477 research outputs found
On embryo implantation
No full textHomburg, R. [Promotor]Hompes, P.G.A. [Copromotor]Lambalk, C.B. [Copromotor
Clinical work-up strategies before IUI
No full textHomburg, R. [Promotor]Hompes, P.G.A. [Copromotor]Lambalk, C.B. [Copromotor
Neuroendocrine regulation in PCOS
No full textLambalk, C.B. [Promotor]Hompes, P.G.A. [Copromotor]Homburg, R. [Copromotor
External validation of anti-Müllerian hormone based prediction of live birth in assisted conception
No full text<p>Background - Chronological age and oocyte yield are independent determinants of live birth in assisted conception. Anti-Müllerian hormone (AMH) is strongly associated with oocyte yield after controlled ovarian stimulation. We have previously assessed the ability of AMH and age to independently predict live birth in an Italian assisted conception cohort. Herein we report the external validation of the nomogram in 822 UK first in vitro fertilization (IVF) cycles.</p>
<p>Methods - Retrospective cohort consisting of 822 patients undergoing their first IVF treatment cycle at Glasgow Centre for Reproductive Medicine. Analyses were restricted to women aged between 25 and 42 years of age. All women had an AMH measured prior to commencing their first IVF cycle. The performance of the model was assessed; discrimination by the area under the receiver operator curve (ROCAUC) and model calibration by the predicted probability versus observed probability.</p>
<p>Results - Live births occurred in 29.4% of the cohort. The observed and predicted outcomes showed no evidence of miscalibration (p = 0.188). The ROCAUC was 0.64 (95% CI: 0.60, 0.68), suggesting moderate and similar discrimination to the original model. The ROCAUC for a continuous model of age and AMH was 0.65 (95% CI 0.61, 0.69), suggesting that the original categories of AMH were appropriate.</p>
<p>Conclusions - We confirm by external validation that AMH and age are independent predictors of live birth. Although the confidence intervals for each category are wide, our results support the assessment of AMH in larger cohorts with detailed baseline phenotyping for live birth prediction.</p>
Co-creation in brand development between Europe and China: Creating a tool using Artificial Intelligence to improve collaboration
No full textOrange Branding is a Dutch Brand Strategy and Design agency based in Amsterdam and operating in China (Shanghai, Guangzhou, and Shenzhen) since 2005. They have clients of various sizes in various industries, but in this project, we focused on companies interested in Cross-border e-commerce. When these businesses want to operate abroad, they will need a well-built brand. However, the value of branding has not yet been widely understood in China. Therefore, we ought to design a method to improve this understanding. Furthermore, research has shown that clients and brand designers need to work together to achieve the most optimal result. Accordingly, the research question answered in this thesis reads:How can we improve co-creation in the brand development process between Dutch designers and Chinese clients?To answer the research question, we have analyzed existing branding methods: Cultural Branding, Co-creating Brand Meaning, and OB’s usual methods. Furthermore, we researched Chinese culture in general and, regarding branding, to determine how a European designer should collaborate with a Chinese client. Lastly, we examined different Artificial Intelligence (AI) types to use in a new Branding Method.What makes Cultural Branding unique is its story-based approach. Douglas Holt believes a brand has to offer a story, or myth, to its consumers. Consumers must want to use a brand’s products in order to live that story and build identity.Co-creating Brand meaning tells us that the company behind a brand is the source of inspiration for the Brand Identity. Knowing this, a designer should not exclude the client from the brand development process but involve him in. However, the client must not acquire too much creative freedom, so it is the designer’s job to balance involvement and creation. We argue that AI can provide tools with which a designer can achieve this balance. We conducted a pilot experiment to test the value of AI as a tool in brand development. Since the client inspires the Brand Identity, we wanted to see if we can use Machine Learning (a type of AI) to determine brand personalities. Therefore, we collected approximately 3500 images, labeled with one of Aaker’s Five Dimensions of Brand Personality: Sincerity, Excitement, Competence, Sophistication, and Ruggedness. Therefore, we created the Orange Branding ‘Aaker Personality Prediction Algorithm’ or ‘OB-APPA’. APPA is an ML algorithm that was trained using these images and is able to predict the personality of an image. The OB team in China posed as imaginary clients and supplied new images for six fictional brands. Then, with the predictions from APPA, we manifested these predictions into visual brand styles. Next, the OB China team provided feedback on whether the created styles fit their intended fictional brand’s identity.After examining the feedback, we conclude that the use of APPA could be very beneficial for a design agency like OB. OB can benefit from using APPA as their clients often supply a design brief which leaves almost complete creative freedom. APPA could efficiently deduce the desired brand personality, which will narrow the design brief. Consequently, an additional step in APPA could also predict the associated Brand Archetype. Combining the improved APPA with generative branding tools like Tailor Brands, IDEO’s font map, Front brief, and Colour Thief can generate branding elements in a short amount of time and make the system usable from anywhere.Strategic Product Desig
Development of a model of three-dimensional imaging for the preoperative planning of TaTME
No full textSince total mesorectal excision (TME) was first described in the early 1930s and later popularised by Heald [1], efforts have been made to standardise the technique, following the correct embryological planes and using appropriate landmarks. Laparoscopic and robotically assisted approaches to the rectum have gained popularity during recent years, compelling colorectal surgeons to develop their skills and knowledge. Transanal TME (TaTME) is a new addition to the approaches in rectal surgery. Despite being associated with several benefits in selected patients, TaTME requires advanced technical skills and, more importantly, knowledge of the pelvic structures, planes and spaces as they are encountered moving cephalad from the perineum. Magnetic resonance imaging (MRI) is the gold standard for imaging of the pelvis and pelvic floor, but understanding of relevant anatomy when performing a new technique may be hampered by difficulty in interpretation of two-dimensional (2D) images when considering three-dimensional (3D) structures. We describe a new tool that could help understanding of TaTME planes and preoperative planning
Is aspirin effective in women undergoing in vitro fertilization (IVF)? Results from an individual patient data meta-analysis (IPD MA)
No full textBACKGROUND Aspirin is believed to improve the outcome of IVF, but previous conventional meta-analyses on the subject are conflicting. Therefore, we performed a meta-analysis with individual patient data (IPD MA) of randomized clinical trials (RCTs) on the subject. METHODS A systematic literature search was conducted to identify RCTs assessing the effectiveness of aspirin in IVF. Authors were asked to share their original data. In a one step meta-analytic approach, the treatment effect of aspirin was estimated with odds ratios (ORs) and 95% confidence intervals (CIs) using logistic regression, based on the intention to treat principle. RESULTS Ten studies fulfilled the inclusion criteria. Authors of six studies provided IPD, including 1119 patients (562 placebo and 557 aspirin). There were 160 clinical pregnancies in the aspirin (28.8%) and 179 (31.9%) in the placebo group [OR 0.86, 95% CI (0.69–1.1)]. There were 129 ongoing pregnancies in the aspirin (23.6%) and 147 in the placebo group (26.7%) [OR 0.85, 95% CI (0.65–1.1)]. Whereas the conventional meta-analysis limited to studies that could provide IPD showed an OR of 0.89 (95% CI 0.69–1.2), the conventional meta-analysis limited to the eight studies of which method of randomization could be confirmed showed an OR of 0.94 (95% CI 0.76–1.17) and the conventional meta-analysis including all 10 eligible RCTs identified with our search changed the OR to 1.07 (95% CI 0.81–1.41). This difference in direction of effect, derived from the studies not able to share IPD of which quality of randomization could not be confirmed. CONCLUSIONS Aspirin does not improve pregnancy rates after IVF.E. Groeneveld, K.A. Broeze, M.J. Lambers, M. Haapsamo, K. Dirckx, B.C. Schoot, B. Salle, C.I. Duvan, R. Schats, B.W. Mol, and P.G.A. Hompes, for the IPD MARIA study grou
Rectal cancer:Trends and hospital variation
No full textOptimising the multimodality treatment and outcomes for rectal cancer care includes the quality assessment on an international, national and hospital level. Clinical auditing is considered to provide these insights using benchmarked feedback information. The Dutch ColoRectal Audit (DCRA) is a multidisciplinary audit containing high quality short-term data of treated colorectal cancer patients, used as important source of information in provided rectal cancer care on a population-based level. This thesis mainly focused on circumferential resection margin (CRM), a pathological outcome and prognostic factor used in surgically resected rectal cancer patients. We have investigated whether trends or hospital variation on rectal cancer care have impacted CRM outcomes and predicts long-term oncological outcomes. Giving continuously feedback information reflecting daily practice on provided rectal cancer care regarding new treatments, quality, hospital variation, and adherence of the guideline including its outcomes, will potentially facilitate improvement cycles in hospitals or leading to structural changes such as guideline revision. Evaluating current management of rectal cancer care, showed that nowadays still substantial hospital variation exists in providing rectal cancer care. The different studies demonstrate the increased use of a patient-tailored or individualised approach in the treatment of rectal cancer. Specialists tend to use other factors than current guideline recommendations, like patient preferences and the growing availability of different treatment options and surgical techniques
The “Phillips” Ileostomy Correction Technique for Prolapsed Stoma
No full textINTRODUCTION: Stoma prolapse is a common complication associated with ostomy creation, causing leakage, obstruction, and sometimes incarceration. Sometimes ileostomy prolapse cannot be treated with resection and alternative methods must be applied. We propose a new surgical revisional technique for ileostomy prolapse. TECHNIQUE: Under general anesthesia, the prolapsed stoma is dissected and freed from the fascia and skin. The bowel is everted to create a nipple of 2-3 cm and subsequently fixed with a 3-row linear stapler, creating a "Phillips ileostomy." The ileostomy is then sutured to the skin with 3-0 full thickness stitches. RESULTS: In our center, 3 patients were treated in a day surgery setting, and no complication occurred. One patient reported a prolapse recurrence after 6 months and was successfully treated with the same technique with no recurrence at 1 year. CONCLUSIONS: The 3-row stapler fixation of prolapsed ileostomy is simple to perform, preserves the bowel, and can be performed in the day surgery setting
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