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The formability of sheet-metal with a folding-bottom circular hollow tube has been studied both by numerical simulation and experiment. A mesh-convergence analysis has been carried out to determine an optimum element size for purposes of numerical simulation. The geometry and dimension of the dies and of the punch are designed to simulate the multi-stage deep drawing operation to take place. During the deep drawing operation, the strains of the sheet blank are always located in the second quadrant of the forming limit diagrams, and it continuously moves in a linear state to the left side of the diagram. At the final stage, the tube is drawn to a certain height without evidence of fracture. In order to obtain a quality product, an optimization of input parameters for the deep drawing operation is conducted using Taguchi method. Finally, a validation test is also employed to demonstrate the accuracy of forming processes. The result reveals sufficient agreement in both geometry and dimension between simulated and actual tubes to meet a good quality standard.

Endometriosis has been shown to increase the risk of gynecological cancers. However, the effect of gestrinone, a clinical endometriosis drug, on gynecological cancers remains unclear. This study aimed to understand the effect of gestrinone on gynecological cancers. A retrospective study was conducted using the Longitudinal Health Insurance Database 2000 of the Taiwan National Health Insurance Research Database (NHIRD) to observe the risk of gynecological cancers. Medication records from the Department of Obstetrics and Gynecology, Chung Shan Medical University Hospital CSMUH and cancer records from the Taiwan Cancer Registry were collected to analyze the correlation between gestrinone use and gynecological cancers. Subsequently, human cell lines were used to investigate the effect of gestrinone on gynecological cancers. A total of 8330 endometriosis patients were enrolled, and analyses revealed that endometriosis patients had a higher risk of developing ovarian and endometrial cancer. However, the rate of cervical cancer was not statistically different (P = 0.249). Analyses of both the NHIRD and CSMUH databases revealed that gestrinone may reduce the risk of gynecological cancer. Cellular experiments verified the anticancer effects of gestrinone, which effectively and specifically inhibited the growth of HeLa cervical cancer cells, decreased P21 expression via JNK phosphorylation, and induced apoptosis. Combining the results of clinical database analysis and cell experiments, our findings prove that gestrinone has the potential to protect against cancer through regulation of the JNK-P21 axis. Repurposing the anticancer efficacy of gestrinone may be a strategy for targeted therapy in the future.

Background: Does the presence of single-nucleotide polymorphisms (SNPs) in the leukemia inhibitory factor (LIF) gene affect ovarian response in infertile young women? Methods: This was a case–control study recruiting 1744 infertile women between January 2014 to December 2015. The 1084 eligible patients were stratified into four groups using the POSEIDON criteria. The gonadotropin-releasing hormone receptor (GnRHR), follicle-stimulating hormone receptor (FSHR), anti-Müllerian hormone (AMH), and LIF SNP genotypes were compared among the groups. The distributions of LIF and FSHR among younger and older patients were compared. Clinical outcomes were also compared. Results: The four groups of poor responders had different distributions of SNP in LIF. The prevalence of LIF genotypes among young poor ovarian responders differed from those of normal responders. Genetic model analyses in infertile young women revealed that the TG or GG genotype in the LIF resulted in fewer oocytes retrieved and fewer mature oocytes relative to the TT genotypes. In older women, the FSHR SNP genotype contributed to fewer numbers of mature oocytes. Conclusions: LIF and FSHR SNP genotypes were associated with a statistically significant reduction in ovarian response to controlled ovarian hyperstimulation in younger and older women with an adequate ovarian reserve, respectively.

Background: Following preimplantation genetic testing for aneuploidy (PGT-A) cycles, the postimplantation development of vitrified-warmed blastocysts expanded on day 5 (D5) versus (vs.) day 6 (D6) has remained unclear, indicating that the ploidy status may not be the only intrinsic factor influencing the development of implanted embryos. Methods: Single-embryo transfers (SETs) of euploid or low-level mosaic blastocysts were performed between January 2018 and December 2020. Continuous TL monitoring was then conducted to evaluate the developmental features of individual embryos. After the data of successful SETs were analyzed, the LB rates were compared between the D5 (n = 200) and D6 (n =56) groups as primary outcomes. The correlations between the embryonic features and LB probability were then determined as secondary outcomes. Results: According to the univariate (odds ratio [OR] = 0.445, 95% confidence interval [CI] = 0.216–0.916; P < 0.05) and multivariate (adjusted OR = 0.385, 95% confidence interval = 0.184–0.805, P < 0.05) logistic regression analyses, the LB probability was negatively associated with the D6 group. The LB rate of the D5group was higher than the D6 group (86% vs. 73.2%; P < 0.05). TL monitoring also revealed that, compared with the D5 implanted blastocysts, the D6 implanted blastocysts exhibited comparable dysmorphisms except the multinucleation at the 4-cell stage (12.5% vs. 3.5%, P < 0.05) and direct uneven cleavage (3.6% vs. 0%, P < 0.05). Moreover, D6 implanted blastocysts had considerably slower developmental kinetics and poorer blastocyst morphologies. Logistic regression analysis confirmed that the LB rate was not associated with developmental kinetics or dysmorphisms but rather with blastocyst morphology (inner cell mass [ICM] grade ≤ C vs. ICM grade A, adjusted OR = 0.212, 95% confidence interval = 0.058–0.77, P < 0.05; trophectoderm [TE] grade ≤ C vs. TE grade A, adjusted OR = 0.182, 95% confidence interval = 0.049–0.672, P < 0.05). Conclusions: After successful implantation, D6 blastocysts have a considerably lower LB rate than D5 blastocysts. As determined by TL monitoring, the diminished blastocyst morphology is the primary reason underlying the decreased likelihood of LB.

Background: To identify the correlation among female age, cellular aging markers, and aneuploidy rate in in vitro fertilization (IVF) and the preimplantation genetic test for aneuploidy (PGT-A) cycles. Methods: This is a prospective cohort study recruiting 110 infertile women between August 2017 and July 2018. They were divided into young-age (

Obstructive sleep apnea (OSA) yields intermittent hypoxia, hypercapnia, and sleep fragmentation. OSA is associated with chronic medical conditions such as cardiovascular diseases, metabolic syndrome, and neurocognitive dysfunction. However, the risk of infertility in OSA remains unclear due to limited data and lack of long-term population-based studies. The study aims to assess the risk of infertility in obstructive sleep apnea (OSA) by means of a population-based cohort study. The data was utilized from the Taiwan National Health Insurance Research Database (NHIRD) to conduct a population-based cohort study (1997–2013). Compared with the Non-OSA group, the male with OSA and surgery group has the OR (odds ratio) of infertility of 2.70 (95% CI, 1.46–4.98, p = 0.0015), but no significance exists in females with OSA. When the data was stratified according to age and gender, some associations in the specific subgroups were significant. Respectively, males aged 20–35 years old and aged 35–50 years old with a history of OSA and surgery both had a positive association with infertility. (aOR: 3.19; 95% CI, 1.18–8.66, p = 0.0227; aOR: 2.57; 95% CI, 1.18–5.62 p = 0.0176). Male patients with OSA suffer from reduced fertility, but no significant difference was noted in females with OSA. The identification of OSA as a risk factor for male infertility will aid clinicians to optimize long-term medical care. Furthermore, more studies will be encouraged to clarify the effect of OSA on female fertility.

Obstructive sleep apnea (OSA), lower urinary tract symptoms (LUTS), and erectile dysfunction (ED) are chronic conditions that seriously affect middle-aged men. This study aimed to evaluate the changes in the presence of these conditions after transoral robotic surgery (TORS) for OSA. This prospective observational study recruited 48 men with moderate-to-severe OSA (mean age 40.6 ± 8.1 years) who underwent TORS from October 2019 to November 2021 at a tertiary center. Baseline polysomnographic parameters, Epworth Sleepiness Scale (ESS), and demographic characteristics were measured. The evaluations of LUTS and ED were based on self-administered International Prostate Symptom Score (IPSS) and International Index of Erectile Function (IIEF-5) questionnaires, respectively, before TORS. The treatment outcomes were assessed three months postoperatively in the patients undergoing TORS due to moderate-to-severe OSA. There was significant Apnea-Hypopnea Index (AHI) reduction from 53.10 ± 25.77 to 31.66 ± 20.34 three months after undergoing TORS (p < 0.001). There was also a significant decrease in the total IPSS score (5.06 ± 5.42 at baseline to 2.98 ± 2.71 at three months postoperatively, p = 0.001), the storage domain, and the voiding domain (p < 0.05). The ED also improved significantly, as seen in the IIEF score (20.98 ± 3.32 to 22.17± 3.60, p = 0.007). The reduction of AHI was associated with changes in body weight and the lowest oxygen saturation (SpO2) levels during sleep (rho = 0.395, p = 0.005; rho = 0.526, p < 0.001, respectively). However, the reduction in AHI was not significantly associated with improvement in IPSS or IIEF scores (p > 0.05). For men with moderate-to-severe OSA, TORS can significantly improve the polysomnography parameters, sleep-related questionnaire scores, and quality of life, and alleviate ED and LUTS. AHI reduction is not a crucial factor for ED and LUTS improvement after TORS for OSA, especially in ED.