Hasil untuk "Gynecology and obstetrics"

A. Bhide, G. Acharya, A. Baschat et al.

The International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) is a scientific organization that encourages sound clinical practice, teaching and research related to diagnostic imaging in women’s healthcare. The ISUOG Clinical Standards Committee (CSC) has a remit to develop Practice Guidelines and Consensus Statements as educational recommendations that provide healthcare practitioners with a consensus-based approach for diagnostic imaging. They are intended to reflect what is considered by ISUOG to be the best practice at the time at which they are issued. Although ISUOG has made every effort to ensure that Guidelines are accurate when issued, neither the Society nor any of its employees or members accepts any liability for the consequences of any inaccurate or misleading data, opinions or statements issued by the CSC. They are not intended to establish a legal standard of care because interpretation of the evidence that underpins the Guidelines may be influenced by individual circumstances and available resources. Approved Guidelines can be distributed freely with the permission of ISUOG (info@isuog.org).

Yaman Degirmenci, Gilbert Georg Klamminger, Andrea Appel et al.

ABSTRACT Recurrent apical prolapse after failed sacrocolpopexy poses a surgical challenge, with limited evidence on surgical treatments. This case series evaluates the feasibility and 1‐year outcomes of sacrospinous ligament fixation (SSLF) of the residual cervix in this setting. Three postmenopausal women with symptomatic recurrent apical prolapse underwent SSLF after prior laparoscopic sacrocolpopexy. At 3‐ and 12‐month follow‐up, all patients showed sustained apical support (POP‐Q C −8), with significant improvement in symptoms and quality of life (ICIQ‐VS scores). Mild, asymptomatic anterior compartment descent was noted in two cases. SSLF of the cervix appears to be a safe, effective, and minimally invasive alternative to redo sacrocolpopexy for selected patients with recurrent apical prolapse.

Majid Movahed Majd, Razieh Rayanpour, Farzaneh Mosahebfard

Abstract Introduction The number of postmenopausal women is expected to grow dramatically in the coming decades in Iran. Adopting a health-promoting lifestyle (HPL) is essential for improving health and quality of life of this population. This study pursues two objectives: (1) to assess the HPL levels among Iranian postmenopausal women and (2) to investigate the socio-demographic and psychological variables including self-efficacy and self-esteem associated with HPL. Methods In this cross-sectional study with correlational design, 400 married postmenopausal women in Shiraz (southwestern Iran) were selected via stratified random sampling. The data collection tools were the Health-Promoting Lifestyle Profile-II (HPLP-II), General Self-Efficacy Scale (GSE), the Rosenberg Self-Esteem Scale, and a sociodemographic information questionnaire. Pearson’s correlation coefficient test, independent samples t-tests, and stepwise multiple linear regression were used for analyzing the data in SPSS v. 22. Results The average age of natural menopause among participants was 49.33 ± 3.43 years, and they had relatively good HPLP (136.52 ± 21.46). The results highlighted that among all the HPLP subscales, the highest mean score was observed for health responsibility (33.62 ± 6.98), whereas the lowest scores were observed for stress management (12.26 ± 3.13) and physical activity (17.64 ± 6.52). Both self-efficacy (r = 0.445, p < 0.01) and self-esteem (r = 0.425, p < 0.01) demonstrated significant, moderate positive correlations with the total HPL score. Also, there was a significant association between the total HPLP score and two demographic variables: women’s education (r = 0.17, p < 0.01) and husband’s educational level (r = 0.113, p < 0.05). In addition, the HPLP total score had a significant negative relationship with the number of children (r=-0.114, p < 0.05). The stepwise multiple linear regression analysis revealed that the variables independently associated with the HPL of participants were self-efficacy (β = 0.32, p < 0.001), self-esteem (β = 0.27, p < 0.001), and occupation (β = 0.144, p < 0.001). Conclusion It is suggested that health care professionals implement comprehensive planning to enhance the HPL of postmenopausal women. Interventions aimed at improving HPL in this population should prioritize strategies to enhance self-efficacy and self-esteem. Particular attention should be paid to women with lower education, unemployment, and a higher number of children.

Lifeng Qi, Xin Yao, Xin You et al.

Abstract Background The development of reliable biomarkers for evaluating bevacizumab responsiveness following neoadjuvant therapy (NAC) could enable rapid identification of non-responding ovarian cancer patients, who may then be redirected promptly to alternative therapies with higher efficacy potential. Given that microvascular density (MVD) serves as a well-established surrogate marker for tumor angiogenesis, this study specifically investigated its potential role as a predictive biomarker for bevacizumab treatment outcomes in advanced ovarian cancer patients undergoing neoadjuvant regimens. Patients and methods We conducted a multicenter, retrospective study to investigate the prognostic and predictive value of the tumor marker MVD in a real-world clinical setting. The study included 142 patients selected from five institutions. These patients had been treated with platinum-based neoadjuvant chemotherapy (NAC), with or without bevacizumab, followed by interval debulking surgery (IDS). Subsequently, they received adjuvant chemotherapy combined with bevacizumab, which was then transitioned to bevacizumab maintenance monotherapy. MVD was evaluated by immunohistochemical (IHC) staining of CD34 in post-NAC surgical specimens. Results Using a cutoff value of 33.8 microvessels/high-power field (HPF), which was determined based on the median of all measured MVD values, patients were stratified into high and low MVD subgroups. In the high MVD subgroup, the supplementation of standard platinum-based neoadjuvant chemotherapy with bevacizumab demonstrated significant survival benefits. This combination therapy achieved a 50% reduction in progression risk (HR: 0.500; 95% CI, 0.258–0.972; P = 0.041) and a 51% decrease in mortality risk (HR: 0.490; 95% CI, 0.225–0.819; P = 0.010), translating to clinically meaningful survival extensions of 4.7 months in median progression-free survival (P = 0.037) and 5.7 months in median overall survival (P = 0.008). Conversely, in the low MVD subgroup, bevacizumab augmentation of platinum/paclitaxel-based neoadjuvant chemotherapy failed to demonstrate statistical significance in either progression-free survival (HR: 0.620; 95% CI, 0.339–1.135; P = 0.121) or overall survival (HR: 0.664; 95% CI, 0.377–1.169; P = 0.156). Conclusions Our real-world study provides preliminary evidence that bevacizumab may confer differential prognostic benefits in AOC patients undergoing NAC followed by IDS, contingent upon tumor MVD quantified via CD34 immunohistochemistry, though it is important to acknowledge the lack of independent external validation for these findings. This potential biomarker-driven therapeutic heterogeneity preliminarily underscores the possibility of developing adaptive treatment algorithms that stratify patients based on angiogenic susceptibility profiles, which may lay a foundation for exploring precision administration of anti-VEGF therapy in a cost-effective paradigm.

Menglin Cong, Shufeng Li, Yu Fu et al.

Abstract Osteosarcoma (OS) is the most common primary bone malignancy because of its extra high tendency of metastasis. In-depth research is needed to uncover the pathogenesis of patients with OS cells. We collected 74 tissue samples from patients with OS cells and measured the expression levels of ghrelin by immunohistochemistry. Ghrelin was added into OS cell lines in CCK8 assays, JC-1 staining and Western blot analysis were performed to explore its effect on the aggressiveness of OS cells and drug resistance. To determine its function, ghrelin was overexpressed or knocked down in OS cells and then detect cell proliferation in the xenograft mouse model and orthotopic model. Western blot analysis was performed to explore ghrelin-regulated signal pathways. In this work, we identified the relation between the level of ghrelin expression and poor prognosis of OS patients. As well as promoting proliferation, migration, and invation, ghrelin promotes the survival of OS in vitro as well as in vivo, and reduces the apoptosis of OS cells. What’s more, ghrelin increases the resistance of cis-platinum by changing mitochondrial function and decreases the expression of MDR-1. Above all, these results demonstrated ghrelin exerts tumorigenic and metastatic effects and may be a potential therapeutic target.

Hassine Saber Abouda, MD, Haithem Aloui, MD, Eya Azouz, MD et al.

Introduction: The gold standard for treating the placenta accreta spectrum (PAS) is a cesarean hysterectomy, which harms fertility. Another conservative surgical approach allows the uterus to be preserved: one-step conservative surgery. We will compare these two approaches through the “CMNT PAS” study. Before this main study, we conducted a pilot study to determine the required sample size. Study Design: This pilot study, conducted over 31 months, included patients who underwent surgery for suspected PAS based on imaging findings. Participants were divided into the conservative surgery group (CSG: 6 patients) and the Caesarean Hysterectomy Group (control group [CG]: 6 patients). For the CSG, our team adapted the approach described in previous research by Palacios-Jaraquemada. Results: The primary objective of our study is to ascertain the appropriate sample size for our main investigation on the conservative surgical management of PAS. Concerning the primary outcome, the estimated amount of blood loss was lower in CSG compared to CG, although this difference was not statistically significant (1298.04±556 mL vs 891.051±348 mL, P=.159). The mean decrease in hemoglobin (Δ Hb) was 2.8±1.3251 g/dL in the CG group compared to 1.933±1.0614 g/dL in the CSG group (P=.240). The mean number of transfused red blood cell units was 3±3.2249 in the CG group and 1.5±1.64317 in the CSG group (P=.334). Conclusion: The estimated blood loss between the two groups is not statistically significant. The required sample size is 22 patients.

Taghreed Ahmed, Ahmed Younes, and Islam Elkabani

The construction of quantum computers is based on the synthesis of low-cost quantum circuits. The quantum circuit of any Boolean function expressed in a Positive Polarity Reed-Muller $PPRM$ expansion can be synthesized using Multiple-Control Toffoli ($MCT$) gates. This paper proposes two algorithms to construct a quantum circuit for any Boolean function expressed in a Positive Polarity Reed-Muller $PPRM$ expansion. The Boolean function can be expressed with various algebraic forms, so there are different quantum circuits can be synthesized for the Boolean function based on its algebraic form. The proposed algorithms aim to map the $MCT$ gates into the $NCV$ gates for any quantum circuit by generating a simple algebraic form for the Boolean function. The first algorithm generates a special algebraic form for any Boolean function by rearrangement of terms of the Boolean function according to a predefined degree of term $d_{term}$, then synthesizes the corresponding quantum circuit. The second algorithm applies the decomposition methods to decompose $MCT$ circuit into its elementary gates followed by applying a set of simplification rules to simplify and optimize the synthesized quantum circuit. The proposed algorithms achieve a reduction in the quantum cost of synthesized quantum circuits when compared with relevant work in literature. The proposed algorithms synthesize quantum circuits that can applied on IBM quantum computer.

Benedikt Hilmes, Nick Rossenbach, and Ralf Schlüter

In this work we evaluate the utility of synthetic data for training automatic speech recognition (ASR). We use the ASR training data to train a text-to-speech (TTS) system similar to FastSpeech-2. With this TTS we reproduce the original training data, training ASR systems solely on synthetic data. For ASR, we use three different architectures, attention-based encoder-decoder, hybrid deep neural network hidden Markov model and a Gaussian mixture hidden Markov model, showing the different sensitivity of the models to synthetic data generation. In order to extend previous work, we present a number of ablation studies on the effectiveness of synthetic vs. real training data for ASR. In particular we focus on how the gap between training on synthetic and real data changes by varying the speaker embedding or by scaling the model size. For the latter we show that the TTS models generalize well, even when training scores indicate overfitting.

Kazuto Nakamura, Keiko Kigure, Toshio Nishimura et al.

Abstract Background The incidence of cervical intraepithelial neoplasia is increasing in Japan. Although human papillomavirus (HPV) vaccination and cancer screening are crucial in preventing cancer-related mortality, the cervical cancer screening rate in Japan was only approximately 43.6% in 2022. This study aimed to conduct an epidemiological analysis of cervical cancer by collecting data from individual patients. Methods A questionnaire survey was administered to patients who visited our hospital between January 2017 and July 2023 owing to abnormal cervical cytological findings or a cancer diagnosis. Patients answered questions regarding their history of cervical cancer screening as well as their knowledge of HPV and cervical cancer. Results During the study period, 471 patients participated in the survey, with 35 declining to participate. Patients with Stage 1b1–4b primarily sought medical attention due to self-reported symptoms (P < 0.001); however, they were less likely to have undergone cervical cancer screening (P < 0.001). Additionally, older patients were less likely to be aware of the association of HPV with cervical and other cancers. Notably, 28 of the 129 patients with stage 1b1–4b cancer underwent cervical cancer screening within 2 years. The tumor location within the endocervical canal emerged as a significant factor contributing to the difficulty for an accurate diagnosis of precancerous or cervical cancer during cervical screening. Furthermore, non- squamous cell carcinoma (SCC) histology was another possible factor. Conclusions Our findings suggest the need to widely disseminate information regarding the significance of cancer screening to increase cancer screening rates. Moreover, establishing strategies for improving the accuracy of detecting lesions during screening for non-SCC and endocervical canal tumors is crucial.

Lucía Castaño Frías, Carmen Tudela-Littleton Peralta, Natalia Segura Oliva et al.

Background: <i>Listeria monocytogenes</i>, a Gram-positive intracellular bacillus, causes listeriosis, which is primarily transmitted through contaminated food and vertical transmission. The incidence of the disease is estimated to be between one and ten cases per million globally, with pregnant women being particularly vulnerable. Objective: The aim was to describe the clinical characteristics, management, and outcomes of cases of gestational listeriosis at Hospital Materno Infantil de Málaga in order to improve our understanding, diagnosis, and treatment of this disease. Methods: A retrospective analysis of six confirmed cases of listeriosis was performed in pregnant women or neonates. Diagnostic confirmation was achieved using analytic and microbiological methodologies, including blood cultures and the measurement of C-reactive protein (CRP). Ethical approval was obtained, and clinical data were reviewed for reasons related to consultation, treatment approaches, and complications. Results: The most frequently observed symptoms were fever and abdominal pain, with complications such as intrauterine death and suspected chorioamnionitis. Four patients were treated with antibiotics, leading to improved outcomes. No severe complications such as neurolisteriosis were observed. Conclusions: Pregnant women are more susceptible to <i>L. monocytogenes</i>, which can cause mild maternal symptoms but severe foetal outcomes, including prematurity, foetal death, or neonatal infections. Early diagnosis and prompt treatment are crucial for improving maternal–foetal outcomes.

Qun Huang, Yuanbin Li, Zhuang Chen et al.

Abstract Background Polycystic ovary syndrome (PCOS) is a frequent and complicated endocrine disease that remains a major reason for infertility. Bushenhuoluo Decotion (BSHLD) has been validated to exhibit curative effects on PCOS. This study was aimed to explore the potential mechanism underlying the therapeutic action of BSHLD. Methods PCOS rat model was induced by dehydroepiandrosterone (DHEA). Serum hormone and cytokines levels and ovarian pathological alterations were measured to assess ovarian function. Exosomes (Exos) were identified by Transmission electron microscopy and Nanoparticle Tracking Analysis. RT-qPCR, Western blotting, immunohistochemical staining, and immunofluorescence staining were performed to detect molecule expressions. Proliferation and pyroptosis of granulosa cells (GCs) were evaluated by CCK-8 and flow cytometry, respectively. The binding relationship between miR-30a-5p and suppressor of cytokine signaling 3 (SOCS3) was verified by dual luciferase reporter and RIP assays. Results BSHLD treatment improved serum hormone abnormality, insulin sensitivity, and ovarian morphologic changes of PCOS rats. Moreover, BSHLD treatment restrained the excessive autophagy and pyroptosis in ovarian tissues of PCOS rats. Moreover, BSHLD reduced the expression of miR-30a-5p in serum, serum-derived Exos, and ovarian tissues, thus inhibiting autophagy and NLRP3-mediated pyroptosis in GCs. Mechanistically, SOCS3 was proved as a target of miR-30a-5p and could activate mTOR/P70S6K pathway to repress autophagy. The inhibitory effect of miR-30a-5p deficiency on autophagy and pyroptosis of GCs was attenuated by rapamycin. Conclusion Collectively, BSHLD suppressed autophagy and pyroptosis to improve POCS by regulating exosomal miR-30a-5p/SOCS3/mTOR signaling.

Yazan AlHabil, Anas N. Owda, Basil J. Zaid et al.

Abstract Background Inadequate surgical interventions can lead to serious complications such as tubo-ovarian abscesses in the upper female genital system, often resulting from untreated pelvic inflammatory disease. Pelvic inflammatory disease, caused by infections like Chlamydia trachomatis and Neisseria gonorrhoeae, leads to scarring and adhesions in the reproductive organs, with common risk factors including intrauterine device use and multiple sexual partners. Pelvic inflammatory disease primarily affects sexually active young women and can manifest with varied symptoms, potentially leading to complications like ectopic pregnancy, infertility, and chronic pelvic pain if untreated. Case presentation This case report presents a unique scenario involving a 17-year-old sexually inactive female who experienced concurrent tubo-ovarian abscess, acute cystitis, and pancolitis following laparoscopic ovarian cystectomy. Pelvic inflammatory disease and its complications are well-documented, but the simultaneous occurrence of acute cystitis and pancolitis in this context is unprecedented in the medical literature. The patient’s presentation, clinical course, and management are detailed, highlighting the importance of considering diverse and severe complications in individuals with a history of gynecological surgeries. Conclusions Our case report highlights the need for healthcare professionals to remain vigilant for atypical presentations of gynecological complications and emphasizes the value of interdisciplinary collaboration for optimal patient care. We encourage further research and awareness to enhance understanding and recognition of complex clinical scenarios associated with gynecological procedures.

Cheng Guo, Leidong Fan, Ziyu Xue et al.

In media industry, the demand of SDR-to-HDRTV up-conversion arises when users possess HDR-WCG (high dynamic range-wide color gamut) TVs while most off-the-shelf footage is still in SDR (standard dynamic range). The research community has started tackling this low-level vision task by learning-based approaches. When applied to real SDR, yet, current methods tend to produce dim and desaturated result, making nearly no improvement on viewing experience. Different from other network-oriented methods, we attribute such deficiency to training set (HDR-SDR pair). Consequently, we propose new HDRTV dataset (dubbed HDRTV4K) and new HDR-to-SDR degradation models. Then, it's used to train a luminance-segmented network (LSN) consisting of a global mapping trunk, and two Transformer branches on bright and dark luminance range. We also update assessment criteria by tailored metrics and subjective experiment. Finally, ablation studies are conducted to prove the effectiveness. Our work is available at: https://github.com/AndreGuo/HDRTVDM.

Kwamena Sekyi Dickson, Joshua Okyere, Bright Opoku Ahinkorah et al.

Abstract Background Each day, an estimated 800 women die from preventable pregnancy and childbirth related complications, where 99% of these avoidable deaths happen in low-and middle-income countries. Skilled attendance during antenatal care (ANC) plays a role in reducing maternal and child mortality. However, the factors that predict the utilisation of skilled ANC services in sub-Saharan Africa (SSA) remains sparsely investigated. Therefore, we examined women’s utilisation of skilled ANC services in SSA. Methods The research used pooled data from the most recent Demographic and Health Surveys conducted in 32 countries in SSA between January 1, 2010, and December 31, 2019. Binary logistic regression was used to examine the predictors of skilled ANC services utilisation. The results are presented as crude and adjusted odds ratios (aOR) with 95% confidence interval (CI). Results The prevalence of skilled ANC services utilisation in SSA was 76.0%, with the highest and lowest prevalence in Gambia (99.2%) and Burundi (8.4%), respectively. Lower odds of ANC from skilled providers was found among women aged 45–49 compared to those aged 20–24 (aOR = 0.86, CI = 0.79–0.94); widowed women compared to married women (aOR = 0.84, CI = 0.72–0.99); women who consider getting permission to visit the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.74, CI = 0.71–0.77); women who consider getting money needed for treatment as not a big problem compared to those who consider that as a big problem (aOR = 0.84, CI = 0.72–0.99); and women who consider distance to the health facility as a big problem compared to those who consider that as not a big problem (aOR = 0.75, CI = 0.72–0.77). Conclusion SSA has relatively high prevalence of skilled ANC services utilisation, however, there are substantial country-level disparities that need to be prioritised. Increasing maternal reproductive age being widowed and far distance to health facility were factors that predicted lower likelihood of skilled ANC services utilisation. There is, therefore, the need to intensify female formal education, invest in community-based healthcare facilities in rural areas and leverage on the media in advocating for skilled ANC services utilisation.

Junfeng Chen, Guocheng Wang, Xiaomei Luo et al.

Cuproptosis is the most recently discovered mode of cell death. It could affect the metabolism of cancer cells and surrounding infiltrating immune cells. In recent years, many studies have also shown that the tumor microenvironment (TME) plays a critical role in tumor growth and development. Mounting evidence suggests that Cuproptosis would bring unique insights into the development of pharmacological and nonpharmacological therapeutic techniques for cancer prevention and therapy. However, no study has been done on the combination of cuproptosis and TME in any cancer. Herein, we investigated the relationship between cuproptosis-related genes (CRGs), TME, and the prognosis of patients with Uterine Corpus Endometrial Carcinoma (UCEC). We identified three CRGs clusters based on 10 CRGs and three CRGs gene clusters based on 600 differentially expressed genes (DEGs) with significant prognostic differences. Following that, the CRGs score based on DEGs with significant prognostic differences was established to evaluate the prognosis and immunotherapeutic efficacy of UCEC patients. The CRGs score was shown to be useful in predicting clinical outcomes. Patients with a low CRGs score seemed to have a better prognosis, a better immunotherapeutic response, and a higher tumor mutation burden (TMB). In conclusion, our study explored the influence of cuproptosis patterns and TME on the prognosis of cancer patients, thereby improving their prognosis.

Jen-Yu Wen, Chung-Fen Liu, Ming-Ting Chung et al.

Objective: To decrease multiple pregnancy risk and sustain optimal pregnancy chance by choosing suitable number of embryos during transfer, this study aims to construct artificial intelligence models to predict the pregnancy outcome and multiple pregnancy risk after IVF-ET. Materials and methods: From Jan 2010 to Dec 2019, 1507 fresh embryo transfer cycles contained 20 features were obtained. After eliminating incomplete records, 949 treatment cycles were included in the pregnancy model dataset and 380 cycles in the twin pregnancy model dataset. Six machine learning algorithms were used for model building based on the dataset which 70% of the dataset were randomly selected for training and 30% for validation. Model performances were quantified with the area under the receiver operating characteristic curve (AUC), accuracy, specificity, and sensitivity. Results: Models built with XGBoost performed best. The pregnancy prediction model produced accuracy of 0.716, sensitivity of 0.711, specificity of 0.719, and AUC of 0.787. The multiple pregnancy prediction model produced accuracy of 0.711, sensitivity of 0.649, specificity of 0.740, and AUC of 0.732. Conclusions: The AI models provide reliable outcome prediction and could be a promising method to decrease multiple pregnancy risk after IVF-ET.

Derek Miller, Roberto Romero, Marian Kacerovsky et al.

Interferon epsilon (IFNe) is a recently described cytokine that is constitutively expressed in the female reproductive tract. However, the role of this hormonally regulated cytokine during human pregnancy is poorly understood. Moreover, whether IFNe participates in host immune response against bacteria-driven intra-amniotic infection or cervical human papillomavirus infection during pregnancy is unknown. Herein, using a unique set of human samples derived from multiple study cohorts, we aimed to uncover the role of IFNe in normal and complicated pregnancies. We showed that IFNe is expressed in the myometrium, cervix, and chorioamniotic membranes, and may therefore represent a constitutive element of host defense mechanisms in these tissues during pregnancy. The expression of IFNe in the myometrium and cervix appeared greater in late gestation than in mid-pregnancy, but did not seem to be impacted by labor. Notably, concentrations of IFNe in amniotic fluid, but not cervical fluid, were increased in a subset of women undergoing spontaneous preterm labor with intra-amniotic infection, indicating that IFNe could participate in anti-microbial responses in the amniotic cavity. However, stimulation with Ureaplasma parvum and/or lipopolysaccharide did not enhance IFNE expression by amnion epithelial or cervical cells in vitro, implicating alternative sources of this cytokine during intra-amniotic or cervical infection, respectively. Collectively, our results represent the first characterization of IFNe expression by human reproductive and gestational tissues during normal pregnancy and suggest a role for this cytokine in intra-amniotic infection leading to preterm birth.

Tomoyoshi Shimobaba, Sota Oshima, Takashi Kakue et al.

Holographic information hiding is a technique for embedding holograms or images into another hologram, used for copyright protection and steganography of holograms. Using deep neural networks, we offer a way to improve the visual quality of embedded holograms. The brightness of an embedded hologram is set to a fraction of that of the host hologram, resulting in a barely damaged reconstructed image of the host hologram. However, it is difficult to perceive because the embedded hologram's reconstructed image is darker than the reconstructed host image. In this study, we use deep neural networks to restore the darkened image.

Haseeb Ur Rehman, Faouzi Bellili, Amine Mezghani et al.

This paper tackles the problem of joint active and passive beamforming optimization for an intelligent reflective surface (IRS)-assisted multi-user downlink multiple-input multiple-output (MIMO) communication system. We aim to maximize spectral efficiency of the users by minimizing the mean square error (MSE) of the received symbol. For this, a joint optimization problem is formulated under the minimum mean square error (MMSE) criterion. First, block coordinate descent (BCD) is used to decouple the joint optimization into two sub-optimization problems to separately find the optimal active precoder at the base station (BS) and the optimal matrix of phase shifters for the IRS. While the MMSE active precoder is obtained in a closed form, the optimal phase shifters are found iteratively using a modified version (also introduced in this paper) of the vector approximate message passing (VAMP) algorithm. We solve the joint optimization problem for two different models for IRS phase shifts. First, we determine the optimal phase matrix under a unimodular constraint on the reflection coefficients, and then under the constraint when the IRS reflection coefficients are modeled by a reactive load, thereby validating the robustness of the proposed solution. Numerical results are presented to illustrate the performance of the proposed method using multiple channel configurations. The results validate the superiority of the proposed solution as it achieves higher throughput compared to state-of-the-art techniques.

Rong Li, Xiaoqiu Wang, Zhenyao Huang et al.

Summary: The loss of uterine epithelial progesterone receptor (PGR) is crucial for successful embryo implantation in both humans and mice. The two major isoforms PGRA and PGRB have divergent functions under both physiological and pathological conditions. The present study compares phenotypes and gene signatures of PGRA and PGRB in uterine epithelium using uterine epithelial-specific constitutively expressed PGRA or PGRB mouse models. The cistrome and transcriptome analysis reveals substantial overlap between epithelial PGRA and PGRB, and both disrupt embryo implantation through FOXO1 pathways. Constitutive epithelial PGRA and PGRB expression impairs ESR1 occupancy at the promoter of Lif leading to reduced Lif transcription and further exaggerates SGK1 expression leading to enhanced PI3K-SGK1 activities, and both contribute to the decline of nuclear FOXO1 expression. Our study demonstrates that PGRA and PGRB in the uterine epithelium act on a similar set of target genes and commonly regulate the LIF-SGK1-FOXO1 signaling pathway for embryo implantation.