mellitus (P=.105 and P=.483 for unadjusted and adjusted models, respectively). The findings were similar to the association of gestational diabetes mellitus with the risk of large for gestational fetuses and the growth of each biometric index. When stratified by type of gestational diabetes mellitus treatment, twin pregnancies with gestational diabetes mellitus was associated with accelerated fetal growth only in the subgroup of women with medically treated gestational diabetes mellitus (P<.001), which represented 12% (n=21) of the twin pregnancy group with gestational diabetes mellitus. In contrast to singleton pregnancies, twin pregnancies with gestational diabetes mellitus is less likely to be associated with accelerated fetal growth. This finding has raised the question of whether the diagnostic criteria for gestational diabetes mellitus and the blood glucose targets in women diagnosed with gestational diabetes mellitus should be individualized for twin pregnancies.

Maternal lipid levels in preeclampsia: singleton vs. twin pregnancies

Objective To compare the maternal lipid levels in preeclampsia (PE) patients between singleton and twin pregnancies. Methods In this retrospective study, pregnant women with PE were divided into singleton group (n = 702) and twin group (n = 198). Serum lipids which include total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were measured and the TC/HDL-C ratio, TG/HDL-C ratio, and LDL-C/HDL-C ratio were calculated and compared between the two groups. Covariance analysis was used to correct the potential factors affecting serum lipid levels such as maternal age, pre-pregnancy body mass index, gestational weight gain, etc. Results The levels of TC, TG, LDL-C, and TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio in twin PE were significantly higher than those in singleton PE group, and there was no significant difference in the level of HDL-C between the two groups. In late-onset PE patients, the lipid levels of TC, TG, LDL-C, and TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio in twin PE group were significantly higher than those in singleton PE group, with no significant difference in the level of HDL-C. However, in early-onset PE patients, there were no significant differences in the lipid levels between the two groups. Conclusions There were more obvious lipid disturbances such as higher levels of TC, TG, LDL-C, and TC/HDL-C ratio, TG/HDL-C ratio, LDL-C/HDL-C ratio in twin PE group than singleton PE group. The differences of lipid levels appeared mainly in late-onset PE group, while the lipid levels in twin PE group were similar to those in singleton PE group during pregnancy in early-onset PE group.

Comparative evaluation of Skeletal, Dental, and Soft Tissue Changes in Class II Division 1 Malocclusion Cases Treated with Twin Block and innovative Clear Block Appliance - A Prospective Interventional Study

The present study was undertaken to evaluate and compare the skeletal, dental, and soft tissue changes in skeletal Class II division 1 cases treated with Twin Block and Clear Block appliances using a cephalogram. A total of 40 patients of age between 12-14 years were randomly divided into two equal groups. Group 1: treated with Twin Block appliance and Group 2: treated with Clear Block appliance. The pre-treatment lateral cephalogram was taken and skeletal, dental, and soft tissue parameters were evaluated and the appliance was delivered. After 8 months, another lateral cephalogram of all the cases was taken and analyzed. The pre and post-treatment values were compared between the two groups. The pre-treatment cases were almost comparable in skeletal, dental, and soft tissue features in both groups. There was a significant change in mandibular growth by SNB angle. The retrusion and extrusion of maxillary incisors as well as a proclination and extrusion of mandibular incisors were seen in group 1 while no change was observed in group 2. Treatment with Clear Block appliances has shown significant and favorable Skeletal, Dental and Soft tissue changes which are similar to already proven by the Twin Block appliance. Clear Block provides an esthetic and less bulky option for growth modification with similar results as compared to conventional Twin Block with the additional benefit of preventing lower incisor proclination.

COMPARATIVE ANALYSIS OF THE NEONATE BIRTH WEIGHT IN DIFFERENT TYPES OF TIN PREGNANCY

The relevance of the study lies in the significant increase in multiple pregnancies connected with the higher risk of perinatal complications, the controversy over the effects of chorionicity and sex of the babies on their birth weight, the need for timely diagnosis of fetal growth restriction, and associated morbidity.&#x0D; The objective of this study was to compare fetal weights at the birth of different variants of twins depending on chorionicity, gestational age, and sex.&#x0D; Materials and methods. During 2016-2020, 440 pairs of twins were examined: 375 dichorionic diamniotic and 65 monochorionic diamniotic (38 – boys, 27 – girls). Among dichorionic couples there were 186 (49.6%) opposite-sex, 98 (26.1%) same-sex males and 91 (24.3%) same-sex females. Fetal weight was measured at birth, and its relationship to chorionicity, fetal sex, a combination of same-sex or opposite-sex co-twins, and gestational age was assessed.&#x0D; Results. The average weight of 750 fetuses from dichorionic pairs (2570.0 ± 506.43 g) significantly exceeded the weight of 130 fetuses from monochorionic pairs (2333.4 ± 567.24 g, p &lt; 0.0001). The same-sex male (2603.8 ± 532.29 g) and opposite-sex dichorionic diamniotic (2595.6 ± 490.17 g). twins’ masses significantly surpassed the mass of all other twins (p &lt;0.05). In the group of dichorionic twins, the weight of boys exceeded the weight of girls (2638.1 ± 525.96 g vs. 2499.4 ± 475.84 g, p = 0.0002). This pattern was observed both inside the opposite-sex pairs (2674.2 ± 518.17 g vs. 2517.1 ± 448.24 g, p = 0.0019), and same-sex couples of boys compared to same-sex couples of girls (2603.8 ± 532.29 g and 2481.4 ± 503.08 g, respectively, p = 0.0224). No significant difference in the weight of girls of opposite-sex twins compared to same-sex couples was seen. In monochorionic pairs, the weight of male and female fetuses did not differ significantly. Birth weight discordance was found in all types of twins, the highest percentage of discordance was registered in monochorionic boys – 23.7%, second place in frequency took male dichorionic twins – 20.4%. Among the 30 discordant dichorionic opposite-sex twins in 19 (63.3%) cases, the male fetus was heavier. There was no significant difference in fetal weight when women were fertilized naturally and using assisted reproductive technologies. The average weight of children born by surrogate mothers exceeded the weight of children born by non-surrogate mothers (p = 0.0466). In the first pregnancy, children were born with a lower body weight compared to children born as a result of repeated pregnancies and in women who had a history of childbirth.&#x0D; Conclusion. The average weight of the fetuses of dichorionic twins was higher than the weight of the neonates f monochorionic pairs. The prevalence of the weight of boys over the weight of girls from dichorionic pairs and the absence of sex difference in fetal weight in monochorionic twins indicates the possibility of different functional activity of the placenta in fetuses of different sexes. Small for gestational age newborns were most often found in the group of female monochorionic twins and opposite-sex dichorionic pairs. Discordance of fetal mass was most common in monochorionic same-sex male twins. In discordant opposite-sex couples, the male fetus more often was heavier. There was no significant difference in newborn weight when women were fertilized naturally and with the use of assisted reproductive technologies. The average weight of surrogate-born children exceeded the weight of children born by non-surrogate mothers. In the first pregnancy, children were born with a lower body weight compared to children of multiparous and multigravida women.

Forensic investigation for twin identification from speech: perceptual and gamma-tone features and models

To assist an investigation process, forensic experts compare and analyze audio recordings. Speech utterances are compared by humans and/or machines for use in court for investigation. Scientific research community insists for specific automatic or human-based approach to identify uniquxy2e audio features from identical twins group. Filters can be employed to enhance an audio recording for improving clarity. This may entail removal of unnecessary noise to enrich the intelligibility of speech. Forensic audio experts can examine a variety of characteristics of the audio recording to decide the possibility of alterations in the collected evidences. This includes confirming the integrity and authenticating that the content is what it purports to be. Thiswork named as FIST(Forensic Investigation for Twin Identification from Speech: Perceptual and Gamma-tone Features and Models) proposes an automated system to identify a twin from identical twin pairs by the use of gamma-tone features and perceptual features.The proposed features are excerpted from the set of training speeches and templates are created for each twin based on vector quantisation (VQ), Fuzzy C means clustering (FCM) and multivariate hidden Markov modelling (MHMM) techniques. For testing, features are extracted from the set of test utterances and worked out to the templates for classification. Based on the type of classifier used, classification of twin is carried out with minimum distance and maximum loglikelihood value. The proposed features are examinedfor sub-optimal and true success rates as key performance metrics to assess the system and also a comparative analysis is made across the proposed features. Among the inspected features, Gammatone energy features expose better performance in comparison to perceptual features by attaining the overall sub-optimal success rate and true success rate as97.8375% and 92.75% for Gammatone energy features with VQ based modelling technique. This work FIST has also been analysed by inducing disturbance in the form of speech interference from their own twin pairs and Gamma-tone energy feature with VQ based modelling technique performs better for twin identification. A high claim of 99.625% and 95.0625% accuracy has been achieved by employing decision level fusion classifier.

Automorphisms of odd Coxeter groups

An odd Coxeter group $W$ is one which admits a Coxeter system $(W,S)$ for which all the exponents $m_{ij}$ are either odd or infinity. The paper investigates the family of odd Coxeter groups whose associated labeled graphs $\mathcal{V}_{(W,S)}$ are trees. It is known that two Coxeter groups in this family are isomorphic if and only if they admit Coxeter systems having the same rank and the same multiset of finite exponents. In particular, each group in this family is isomorphic to a group that admits a Coxeter system whose associated labeled graph is a star shaped tree. We give the complete description of the automorphism group of this group, and derive a sufficient condition for the splitting of the automorphism group as a semi-direct product of the inner and the outer automorphism groups. As applications, we prove that Coxeter groups in this family satisfy the $R_\infty$-property and are (co)-Hopfian. We compare structural properties, automorphism groups, $\R_\infty$-property and (co)-Hopfianity of a special odd Coxeter group whose only finite exponent is three with the braid group and the twin group.

Intra- and Inter-Group Differences in the Cognitive Skills of Toddler Twins with Birth Weight Discordance: The Need to Enhance Their Future from Early Education

Strengthening of early schooling enhances Equal and Inclusive Education (Sustainable Development Goal 4). Early education protects infant development and learning, especially for children suffering from pathologies and risk factors, such as twin birth weight discordance (BWD). These children—particularly the lighter twin—frequently show disadvantages in their cognitive skills. However, research about this issue is particularly scarce. The aims of this study were to (1) analyze the development of cognitive skills in each type of birth weight discordant twins (heavier and lighter ones) at 18, 21, and 24 months; and (2) discover whether there were differences between the two groups of twins in their cognitive skills. A nomothetic, follow-up, and multidimensional observational design was used. The cognitive skills of 32 birth weight discordant twins were observed while they played at 18, 21, and 24 months. The T-pattern analysis was performed using Thème software (Reykjavík, Iceland) to detect the sequential and temporal structure of infant behavior; indicative of cognitive skills. Results showed: (1) longitudinal intra-group differences in both groups of twins; and (2) some inter-group differences, mainly favoring the heavier twins. These results must be considered for designing early educational practices that allow all twins to be prepared for successful future learning.

Twin study\u2014genetic comparison of matrix versus intramatrix rotation in the mandible and three different occlusal planes

BackgroundThe purpose of this study is to investigate the heritability of total rotation, matrix rotation, and intramatrix rotation of the mandible in Korean monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings.Materials and methodsThe samples consisted of 75 pairs of Korean twins (39.7 + 9.26 years; MZ group, 36 pairs; DZ group, 13 pairs; sibling group, 26 pairs). Lateral cephalograms were taken, and 13 variables related to internal and external mandible rotation were measured. Three types of occlusal planes (bisected occlusal plane, functional occlusal plane, and the MM bisector occlusal plane) were used to evaluate genetic influence on the occlusal plane. Heritability (h2) was calculated by using the intraclass correlation coefficient (ICC) and Falconer’s method.ResultsWith regard to mandibular rotation, the MZ twin group showed significantly higher ICC values compared to the DZ twin and sibling groups. The ICC mean values for 13 cephalometric measurements were 0.85 (MZ), 0.62 (DZ), and 0.52 (siblings) respectively. The heritability of the total rotation (0.48) and matrix rotation (0.5) between the MZ and DZ groups was higher than that of the intramatrix rotation (− 0.14). All of the three types of occlusal plane showed high heritability, and among the three types, the functional occlusal plane showed the highest heritability (h2 = 0.76).ConclusionBased on these findings that showed a strong genetic effect on total rotation and matrix rotation, maintaining these rotations should be carefully considered in the orthodontic treatment plan, while the lower border of the mandible may be responsive to various treatments. Occlusal plane change, especially with regard to the functional occlusal plane, may not be stable due to strong genetic influences.

Risk of Fetal Loss after Amniocentesis in Twins Comparing with Singleton Pregnancy

Introduction: Amniocentesis is one of the most widely used diagnostic interventions but despite its many advantages, it has side effects such as fetal loss. The importance of fetal loss after amniocentesis in twin pregnancies is very important and some researchers believe that in twin pregnancies, the risk of fetal loss after amniocentesis is higher than singleton. Therefore, the present study examined the rate of fetal loss after amniocentesis in twin pregnancies compared to singleton pregnancies.&#x0D; &#x0D; Methods: This prospective descriptive-analytical study was performed on 712 mothers with singleton (628 cases) and twin (84 cases) pregnancies who referred to the obstetrics and gynecology clinic of Imam Khomeini Hospital in Ahvaz with Amniocentesis due to several reason during 2016-2020. A questionnaire containing information such as age, gestational age, number of pregnancies, childbirth and abortion, the cause of the diagnostic test, quarterly screening and NT ultrasound, and the result of amniocentesis were completed for patients. Patients were followed up during the first week, two weeks, and 60 days after amniocentesis, and finally data were analyzed by SPSS version24.&#x0D; &#x0D; Results: The mean age of the patients was 31.96 &amp;plusmn; 6.33 years and the mean gestational age at amniocentesis for all patients was 15.37 &amp;plusmn; 0.7. The mean NT in patients in the two groups did not differ significantly (1.60&amp;plusmn;0.44 vs 1.54&amp;plusmn;4.64, p=0.56). the prevalence of preterm in twin mothers was 13.1% and, in the singleton was 1.75% (p = 0.01). The occurrence of fetal loss was 2.4% in the twin group and 2.07% in the singleton group which was not statistically significant (p = 0.56). in the twin group, one (50%) fetal loss occurred in the first week and another one (50%) occurred between 15 and 60 days. But in the singleton group, 7 cases (63.6%) in the first week, 1 case (9%) in 15 to 60 days, and 3 cases (27.3) after more than 60 days lost the fetus. Previous pregnancy records in twins showed that the mean Gravid (p = 0.01), Parity (p = 0.01) and Living child (p = 0.02) in preterm twins&amp;#39; patients were statistically significantly lower than in the term patients.&#x0D; &#x0D; Conclusion: Our findings show that fetal loss following amniocentesis in twin pregnancies does not increase significantly compared to singleton pregnancies. However, our findings require repeated study in bigger sample size and as multi-centered as possible then It can be generalized to wider communities.