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At least 343 records · Page 19Linked to original sources
PubMed2004

What is the most relevant standard of success in assisted reproduction? Redefining success in the context of elective single embryo transfer: evidence, intuition and financial reality.

Treatment-related multiple pregnancy poses the biggest threat to the safety of IVF. Despite a double embryo transfer (DET) policy in most European centres, twin rates continue to be unacceptably high, at 20-35%. Elective single embryo transfer (SET) is an effective way to minimize twin pregnancies, but the debate surrounding its routine clinical use continues. A review of the literature was undertaken in order to seek evidence about the effectiveness of SET, and identify barriers to its acceptance in clinical practice. Data from randomized controlled trials (RCTs) indicate that SET results in lower live birth rates per fresh IVF cycle (odds ratio 0.53; 95% confidence interval 0.31-0.89; P = 0.02) in comparison with DET. Data on cumulative live birth rates are unavailable from RCTs, although the expectation is that these are comparable in the two groups. SET is unlikely to be suitable for all women undergoing IVF and outcomes may be sensitive to different laboratory protocols. The perceived effectiveness of SET is influenced by the way existing evidence is interpreted. Other factors affecting the routine use of SET include laboratory techniques, individual preferences and funding issues.

Embryo Transfer↗
PubMed1994

Probing the nature of substrate binding in Humicola lanuginosa lipase through X-ray crystallography and intuitive modelling.

The catalytic triad of the neutral lipase from Humicola lanuginosa is buried by a short helix under aqueous conditions rendering the enzyme inactive. Upon adsorption to a lipid substrate interface this helix is displaced, thereby exposing the active site (interfacial activation). By covalently linking inhibitors to the active serine, it is possible to crystallize the enzyme in an interfacially activated state. Two such structures are reported here which mimic the tetrahedral transition states of lipolysis. To date, no crystal structures of a lipase--triglyceride complex exist for this enzyme. Therefore, possible interactions between this lipase and its substrate have been analysed through molecular modelling.

Binding Sites↗
PubMed1993

Critical decision method: a technique for eliciting concrete assessment indicators from the intuition of NICU nurses.

Two studies supporting the use of the Critical Decision method (CDM) in eliciting knowledge from expert neonatal intensive care unit (NICU) nurses are presented. The first examines the utility of CDM in the nursing profession. In this study, significantly more information was elicited in CDM interviews than in non-CDM interviews. In the second study, cues, indicators, and exemplars were extracted from CDM incident accounts to form a guide to early sepsis assessment in the NICU that contains information not available in the current literature. All evaluators rated the guide as useful. Implications for future research, including generalizability to other areas of nursing, are discussed.

Cognition↗