Objective To explore the optimal time for initiating in vitro fertilization and embryo transfer (IVF-ET) in women with complete remission after fertility-sparing treatment for grade I endometrial cancer (EC) or atypical endometrial hyperplasia (AEH). Patients and methodsYoung women who demonstrated complete remission after fertility-sparing treatment for grade I EC or AEH and underwent IVF-ET treatment were included. A generalized estimating equation (GEE) was used to compare the outcomes of controlled ovarian hyperstimulation (COH) and embryo transfer at different times after discontinuing high-dose progesterone therapy, and patients were divided into three groups: ≤ 3 months (time 1), 3-9 months (time 2) and > 9 months (time 3). Results Thirty-seven women with complete remission after fertility-sparing treatment for grade I EC or AEH underwent 75 IVF-ET cycles. Regarding initiation of COH, 10 cycles for time 1, 31 cycles for time 2 and 34 cycles for time 3 were included. The odds ratios (95% confidence intervals) for the number of available embryos at time 2 and time 3 were 1.82 (1.08-3.08) and 2. 45 (1.39-4.33), and those for the number of high-quality embryos at time 2 and time 3 were, respectively, 3.64 (1.34-9.87) and 3.62 (1.10-11.91), compared with that at time 1. Nineteen (51.4%) women had at least one clinical pregnancy and 13 (35.1%) women had live births. During a median follow-up period of 51 months (range 5-168 months), 10 (27.0%) women had disease relapse, with a median interval of 15.5 months (range 5-104 months). Conclusion Initiating IVF-ET 3 months after ceasing high-dose progesterone therapy can lead to better outcomes of controlled ovarian hyperstimulation for women with endometrial cancer or atypical endometrial hyperplasia.

In high-rise modular housing complex projects, tower crane layout planning is the key to ensuring the efficient lifting of components during construction. To improve the lifting efficiency of the cranes and control costs, the layout plan should minimize the distance the tower cranes must move the prefabricated units. The distance between the trailer holding the components, the tower crane, and the structure under construction should be kept to a minimum. However, most current studies consider the relative positions of the tower crane and the trailer without fully considering the movement efficiency of the trailer, and when multiple trailers and multiple tower cranes are involved, the optimization scheme is more complicated. In this study, a mathematical model based on mixed integer linear programming (MILP) is built to determine the type and location of tower cranes as well as the location of trailers to solve the problem of situating multiple tower cranes in a high-rise modular housing complex project. Finally, the validity and practicality of the model are demonstrated with case studies.

ObjectiveThe objective of the study was to compare the effects of assisted reproductive technology (ART) and spontaneous pregnancy on pregnancy outcomes in women with endometrial carcinoma (EC) and atypical endometrial hyperplasia (AEH) following fertility-sparing treatments.MethodsRelevant studies published through July 2020 were identified from PubMed and Web of Science literature searches. The pregnancy outcomes of ART and spontaneous pregnancy were summarized and compared for women with complete remission of EC/AEH after fertility-sparing treatments. A subgroup analysis was performed based on whether patients had receivedin vitrofertilization and embryo transfer (IVF-ET) treatment. The complete remission and recurrence rates of EC/AEH following fertility-sparing treatments were estimated. The effect of pregnancy on recurrence rates of EC/AEH was also calculated.ResultsSixteen observational studies reporting pregnancy outcomes or recurrence with ART or spontaneous pregnancy for women with EC/AEH after fertility-sparing treatments were included. The complete remission rate of EC/AEH was 81.5% (95%CI, 78%–85%). Compared with spontaneous pregnancy, the pregnancy rate of ART was significantly higher (66.8% vs. 43.7%, OR ​= ​2.64, 95%CI 1.71–4.05,P<0.00001,I2 ​= ​14%). Subgroup analysis showed that the pregnancy rate of IVF-ET was significantly higher than that of spontaneous pregnancy (62.7% vs. 35.1%, OR ​= ​2.85, 95%CI 1.44-5.63,P ​= ​0.003,I2 ​= ​29%). The live birth rate of ART was significantly higher than that of spontaneous pregnancy (75.3% vs. 47.8%, OR ​= ​3.96, 95%CI1.76-8.77,P ​= ​0.0009,I2 ​= ​45%). The recurrence rate of EC/AEH was 31% (95%CI 24%–39%). Clinical pregnancy could reduce the recurrence rate of EC/AEH, but there was no significant evidence of an association.ConclusionsART, especially IVF-ET, could significantly improve pregnancy outcomes in women with EC/AEH receiving fertility-sparing treatments. Following complete remission, ART treatment might be a better option for women with EC/AEH than spontaneous pregnancy.

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