Publications by authors named "C Kremer"

183 Publications

Improving IUI success by performing modified slow-release insemination and a patient-centred approach in an insemination programme with partner semen: a prospective cohort study.

Facts Views Vis Obgyn 2021 Dec;13(4):359-367

Background: Pregnancy rates after in vitro fertilisation (IVF) treatment continue to improve, while intrauterine insemination (IUI) programmes show no such trend. There is a need to improve success rates with IUI to retain it as a viable option for couples who prefer avoiding IVF as a first line treatment.

Objective: To investigate if a modified slow-release insemination (SRI) increases the clinical pregnancy rate (CPR) after intrauterine insemination (IUI) with partner semen.

Materials And Methods: This was a prospective cohort study in a Belgian tertiary fertility centre. Between July 2011 and December 2018, we studied data from an ongoing prospective cohort study including 989 women undergoing 2565 IUI procedures for unexplained or mild/moderate male infertility. These data were analysed in order to study the importance of different covariates influencing IUI success. Generalised estimating equations (GEEs) were used for statistical analysis. Results of two periods (2011-2015, period 1 and 2016-2018, period 2) were examined and compared. From January 2016 (period 2) onwards, a standardised SRI procedure instead of bolus injection of sperm was applied. The primary outcome parameter was the difference in clinical pregnancy rate (CPR) per cycle between period 1 (bolus IUI) and period 2 (modified SRI). Secondary outcome results included all other parameters significantly influencing CPR after IUI.

Results: Following the application of modified SRI the CPR increased significantly, from 9.03% (period 1) to 13.52% (period 2) (p = 0.0016). Other covariates significantly influencing CPR were partner's age, smoking/non-smoking partner, BMI patient, ovarian stimulation protocol and Inseminating Motile Count (after semen processing).

Conclusions: Conclusions: The intentional application of modified slow-release of processed semen appears to significantly increase CPRs after IUI with homologous semen. Future studies should investigate whether SRI, patient-centred measures, or a combination of both, are responsible for this improvement.
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http://dx.doi.org/10.52054/FVVO.13.4.045DOI Listing
December 2021

Economic assessment of molecular imaging in the oncology treatment process.

Eur J Radiol 2022 Jan 13;146:110105. Epub 2021 Dec 13.

Department of Radiology and Nuclear Medicine, University Medical Center Mannheim, Medical Faculty Mannheim of the University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany. Electronic address:

The development towards targeted treatments in oncology has been accompanied by significant improvements in molecular imaging. Yet, broad application of novel imaging techniques has partly been slowed down due to economical considerations. Building on the broad positive evidence of its diagnostic accuracy, modelling of effects on long-term costs and effectiveness may help to foster a broader application and acceptance of comprehensive molecular imaging techniques, such as PET/MRI. In this article, common economic evaluation techniques and cost-effectiveness analysis (CEA) evaluation methods will be introduced including Markov models and incremental cost-effectiveness ratios (ICER). This is complemented with a review of literature on recently published cost-effectiveness of molecular imaging. Additionally, the strategic relevance of CEAs for the molecular imaging community is discussed and combined with a global outlook.
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http://dx.doi.org/10.1016/j.ejrad.2021.110105DOI Listing
January 2022

Transmission of SARS-CoV-2 After COVID-19 Screening and Mitigation Measures for Primary School Children Attending School in Liège, Belgium.

JAMA Netw Open 2021 10 1;4(10):e2128757. Epub 2021 Oct 1.

Department of Infectious Diseases, Liège University Hospital, Liège, Belgium.

Importance: Recent data suggest a relatively low incidence of COVID-19 among children. The possible role that children attending primary school may play in the transmission of SARS-CoV-2 remains poorly understood.

Objective: To gain a better understanding of the possible role of children in the transmission of SARS-CoV-2.

Design, Setting, And Participants: This prospective cohort study was conducted from September 21 to December 31, 2020, in a primary school in Liège, Belgium, among a volunteer sample of 181 children, parents, and school employees.

Exposures: Participants were tested for SARS-CoV-2 infection once a week for 15 weeks through throat washing, performed with 5 mL of saline and collected in a sterile tube after approximately 30 seconds of gargling. Quantitative reverse transcription-polymerase chain reaction was performed to detect SARS-CoV-2 infection.

Main Outcomes And Measures: In case of test positivity, participants were asked to complete a questionnaire aimed at determining the timing of symptom onset and symptom duration. SARS-CoV-2 genetic sequencing was also performed. Confirmed cases were linked based on available information on known contacts and viral sequences.

Results: A total of 181 individuals participated in this study, including 63 children (34 girls [54.0%]; mean [SD] age, 8.6 [1.9] years [range, 5-13 years]) and 118 adults (75 women [63.6%]; mean [SD] age, 42.5 [5.7] years [range, 30-59 years]). Forty-five individuals (24.9%) tested positive: 13 children (20.6%; 95% CI, 10.6%-30.6%) and 32 adults (27.1%; 95% CI, 19.1%-35.7%) (P = .34). Children were more often asymptomatic compared with adults (6 [46.2%; 95% CI, 19.1%-73.3%] vs 4 of 31 [12.9%; 95% CI, 1.3%-24.5%]; P = .04). The median duration of symptoms was shorter in children than in adults (0.00 days [IQR, 0.00-1.00 days] vs 15.00 days [IQR, 7.00-22.00 days]). A reconstruction of the outbreak revealed that most transmission events occurred between teachers and between children within the school. Of the observed household transmission events, most seemed to have originated from a child or teacher who acquired the infection at school.

Conclusions And Relevance: Despite the implementation of several mitigation measures, the incidence of COVID-19 among children attending primary school in this study was comparable to that observed among teachers and parents. Transmission tree reconstruction suggests that most transmission events originated from within the school. Additional measures should be considered to reduce the transmission of SARS-CoV-2 at school, including intensified testing.
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http://dx.doi.org/10.1001/jamanetworkopen.2021.28757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8511974PMC
October 2021

Autoimmune screening before adenovirus vector-based DNA vaccine in women may avoid underuse for all the subjects.

Neurol Sci 2021 Dec;42(12):5421-5423

Stroke Unit and Division of Internal and Cardiovascular Medicine, Santa Maria della Misericordia Hospital, University of Perugia, Piazzale Menghini 1, 06129, Perugia, Italy.

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http://dx.doi.org/10.1007/s10072-021-05620-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8491439PMC
December 2021

Hand-Arm Vibration Controls for Jackleg Rock Drills: A Pilot Study Assessing Ergonomic Hazards.

Min Metall Explor 2021 ;38(5):1933-1941

Department of Safety, Health and Industrial Hygiene, Montana Technological University, Butte, Montana 59701.

Jackleg drill operators are exposed to harmful levels of hand-arm vibration (HAV). Anti-vibration handles and gloves provide modest reductions in HAV exposures and forearm muscle exertion from the use of AV handles and gloves by jackleg drill operators. The goal of this pilot study was to investigate changes in HAV with the use of anti-vibration gloves and handles compared to forearm muscle exertion experienced by operators and measured with surface electromyography (EMG). Five subjects operated the drill under four different cases: no anti-vibration controls, anti-vibration gloves only, anti-vibration handle only, and simultaneous anti-vibration handle and glove use. Muscle exertion was expressed as a percent of maximum voluntary contraction (%MVC) and was compared using Welch's ANOVA with Games-Howell post-hoc comparisons. The case with both anti-vibration controls in use simultaneously (largest grip diameter) was associated with a mean %MVC of 36.13% during operation for all forearm muscles combined, which was significantly higher than the other cases (p < 0.05). There were no statistically significant differences in mean HAV exposures. The anti-vibration handle with anti-vibration glove case only increased the maximum allowable exposure time by eight minutes as compared to the control case without any anti-vibration controls. These results suggest that the modest HAV exposure reductions from the use of anti-vibration handles and gloves may pale in comparison to the increased muscle exertion resulting from their use, and this tradeoff among jackleg drill operators is a potential concern that warrants further investigation.
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http://dx.doi.org/10.1007/s42461-021-00451-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8455128PMC
January 2021
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