Comorbidity of Internet use disorder and attention deficit hyperactivity disorder: Two adult case-control studies.

PubMed

Bielefeld, Martin; Drews, Marion; Putzig, Inken; Bottel, Laura; Steinbüchel, Toni; Dieris-Hirche, Jan; Szycik, Gregor R; Müller, Astrid; Roy, Mandy; Ohlmeier, Martin; Theodor Te Wildt, Bert

2017-12-01

Objectives There is good scientific evidence that attention deficit hyperactivity disorder (ADHD) is both a predictor and a comorbidity of addictive disorders in adulthood. These associations not only focus on substance-related addictions but also on behavioral addictions like gambling disorder and Internet use disorder (IUD). For IUD, systematic reviews have identified ADHD as one of the most prevalent comorbidities besides depressive and anxiety disorders. Yet, there is a need to further understand the connections between both disorders to derive implications for specific treatment and prevention. This is especially the case in adult clinical populations where little is known about these relations so far. This study was meant to further investigate this issue in more detail based on the general hypothesis that there is a decisive intersection of psychopathology and etiology between IUD and ADHD. Methods Two case-control samples were examined at a university hospital. Adult ADHD and IUD patients ran through a comprehensive clinical and psychometrical workup. Results We found support for the hypothesis that ADHD and IUD share psychopathological features. Among patients of each group, we found substantial prevalence rates of a comorbid ADHD in IUD and vice versa. Furthermore, ADHD symptoms were positively associated with media use times and symptoms of Internet addiction in both samples. Discussion Clinical practitioners should be aware of the close relationships between the two disorders both diagnostically and therapeutically. When it comes to regain control over one's Internet use throughout treatment and rehabilitation, a potential shift of addiction must be kept in mind on side of practitioners and patients.

Acceptability of randomization to levonorgestrel versus copper intrauterine device among women requesting IUD insertion for contraception

PubMed Central

Achilles, Sharon L.; Chen, Beatrice A.; Lee, Jessica K.; Gariepy, Aileen M.; Creinin, Mitchell D.

2015-01-01

Objective Assess feasibility of randomizing women to intrauterine device (IUD) type. Study Design Women enrolling in a 2-month study who desired an IUD for contraception were randomized 1:1 to receive a levonorgestrel 52mg IUD (LNG-IUD) or copper T380A (Cu-IUD), understanding they could switch IUD type at the end of the study. Results Randomization to IUD type was acceptable to 54/55 (98%) women who screened. All 32 enrolled participants completed follow-up. Two women exchanged their IUD (Cu-IUD to LNG-IUD) and 2 requested removal (1 LNG-IUD, 1 Cu-IUD). Overall, 88% continued their assigned IUD. Conclusions Randomization to IUD type is feasible and few women change their IUD. PMID:26297203

Investigating the Effect of Personality, Internet Literacy, and Use Expectancies in Internet-Use Disorder: A Comparative Study between China and Germany

PubMed Central

Brand, Matthias; Li, Mei; Zhou, Min; Sha, Peng

2018-01-01

Research on Internet-use Disorder (IUD) has increased rapidly, indicating its clinical and global importance. Past studies suggested cultural diversity regarding the prevalence of an IUD, e.g., between Asian and European countries. Additionally, it was found that personality factors, Internet-related cognitions and specific competences seem to influence IUD tendencies, but research lacks in cultural comparative studies regarding these mechanisms. This study focuses on differences between Germany and China regarding the above-mentioned characteristics. German (n = 411; M = 20.70 years, SD = 3.34 years) and Chinese participants (n = 410; M = 20.72 years, SD = 2.65 years) answered the short Internet Addiction Test, Big Five Inventories, the Internet-use Expectancies Scale, as well as the Internet Literacy Questionnaire. The results revealed higher occurrence of IUD symptoms in China. Furthermore, Chinese participants scored significantly higher on neuroticism and agreeableness, whereas German participants scored higher on extraversion and openness. Compared to German participants, Chinese showed higher expectancies to avoid negative feelings online and to be positively reinforced. Regarding Internet literacy, German participants indicated higher skills concerning the reflection and critical analysis of online content, whereas Chinese showed higher expertise in producing and interacting online. Further, simple slope analyses indicated that certain Internet literacy domains were related differentially to IUD symptoms in Germany and China. While Chinese participants with higher reflective skills indicated highest IUD symptoms, reflective skills revealed no effect in Germany. Additionally, higher self-regulative skills correlated with lower IUD symptoms in the German, but not in the Chinese sample. The results give a hint to potential cultural differences regarding IUD, especially on the predictive and protective role of Internet literacy domains. PMID:29570663

Investigating the Effect of Personality, Internet Literacy, and Use Expectancies in Internet-Use Disorder: A Comparative Study between China and Germany.

PubMed

Stodt, Benjamin; Brand, Matthias; Sindermann, Cornelia; Wegmann, Elisa; Li, Mei; Zhou, Min; Sha, Peng; Montag, Christian

2018-03-23

Research on Internet-use Disorder (IUD) has increased rapidly, indicating its clinical and global importance. Past studies suggested cultural diversity regarding the prevalence of an IUD, e.g., between Asian and European countries. Additionally, it was found that personality factors, Internet-related cognitions and specific competences seem to influence IUD tendencies, but research lacks in cultural comparative studies regarding these mechanisms. This study focuses on differences between Germany and China regarding the above-mentioned characteristics. German ( n = 411; M = 20.70 years, SD = 3.34 years) and Chinese participants ( n = 410; M = 20.72 years, SD = 2.65 years) answered the short Internet Addiction Test, Big Five Inventories, the Internet-use Expectancies Scale, as well as the Internet Literacy Questionnaire. The results revealed higher occurrence of IUD symptoms in China. Furthermore, Chinese participants scored significantly higher on neuroticism and agreeableness, whereas German participants scored higher on extraversion and openness. Compared to German participants, Chinese showed higher expectancies to avoid negative feelings online and to be positively reinforced. Regarding Internet literacy, German participants indicated higher skills concerning the reflection and critical analysis of online content, whereas Chinese showed higher expertise in producing and interacting online. Further, simple slope analyses indicated that certain Internet literacy domains were related differentially to IUD symptoms in Germany and China. While Chinese participants with higher reflective skills indicated highest IUD symptoms, reflective skills revealed no effect in Germany. Additionally, higher self-regulative skills correlated with lower IUD symptoms in the German, but not in the Chinese sample. The results give a hint to potential cultural differences regarding IUD, especially on the predictive and protective role of Internet literacy domains.

Trends and determinants of IUD use in the USA, 2002-2012.

PubMed

Mosher, William D; Moreau, Caroline; Lantos, Hannah

2016-08-01

What factors and subgroups have propelled the recent increase in intrauterine device (IUD) use in the USA? The increase in IUD use, from 1.8 to 9.5% in the USA between 2002 and 2012, was driven primarily by a marked uptake among parous women who intended to have more children. Recent data suggest an unprecedented increase in IUD use among women in the USA, yet less is known about how this increase has affected the overall proportion of women, at risk of unintended pregnancy, who are using contraception and which social and economic groups are involved. Data are drawn from the 2002 and 2011-2013 National Surveys of Family Growth. The surveys were based on cross-sectional, national samples of women of 15-44 years of age in the USA. Women responded to in-person interviews, which lasted an average of 80 min. The response rate was 80% in 2002 and 73% in 2011-2013. The sample included 7643 completed interviews in 2002 and 5601 interviews in 2011-2013. This study was limited to women at risk of unintended pregnancy, i.e. women who were sexually active in the previous 3 months (using contraception or not); it excludes women who were sterile, currently pregnant or trying to conceive. Altogether, 5181 women were at risk in the 2002 sample and 3681 were at risk in the 2012 sample. We used descriptive statistics to investigate trends in contraceptive use patterns by women's sociodemographic characteristics between 2002 and 2012 and used logistic regression to identify current predictors of IUD use in 2012. IUD use increased from 1.8% in 2002 to 9.5% in 2012 (P < 0.001). The surge was especially marked among parous women who intended to have more children (4.2% in 2002 to 19.3% in 2012; P < 0.001); it occurred to a lesser extent among parous women who did not intend to have more children (2.0-9.7% P < 0.001), suggesting that IUDs are more often used for spacing than for ending childbearing in the USA. The most important predictors of IUD use in 2012 were age, parity and intent to have children. Dissatisfaction with a previous method was also associated with IUD use (adjusted odds ratio = 1.89, P < 0.001). As with all cross-sectional studies, causal inference is limited. Data are self-reported, but the survey had a high response rate and rigorous quality controls. This study shows promising trends in the use of highly effective contraceptive methods in the USA, which may help to explain recently reported declines in unintended pregnancy in the USA. Caroline Moreau was supported by the William Robertson endowment funds. The work of Hannah Lantos and William Mosher on this analysis was supported by the Department of Population Family and Reproductive Health, The Johns Hopkins Bloomberg School of Public Health. The authors declare that no conflict of interest exists. © The Author 2016. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The 2D:4D Marker and Different Forms of Internet Use Disorder.

PubMed

Müller, Marko; Brand, Matthias; Mies, Julia; Lachmann, Bernd; Sariyska, Rayna Yordanova; Montag, Christian

2017-01-01

Internet use disorder (IUD) presents a growing problem worldwide. Among others, it manifests in loss of control over Internet usage and social problems due to problematic Internet use. Although IUD currently is not an official diagnosis in DSM-5 or ICD-10, mounting evidence suggests that IUD indeed could be categorized as a behavioral addiction. On a systemic neuroscientific level, IUD is well characterized and dysfunctions in the fronto-striatal-limbic loop have been observed in persons being afflicted with IUD. On a molecular level underlying these neural dysfunctions less is known. Therefore, the present research investigates the influence of prenatal testosterone as measured via the 2D:4D marker of the hand on IUD. Testosterone represents an interesting hormonal marker, because sex differences in IUD have been observed, e.g., males show higher tendencies toward Internet gaming disorder (IGD) or females toward overusage of online social networks (both compared to the contrary sex). In N  = 217 participants associations between the 2D:4D marker of the hand and both unspecified IUD and specific forms of IUD were investigated. It appeared that more female hands (right side; characterized by higher digit ratio of the index to the ring finger, i.e., >1, meaning lower prenatal testosterone) were associated with lower IGD ( rho  = -0.17, p  = 0.01, N  = 211). This effect was driven by the facet of loss of control of Internet Gaming in the whole sample ( rho  = -0.20, p  < 0.01, N  = 211) and the female subsample ( rho  = -0.20, p  = 0.02, N(f)  = 137). Aside from this, a negative association appeared between the facet of loss of control of generalized IUD and the right digit ratio in males underlining earlier work. In sum, the present work demonstrates that the 2D:4D marker is an interesting marker for Internet addiction and can be easily included as a biomarker to understand the biological underpinnings of Internet (over-)usage.

The 2D:4D Marker and Different Forms of Internet Use Disorder

PubMed Central

Müller, Marko; Brand, Matthias; Mies, Julia; Lachmann, Bernd; Sariyska, Rayna Yordanova; Montag, Christian

2017-01-01

Internet use disorder (IUD) presents a growing problem worldwide. Among others, it manifests in loss of control over Internet usage and social problems due to problematic Internet use. Although IUD currently is not an official diagnosis in DSM-5 or ICD-10, mounting evidence suggests that IUD indeed could be categorized as a behavioral addiction. On a systemic neuroscientific level, IUD is well characterized and dysfunctions in the fronto-striatal-limbic loop have been observed in persons being afflicted with IUD. On a molecular level underlying these neural dysfunctions less is known. Therefore, the present research investigates the influence of prenatal testosterone as measured via the 2D:4D marker of the hand on IUD. Testosterone represents an interesting hormonal marker, because sex differences in IUD have been observed, e.g., males show higher tendencies toward Internet gaming disorder (IGD) or females toward overusage of online social networks (both compared to the contrary sex). In N = 217 participants associations between the 2D:4D marker of the hand and both unspecified IUD and specific forms of IUD were investigated. It appeared that more female hands (right side; characterized by higher digit ratio of the index to the ring finger, i.e., >1, meaning lower prenatal testosterone) were associated with lower IGD (rho = −0.17, p = 0.01, N = 211). This effect was driven by the facet of loss of control of Internet Gaming in the whole sample (rho = −0.20, p < 0.01, N = 211) and the female subsample (rho = −0.20, p = 0.02, N(f) = 137). Aside from this, a negative association appeared between the facet of loss of control of generalized IUD and the right digit ratio in males underlining earlier work. In sum, the present work demonstrates that the 2D:4D marker is an interesting marker for Internet addiction and can be easily included as a biomarker to understand the biological underpinnings of Internet (over-)usage. PMID:29249989

Clinical training alone is not sufficient for reducing barriers to IUD provision among private providers in Pakistan

PubMed Central

2011-01-01

Background IUD uptake remains low in Pakistan, in spite of three major efforts to introduce the IUD since the 1960s, the most recent of these being through the private sector. This study examines barriers to IUD recommendation and provision among private providers in Pakistan. Methods A facility-based survey was conducted among randomly selected private providers who were members of the Greenstar network and among similar providers located within 2 Kilometers. In total, 566 providers were interviewed in 54 districts of Pakistan. Logistic regression analysis was conducted to determine whether correct knowledge regarding the IUD, self-confidence in being able to insert the IUD, attitudes towards suitability of candidates for the IUD and medical safety concerns were influenced by provider type (physician vs. Lady Health Visitor), whether the provider had received clinical training in IUD insertion in the last three years, membership of the Greenstar network and experience in IUD insertion. OLS regression was used to identify predictors of provider productivity (measured by IUD insertions conducted in the month before the survey). Results Private providers consider women with children and in their peak reproductive years to be ideal candidates for the IUD. Women below age 19, above age 40 and nulliparous women are not considered suitable IUD candidates. Provider concerns about medical safety, side-effects and client satisfaction associated with the IUD are substantial. Providers' experience in terms of the number of IUDs inserted in their careers, appears to improve knowledge, self-confidence in the ability provide the IUD and to lower age-related attitudinal barriers towards IUD recommendation. Physicians have greater medical safety concerns about the IUD than Lady Health Visitors. Clinical training does not have a consistent positive effect on lowering barriers to IUD recommendation. Membership of the Greenstar network also has little effect on lowering these barriers. Providers' barriers to IUD recommendation significantly lower their monthly IUD insertions. Conclusions Technical training interventions do not reduce providers' attitudinal barriers towards IUD provision. Formative research is needed to better understand reasons for the high levels of provider barriers to IUD provision. "Non-training" interventions should be designed to lower these barriers. PMID:22208449

One-year continuation of copper or levonorgestrel intrauterine devices initiated at the time of emergency contraception.

PubMed

Sanders, J N; Turok, D K; Royer, P A; Thompson, I S; Gawron, L M; Storck, K E

2017-08-01

This study compares 1-year intrauterine device (IUD) continuation among women presenting for emergency contraception (EC) and initiating the copper (Cu T380A) IUD or the levonorgestrel (LNG) 52 mg IUD plus 1.5 mg oral LNG. This cohort study enrolled 188 women who presented at a single family planning clinic in Utah between June 2013 and September 2014 and selected either the Cu T380A IUD or LNG 52 mg IUD plus oral LNG for EC. Trained personnel followed participants by phone, text or e-mail for 12 months or until discontinuation occurred. We assessed reasons for discontinuation and used Cox proportional hazard models, Kaplan-Meier estimates and log-rank tests to assess differences in continuation rates between IUDs. One hundred seventy-six women received IUDs; 66 (37%) chose the Cu T380A IUD and 110 (63%) chose the LNG 52 mg IUD plus oral LNG. At 1 year, we accounted for 147 (84%) participants, 33 (22%) had requested removals, 13 (9%) had an expulsion and declined reinsertion, 3 (2%) had a pregnancy with their IUD in place and 98 (67%) were still using their device. Continuation rates did not differ by IUD type; 60% of Cu T380A IUD users and 70% of LNG 52 mg IUD plus oral LNG users were still using their device at 12 months (adjusted hazard ratio 0.72, 95% confidence interval 0.40-1.3). Two-thirds of women who chose IUD placement at the EC clinical encounter continued use at 1 year. Women initiating Cu T380A IUD and LNG 52 mg IUD had similar 1-year continuation rates. These findings support same-day insertion of IUDs for women who are seeking EC and would like to use a highly effective reversible method going forward. Providing IUD options for EC users presents an opportunity to increase availability of highly effective contraception. Copyright © 2017. Published by Elsevier Inc.

Clinical characteristic and intraoperative findings of uterine perforation patients in using of intrauterine devices (IUDs).

PubMed

Sun, Xin; Xue, Min; Deng, Xinliang; Lin, Yun; Tan, Ying; Wei, Xueli

2018-01-01

Intrauterine devices (IUDs) are the most popular form of contraception used worldwide; however, IUD is not risk-free. IUD migrations, especially uterine perforations, were frequently occurred in patients. The aim of this study was to investigate the clinical characteristics and intraoperative findings in patients with migrated IUDs. 29 cases of uterine perforation associated with migrated IUDs and 69 control patients were followed between January 2008 to March 2015. Patients who used IUDs within first 6 months from the last delivery experienced a characteristically high rate of the perforation of the uterine wall. A significantly larger number of IUD insertion associated with uterine perforation were performed in rural hospitals or operated at a lower level health care system. There was no clear difference in the age and presented symptoms in patients between two groups. Majority of contraceptive intrauterine devices was the copper-releasing IUDs. Furthermore, patients who used V-shaped IUD showed significantly higher incidence of pelvic adhesions when compared with the users of O-shaped IUDs. Unique clinical characteristics of IUD migration were identified in patients with uterine perforation. Hysteroscopy and/or laparoscopy were the effective approaches to remove the migrated IUDs. Improving operating skills is required at the lower level of health care system.

Emergency contraception: A multispecialty survey of clinician knowledge and practices.

PubMed

Batur, Pelin; Cleland, Kelly; McNamara, Megan; Wu, Justine; Pickle, Sarah

2016-02-01

To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods. A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression. The final sample included 1684 providers (response rate=51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide LNG EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide LNG, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods [UPA and copper intrauterine device (IUD)] were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC. Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health. In our sample of 1684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of EC (UPA and the copper IUD) are far lower than for LNG EC. Women should be offered the full range of EC methods. Copyright © 2016 Elsevier Inc. All rights reserved.

Emergency Contraception: A multi-specialty survey of clinician knowledge and practices

PubMed Central

Batur, Pelin; Cleland, Kelly; McNamara, Megan; Wu, Justine; Pickle, Sarah

2015-01-01

Objectives To assess knowledge and provision of emergency contraception (EC), particularly the most effective methods. Study Design A web-based survey was distributed to a cross-sectional convenience sample of healthcare providers across specialties treating reproductive-aged women. The survey was sent to 3,260 practicing physicians and advanced practice clinicians in 14 academic centers between February 2013 and April 2014. We analyzed responses by provider specialty using multivariable logistic regression. Results The final sample included 1,684 providers (response rate = 51.7%). Ninety-five percent of the respondents had heard of levonorgestrel (LNG) EC. Among reproductive health specialists, 81% provide levonorgestrel EC in their practice, although only half (52%) had heard of ulipristal acetate (UPA) and very few provide it (14%). The majority in family medicine (69%) and emergency medicine (74%) provide levonorgestrel, in contrast to 42% of internists and 55% of pediatricians. However, the more effective methods (UPA and copper IUD) were little known and rarely provided outside of reproductive health specialties; 18% of internists and 14% of emergency medicine providers had heard of UPA and 4% provide it. Only 22% of emergency providers and 32% of pediatricians had heard of the copper IUD used as EC. Among reproductive health specialists, only 36% provide copper IUD as EC in their practice. Specialty, provider type and proportion of women of reproductive age in the practice were related to knowledge and provision of some forms of EC. Conclusions Awareness and provision of the most effective EC methods, UPA and the copper IUD (which are provider-dependent), are substantially lower than for LNG EC, especially among providers who do not focus on reproductive health. Implications In our sample of 1,684 healthcare providers from diverse specialties who treat reproductive-aged women, knowledge and provision of the most effective forms of emergency contraception (ulipristal acetate and the copper IUD) are far lower than for levonorgestrel EC. Women should be offered the full range of EC methods. PMID:26363429

Preference for and efficacy of oral levonorgestrel for emergency contraception with concomitant placement of a levonorgestrel IUD: a prospective cohort study.

PubMed

Turok, David K; Sanders, Jessica N; Thompson, Ivana S; Royer, Pamela A; Eggebroten, Jennifer; Gawron, Lori M

2016-06-01

We assessed intrauterine device (IUD) preference among women presenting for emergency contraception (EC) and the probability of pregnancy among concurrent oral levonorgestrel (LNG) plus LNG 52 mg IUD EC users. We offered women presenting for EC at a single family planning clinic the CuT380A IUD (copper IUD) or oral LNG 1.5 mg plus the LNG 52 mg IUD. Two weeks after IUD insertion, participants reported the results of a self-administered home urine pregnancy test. The primary outcome, EC failure, was defined as pregnancies resulting from intercourse occurring within five days prior to IUD insertion. One hundred eighty-eight women enrolled and provided information regarding their current menstrual cycle and recent unprotected intercourse. Sixty-seven (36%) chose the copper IUD and 121 (64%) chose oral LNG plus the LNG IUD. The probability of pregnancy two weeks after oral LNG plus LNG IUD EC use was 0.9% (95% CI 0.0-5.1%). The only positive pregnancy test after treatment occurred in a woman who received oral LNG plus the LNG IUD and who had reported multiple episodes of unprotected intercourse including an episode more than 5 days prior to treatment. Study participants seeking EC who desired an IUD preferentially chose oral LNG 1.5 mg with the LNG 52 mg IUD over the copper IUD. Neither group had EC treatment failures. Including the option of oral LNG 1.5 mg with concomitant insertion of the LNG 52 mg IUD in EC counseling may increase the number of EC users who opt to initiate highly effective reversible contraception. Consideration should be given to LNG IUD insertion with concomitant use of oral LNG 1.5 mg for EC. Use of this combination may increase the number of women initiating highly effective contraception at the time of their EC visit. Copyright © 2016 Elsevier Inc. All rights reserved.

"Birth Control can Easily Take a Back Seat": Challenges Providing IUDs in Community Health Care Settings.

PubMed

Biggs, M Antonia; Kaller, Shelly; Harper, Cynthia C; Freedman, Lori; Mays, Aisha R

2018-01-01

To assess community health centers' (CHCs) capacity to offer streamlined intrauterine devices (IUDs) services. Prior to implementing a contraceptive training project, we surveyed health care staff (N=97) from 11 CHC sites that offer IUDs onsite. Twenty interviews with clinicians explored more deeply their challenges offering IUDs in the CHC setting. Most practices required multiple visits for IUD placement, most (66%) clinician survey respondents had placed an IUD and 19% had placed an IUD as emergency contraception. Need for screening tests, scheduling challenges, pressures to meet patient quotas, and lack of priority given to women's health hindered streamlined IUD provision. Although access to IUDs has increased, significant barriers to provision in CHC settings persist. Clinic policies may need to address a variety of system and provider-level barriers to meet the needs of patients.

Intrauterine Devices

MedlinePlus

... IUD can be removed at any time. Most women get pregnant right away after the IUD is taken out. ● IUDs ... a lifetime™ AMERICAN COLLEGE OF NURSE- MIDWIVES With women , for a lifetime™ AMERICAN COLLEGE OF NURSE -MIDWIVES IS THE IUD RIGHT FOR ME? Who Can Use an IUD? ● Any ...

A Survey of Inhalant Use Disorders among Delinquent Youth: Prevalence, Clinical Features, and Latent Structure of DSM-IV Diagnostic Criteria

PubMed Central

Howard, Matthew O; Perron, Brian E

2009-01-01

Background Inhalant use is among the most pernicious and poorly understood forms of adolescent substance use. Many youth in the juvenile justice system have used inhalants, but little is known about inhalant use disorders (IUDs) in antisocial youth populations. The purpose of this study was to examine the prevalence, clinical features, and latent structure of DSM-IV IUDs in a state population of antisocial youth. Methods Cross-sectional survey conducted in 2003. Of 740 youth residing in Missouri State Division of Youth Services' (MDYS) residential treatment facilities at the time the study was conducted, 723 (97.7%) completed interviews. Eighty-seven percent were male, with a mean age of 15.5 (SD = 1.2). Nearly 4 in 10 youth (38.5%; n = 279) reported lifetime inhalant use. Youth ranged from very mildly to severely antisocial. Results Of 279 inhalant users, 52 (18.6%) met DSM-IV inhalant abuse criteria and 79 (28.3%) met inhalant dependence criteria. Five of 10 IUD criteria were met by > 10% of the total sample. Latent class analyses demonstrated a substantial concordance between DSM-IV-defined IUDs and an empirically-derived classification based on responses to DSM-IV IUD diagnostic criteria. Conclusion IUDs and constituent criteria were prevalent among youth in the juvenile justice system. Two groups of problem inhalant users were identified, symptomatic users-DSM-IV inhalant abuse and highly symptomatic users-DSM-IV inhalant dependence, which differed primarily in severity of inhalant-related problems. Inhalant screening, prevention and treatment efforts in juvenile justice settings are rarely delivered, but critically needed. PMID:19267939

[Intrauterine contraception].

PubMed

Tauber, P F

1984-09-01

Approximately 60 million women worldwide use IUDs. Despite worldwide distribution, the total number of IUD carriers has barely increased since 1970. Due to its risks and side effects there is a retrograding tendency both in West Germany and the US. To generate positive development, 3 basic trends have emerged: 1) Restrictive usage of the pharmacologically inactive, 1st generation IUDs such as the Lippes Loop or the Saf-T-Coil, 2) the increasing usage of small plastic IUDs with bioactive alloys to decrease failure rates such as the copper (2nd generation) or hormone-releasing IUDs, and 3) improvements made by changing its design to reduce side effects without loss of contraceptive effectiveness. Almost all IUDs increase monthly blood loss by 50-100%. The risk of illness for women with IUDs is 2-3 times higher than for a woman without or with other contraceptive methods. About 20% of all expulsions occur unnoticed. There are 2 kinds of perforations: primary (iatrogenic), at time of insertion, and secondary, some time after insertion. The IUD failure rate is about 1-3 pregnancies/100 woman years. In case of pregnancy, the IUD must be removed immediately. IUD insertion requires consent of the woman and can be made to women from 16 years on, presupposing moral maturity. IUD insertion after a miscarriage or abortion does not lead to risks or complications. Due to its corrosive quality, the copper IUD can only remain inside the uterus for a limited time. IUDs could become an excellent contraceptive method if it were possible to decrease bleeding, design easily-removeable IUDs, and prolong their potential for duration in the body.

[IUD-related anatomical, cytological and pathological modifications in the uterine tract (author's transl)].

PubMed

Levrier, M

1982-05-01

This paper presents a study of the anatomical, cytological, and pathological reactions of the vaginal, cervical, and endometrial mucosa in 445 women wearing inert IUDs, copper IUDs, and progesterone-releasing IUDs. Vaginal cytology does not seem to be affected by any type of IUD. Cervical cytology shows with time increased levels of leuko-histiocytosis and at 18 months cellular alterations are evident; in the series presented here after 24 months there were 2% of cases of light or moderate dysplasia. Endometrial cytology shows cellular inflammation, which worsens with time. Endometrial histology shows: 1) for inert IUDs and after 3-4 years of use, a histio-leukocytic action is evident; 2) for copper IUDs there is no particular alteration for the 1st months; after 18-24 months papillary metaplasia is evident; and 3) for progesterone-releasing IUDs a lympho-plasmocytic infiltration is visible in the 1st month of use, with typical hormonal reactions. This study shows that the uterine mucosa is not affected by an IUD for the 1st 2 years of use, after which the signs of inflammatory reaction are minor and common to any IUD type. The regeneration of the mucosa is very quick after IUD removal.

Assessing the intrauterine device.

PubMed

Mishell, D R

1975-01-01

The data that have accumulated in the 15 years of use of the IUD are examined, the problems involved in attempting to derive meaningful data are discussed and important research directions are highlighted in an attempt to assess the IUD as a contraceptive measure in light of negative reports appearing in the news media. Reliable epidemiologic information about IUD experience before 1970 are available in the reports of the Cooperative Statistical Program. Currently available IUD designs include the Lippes loop, copper-7, double coil, copper T and progesterone T. It has been observed that several factors may be responsible for the variation in performance of IUDs. These include: patient population, physician experience, side effect tolerance, clinic attitude and additional contraceptives (whether a patient is encouraged to use additional contraception with the IUD). The only valid method of comparison of different IUDs is to perform randomized insertion of the devices in the same clinic using the same personnel and the same time period and to analyze the methods by life table analysis. Medical problems in IUD use were discussed including bleeding (either heavy and/or prolonged menses or intermenstrual bleeding), perforation, pregnancy with an IUD in situ, and infection. The contraceptive action of the IUD is associated with the production of a local sterile inflammatory reaction caused by the presence of the foreign body in the uterus. Research should be directed toward improving the design of IUD inserters because placement of the IUD within the uterine cavity is of extreme importance for IUD effectiveness.

Factors associated with low-lying intrauterine devices: a cross-sectional ultrasound study in a cohort of African-American women.

PubMed

Moshesh, Malana; Saldana, Tina; Deans, Elizabeth; Cooper, Tracy; Baird, Donna

2018-03-14

The object of this study is to examine factors and symptoms associated with low-lying IUDs as defined by ultrasound. This is a cross-sectional sub-study of participants in the Study of Environment, Life-style, and Fibroids (SELF). SELF participants had screening ultrasounds for fibroids at study enrollment; those with an IUD in place are included in this sub-study. Low-lying IUDs were identified and localized. Logistic regression was used to identify factors and symptoms associated with low-lying IUDs. Among 168 women with IUDs at ultrasound, 28 (17%) had a low-lying IUD. Having a low-lying IUD was associated with low education level (≤high school: aOR 3.1 95% CI 1.14-8.55) and with increased BMI (p=.002). Women with a low-lying IUD were more likely to report a "big problem" with dysmenorrhea (the highest option of the Likert scale) as compared to women with a normally-positioned IUD (OR 3.2 95% CI 1.07-9.54). Our study found that women with a low-lying IUD are more likely to be of lower education and higher BMI, and to report more dysmenorrhea. Women who are obese may benefit from additional counseling and closer follow-up after IUD placement. Future research is warranted to investigate IUD placement and possible IUD migration among women who are obese. Copyright © 2018 Elsevier Inc. All rights reserved.

Accuracy of Information about the Intrauterine Device on the Internet

PubMed Central

Madden, Tessa; Cortez, Sarah; Kuzemchak, Marie; Kaphingst, Kimberly A.; Politi, Mary C.

2015-01-01

Background Intrauterine devices (IUDs) are highly effective methods of contraception, but use continues to lag behind less effective methods such as oral contraceptive pills and condoms. Women who are aware of the actual effectiveness of various contraceptive methods are more likely to choose the IUD. Conversely, women who are misinformed about the safety of IUDs may be less like to use this method. Individuals increasingly use the Internet for health information. Information about IUDs obtained through the Internet may influence attitudes about IUD use among patients. Objective Our objective was to evaluate the quality of information about intrauterine devices (IUDs) among websites providing contraceptive information to the public. Study Design We developed a 56-item structured questionnaire to evaluate the quality of information about IUDs available through the Internet. We then conducted an online search to identify websites containing information about contraception and IUDs using common search engines. The search was performed in August 2013 and websites were reviewed in October 2015 to ensure no substantial changes. Results Our search identified over 2000 websites, of which 108 were eligible for review; 105 (97.2%) of these sites contained information about IUDs. Eighty-six percent of sites provided at least one mechanism of the IUD. Most websites accurately reported advantages of the IUD including that it is long-acting (91%), highly effective (82%), and reversible (68%). However, only 30% of sites explicitly indicated that IUDs are safe. Fifty percent of sites (n=53) contained inaccurate information about the IUD such as an increased risk of pelvic inflammatory disease beyond the insertion month (27%) or that women in non-monogamous relationships (30%) and nulliparous women (20%) are not appropriate candidates. Forty-four percent of websites stated that a mechanism of IUDs is prevention of implantation of a fertilized egg. Only 3% of websites incorrectly stated that IUDs are an abortifacient. More than a quarter of sites listed an inaccurate contraindication to the IUD such as nulliparity, history of pelvic inflammatory disease, or history of an ectopic pregnancy. Conclusions The quality of information about IUDs available on the Internet is variable. Accurate information was mixed with inaccurate or outdated information that could perpetuate myths about IUDs. Clinicians need knowledge about accurate,, evidence-based Internet resources to provide to women given the inconsistent quality of information available through online sources. PMID:26546848

Accuracy of information about the intrauterine device on the Internet.

PubMed

Madden, Tessa; Cortez, Sarah; Kuzemchak, Marie; Kaphingst, Kimberly A; Politi, Mary C

2016-04-01

Intrauterine devices (IUDs) are highly effective methods of contraception, but use continues to lag behind less effective methods such as oral contraceptive pills and condoms. Women who are aware of the actual effectiveness of various contraceptive methods are more likely to choose the IUD. Conversely, women who are misinformed about the safety of IUDs may be less likely to use this method. Individuals increasingly use the Internet for health information. Information about IUDs obtained through the Internet may influence attitudes about IUD use among patients. Our objective was to evaluate the quality of information about IUDs among World Wide Web sites providing contraceptive information to the public. We developed a 56-item structured questionnaire to evaluate the quality of information about IUDs available through the Internet. We then conducted an online search to identify web sites containing information about contraception and IUDs using common search engines. The search was performed in August 2013 and web sites were reviewed again in October 2015 to ensure there were no substantial changes. Our search identified >2000 web sites, of which 108 were eligible for review; 105 (97.2%) of these sites contained information about IUDs. Of sites, 86% provided at least 1 mechanism of the IUD. Most web sites accurately reported advantages of the IUD including that it is long acting (91%), highly effective (82%), and reversible (68%). However, only 30% of sites explicitly indicated that IUDs are safe. Fifty percent (n = 53) of sites contained inaccurate information about the IUD such as an increased risk of pelvic inflammatory disease beyond the insertion month (27%) or that women in nonmonogamous relationships (30%) and nulliparous women (20%) are not appropriate candidates. Among sites, 44% stated that a mechanism of IUDs is prevention of implantation of a fertilized egg. Only 3% of web sites incorrectly stated that IUDs are an abortifacient. More than a quarter of sites listed an inaccurate contraindication to the IUD such as nulliparity, history of pelvic inflammatory disease, or history of an ectopic pregnancy. The quality of information about IUDs available on the Internet is variable. Accurate information was mixed with inaccurate or outdated information that could perpetuate myths about IUDs. Clinicians need knowledge about accurate, evidence-based Internet resources to provide to women given the inconsistent quality of information available through online sources. Copyright © 2016 Elsevier Inc. All rights reserved.

Healthcare Provider Attitudes of Safety of Intrauterine Devices in the Postpartum Period.

PubMed

Rauh-Benoit, Lisa A; Tepper, Naomi K; Zapata, Lauren B; Whiteman, Maura K; Curtis, Kathryn M; Mandel, Michele G; Marchbanks, Polly A; Jamieson, Denise J

2017-07-01

Immediate postpartum intrauterine devices (IUDs) have been underutilized in the United States despite their known safety. Understanding how providers' attitudes contribute to underutilization is important in improving access. Our objective was to examine healthcare providers' perceptions of the safety of immediate postpartum IUDs before publication of United States contraceptive guidelines. We analyzed survey data collected from December 2009 to March 2010 from 635 office-based physicians and 1368 Title X clinic providers (overall response rate of 64.8%). Providers were asked how safe they thought copper and levonorgestrel (LNG) IUDs were in postpartum women (very safe, safe, unsafe, very unsafe, and unsure). Multivariable logistic regression was used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (95% CIs) for characteristics associated with considering immediate and delayed postpartum IUDs to be safe. Less than 40% of respondents considered immediate or delayed IUD insertion to be safe. Providers with <1 day of family planning training had decreased odds of considering immediate postpartum IUD insertion to be safe compared with unsafe/unsure (aOR 0.18, 95% CI 0.04-0.84 for copper IUD and aOR 0.17, 95% CI 0.04-0.81 for LNG-IUD). Providers without training in postpartum or interval copper IUD insertion had decreased odds of considering immediate postpartum copper IUD insertion (aOR 0.40, 95% CI 0.16-0.79) and delayed postpartum insertion for both IUD types to be safe (aOR 0.34, 95% CI 0.18-0.66 for copper IUD and aOR 0.41, 95% CI 0.21-0.77 for LNG-IUD). Before United States contraceptive guidelines, a majority of providers perceived immediate postpartum IUDs to be unsafe.

Effects of Intrauterine Devices in Mares: A Histomorphological and Immunohistochemical Evaluation of the Endometrium.

PubMed

Klein, V; Müller, K; Schoon, H A; Reilas, T; Rivera del Alamo, M M; Katila, T

2016-02-01

Oestrous suppression by intrauterine devices (IUDs) is caused by prolongation of luteal function, but the biological mechanism is unknown. The aim of the study was to investigate mechanisms which could explain the action of IUDs. Thirty mares were age-matched and either inseminated (AI, n = 15) or fitted with an IUD (IUD, n = 15) and subsequently divided into four groups: AI-P, pregnant (n = 8); AI-N, non-pregnant (n = 7); IUD-P, prolonged luteal phase (n = 7); and IUD-N, normal luteal phase (n = 8). The median ages were 5.5 and 7 years in AI-P and IUD-P groups and 14 and 11 years in AI-N and IUD-N groups, respectively. On Day 15 after ovulation, an endometrial biopsy was obtained to study histomorphological and immunohistochemical expression patterns of uterine proteins (uteroferrin, UF; uterocalin, UC; uteroglobin, UG), oestrogen and progesterone receptors (ER, PR), proliferation marker Ki-67 and content of inflammatory cells. Expression of UF was higher in IUD mares; the difference between pregnant and IUD-P mares was significant. Mares exhibiting a prolonged luteal phase (AI-P, IUD-P) showed only mild angiosclerosis and lower expression of both ER and PR than mares with a normal luteal phase (AI-N, IUD-N). No significant differences were detected in the numbers of inflammatory cells, with the exception of macrophages, which were more numerous in AI-P than AI-N mares. Although inflammatory cells were not detected in IUD mares, increased UF levels may indicate chronic inflammation. Young age and normality of the endometrial blood vessels may improve the efficacy of IUDs. © 2015 Blackwell Verlag GmbH.

Effects of intrauterine contraception on the vaginal microbiota.

PubMed

Bassis, Christine M; Allsworth, Jenifer E; Wahl, Heather N; Sack, Daniel E; Young, Vincent B; Bell, Jason D

2017-09-01

There have been conflicting reports of altered vaginal microbiota and infection susceptibility associated with contraception use. The objectives of this study were to determine if intrauterine contraception altered the vaginal microbiota and to compare the effects of a copper intrauterine device (Cu-IUD) and a levonorgestrel intrauterine system (LNG-IUS) on the vaginal microbiota. DNA was isolated from the vaginal swab samples of 76 women using Cu-IUD (n=36) or LNG-IUS (n=40) collected prior to insertion of intrauterine contraception (baseline) and at 6 months. A third swab from approximately 12 months following insertion was available for 69 (Cu-IUD, n=33; LNG-IUS, n=36) of these women. The V4 region of the bacterial 16S rRNA-encoding gene was amplified from the vaginal swab DNA and sequenced. The 16S rRNA gene sequences were processed and analyzed using the software package mothur to compare the structure and dynamics of the vaginal bacterial communities. The vaginal microbiota from individuals in this study clustered into 3 major vaginal bacterial community types: one dominated by Lactobacillus iners, one dominated by Lactobacillus crispatus and one community type that was not dominated by a single Lactobacillus species. Changes in the vaginal bacterial community composition were not associated with the use of Cu-IUD or LNG-IUS. Additionally, we did not observe a clear difference in vaginal microbiota stability with Cu-IUD versus LNG-IUS use. Although the vaginal microbiota can be highly dynamic, alterations in the community associated with the use of intrauterine contraception (Cu-IUD or LNG-IUS) were not detected over 12 months. We found no evidence that intrauterine contraception (Cu-IUD or LNG-IUS) altered the vaginal microbiota composition. Therefore, the use of intrauterine contraception is unlikely to shift the composition of the vaginal microbiota such that infection susceptibility is altered. Copyright © 2017 Elsevier Inc. All rights reserved.

Comparison of levonorgestrel-releasing intrauterine device with oral progestins in heavy menstrual bleeding (HMB) cases with uterine leiomyoma (LNG-IUD and oral progestin usage in myoma uteri).

PubMed

Tosun, Ayse Kavasoglu; Tosun, Ismet; Suer, Necdet

2014-07-01

To compare the effectiveness and acceptability of LNG-IUD with oral progesterone (norethisterone acetate; NETA) in achieving a reduction in volume of the myomas, hemoglobin levels, satisfaction of the women. This study includes randomized 30 women treated by LNG-IUD and randomized 30 women treated by oral norethisterone (NETA). All these participants in the study have received medical treatment and had been registered as patients in Istanbul Medeniyet University Göztepe Education and Research Hospital. Leiomyoma volumes and hemoglobin levels have been determined. In the third and sixth months, these measurements have been done again. We examined the adverse effects and the treatment continuity. For the statistical analysis of the findings NCSS [Number Cruncher Statistical System] 2007 & PASS 2008 program; student t, Mann Whitney U, Paired Samples t, Wilcoxon Signed Ranks, Ki-Kare, Fisher's Exact Ki-Kare tests have been used. After six months treatment, the reduction of bleeding determined by Visual Bleeding Score (VBS) in LNG-IUD group is 80% and in oral norethisteron group is 56%; in both groups leiomyoma volumes and hemoglobin levels were significantly high. LNG-IUD is a good alternative treatment to the oral progesterone in long term minimizing the hysterectomy for myoma uteri because of the good patient tolerance and easy usage.

IUD knowledge and experience among family medicine residents.

PubMed

Schubert, Finn D; Herbitter, Cara; Fletcher, Jason; Gold, Marji

2015-06-01

The intrauterine device (IUD) is a highly effective contraceptive method with few contraindications; however, clinician lack of training in insertion and misconceptions about IUD risks are barriers to utilization. Previous research has shown gaps in IUD training in family medicine residency programs. An online survey addressing experience with IUD insertion, knowledge of patient eligibility and IUD risks, and intent to insert IUDs in practice was circulated to residents at 15 US family medicine residency programs. Programs were eligible to participate if they were receiving funding to enhance training in family planning and abortion care and interested in additional support to enhance IUD training. The overall response rate for the surveys was 76.1% (332/436). Experience with the levonorgestrel intrauterine system was more common than with the copper IUD. Residents performed well on knowledge questions, but many would not insert in common patient scenarios in which insertion was not contraindicated, including a history of sexually transmitted infection in the past 6 months (48.2% would not insert), a history of ectopic pregnancy (37.0%), no pap smear in the past year (30.7%), or if the patient was not in a monogamous relationship (29.2%). The vast majority of residents (88.7%) reported that they were likely or very likely to provide IUDs in their future family medicine practice. Although residents overwhelmingly expressed interest in providing IUDs after residency, our results suggest that additional clinical and didactic training is needed, particularly interventions targeted at dispelling misconceptions about patient eligibility for IUDs.

Association of Short-term Bleeding and Cramping Patterns with Long-Acting Reversible Contraceptive Method Satisfaction

PubMed Central

Diedrich, Justin T.; Desai, Sanyukta; Zhao, Qiuhong; Secura, Gina; Madden, Tessa; Peipert, Jeffrey F.

2014-01-01

Objectives To examine the short-term (3 and 6-month), self-reported bleeding and cramping patterns with intrauterine devices (IUDs) and the contraceptive implant, and the association of these symptoms with method satisfaction. Study Design We analyzed 3 and 6-month survey data from IUD and implant users in the Contraceptive CHOICE Project, a prospective cohort study. Participants who received a long-acting reversible contraceptive (LARC) method (levonorgestrel intrauterine system (LNG-IUS), copper IUD, or the etonogestrel implant) and completed their 3- and 6-month surveys were included. Univariable and multivariable analyses were performed to examine the association of bleeding and cramping patterns with short-term satisfaction. Results Our analytic sample included 5,011 CHOICE participants: 3001 LNG-IUS users, 826 copper IUD users, and 1184 implant users. At 3 months, over 65% of LNG-IUS and implant users reported no change or decreased cramping, while 63% of copper IUD users reported increased menstrual cramping. Lighter bleeding was reported by 67% of LNG-IUS users, 58% of implant users, and 8% of copper IUD users. Satisfaction of all LARC methods was high (≥90%) and significantly higher than non-LARC methods (p<0.001). LARC users with increased menstrual cramping (HR 0.96, 95% CI 0.92 – 0.99), heavier bleeding (HR 0.91, 95% CI 0.87 – 0.96), and increased bleeding frequency (HR 0.92, 95% CI 0.89 – 0.96) were less likely to report being very satisfied at 6 months. Conclusion Regardless of the LARC method, satisfaction at 3 and 6 months is very high. Changes in self-reported bleeding and cramping are associated with short-term LARC satisfaction. PMID:25046805

Association of short-term bleeding and cramping patterns with long-acting reversible contraceptive method satisfaction.

PubMed

Diedrich, Justin T; Desai, Sanyukta; Zhao, Qiuhong; Secura, Gina; Madden, Tessa; Peipert, Jeffrey F

2015-01-01

We sought to examine the short-term (3- and 6-month), self-reported bleeding and cramping patterns with intrauterine devices (IUDs) and the contraceptive implant, and the association of these symptoms with method satisfaction. We analyzed 3- and 6-month survey data from IUD and implant users in the Contraceptive CHOICE Project, a prospective cohort study. Participants who received a long-acting reversible contraceptive (LARC) method (levonorgestrel-releasing intrauterine system [LNG-IUS], copper IUD, or the etonogestrel implant) and completed their 3- and 6-month surveys were included. Univariable and multivariable analyses were performed to examine the association of bleeding and cramping patterns with short-term satisfaction. Our analytic sample included 5011 Contraceptive CHOICE Project participants: 3001 LNG-IUS users, 826 copper IUD users, and 1184 implant users. At 3 months, >65% of LNG-IUS and implant users reported no change or decreased cramping, while 63% of copper IUD users reported increased menstrual cramping. Lighter bleeding was reported by 67% of LNG-IUS users, 58% of implant users, and 8% of copper IUD users. Satisfaction of all LARC methods was high (≥90%). LARC users with increased menstrual cramping (relative risk adjusted [RRadj], 0.78; 95% confidence interval [CI], 0.72-0.85), heavier bleeding (RRadj, 0.83; 95% CI, 0.76-0.92), and increased bleeding frequency (RRadj, 0.73; 95% CI, 0.67-0.80) were less likely to report being very satisfied at 6 months. Regardless of the LARC method, satisfaction at 3 and 6 months is very high. Changes in self-reported bleeding and cramping are associated with short-term LARC satisfaction. Copyright © 2015 Elsevier Inc. All rights reserved.

Fertility after intrauterine device removal: a pilot study.

PubMed

Stoddard, Amy M; Xu, Hanna; Madden, Tessa; Allsworth, Jenifer E; Peipert, Jeffrey F

2015-06-01

Despite high efficacy, only 7.7% of women in the United States currently using contraception use an IUD. There is little published contemporary data about fertility rates after IUD use, especially in nulliparous women and women using the hormonal IUD. We recruited sexually active women 18 to 35 years of age enrolled in the Contraceptive CHOICE Project who had discontinued a contraceptive method and desired pregnancy. In this pilot project, we enrolled 69 former IUD users (19 copper and 50 levonorgestrel) and 42 former non-IUD users. Pregnancy rates at 12 months were similar between the two groups; 81% of IUD users became pregnant compared to 70% of non-IUD users (p = 0.18). In the Cox model, there was no difference in the time to pregnancy in IUD users compared to non-IUD users (HRadj 1.19, 95% CI 0.74-1.92). African American race was the only variable associated with reduced fertility (HRadj 0.40, 95% CI 0.24-0.67). We found no difference in 12-month pregnancy rates or time to pregnancy between former IUD users and users of other contraceptive methods. However, there was a clinically and statistically significant reduction in fertility in African American women.

Emergency contraception with a copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates.

PubMed

Turok, David K; Jacobson, Janet C; Dermish, Amna I; Simonsen, Sara E; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A

2014-03-01

We investigated the 1-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 intrauterine device (IUD) or oral levonorgestrel (LNG) for EC. This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Of the 542 women who presented for EC, agreed to participate in the trial and met the inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG [hazard ratio (HR) 0.53, 95% confidence interval (CI): 0.29-0.97, p=.041]. By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users (HR 0.42, 95% CI: 0.20-0.85, p=.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26-0.96, p=.037). One year after presenting for EC, women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. Compared to EC users who choose oral levonorgestrel, those who select the copper IUD have lower rates of pregnancy in the next year. Greater use of the copper IUD for EC may lower rates of unintended pregnancy in high-risk women. Copyright © 2014 Elsevier Inc. All rights reserved.

Levonorgestrel-Releasing Intrauterine Device Use in Female Adolescents with Heavy Menstrual Bleeding and Bleeding Disorders: Single Institution Review.

PubMed

Adeyemi-Fowode, Oluyemisi A; Santos, Xiomara M; Dietrich, Jennifer E; Srivaths, Lakshmi

2017-08-01

To identify complications and efficacy of the levonorgestrel-releasing intrauterine device (LNgIUD) in adolescents with heavy menstrual bleeding (HMB) and bleeding disorders (BD). A retrospective chart review of 13 postmenarchal adolescent girls with HMB/BD who underwent placement of an LNgIUD. Placement of an LNgIUD. Primary outcome was to identify complications from placement of an LNgIUD. Secondary outcome was to evaluate the efficacy of the LNgIUD in adolescents with BD. Thirteen patients met study criteria. The mean age of diagnosis of HMB was 14.08 ± 1.75 years. BD or bleeding risk factor diagnoses included low von Willebrand (VW) activity in 5, type I VW disease in 5, type IIM VW disease in 1, low VW activity and factor 7 deficiency in 1, and acquired VW disease and factor 7 deficiency in 1. Before LNgIUD placement, other hormonal therapy (n = 13) and hemostatic therapy (antifibrinolytic agents, desmopressin acetate; n = 8) yielded poor control of HMB. The LNgIUD was placed using anesthesia with periprocedure hemostatic therapy with no complications. All patients reported significant improvement in HMB after LNgIUD placement and 60% achieved amenorrhea, with mean time to improvement of 94 ± 69 days. Mean hemoglobin and ferritin levels increased after LNgIUD placement compared with before LNgIUD placement values (P = .02, P = .0085, respectively). Use of supplemental hormonal and hemostatic agents decreased (n = 4) after LNgIUD placement. None required LNgIUD removal; 1 spontaneously expelled the LNgIUD with subsequent replacement. Study results indicated the LNgIUD is an effective therapeutic option in postmenarchal adolescents with HMB due to BD/bleeding risk factor with minimal complications, high compliance rate, improvement in HMB and anemia, and no periprocedural bleeding with hemostatic management. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Intracesarean insertion of the Copper T380A versus 6 weeks postcesarean: a randomized clinical trial.

PubMed

Lester, Felicia; Kakaire, Othman; Byamugisha, Josaphat; Averbach, Sarah; Fortin, Jennifer; Maurer, Rie; Goldberg, Alisa

2015-03-01

To compare rates of Copper T380A intrauterine device (IUD) utilization and satisfaction with immediate versus delayed IUD insertion after cesarean delivery in Kampala, Uganda. This study was a randomized clinical trial of women undergoing cesarean section who desired an IUD in Kampala, Uganda. Participants were randomly assigned to IUD insertion at the time of cesarean delivery or 6weeks afterward. The primary outcome was IUD utilization at 6months after delivery. Among 68 women who underwent randomization, an IUD was inserted in 100% (34/34) of the women in the immediate insertion group and in 53% (18/34) in the delayed group. IUD use at 6 months was higher in the immediate insertion group (93% vs. 50% after delayed insertion; p<.0001). Infection and expulsion were rare and did not differ between groups. When we pooled both groups and looked at IUD users compared to nonusers, 91% (39/43) of IUD users were satisfied or very satisfied with their contraceptive method compared to 44% (11/25) of nonusers (p<.0001). Women who chose not to be in the study or had the IUD removed often did so because of perceived husband or community disapproval. The 6-month utilization of an IUD after immediate insertion was significantly higher than after delayed insertion without increased complications. Contraceptive satisfaction was significantly higher among IUD users than nonusers. Community and husband attitudes influence IUD utilization and continuation in Kampala, Uganda. This work is important because it shows the safety and efficacy of providing IUDs during cesarean section in a setting where access to any healthcare, including contraception, can be extremely limited outside of childbearing and the consequences of an unintended, closely spaced pregnancy after a cesarean section can be life threatening. Copyright © 2015 Elsevier Inc. All rights reserved.

Predictors of men's acceptance of modern contraceptive practice: study in rural Vietnam.

PubMed

Ha, Bui Thi Thu; Jayasuriya, Rohan; Owen, Neville

2005-12-01

Studies have shown family planning adoption is likely to be more effective for women when men are actively involved. The transtheoretical model of behavior change was used to examine men's involvement in general contraception and intrauterine device (IUD) use by their wives. The study was carried out in rural Vietnam with 651 eligible participants. Cons of IUD use for men in precontemplation and contemplation/preparation were significantly higher than those in the action/maintenance stages, whereas the reverse was true for pros of IUD. The self-efficacy for convincing wife to have IUD in precontemplation was significantly lower than for those in higher stages. Women's education and ages, spontaneous recall of modern contraceptive method, cons for IUD, and self-efficacy for contraception and for convincing wives to get IUD inserted (or continue use) were significant predictors of men's readiness to accept IUD. Interventions are targeted to reduce cons and increase self-efficacy for IUD use.

Knowledge and attitudes about intrauterine devices among women's health care providers in El Salvador.

PubMed

Hohmann, Heather Lyn; Cremer, Miriam L; Gonzalez, Enrique; Maza, Mauricio

2011-03-01

In order to gain an understanding of Salvadoran health care providers' clinical knowledge, attitudes, and practice toward the intrauterine device (IUD), Ministry of Health providers completed a self-administered, anonymous survey. Surveys were completed by 135 participants. The majority (94.7% and 97.0%) agreed the IUD is a safe and effective form of contraception. Only 46.6% of participants had ever received training in IUD placement, and 32.0% of them had ever inserted more than 10 IUDs. The majority of providers (54.2%) believed that the IUD was associated with a higher rate of infection than is described in the literature. Lack of formal training and knowledge about persistent infection rates associated with IUDs may contribute to low IUD placement by Salvadoran providers. Health care providers surveyed are open to learning more about the IUD and sharing the information with their patients.

Copper intrauterine device for emergency contraception: clinical practice among contraceptive providers.

PubMed

Harper, Cynthia C; Speidel, J Joseph; Drey, Eleanor A; Trussell, James; Blum, Maya; Darney, Philip D

2012-02-01

The copper intrauterine device (IUD) is the most effective emergency contraceptive available but is largely ignored in clinical practice. We examined clinicians' recommendations of the copper IUD for emergency contraception in a setting with few cost obstacles. We conducted a survey among clinicians (n=1,246; response rate 65%) in a California State family planning program, where U.S. Food and Drug Administration-approved contraceptives are available at no cost to low-income women. We used multivariable logistic regression to measure the association of intrauterine contraceptive training and evidence-based knowledge with having recommended the copper IUD for emergency contraception. The large majority of clinicians (85%) never recommended the copper IUD for emergency contraception, and most (93%) required two or more visits for an IUD insertion. Multivariable analyses showed insertion skills were associated with having recommended the copper IUD for emergency contraception, but the most significant factor was evidence-based knowledge of patient selection for IUD use. Clinicians who viewed a wide range of patients as IUD candidates were twice as likely to have recommended the copper IUD for emergency contraception. Although more than 93% of obstetrician-gynecologists were skilled in inserting the copper IUD, they were no more likely to have recommended it for emergency contraception than other physicians or advance practice clinicians. Recommendation of the copper IUD for emergency contraception is rare, despite its high efficacy and long-lasting contraceptive benefits. Recommendation would require clinic flow and scheduling adjustments to allow same-day IUD insertions. Patient-centered and high-quality care for emergency contraception should include a discussion of the most effective method. III.

Emergency contraception with a Copper IUD or oral levonorgestrel: an observational study of 1-year pregnancy rates

PubMed Central

Turok, David K.; Jacobson, Janet C.; Dermish, Amna I.; Simonsen, Sara E.; Gurtcheff, Shawn; McFadden, Molly; Murphy, Patricia A.

2014-01-01

Objective We investigated the one-year pregnancy rates for emergency contraception (EC) users who selected the copper T380 IUD or oral levonorgestrel (LNG) for EC. Study Design This prospective study followed women for 1 year after choosing either the copper T380 IUD or oral LNG for EC. The study was powered to detect a 6% difference in pregnancy rates within the year after presenting for EC. Results Of the 542 women who presented for EC, agreed to participate in the trial, and meet inclusion criteria, 215 (40%) chose the copper IUD and 327 (60%) chose oral LNG. In the IUD group, 127 (59%) were nulligravid. IUD insertion failed in 42 women (19%). The 1-year follow-up rate was 443/542 (82%); 64% of IUD users contacted at 1 year still had their IUDs in place. The 1-year cumulative pregnancy rate in women choosing the IUD was 6.5% vs. 12.2% in those choosing oral LNG (HR= 0.53, 95% CI: 0.29–0.97, p=0.041). By type of EC method actually received, corresponding values were 5.2% for copper IUD users vs. 12.3% for oral LNG users, HR 0.42 (95% CI: 0.20–0.85, p= 0.017). A multivariable logistic regression model controlling for demographic variables demonstrates that women who chose the IUD for EC had fewer pregnancies in the following year than those who chose oral LNG (HR 0.50, 95% CI: 0.26–0.96, p=0.037). Conclusion One year after presenting for EC women choosing the copper IUD for EC were half as likely to have a pregnancy compared to those choosing oral LNG. PMID:24332433

Twelve-month contraceptive continuation and repeat pregnancy among young mothers choosing postdelivery contraceptive implants or postplacental intrauterine devices.

PubMed

Cohen, Rebecca; Sheeder, Jeanelle; Arango, Natalia; Teal, Stephanie B; Tocce, Kristina

2016-02-01

To compare discontinuation rates and incidence of repeat pregnancy within 1 year among young mothers choosing postplacental intrauterine devices (IUDs) versus postpartum contraceptive implants. We enrolled a prospective cohort of postpartum adolescents and young women who chose either postplacental IUDs or postpartum contraceptive implants prior to hospital discharge. We used chart review and phone interviews to assess device discontinuation (by request or expulsion) and pregnancy within 12 months. Of the 244 13-22 year-old participants, 82 chose IUDs (74 levonorgestrel IUDs and 8 copper IUDs), and 162 chose implants. Both groups had participant-requested discontinuation rates of 14% (9/67 IUD; 19/135 implant) within 1 year. Participants choosing IUDs had a 25% (17/67) expulsion rate. Median time to expulsion was 4.1 weeks (range: 0.4-29.3 weeks, 16/17 within 12 weeks), and participants recognized 15/17 expulsions. IUD initiators had significantly higher pregnancy rates by 12 months (7.6% vs. 1.5%, p=0.04). Most pregnancies occurred when women discontinued their initial device and did not start alternative contraception. Participant-requested discontinuation was similar in both groups. Differences in overall device discontinuation rates were due to IUD expulsions. Pregnancy rates by 12 months postpartum were lower than previously reported in this age group in both implant initiators and IUD initiators. Young mothers who choose postplacental IUDs or postpartum contraceptive implants are unlikely to request removal within the first year. Clinicians should counsel postplacental IUD users that early expulsion is common (25%) and may be unrecognized (11% of expulsions). Patients should have a plan for contraceptive management should expulsion occur. Copyright © 2016 Elsevier Inc. All rights reserved.

Comparison of human papillomavirus infection and cervical cytology in women using copper-containing and levonorgestrel-containing intrauterine devices.

PubMed

Lekovich, Jovana P; Amrane, Selma; Pangasa, Misha; Pereira, Nigel; Frey, Melissa K; Varrey, Aneesha; Holcomb, Kevin

2015-05-01

To investigate whether there is a difference in cervical cytology and high-risk human papillomavirus (HPV) infection clearance between levonorgestrel- and copper-containing intrauterine device (IUD) users. The electronic medical record system was searched by the appropriate procedural code for IUD insertion for all patients undergoing IUD placement during the study period (January 31, 2005 to January 31, 2012). Patients who received treatment for cervical dysplasia, had their IUDs removed, or conceived during the study period were excluded. High-risk HPV and cervical cytology results immediately preceding and after IUD placement were obtained. One hundred fifty patients had a copper-containing and 152 patients a levonorgestrel-containing IUD placed. The groups were comparable in terms of age, body mass index, duration of follow-up, and percentage of smokers. Sixty-six patients were high-risk HPV-positive before IUD insertion (30 in copper compared with 36 in the levonorgestrel IUD group, P=.4), and the groups had similar follow-up times (364.1±26.3 compared with 357.2±29.7 days, respectively, between the IUD placement and a repeat Pap test with high-risk HPV cotesting, P=.2). Of those, 21 (70%; 95% confidence interval [CI] 53.6-86.4%) cleared the infection after copper-containing IUD placement compared with 15 (42%; 95% CI 25.6-57.8%) in the levonorgestrel group (P=.04). There were only two (1.7%) new high-risk HPV infections in the copper compared with eight (6.9%) in the levonorgestrel group (P=.056). Our data suggest that levonorgestrel-containing IUD could be associated with decreased high-risk HPV infection clearance and possibly increased acquisition compared with the copper-containing IUD. II.

Laparoscopic management of a translocated intrauterine device embedded in the gastric serosa.

PubMed

Bozkurt, Murat; Yumru, Ayse Ender; Coskun, Ebru Inci; Ondes, Banu

2011-10-01

Intrauterine devices (IUD) are the most common contraceptive methods all over the world. Besides many advantages, there are also some complications of this method. The most important complication of IUD is uterine perforation. The reported incidence of IUD perforation ranges from 0.2 to 9.6 per thousand insertions. In this article we would like to report a case that has an IUD migrated to the gastric serosa. A 41 years-old Turkish woman presented with abdominal pain. Plain X-ray of the abdomen demonstrated two IUDs, one in the upper quadrant of the abdomen, the other in the pelvic area and determined in the endometrium by TV-USG (transvaginal ultrasonography). Laparascopy was performed and the IUD, lying over the omentum of stomach was removed. This report demonstrates the first case in the literature that has an IUD embedded in the gastric serosa and also a second IUD in uterine cavity. The management was performed laparoscopically. No complication was observed during and after operation.

Comparative contraceptive effectiveness of levonorgestrel-releasing and copper intrauterine devices: the European Active Surveillance Study for Intrauterine Devices.

PubMed

Heinemann, Klaas; Reed, Suzanne; Moehner, Sabine; Minh, Thai Do

2015-04-01

The objective was to measure the rate of unintended pregnancies in women using levonorgestrel-releasing intrauterine systems (LNG IUSs, releasing 20 mcg LNG daily) and copper intrauterine devices (IUDs) in a typical population of IUD users and to describe associated complications. A multinational, prospective, non-interventional cohort study of new users of LNG IUS and copper IUDs was performed. Following a baseline survey, study participants and their physicians completed one follow-up questionnaire after 12 months. A multifaceted four-level follow-up procedure minimized loss to follow-up. Patient-reported outcomes were validated by the treating physicians. A total of 61,448 women with a newly inserted IUD were enrolled in six European countries between 2006 and 2012. The copper IUD cohort contained more than 30 different types. Validated 1-year follow-up information for 58,324 users between 18 and 50 years of age (70% using LNG IUS, 30% using copper IUDs) was collected. A total of 118 contraceptive failures occurred (26 LNG, 92 copper). Both types of IUD were highly effective, with overall Pearl indices of 0.06 [95% confidence interval (CI): 0.04-0.09] and 0.52 (95% CI: 0.42-0.64) for LNG IUS and copper IUDs, respectively. The adjusted hazard ratio for LNG IUS vs. copper IUDs was 0.16 (95% CI: 0.10-0.25). Tenty-one pregnancies (7 LNG IUS, 14 copper IUD) were ectopic, yielding an adjusted hazard ratio for ectopic pregnancy of 0.26 (95% CI: 0.10-0.66). The contraceptive failure rate was low with both IUDs. However, the LNG IUS was associated with a significantly lower risk of pregnancy, including ectopic pregnancy, than the copper IUDs. To our knowledge, this is the first large-scale, multinational, prospective epidemiological study to measure and compare the contraceptive effectiveness of LNG IUSs and copper IUDs during routine clinical practice. Clinicians and patients should be aware of differences in rates of unintended pregnancies and associated complications in relation to IUD us. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Safety and efficacy in parous women of a 52-mg levonorgestrel-medicated intrauterine device: a 7-year randomized comparative study with the TCu380A.

PubMed

Rowe, Patrick; Farley, Tim; Peregoudov, Alexandre; Piaggio, Gilda; Boccard, Simone; Landoulsi, Sihem; Meirik, Olav

2016-06-01

To compare rates of unintended pregnancy, method continuation and reasons for removal among women using the 52-mg levonorgestrel (daily release 20 microg) levonorgestrel IUD (LNG-IUD) or the copper T 380A (TCu380A) intrauterine device. This was an open-label 7-year randomized controlled trial in 20 centres, 11 of which in China. Data on 1884 women with interval insertion of the LNG-IUD and 1871 of the TCu380A were analysed using life tables with 30-day intervals and Cox proportional hazards models. The cumulative 7-year pregnancy rate of the LNG-IUD was 0.5 (standard error 0.2) per 100, significantly lower than 2.5 (0.4) per 100 of the TCu380A, cumulative method discontinuation rates at 7 years were 70.6 (1.2) and 40.8 (1.3) per 100, respectively. Dominant reasons for discontinuing the LNG-IUD were amenorrhea (26.1 [1.3] per 100) and reduced bleeding (12.5 [1.1] per 100), particularly in Chinese women and, for the TCu380A, increased bleeding (9.9 [0.9] per 100), especially among non-Chinese women. Removal rates for pain were similar for the two intrauterine devices (IUDs). Cumulative rates of removal for symptoms compatible with hormonal side effects were 5.7 (0.7) and 0.4 (0.2) per 100 for the LNG-IUD and TCu380A, respectively, and cumulative losses to follow-up at 7 years were 26.0 (1.4) and 36.9 (1.3) per 100, respectively. The LNG-IUD and the TCu380A have very high contraceptive efficacy, with the LNG-IUD significantly higher than the TCu380A. Overall rates of IUD removals were higher among LNG-IUD users than TCu380A users. Removals for amenorrhea appeared culturally associated. The 52-mg LNG-IUD and the TCu380A have very high contraceptive efficacy through 7 years. As an IUD, the unique side effects of the LNG-IUD are reduced bleeding, amenorrhea and symptoms compatible with hormonal contraceptives. Copyright © 2016. Published by Elsevier Inc.

Colonoscopic Removal of an Intrauterine Device That Had Perforated the Rectosigmoid Colon

PubMed Central

Huh, Jin Myeong; Kim, Ki Seok; Cho, Yong Seok; Lee, Jae Uk; Baek, Seong Deuk; Moon, Sin Kil

2018-01-01

The intrauterine device (IUD) is a widely used contraceptive method. One of the most serious and rare complications of using an IUD is colon perforation. We report a case of colonoscopic removal of an IUD that had perforated into the rectosigmoid colon in a 42-year-old woman who presented with no symptoms. Colonoscopy showed that the IUD had penetrated into rectosigmoid colon wall and that an arm of the IUD was embedded in the colon wall. We were able to remove the IUD easily by using colonoscopy. The endoscopic approach may be considered the first choice therapy for selected patients. PMID:29742863

Knowledge and perceptions of the intrauterine device among family planning providers in Nepal: a cross-sectional analysis by cadre and sector.

PubMed

Chakraborty, Nirali M; Murphy, Caitlin; Paudel, Mahesh; Sharma, Sriju

2015-01-28

Nepal has high unmet need for family planning and low use of intrauterine devices (IUDs). While clients' attitudes toward the IUD are known in a variety of contexts, little is known about providers' knowledge and perceptions of the IUD in developing countries. Nepal's liberal IUD service provision policies allow the opportunity to explore provider knowledge and perceptions across cadres and sectors. This research contributes to an understanding of providers' IUD perceptions in low-resource environments, and increases evidence for IUD task-sharing and private sector involvement. A questionnaire was administered to 345 nurses and auxiliary nurse midwives (ANMs) affiliated with the private Mahila Swastha Sewa (MSS) franchise, public sector, or private non-franchise sector. All providers had been trained in TCu 380A IUD insertion and removal. The questionnaire captured providers' IUD experience, knowledge, and perceived barriers to recommendation. Descriptive, multivariate linear, and multinomial logistic regression was conducted, comparing providers between cadre and sector. On average, providers answered 21.5 of 35 questions correctly, for a score of 61.4%. Providers scored the lowest on IUD medical eligibility, answering 5.9 of 14 questions correctly. Over 50% of providers were able to name the four side effects most frequently associated with the IUD; however, one-third of all providers found at least one of these side effects unacceptable. Adjusted results show that cadre does not significantly impact provider's IUD knowledge scores or side effect perceptions. Public sector affiliation was associated with higher knowledge scores regarding personal characteristic eligibility and more negative perceptions of two normal IUD side effects. IUD knowledge is significantly associated with provider's recent training and employment at multiple facilities, and side effect perceptions are significantly associated with client volume, range of family planning methods, and region. Provider knowledge and attitudes towards IUD provision are similar across cadre and sector, supporting WHO task-sharing guidelines and validating Nepal's family planning policies. However, overall provider knowledge is low. We recommend that providers need to receive further training and support to improve knowledge, manage side effects, and recognize women in periods of high unmet need--such as post-partum or post-abortion women--as suitable candidates for IUDs.

Ugandan Women’s View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks

PubMed Central

Twesigye, Rogers; Buyungo, Peter; Kaula, Henry; Buwembo, Dennis

2016-01-01

ABSTRACT Background: Between 2001 and 2006, IUD use in Uganda stagnated at 0.2% among women of reproductive age (WRA) ages 15–49. By 2011, IUD use had increased slightly to 0.4%. Recent studies report a significant increase in IUD use to 3.8%, but it is still low. Because the IUD is a little-used method in Uganda, we assessed the acceptability of the IUD by surveying women about their perceptions, attitudes, and beliefs. Methods: In August and September 2014, we conducted a cross-sectional survey among 1,505 WRA exiting public and private health facilities in Uganda. We collected information on women’s attitudes, knowledge, and beliefs about the IUD, as well as their perceptions about its availability. We classified women’s responses according to a behavior change framework with 3 summary constructs: opportunity (structural factors that influence behavior), ability (skills to perform the behavior), and motivation (self-interest in adopting the behavior). As these 3 types of factors are more favorable to the desired behavior (in this case, use of the IUD), individuals are more likely to perform the behavior. Cross-tabulations compared the percentage results of perceptions and knowledge by key background characteristics. Results: Most (87.8%) of the surveyed women had heard of the IUD, and nearly two-thirds had a positive attitude toward the method. But a lower percentage (38.6%) had accurate information about the IUD and more than half (51.6%) did not think the method was available in a nearby facility. More than half of the women believed incorrectly that the IUD can damage the womb (57%), that it reduces sexual pleasure (54%), and that it can cause cancer (58%). Current use of family planning or of a modern method specifically was positively associated with awareness and accurate knowledge and beliefs about the IUD. Married women had significantly higher awareness of the IUD than single women, and they had better knowledge and belief scores. The type of facility used for health care services (public, private franchise, or private non-franchise) may also influence acceptance of the IUD. Conclusion: Interventions to increase the use of IUDs in Uganda should address low availability of the method in facilities, as well as misperceptions and misinformation, especially about the safety of the IUD. Demand promotion should address provider misperceptions in addition to client misperceptions and should include interpersonal communication and the mass media. PMID:27540127

Ugandan Women's View of the IUD: Generally Favorable but Many Have Misperceptions About Health Risks.

PubMed

Twesigye, Rogers; Buyungo, Peter; Kaula, Henry; Buwembo, Dennis

2016-08-11

Between 2001 and 2006, IUD use in Uganda stagnated at 0.2% among women of reproductive age (WRA) ages 15-49. By 2011, IUD use had increased slightly to 0.4%. Recent studies report a significant increase in IUD use to 3.8%, but it is still low. Because the IUD is a little-used method in Uganda, we assessed the acceptability of the IUD by surveying women about their perceptions, attitudes, and beliefs. In August and September 2014, we conducted a cross-sectional survey among 1,505 WRA exiting public and private health facilities in Uganda. We collected information on women's attitudes, knowledge, and beliefs about the IUD, as well as their perceptions about its availability. We classified women's responses according to a behavior change framework with 3 summary constructs: opportunity (structural factors that influence behavior), ability (skills to perform the behavior), and motivation (self-interest in adopting the behavior). As these 3 types of factors are more favorable to the desired behavior (in this case, use of the IUD), individuals are more likely to perform the behavior. Cross-tabulations compared the percentage results of perceptions and knowledge by key background characteristics. Most (87.8%) of the surveyed women had heard of the IUD, and nearly two-thirds had a positive attitude toward the method. But a lower percentage (38.6%) had accurate information about the IUD and more than half (51.6%) did not think the method was available in a nearby facility. More than half of the women believed incorrectly that the IUD can damage the womb (57%), that it reduces sexual pleasure (54%), and that it can cause cancer (58%). Current use of family planning or of a modern method specifically was positively associated with awareness and accurate knowledge and beliefs about the IUD. Married women had significantly higher awareness of the IUD than single women, and they had better knowledge and belief scores. The type of facility used for health care services (public, private franchise, or private non-franchise) may also influence acceptance of the IUD. Interventions to increase the use of IUDs in Uganda should address low availability of the method in facilities, as well as misperceptions and misinformation, especially about the safety of the IUD. Demand promotion should address provider misperceptions in addition to client misperceptions and should include interpersonal communication and the mass media. © Twesigye et al.

Intra-uterine contraceptive devices.

PubMed

Elias, J

1985-05-01

Among the advantages of IUDs are the device's high continuation rate, the lack of systemic side effects, and the absence of a need for continual motivation to practice contraception. The effectiveness of plastic IUDs is directly proportional to their surface area, but the degree of excessive bleeding experienced is inversely related to device size. Thus, devices represent a compromise between large size for effectiveness and small size for acceptability. The optimum time to fit an IUD is during the 1st hald of the menstrual cycle. Absolute contraindications to IUD use include the presence of active pelvic inflammatory disease, undiagnosed irregular bleeding, a history of ectopic pregnancy or tubal surgery, and a distorted uteine cavity. Failure rates associated with IUD use range from 2-3% in the 1st year and then decrease. Since the main mechanism of action appears to be production of a sterile inflammatory reaction in the uterine cavity, the IUD prevents intrauterine pregnancy more effectively than ectopic pregnancy. Nonetheless, there is little evidence to suggest that IUD use actually increases the incidence of ectopic pregnancy. Resumption of fertility after IUD removal is not delayed. There is not need to change inert plastic IUDs in women who remain symptom free. The copper devices should be changed every 3-4 years. A search is under way for antifertility agents that can be incorporated into the device to reduce side effects. In general, the IUD is most suitable for older, parous women.

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

21 CFR 884.5360 - Contraceptive intrauterine device (IUD) and introducer.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Contraceptive intrauterine device (IUD) and... Gynecological Therapeutic Devices § 884.5360 Contraceptive intrauterine device (IUD) and introducer. (a) Identification. A contraceptive intrauterine device (IUD) is a device used to prevent pregnancy. The device is...

Despite liability climate, clinicians predict an IUD comeback.

PubMed

1986-12-01

Based on demand by clinicians, women, and and organizations like Planned Parenthood and the American Public Health Association, as well as ongoing work by researchers, it appears that the IUD will come back on the market in the U.S. Since one of the legal objections to IUDs was the claim that the tail may damage the cervical mucosa or provide a path for disease agents, some new IUDs have no tails. H.J. Tatum, developer of the copper Tatum-T IUD, is working on a tailless IUD with a magnetic core so that it can be located by electronic instruments for checkup or removal. The removal device is a pistol like instrument with sensors, grasping elements and feedback to a video screen. Although removal is a complex technical feat, it can be done within as little as 4 sec. with practice. Another approach to bring IUDs back is to smooth out liability litigation, possibly by government controls.

Laparoscopic removal of an intra-abdominal intrauterine device: case and systematic review.

PubMed

Gill, Richdeep S; Mok, Dereck; Hudson, Matthew; Shi, Xinzhe; Birch, Daniel W; Karmali, Shahzeer

2012-01-01

Uterine perforation by intrauterine devices (IUDs) is a rare but well recognized complication. In the past, the presence of adhesions and perforation of viscera often resulted in the need for a laparotomy to remove the IUD. However, advances in laparoscopic technique have allowed surgeons to safely retrieve perforated IUDs. In this review, we analyze uterine perforation by an IUD and assess laparoscopic vs. open methods for removal of a perforated IUD. A systematic search strategy was applied to several electronic bibliographic databases: Medline/Pubmed, Embase, Cochrane Library, and OCLC PapersFirst. Key words used were IUD, laparoscopy, and uterine perforation. One hundred seventy-nine cases of attempted laparoscopic removal of perforated IUDs were identified in the English literature between 1970 and 2009. Patient age ranged from 17 to 49 years. Diagnostic laparoscopy was performed in all 179 cases reported. Laparoscopic removal of perforated IUDs was achieved successfully in 64.2% (115/179) of cases. This systematic review highlights how advances in laparoscopic technique and skill have allowed surgeons to safely retrieve IUDs without laparotomy. We recommend an attempt at laparoscopic removal as first-line treatment in symptomatic patients and as a reasonable treatment option in asymptomatic patients. Copyright © 2012 Elsevier Inc. All rights reserved.

Reasons for Intrauterine Device Use, Discontinuation and Non-Use in Malawi: A Qualitative Study of Women and their Partners.

PubMed

Bryant, Amy G; Hamela, Gloria; Gotter, Ann; Stuart, Gretchen S; Kamanga, Gift

2015-12-01

The copper intrauterine device (IUD) is a safe, long-acting, and effective method of contraception that is under-utilized in many countries, including Malawi. A unique cohort of women who had enrolled in a trial of postpartum IUD use one year earlier gave insights into reasons for using, discontinuing, or not using the IUD. We conducted in-depth interviews with 18 women one year after they participated in a pilot study of a randomized controlled trial of postpartum IUD insertion, and 10 of their male partners. Women and their partners expressed a strong desire for family planning, and perceived numerous benefits of the IUD. However, fear of the IUD was common among successful users and non-users alike. This fear arose from rumours from friends and neighbors who were non-users. How women and their partners responded to this fear affected IUD adoption and continuation. Key themes included (1) Trust in information received from health care providers versus rumours from community members; (2) Partner involvement in IUD decision-making; and (3) Experience with side effects from short-term hormonal contraceptive methods. Broad community education about the IUD's benefits and safety, and proactive counseling to address couples' specific fears, may be needed to increase uptake of the method.

Decreased endometrial HOXA10 expression associated with use of the copper intrauterine-device

PubMed Central

Tetrault, Amy M; Richman, Susan M; Fei, Xiaolan; Taylor, Hugh S

2009-01-01

Objective To characterize human endometrial HOXA10 expression in patients using copper intrauterine devices (IUD). Design Case-control study. Setting Academic medical center Patient(s) Women using copper IUD Interventions(s) Immunohistochemical analysis of endometrial HOXA10 expression in biopsies obtained from 24 women using copper Paraguard T380A as well as in biopsies obtained from 10 normal cycling women who were not using IUD or hormonal contraceptives. Main Outcome Measure(s) Endometrial HOXA10 expression. Result(s) Endometrial HOXA10 expression was markedly decreased in biopsies obtained from women using IUD contraceptive when compared to controls. The mean H score for endometrial stromal cell HOXA10 expression in biopsies obtained from women using Paraguard IUD was 0.21 compared to 2.2 in the control endometrial biopsies (P<0.001). Endometrial glandular expression of HOXA10 was absent in all IUD users. Conclusion(s) Decreased endometrial HOXA10 expression was apparent in women who use a copper IUD. Expression of HOXA10 is essential for endometrial receptivity. A novel mechanism of copper IUD action involves suppression of genes required for endometrial receptivity. The dramatic decrease of endometrial HOXA10 in response to IUD use may contribute to contraceptive efficacy. PMID:18930214

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries

PubMed Central

White, Julia N; Corker, Jamaica

2016-01-01

ABSTRACT Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013–2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. PMID:27540122

Applying a Total Market Lens: Increased IUD Service Delivery Through Complementary Public- and Private-Sector Interventions in 4 Countries.

PubMed

White, Julia N; Corker, Jamaica

2016-08-11

Increasing access to the intrauterine device (IUD), as part of a comprehensive method mix, is a key strategy for reducing unintended pregnancy and maternal mortality in low-income countries. To expand access to IUDs within the framework of informed choice, Population Services International (PSI) has historically supported increased IUD service delivery through private providers. In applying a total market lens to better understand the family planning market and address major market gaps, PSI identified a lack of high-quality public provision of IUDs. In 2013, PSI started a pilot in 4 countries (Guatemala, Laos, Mali, and Uganda) to grow public-provider IUD service delivery through increased public-sector engagement while maintaining its ongoing focus on private providers. In collaboration with country governments, PSI affiliates carried out family planning market analyses in the 4 pilot countries to identify gaps in IUD service delivery and create sustainable strategies for scaling up IUD services in the public sector. Country-specific interventions to increase service delivery were implemented across all levels of the public health system, including targeted advocacy at the national level to promote government ownership and program sustainability. Mechanisms to ensure government ownership were built into the program design, including a proof-of-concept approach to convince governments of the feasibility and value of taking over and scaling up interventions. In the first 2 years of the pilot (2013-2014), 102,055 IUD services were provided to women at 417 targeted public-sector facilities. These preliminary results suggest that there is untapped demand for IUD service delivery in the public sector that can be met in part through greater participation of the public sector in family planning and IUD provision. © White et al.

Menstrual characteristics and ultrasonographic uterine cavity measurements predict bleeding and pain in nulligravid women using intrauterine contraception.

PubMed

Kaislasuo, Janina; Heikinheimo, Oskari; Lähteenmäki, Pekka; Suhonen, Satu

2015-07-01

Is small uterine cavity size as assessed by ultrasonography associated with bleeding problems or pain in nulligravid women using intrauterine contraception, or do other factors affect these parameters? Among levonorgestrel intrauterine system (LNG-IUS) users, small uterine cavity size is not associated with worsened clinical outcome, but is beneficial as women with the smallest cavity measurements were frequently amenorrhoeic and painless at the end of the first year but among copper intrauterine device (IUD) users, no associations between uterine cavity dimensions and clinical outcome were found. Nulligravid and nulliparous women have smaller uterine dimensions than parous women. Previously, many studies have revealed increased discontinuation rates of IUD use as a result of bleeding, pain or expulsion in these women, while recent studies with current models of IUS/IUDs indicate similar continuation and satisfaction rates irrespective of parity. In a pilot study, 165 adult nulligravid women requesting their first IUD between 1 January 2011 and 31 July 2012 were given a free choice between two IUDs with equal frames measuring 32 × 32 mm-the LNG-IUS 52 mg or a copper-releasing IUD. The women were followed for 1 year. The LNG-IUS was chosen by 113 women (68.5%) and the copper IUD by 52 (31.5%). Prior to insertion the women were interviewed concerning their menstrual characteristics and uterine cavity size was measured by 2-D ultrasonography. After insertion the women kept daily records of bleeding and pain for two reference periods of 90 days during the first year (Months 1-3 and 10-12). The correlation between uterine cavity measurements and numbers of days of bleeding/spotting and pain during the reference periods was analysed. Continuation rates were assessed and reasons for discontinuation as well as the effects of baseline participant characteristics on outcomes were analysed in regression models. Both uterine cavity size and baseline menstrual characteristics prior to IUD insertion predicted the numbers of days of bleeding/spotting and pain in LNG-IUS users. Women with small uterine cavity dimensions reported less bleeding/spotting in both reference periods and less pain in the second reference period compared with women with larger dimensions. Baseline scanty spontaneous menstrual bleeding prior to LNG-IUS use (OR 9.4, 95% CI 1.7-51.8, P = 0.01) and smoking (OR 7.8, 95% CI 1.8-33.8, P = 0.006) predicted amenorrhoea in the second reference period. Women with baseline dysmenorrhoea reported more pain with both IUDs. Continuation rates and reasons for discontinuation were similar with both IUDs. No sample size could be calculated to estimate the power as this was a pilot study. As the majority of women chose the LNG-IUS we did not achieve our initial aim of equally sized IUD groups and thus the size of the copper IUD group may have been insufficient to detect differences. These data further encourage promotion of intrauterine contraception among nulligravid women. Routine use of ultrasonography to assess uterine cavity dimensions prior to IUD insertion is not indicated. Supported by Helsinki University Central Hospital research funds, the Swedish Cultural Foundation in Finland and Finska Läkaresällskapet, who provided funds for J.K. O.H. serves on advisory boards for Bayer Healthcare, Gedeon Richter and MSD Finland (part of Merck & Co. Inc.) and has designed educational events with these companies. S.S. has lectured in educational events at Bayer and MSD Finland (part of Merck & Co. Inc.) and is a member of the Advisory Board for Contraception at MSD Finland. The other authors have no conflicts of interest to declare. www.clinicaltrials.gov, NCT01685164. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Continuation rates and reasons for discontinuation of intra-uterine device in three provinces of Pakistan: results of a 24-month prospective client follow-up.

PubMed

Hameed, Waqas; Azmat, Syed Khurram; Ishaque, Muhammad; Hussain, Wajahat; Munroe, Erik; Mustafa, Ghulam; Khan, Omar Farooq; Abbas, Ghazunfer; Ali, Safdar; Asghar, Qaiser Jamshaid; Ali, Sajid; Ahmed, Aftab; Hamza, Hasan Bin

2015-11-25

Long-acting reversible contraceptives, such as the intrauterine device (IUD), remain underutilised in Pakistan with high discontinuation rates. Based on a 24-month prospective client follow-up (nested within a larger quasi-experimental study), this paper presents the comparison of two intervention models, one using private mid-level providers branded as "Suraj" and the other using community midwives (CMWs) of Maternal Newborn and Child Health Programme, for method continuation among IUD users. Moreover, determinants of IUD continuation and the reasons for discontinuation, and switching behaviour were studied within each arm. A total of 1,163 IUD users, 824 from Suraj and 339 from the CMW model, were enrolled in this 24-month prospective client follow-up. Participants were followed-up by female community mobilisers physically every second month to ascertain continued IUD usage and to collect information on associated factors, switching behaviour, reasons for discontinuation, and pregnancy occurrence. The probabilities of IUD continuation and the risk factors for discontinuation were estimated by life table analysis and Cox proportional-hazard techniques, respectively. The cumulative probabilities of IUD continuation at 24 months in Suraj and CMW models were 82% and 80%, respectively. The difference between the two intervention areas was not significant. The probability distributions of IUD continuation were also similar in both interventions (Log rank test: χ(2) = 0.06, df = 1, P = 0.81; Breslow test: χ(2) = 0.6, df = 1, P = 0.44). Health concerns (Suraj = 57.1%, CMW = 38.7%) and pregnancy desire (Suraj = 29.3%, CMW = 40.3%) were reported as the most prominent reasons for IUD discontinuation in both intervention arms. IUD discontinuation was significantly associated with place of residence in Suraj and with age (15-25 years) in the CMW model. CMWs and private providers are equally capable of providing quality IUD services and ensuring higher method continuation. Pakistan's National Maternal Newborn and Child Health programme should consider training CMWs and providing IUDs through them. Moreover, private sector mid-level providers could be engaged in promoting the use of IUDs.

Using Comprehensive Video-Module Instruction as an Alternative Approach for Teaching IUD Insertion.

PubMed

Garcia-Rodriguez, Juan Antonio; Donnon, Tyrone

2016-01-01

Family medicine clinicians and residents have increasing educational and work demands that have made it difficult to provide and access training on specific procedures such as IUD insertion. The purpose of this study was to determine whether the use of video-module instruction could provide residents with the necessary knowledge and skills to perform an IUD insertion correctly when compared with the traditional form of instruction, which is a lecture-demonstration session provided by an academic gynecologist. Thirty-nine family medicine residents participated in the study during the induction period at the beginning of their residency program in July 2012 at the University of Calgary. A randomized, two group pretest/posttest experimental research design was used to compare the procedural knowledge and skills performance (posttest only) of residents trained using an alternative instructional intervention (video-module teaching) with the traditional lecture-demonstration approach to teaching IUD insertion. Both teaching methods were effective in providing procedural knowledge instruction, and the paired-samples t tests results were almost identical: t (37)=1.35. On the other hand, performance scores were significantly higher in the video-module group: t (37)=2.37, 95% CI (0.61, 8.00), with a mean difference in performance of 4.31. There were no significant differences in residents' satisfaction scores, and there was no correlation between the different scores and sex or age or between performance and level of satisfaction. This video-module instruction is an effective method to provide comprehensive IUD insertion training, and the psychomotor skills gain (performance component) was significantly higher than the traditional method of instruction.

Beyond Plan B: A Qualitative Study of Canadian Pharmacists' Emergency Contraception Counselling Practices.

PubMed

Wong, Karen; Hum, Susan; McCarthy, Lisa; Dunn, Sheila

2017-11-01

Pharmacists are often the front-line health care providers for women seeking emergency contraception (EC). This study explored Ontario pharmacists' EC counselling practices and their perceived barriers to recommending the most effective EC method, the copper IUD (Cu-IUD). This qualitative study used one-on-one, semistructured interviews with 20 pharmacists working in pharmacies located within a 1-km radius of a large sexual health clinic that offered postcoital IUDs in downtown Toronto. All pharmacists provided counselling about levonorgestrel (LNG-EC), and all considered it important. Nevertheless, they rarely discussed the Cu-IUD, even in circumstances where LNG-EC could be less effective, such as delayed presentation or for women with BMI >25 kg/m 2 . Some pharmacists felt conflicted in their dual roles as health care and customer service provider when counselling about and selling EC, and many felt uncomfortable discussing body weight. Pharmacists were not well informed about the Cu-IUD. They identified many pharmacist-specific barriers to counselling about the Cu-IUD for EC, as well as health systems issues around Cu-IUD provision and insertion. Ontario pharmacists embraced their role in EC counselling, yet their discussions rarely included the most effective Cu-IUD option. Educating and training pharmacists about the Cu-IUD and establishing referral pathways for IUD insertion could expand their counselling about this EC option. Copyright © 2017 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Effect of clinic related factors on continuation rates of IUDs.

PubMed

Reading, A E; Goldstuck, N D

1982-01-01

This paper concerns factors relating to the clinic and the way in which the insertion of IUDs is managed from a psychological and technical standpoint. 3 aspects of clinical service are examined: 1) the influence of the psychological state at time of insertion, 2) individual differences in relation to side effects amongst users and the way in which those are influenced by managment techniques, and 3) technical aspects of the insertion of the device. Insertion pain and discomfort may influence subsequent tolerance of the IUD in 3 ways: 1) patient compliance may be enhanced by trouble-free insertion, 2) an unpleasant experience may influence attitudes towards the IUD, and 3) the experience of pain at insertion may reduce subsequent tolerance of discomfort. IUDs increase the amount of menstrual flow which, along with pain, constitute frequent requests for removal. Removal rates for pain and bleeding vary from 0-16.8/100 users. Removal rates for bleeding are also influenced by cultural attitudes. Insertion techniques influence acceptability of IUDs. Also, the incidence of expulsion, pregnancy, and removal declines with increasing age and parity. Discontinuation rates after 24 months were 91% for women below 2nd parity and only 37% for women of 6 or more parity. In the youngest age group the discontinuation rate was 76% compared with 35% in the oldest age group. The timing of IUD insertion and positioning of the IUD influence continuation rates. An implication of these concerns is that IUD insertion procedures may have to become more complex to achieve compatibility between IUD-uterine configurations.

Antiprogestin-releasing intrauterine devices

PubMed Central

Nayak, NR; Slayden, OD; Mah, K; Chwalisz, K; Brenner, Robert M

2007-01-01

Intrauterine devices (IUDs) that release progestins are highly effective contraceptives, but they induce breakthrough bleeding that some women find unacceptable. Because progesterone (P) antagonists (AP) are known to suppress the endometrium, induce amenorrhea, and inhibit fertility, AP IUDs may provide an effective contraceptive that also controls endometrial bleeding. Here we assessed the effects of empty (blank) vs AP-releasing (ZK 230 211) IUDs on bleeding patterns and endometrial growth in ovariectomized, artificially cycled macaques. The AP IUDs (but not the blank controls) induced extended, frank menstruation when inserted during the late luteal phase, an indication of local AP action. Over time, endometrial glandular and arterial proliferation were inhibited, steroid receptors were elevated, spiral arteries showed degenerative changes, progesterone withdrawal bleeding was prevented and estradiol-dependent proliferation was suppressed by the AP IUDs. In sum, AP IUDs suppressed the effects of P on endometrial progestational development and blocked the effects of estradiol on endometrial proliferation as previously shown for systemic treatment with APs. Therefore, AP IUDs may provide novel contraceptive devices with minimal breakthrough bleeding. PMID:17531599

An analysis of the personal reasons for discontinuing IUD use.

PubMed

Petta, C A; Amatya, R; Farr, G; Chi, I

1994-10-01

The objective of this study was to evaluate possible factors associated with discontinuing use of TCu 380A IUDs due to personal reasons among 2748 users. Overall, a total of 88 subjects discontinued using the TCu 380A IUD within 12 months postinsertion for personal reasons. The most common reasons were planned pregnancy (32%) and husband or family opinion against IUD use (26%). The gross cumulative 12-month life table discontinuation rate for all personal reasons was 4.0 per 100 women. Having no education and/or living in a rural area were the sociodemographic characteristics associated with an increased risk of discontinuation for personal reasons. Effective and regular counseling about IUD use, especially among illiterate women, may help prevent IUD discontinuations related to personal reasons.

The intrauterine device as emergency contraception: how much do young women know?

PubMed

Goodman, Suzan R; El Ayadi, Alison M; Rocca, Corinne H; Kohn, Julia E; Benedict, Courtney E; Dieseldorff, Jessica R; Harper, Cynthia C

2018-04-18

Unprotected intercourse is common, especially among teens and young women. Access to intrauterine device (IUD) as emergency contraception (EC) can help interested patients more effectively prevent unintended pregnancy and can also offer ongoing contraception. This study evaluated young women's awareness of IUD as EC and interest in case of need. We conducted a secondary analysis of data from young women aged 18-25 years, not desiring pregnancy within 12 months, and receiving contraceptive counseling within a cluster-randomized trial in 40 US Planned Parenthood health centers in 2011-2013 (n=1500). Heath centers were randomized to receive enhanced training on contraceptive counseling and IUD placement, or to provide standard care. The intervention did not focus specifically on IUD as EC. We assessed awareness of IUD as EC, desire to learn more about EC and most trusted source of information of EC among women in both intervention and control groups completing baseline and 3- or 6-month follow-up questionnaires (n=1138). At follow-up, very few young women overall (7.5%) visiting health centers had heard of IUD as EC. However, if they needed EC, most (68%) reported that they would want to learn about IUDs in addition to EC pills, especially those who would be very unhappy to become pregnant (adjusted odds ratio [aOR], 1.3; 95% confidence interval, 1.0-1.6, p<.05). Most (91%) reported a doctor or nurse as their most trusted source of EC information, over Internet (6%) or friends (2%), highlighting providers' essential role. Most young women at risk of unintended pregnancy are not aware of IUD as EC and look to their providers for trusted information. Contraceptive education should explicitly address IUD as EC. Few young women know that the IUD can be used for EC or about its effectiveness. However, if they needed EC, most reported that they would want to learn about IUDs in addition to EC pills, especially those very unhappy to become pregnant. Contraceptive education should explicitly address IUD as EC. Copyright © 2018 Elsevier Inc. All rights reserved.

Knowledge of and Interest in the Copper Intrauterine Device Among Women Seeking Emergency Contraception.

PubMed

Edwards, Christine; Panjwani, Dilzayn; Pendrith, Ciara; Ly, Anna; Dunn, Sheila

2018-01-01

Emergency contraception (EC) includes hormonal pills (levonorgestrel or ulipristal acetate) and the copper IUD (Cu-IUD). The Cu-IUD is more effective for EC than hormonal pills but remains underused, possibly because of lack of knowledge or interest. The objective of this study was to examine knowledge of and interest in the Cu-IUD for EC among Canadian women seeking EC. The study used a cross-sectional convenience survey of English-speaking women presenting for EC at two sexual health clinics in Toronto. The anonymous paper-based survey was completed in the waiting room. The main outcome measures were women's knowledge of and interest in the Cu-IUD for EC. Demographic and reproductive health data were also collected. Between January and December 2013, 124 surveys were completed. Mean age of respondents was 26 years (SD ± 6.9). Most were single (85%), and over one half had completed postsecondary education. Overall, 77% had heard of the Cu-IUD, but only 21% were aware of its use for EC. Over 50% were aware that the Cu-IUD is hormone-free and may be used for long-term contraception. Women were less familiar with the window of administration of the Cu-IUD for EC (26%) and its efficacy (6%). In total, 23% (28 of 124) of women were interested in the Cu-IUD, including eight women scheduled to receive one that day. Women presenting for EC were unaware of the Cu-IUD but were moderately interested in it once informed. Public education and routine counselling about the Cu-IUD at EC visits may increase the uptake of this method. Copyright © 2018 The Society of Obstetricians and Gynaecologists of Canada/La Société des obstétriciens et gynécologues du Canada. Published by Elsevier Inc. All rights reserved.

Postplacental or Delayed Insertion of the Levonorgestrel Intrauterine Device After Vaginal Delivery

PubMed Central

Chen, Beatrice A.; Reeves, Matthew F.; Hayes, Jennifer L.; Hohmann, Heather L.; Perriera, Lisa K.; Creinin, Mitchell D.

2011-01-01

OBJECTIVE To estimate whether 6-month use of the levonorgestrel-releasing intrauterine device (IUD) would be higher when insertion occurred within 10 minutes of placental delivery compared with 6–8 weeks postpartum. METHODS We enrolled pregnant women planning vaginal deliveries and desiring a postpartum levonorgestrel-releasing IUD. Patients were randomly assigned when admitted in labor to postplacental or delayed IUD insertion. The women followed up in person at 6–8 weeks and 6 months and were contacted by telephone at 3 months. Women were ineligible for a study IUD postenrollment for intrapartum events including infection, hemorrhage, and cesarean delivery; these women were contacted by phone at 3 and 6 months. Expelled IUDs were replaced per patient preference. RESULTS Successful IUD placement occurred in 50 of 51 participants (98.0%) and 46 of 51 participants (90.2%) in the postplacental and delayed groups, respectively (P=.2). Expulsion within 6 months occurred in 12 of 50 (24.0%; 95% confidence interval [CI], 13.1–38.2) and two of 46 (4.4%; 95% CI 0.5–14.8) participants, respectively (P=.008). Intrauterine device use at 6 months was 43 of 51 (84.3%; 95% CI 71.4–93.0) and 39 of 51 (76.5%; 95% CI 62.5–87.2), respectively (P=.32). For ineligible patients, only 11 of 41 (26.8%) women were using IUDs at 6 months and two (4.9%) had become pregnant. CONCLUSION Intrauterine device use 6 months after delivery is similar in women who have postpartum or scheduled delayed IUD placement through a study after replacement of expelled IUDs. Expulsions are significantly higher with postplacental compared with delayed IUD placement. Women asked to follow up with their own health care providers for delayed insertion are significantly less likely to receive an IUD. CLINICALTRIALREGISTRATION ClinicalTrials.gov, www.clinicaltrials.gov, NCT00476021. LEVEL OF EVIDENCE I PMID:20966692

Louisiana and Mississippi Family Physicians' Contraception Counseling for Adolescents with a Focus on Intrauterine Contraception.

PubMed

Rubin, Susan E; Coy, Lauren N; Yu, Qingzhao; Muncie, Herbert L

2016-10-01

The adolescent pregnancy rate in Louisiana (LA) and Mississippi (MS) is one of the highest in the United States. One approach to decrease that rate is to increase contraceptive use. We sought to characterize LA and MS family physicians' (FPs) contraception counseling for adolescents with a focus on the intrauterine contraceptive device (IUD). DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Online survey of resident and practicing physician members of the LA and MS Academy of FPs. Three hundred ninety-eight of 1616 invited FPs responded; 244 were included in our analysis. When counseling adolescents about contraception, respondents "frequently discussed" oral contraceptives and condoms 87.5% (210/240) and 83.8% (202/241) of the time, respectively. Newer and more highly effective contraceptives such as the ring, patch, IUD, and implant were "frequently discussed" only 34.6% (82/237)-39.3% (92/234) of the time. In the previous 6 months, 56% (136/243) of respondents ever discussed an IUD with an adolescent. Respondents were more likely to have discussed IUDs if they learned IUD insertion during residency, had on-site access to IUD inserters, believed they were competent and/or comfortable with IUD counseling. In 5 clinical scenarios asking whether the respondent would recommend an IUD to a 17- or a 27-year-old patient (in all scenarios patients were eligible for an IUD), respondents were restrictive overall and significantly fewer would recommend an IUD for the adolescent. Our results suggest that there are missed opportunities for full-scope contraception counseling by LA and MS FPs. When these FPs counsel adolescents about contraception they less frequently discuss newer methods and more highly effective methods. Additionally many LA and MS FPs use overly restrictive eligibility criteria when considering IUDs. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Temporal trends of copper-bearing intrauterine device discontinuation: a population-based birth-cohort study of contraceptive use among rural married women in China.

PubMed

Zhou, Jie; Tan, Xiaodong; Song, Xiangjing; Zhang, Kaining; Fang, Jing; Peng, Lin; Qi, Wencai; Nie, Zonghui; Li, Ming; Deng, Rui; Yan, Chaofang

2015-03-01

Copper-bearing intrauterine device (IUD) insertion for long-term contraceptive use is high in China, but there has been evidence that first-year discontinuation rate of copper-bearing IUD has also increased rapidly in recent years especially among rural married women. To investigate long-term use of copper-bearing IUD, the authors examined the 7-year temporal trends of copper-bearing IUD discontinuation in a population-based birth-cohort study among 720 rural married women in China, from 2004 to 2012. Women requesting contraception were followed-up twice per year after the insertion of IUD. The gross cumulative life table discontinuation rates were calculated for each of the main reasons for discontinuation as well as for all reasons combined. By the end of 7 years, 384 discontinuations were observed. With a stepped-up trend, the gross cumulative life table rate for discontinuation increased from 10.06 (95% confidence interval = 7.86-12.27) per 100 women by the first year to 52.69 (95% confidence interval = 48.94-56.44) per 100 women by the end of 7 years, which increased rapidly in the first 2 years after copper-bearing IUD insertion, flattened out gradually in the following 2 years, then increased again in the last 3 years. Among reported method failure, expulsion and side effects were the main reasons for discontinuation of the copper-bearing IUD but not pregnancy. Personal reasons, such as renewal by personal will had influenced copper-bearing IUD use since the second year and should not be neglected. Based on this study, the temporal trends of copper-bearing IUD discontinuation was in a stepped-up trend in 7 years after insertion. Both reported method failure (expulsion and side effect) and personal reason had effect on the discontinuation of copper-bearing IUD, but pregnancy was no more the most important reason affecting the use of copper-bearing IUD. © 2014 APJPH.

Practice variation in surgical procedures and IUD-insertions among general practitioners in Norway - a longitudinal study.

PubMed

Pahle, Andreas Saxlund; Sørli, Daniel; Kristiansen, Ivar Sønbø; Deraas, Trygve S; Halvorsen, Peder A

2017-01-21

Studies of Primary Health Care (PHC) reveal considerable practice variations in terms of the range of services provided. In Norway, general practitioners (GPs) are traditionally expected to perform IUD-insertions and several surgical procedures as a part of comprehensive PHC. We aimed to investigate variation in the provision of surgical procedures and IUD-insertions across GPs and over time and explore determinants of such variation. Retrospective registry study of Norwegian GPs. From a comprehensive database of GPs' reimbursement claims, we obtained procedure codes and GP characteristics such as age, gender, list size and municipality characteristics from 2006 through 2013. Multivariable logistic regression models were fitted to explore determinants of practice variation. We extracted data from 4,828 GPs. In 2013, 91.0, 76.1 and 74.8% were reimbursed at least once for minor and major surgical procedures and IUD-insertion, respectively. Female GPs had lower odds for performing major surgical procedures (OR 0.38, 95% CI 0.32-0.45) and higher odds for performing IUD-insertions (OR 6.28, 95% CI 4.47-8.82) than male GPs. Older GPs and GPs with shorter patient lists were less likely to perform surgical procedures. GPs with longer patient lists had higher odds for performing IUD-insertions. The proportion of GPs performing surgical procedures increased over time, while the proportion decreased for IUD-insertions. The number of IUD-insertions in specialist care increased from 12,575 in 2011 to 15 216 (+21.0%) in 2014. We observed a large variation in the provision of surgical procedures and IUD-insertions amongst GPs in Norway. The GPs' age, gender, list size and size of municipality were associated with performing the procedures. Our findings suggest a shift of IUD-insertions from primary to specialist care.

Fatal streptococcal toxic shock syndrome from an intrauterine device.

PubMed

Cho, Elizabeth E; Fernando, Dinali

2013-04-01

The occurrence of toxic shock syndrome from an intrauterine device (IUD) is very rare. To raise awareness of the risk of toxic shock syndrome caused by an IUD, to educate others about when to suspect this complication, and to provide treatment recommendations. A 49-year-old woman presented to the Emergency Department in septic shock after complaining of 5 days of nausea, vomiting, and diarrhea. Physical examination findings included a diffusely tender and rigid abdomen with free fluid on bedside sonogram. She was found, on computed tomography of her abdomen and pelvis, to have an IUD with moderate ascites. The IUD was removed, and both her IUD and her blood cultures grew out group A Streptococcus. Despite aggressive medical management, which included multiple vasopressors and broad-spectrum antibiotics, she died from group A streptococcal sepsis, with the IUD as her most likely source. Her clinical presentation and laboratory findings meet the Centers for Disease Control and Prevention diagnostic criteria for streptococcal toxic shock syndrome. Her diagnosis was confirmed by autopsy. IUDs should be considered as a possible source of infection in patients with an IUD who present with symptoms consistent with toxic shock syndrome. These patients need to be aggressively managed with early surgical intervention. Copyright © 2013. Published by Elsevier Inc.

Blood, men and tears: keeping IUDs in place in Bangladesh.

PubMed

Bradley, Janet E; Alam, Mahboob-E-; Shabnam, Fatema; Beattie, Tara S H

2009-06-01

The Intra-Uterine Device (IUD) is an effective method of contraception, but in Bangladesh is associated with high levels of discontinuation within the first year. This study involved data collection from a retrospective cohort of women who had an IUD inserted 12 months earlier. In the cohort, 330 women were interviewed to identify factors associated with discontinuation. Later, 20 women, of the 103 who reported discontinuing because of excessive menstrual bleeding, were interviewed again and in depth about these issues. Of 330 women who had an IUD inserted, 47.3% had discontinued use one year post-insertion. In univariate and multivariate analyses, IUD discontinuation was strongly associated with side-effects (heavier periods; abdominal pain) and spousal factors (not discussing IUD with husband pre-insertion), but not with service delivery factors. In-depth interviews with women who reported excessive blood loss as the main reason for discontinuation found a doubling of both menstrual days and blood loss after IUD insertion. In Bangladesh, women cannot pray, have sexual intercourse, perform household tasks or participate in community activities during menstruation. Thus, women with menstrual side-effects faced serious physical, social and psychological challenges that made continuation difficult. Among those who discontinued, spouses were generally unsupportive and sometimes abusive, particularly when not involved in the decision to use the IUD.

Study on Quality of IUD Services Provided by Trained Professionals at Teaching Institutes.

PubMed

Prasad, Noopur; Jain, M L; Meena, B S

2018-06-01

Access the completeness in IUD services provided by trained professionals and find out the weak links. Study was conducted on 100 IUD trained professionals of tertiary care hospital and nursing teaching institute. All were given questionnaire that was duly filled by them. Data obtained were analysed. Protocols of case selection, pre-insertion counselling, insertion process and follow-up were assessed. All the four criteria were assessed on score of ten. Study group could not get ten points under any of the set criteria. Average of 53% case selection, 31.4% pre-insertion counselling, 42.5% insertion protocols and 46.1% follow-up counselling criteria were observed by study group. Highest compliance of protocols was seen among postgraduate students. Although IUD training is given to all medical professionals and IUD facility is available up to subcentres but the study shows that completeness in services is still lacking. Ensuring ideal place for IUD insertion, proper case selection, use of specific instruments for insertion and observance of insertion protocols are very vital for the success of IUD.

Solid tissue culture for cytogenetic analysis: a collaborative survey for the Association of Clinical Cytogeneticists.

PubMed Central

Rodgers, C S; Creasy, M R; Fitchett, M; Maliszewska, C T; Pratt, N R; Waters, J J

1996-01-01

AIMS: To survey the diagnostic service provided by UK laboratories for the culture of solid tissue samples (excluding tumours) and in particular to examine the variation in culture success rates and the problems of maternal cell overgrowth. METHODS: Twenty seven laboratories took part in a collaborative survey during 1992. Each laboratory submitted data on up to a maximum of 60 consecutive specimens (n = 1361) over a six month period. RESULTS: Skin specimens, the largest category received (n = 520), were the most problematic (51% success rate). Culture success rates were significantly lower (43%) when skin specimens (n = 140) were transported dry to the laboratory. Success rates for skin specimens also varied, depending on the origin of the specimen, from 18% for intra-uterine deaths (IUD) (n = 94) to 85% for neonatal deaths (n = 33) and 83% for live patients (n = 54). Culture of selected extra-fetal tissues from IUD, stillbirths and following elective termination of pregnancy (TOP) gave comparable success rates to those achieved for skin samples from neonatal deaths and live births. Skewed sex ratios, female > male, were identified for products of conception (POC) (n = 298) and placental biopsy specimens (n = 97). CONCLUSIONS: By appropriate selection, transport and processing of tissues, and in particular by avoiding relying solely on skin samples from IUD, stillbirths and TOP, an increase in culture success rates for solid tissue samples submitted for cytogenetic analysis could be achieved. The high risk of maternal cell contamination from POC and placental biopsy specimens was also identified in this survey. PMID:8881913

The effects of simulated patients and simulated gynecologic models on student anxiety in providing IUD services.

PubMed

Khadivzadeh, Talat; Erfanian, Fatemeh

2012-10-01

Midwifery students experience high levels of stress during their initial clinical practices. Addressing the learner's source of anxiety and discomfort can ease the learning experience and lead to better outcomes. The aim of this study was to find out the effect of a simulation-based course, using simulated patients and simulated gynecologic models on student anxiety and comfort while practicing to provide intrauterine device (IUD) services. Fifty-six eligible midwifery students were randomly allocated into simulation-based and traditional training groups. They participated in a 12-hour workshop in providing IUD services. The simulation group was trained through an educational program including simulated gynecologic models and simulated patients. The students in both groups then practiced IUD consultation and insertion with real patients in the clinic. The students' anxiety in IUD insertion was assessed using the "Spielberger anxiety test" and the "comfort in providing IUD services" questionnaire. There were significant differences between students in 2 aspects of anxiety including state (P < 0.001) and trait (P = 0.024) and the level of comfort (P = 0.000) in providing IUD services in simulation and traditional groups. "Fear of uterine perforation during insertion" was the most important cause of students' anxiety in providing IUD services, which was reported by 74.34% of students. Simulated patients and simulated gynecologic models are effective in optimizing students' anxiety levels when practicing to deliver IUD services. Therefore, it is recommended that simulated patients and simulated gynecologic models be used before engaging students in real clinical practice.

Fertility control using intrauterine devices: an alternative for population control in wild horses.

PubMed

Daels, P F; Hughes, J P

1995-10-01

The purpose of this study was to develop a contraceptive method for feral horses. The feral horse population has increased significantly in recent years despite attempts to control numbers. As in most wild animal population control programs, contraceptive methods must be easy to apply, cause minimal disruption to the social structure and be fully reversible. In the present study, we tested the effectiveness of an intrauterine device (IUD) for fertility control in mares. Six mares were fitted with a silastic O-ring-shaped IUD on July 1 of Year 1. The IUD-treated mares were turned out with 12 nontreated mares and a fertile stallion in a large pasture until October 20 (112 d). None of the IUD-treated mares and all the nontreated mares became pregnant. The IUD-treated mares were maintained separately from the stallion during the winter. Following removal of the IUD on April 27 of Year 2, the mares were again introduced to the pasture with the stallion together with 6 nontreated mares. For the 6 mares previously treated with an IUD, the mean interval from introduction to the stallion to conception was 17.5 +/- 5 d or 1.3 cycles per pregnancy, and all mares produced a normal foal at term. Subsequently, 19 recorded mare breeding seasons resulted in 18 foals. Uterine cytology and histopathology indicate that the IUD causes mild chronic endometritis without permanent changes in the endometrium. We conclude that based on our observations, the O-ring-shaped IUD is an effective, safe and practical contraceptive method for mares.

Body weight and body composition of depot medroxyprogesterone acetate users.

PubMed

Dal'Ava, Natália; Bahamondes, Luis; Bahamondes, M Valeria; Bottura, Bruna F; Monteiro, Ilza

2014-08-01

Weight gain is a concern with the contraceptive depot-medroxyprogesterone acetate (DMPA); however, this issue remains controversial. The objective of this study was to compare body weight (BW) and body composition (BC) in DMPA and copper intrauterine device (IUD) users at baseline and after one year of use. We enrolled new DMPA users and age and weight matched new IUD users into this prospective study. Weight and height were measured, BC (fat and lean mass) was evaluated using dual-energy X-ray absorptiometry, and physical activity was assessed at baseline and at 12 months. Student's paired t test and the Wilcoxon paired test for matched samples were used. Ninety-seven women were enrolled for the study; 26 matched pairs continued using the initial method for at least one year, and completed the baseline and 12 month assessments. An increase of 1.9 kg occurred in BW (p=.02) in DMPA users at 12 months of use, resulting from an increase in fat mass of 1.6 kg (p=.03). Weight remained stable in IUD users; however, there was an increase in lean mass at 12 months of use (p=.001). The number of women practicing physical activity increased in this group. There was a significant difference between the groups regarding the variation in the percentage of central fat (p=.04). Weight gain in the DMPA group after the first year of use resulted from an increase in fat mass. Weight remained stable in the IUD group; however, an increase in lean mass and a reduction in localized abdominal fat mass occurred, possibly because more users were practicing physical activity. There was a greater increase in body weight in DMPA users compared to TCu380A IUD users in the first year of use of the contraceptive method. Furthermore, the weight increase in users of DMPA occurred principally as the result of an increase in fat mass. Physical activity probably could increase the lean mass in the users of TCu380A IUD. Copyright © 2014 Elsevier Inc. All rights reserved.

The efficacy of intrauterine devices for emergency contraception: a systematic review of 35 years of experience

PubMed Central

Cleland, Kelly; Zhu, Haoping; Goldstuck, Norman; Cheng, Linan; Trussell, James

2012-01-01

BACKGROUND Intrauterine devices (IUDs) have been studied for use for emergency contraception for at least 35 years. IUDs are safe and highly effective for emergency contraception and regular contraception, and are extremely cost-effective as an ongoing method. The objective of this study was to evaluate the existing data to estimate the efficacy of IUDs for emergency contraception. METHODS The reference list for this study was generated from hand searching the reference lists of relevant articles and our own article archives, and electronic searches of several databases: Medline, Global Health, Clinicaltrials.gov, Popline, Wanfang Data (Chinese) and Weipu Data (Chinese). We included studies published in English or Chinese, with a defined population of women who presented for emergency contraception and were provided with an IUD, and in which the number of pregnancies was ascertained and loss to follow-up was clearly defined. Data from each article were abstracted independently by two reviewers. RESULTS The 42 studies (of 274 retrieved) that met our inclusion criteria were conducted in six countries between 1979 and 2011 and included eight different types of IUD and 7034 women. The maximum timeframe from intercourse to insertion of the IUD ranged from 2 days to 10 or more days; the majority of insertions (74% of studies) occurred within 5 days of intercourse. The pregnancy rate (excluding one outlier study) was 0.09%. CONCLUSIONS IUDs are a highly effective method of contraception after unprotected intercourse. Because they are safe for the majority of women, highly effective and cost-effective when left in place as ongoing contraception, whenever clinically feasible IUDs should be included in the range of emergency contraception options offered to patients presenting after unprotected intercourse. This review is limited by the fact that the original studies did not provide sufficient data on the delay between intercourse and insertion of the IUD, parity, cycle day of intercourse or IUD type to allow analysis by any of these variables. PMID:22570193

Levonorgestrel Intrauterine Device as an Endometrial Cancer Prevention Strategy in Obese Women: A Cost-Effectiveness Analysis.

PubMed

Dottino, Joseph A; Hasselblad, Vic; Secord, Angeles Alvarez; Myers, Evan R; Chino, Junzo; Havrilesky, Laura J

2016-10-01

To estimate the cost-effectiveness of the levonorgestrel intrauterine device (IUD) as an endometrial cancer prevention strategy in obese women. A modified Markov model was used to compare IUD placement at age 50 with usual care among women with a body mass index (BMI, kg/m) 40 or greater or BMI 30 or greater. The effects of obesity on incidence and survival were incorporated. The IUD was assumed to confer a 50% reduction in cancer incidence over 5 years. Costs of IUD and cancer care were included. Clinical outcomes were cancer diagnosis and deaths from cancer. Incremental cost-effectiveness ratios were calculated in 2015 U.S. dollars per year of life saved. One-way and two-way sensitivity analyses and Monte Carlo probabilistic analyses were performed. For a 50 year old with BMI 40 or greater, the IUD strategy is costlier and more effective than usual care with an incremental cost-effectiveness ratio of $74,707 per year of life saved. If the protective effect of the levonorgestrel IUD is assumed to be 10 years, the incremental cost-effectiveness ratio decreases to $37,858 per year of life saved. In sensitivity analysis, a levonorgestrel IUD that reduces cancer incidence by at least 68% in women with BMIs of 40 or greater or costs less than $500 is potentially cost-effective. For BMI 30 or greater, the incremental cost-effectiveness ratio of IUD strategy is $137,223 per year of life saved compared with usual care. In Monte Carlo analysis, IUD placement for BMI 40 or greater is cost-effective in 50% of simulations at a willingness-to-pay threshold of $100,000 per year of life saved. The levonorgestrel IUD is a potentially cost-effective strategy for prevention of deaths from endometrial cancer in obese women.

Doppler color flow analysis of the uterine arteries before and after intrauterine device insertion: a prospective study.

PubMed

de Souza, Marco Aurélio Martins; Geber, Selmo

2006-02-01

An intrauterine device (IUD) is one of the most frequently used methods of birth control around the world. Although a relationship between its use and menstrual disorders has been well documented, only a few studies have tried to show whether there are any vascular modifications. The aim of our study was to evaluate the influence of an IUD on uterine artery blood flow using Doppler assessment. A total of 100 patients selected for IUD use were prospectively evaluated with Doppler analysis before and 30 days after insertion. The resistive index (RI) and pulsatility index (PI) were used to evaluate uterine artery vascular resistance. Patients were allocated in 2 groups according to whether they were (group 2) or were not (group 1) lactating. The PI and RI of the patients in groups 1 and 2 before and after IUD insertion were not statistically significantly different (P = .298 and .23). When we compared uterine artery blood flow indices before and after IUD insertion for groups 1 and 2 separately, we observed in group 1 that the mean +/- SD PI values were 2.45 +/- 0.62 and 2.55 +/- 0.55 (P = .38) and the RI values were 0.87 +/- 0.08 and 0.87 +/- 0.06 (P = .88) before and after IUD insertion, respectively. In group 2, the PI values were 2.31 +/- 0.55 and 2.37 +/- 0.69 (P = .68) and the RI values were 0.85 +/- 0.07 and 0.86 +/- 0.07 (P = .44) before and after IUD insertion. Finally, we used the mean blood flow indices of the uterine arteries of all patients to compare the effect of IUD insertion. Results were also not statistically significant when we compared PI and RI before and after IUD insertion. The presence of an IUD does not interfere with the vascular resistance of the uterine arteries that can be shown by Doppler flow assessments 1 month after insertion.

Use of effective contraception 6 months after emergency contraception with a copper intrauterine device or ulipristal acetate - a prospective observational cohort study.

PubMed

Envall, Niklas; Groes Kofoed, Nina; Kopp-Kallner, Helena

2016-08-01

Emergency contraception must be followed by the use of an effective method of contraception in order to reduce future risk of unintended pregnancies. Provision of long-acting reversible contraception (LARC) is highly effective in this regard. The aim of our study was to compare use of an effective method of contraception 6 months following insertion of a copper intrauterine device (Cu-IUD) or intake of ulipristal acetate (UPA) for emergency contraception (EC). Women (n = 79) presenting with need for EC at an outpatient midwifery clinic chose either Cu-IUD or UPA according to preference. Follow up was 3 and 6 months later through telephone interviews. Primary outcome was use of an effective contraceptive method at the 6-month follow up. Secondary outcomes included use of an effective contraceptive method at 3 months follow up and acceptability of Cu-IUD. A total of 30/36 (83.3%) women who opted for Cu-IUD for EC used an effective contraceptive method 6 months after their first visit compared with 18/31 (58.1%) women who opted for UPA (p = 0.03). In the Cu-IUD group 28/36 (77.8%) were still using Cu-IUD at 6 months and 31/36 (86%) stated that they would recommend the Cu-IUD to others as an EC method. Significantly more women who chose Cu-IUD for EC used an effective method for contraception at the 6-month follow up. The results of this study support increased use of Cu-IUDs for EC. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Can intrauterine contraceptive devices lead to VulvoVaginal Candidiasis (VVC) and Anemia in Iranian new users?

PubMed

Behboudi-Gandevani, Samira; Imani, Somaieh; Moghaddam-Banaem, Lida; Roudbar-Mohammadi, Shahla

2015-03-01

To assess the prevalence of anemia and VulvoVaginal Candidiasis (VVC) in women before and 3 months after copper Intra Uterine Device (IUD) insertion. Longitudinal prospective study was performed with 101 women aged 15-45 year who wanted to use the IUD at six health centers in Tehran, Iran from November 2011 to August 2012. The pattern of bleeding, Hemoglobin and Hematocirt levels, and Candida colony count/cultures in the women were assessed before and after 3 months of IUD insertion. Data analysis was performed by descriptive and analytical statistics using the SPSS software for Windows. At the end of 3 months, a significant increase in menstrual blood loss and a significant decrease of Hb and HCT (P=0.047 and 0.001, respectively) were reported. Moreover, no difference in the prevalence of anemia before and after IUD insertion was observed. The mean±SD Candida colony counts significantly increased (P=0.001), but positive Candida cultures were not significantly different before and 3 months after IUD insertion. Also, no clinical VVC was reported 3 months after IUD insertion. While BMI≥29 had a positive relationship with Candida colony counts, the results remained unchanged after adjusting for potential risk factors. Despite an increase in bleeding and Candida colony counts in copper IUD users in this study, clinical VVC or anemia cases were not increased, which indicates relative safety of this contraception method. The study findings can be helpful to healthcare professionals and midwives to counsel women who want to start using IUD and also current users who are contemplating IUD removal due to its complications. Copyright © 2014 Elsevier B.V. All rights reserved.

Relationship between uterine volume and discontinuation of treatment with levonorgestrel-releasing intrauterine devices in patients with adenomyosis.

PubMed

Lee, Ki Hwan; Kim, Jang Kew; Lee, Min A; Ko, Young Bok; Yang, Jung Bo; Kang, Byung Hun; Yoo, Heon Jong

2016-09-01

This study is to evaluate the relationship between the uterine volume and the failure of levonorgestrel-releasing intrauterine device (LNG-IUD) in patients with adenomyosis. A total of 171 women with adenomysis were treated with LNG-IUD from November 2009 to December 2011. The amount of menorrhagia, degree of dysmenorrhea, and the uterine volume were compared before and after insertion of LNG-IUD, and the treatment failure of LNG-IUD was observed. The mean age of the participants was 42.5 years (range 29-53 years). The mean uterine volume was 158 mL (range 46-769 mL). Among the total participants, 37 (21.6 %) discontinued the treatment prematurely. There were no different characteristics between the ongoing treatment group and treatment failure group with LNG-IUD. However, there was significant difference of uterine volume between two groups (178 ± 14 and 141 ± 7 mL, P = 0.010). Based on the receiver operator characteristic analysis, the optimum cutoff value of uterine volume more than 150 mL was significantly associated with failure of LNG-IUD (area under curve: 0.763, 95 % CI 0.669-0.856). In univariate analysis, the uterine volume more than 150 mL was the only independent factor for the failure of LNG-IUD (odds ratio 6.76, 95 % CI 1.20-38.02, P = 0.030). The rate of treatment failure after LNG-IUD insertion for the patients with adenomyosis was related to the uterine volume. Specifically, the treatment failure rate of large volume uterus (>150 mL) with LNG-IUD was significantly higher than that of small volume uterus.

Use of sexually transmitted disease risk assessment algorithms for selection of intrauterine device candidates.

PubMed

Morrison, C S; Sekadde-Kigondu, C; Miller, W C; Weiner, D H; Sinei, S K

1999-02-01

Sexually transmitted diseases (STD) are an important contraindication for intrauterine device (IUD) insertion. Nevertheless, laboratory testing for STD is not possible in many settings. The objective of this study is to evaluate the use of risk assessment algorithms to predict STD and subsequent IUD-related complications among IUD candidates. Among 615 IUD users in Kenya, the following algorithms were evaluated: 1) an STD algorithm based on US Agency for International Development (USAID) Technical Working Group guidelines: 2) a Centers for Disease Control and Prevention (CDC) algorithm for management of chlamydia; and 3) a data-derived algorithm modeled from study data. Algorithms were evaluated for prediction of chlamydial and gonococcal infection at 1 month and complications (pelvic inflammatory disease [PID], IUD removals, and IUD expulsions) over 4 months. Women with STD were more likely to develop complications than women without STD (19% vs 6%; risk ratio = 2.9; 95% CI 1.3-6.5). For STD prediction, the USAID algorithm was 75% sensitive and 48% specific, with a positive likelihood ratio (LR+) of 1.4. The CDC algorithm was 44% sensitive and 72% specific, LR+ = 1.6. The data-derived algorithm was 91% sensitive and 56% specific, with LR+ = 2.0 and LR- = 0.2. Category-specific LR for this algorithm identified women with very low (< 1%) and very high (29%) infection probabilities. The data-derived algorithm was also the best predictor of IUD-related complications. These results suggest that use of STD algorithms may improve selection of IUD users. Women at high risk for STD could be counseled to avoid IUD, whereas women at moderate risk should be monitored closely and counseled to use condoms.

A qualitative exploration of emergency contraception users' willingness to select the copper IUD.

PubMed

Wright, Rachel L; Frost, Caren J; Turok, David K

2012-01-01

The copper T intrauterine device (IUD) is an effective but underutilized method of emergency contraception (EC). This study investigates the factors influencing a woman's decision around which method of EC to select. In-depth interviews with 14 IUD and 14 oral EC users aged 18-30 years accessing public health clinics. Emergency contraception users associated long-term methods of contraception with long-term sexual relationships. Women were not aware of the possibility of using the copper IUD for EC. Cost was identified as a major barrier to accessing IUDs. Perceived side effects and impact on future pregnancies further influenced the EC method a participant selected. Women think about contraception in the context of each separate relationship and not as a long-term individual plan. Most women were unaware of the copper IUD for EC. Furthermore, there is little discussion between women and their health-care providers around EC. Copyright © 2012 Elsevier Inc. All rights reserved.

Impact of Vitamin D Supplementation during Lactation on Vitamin D Status and Body Composition of Mother-Infant Pairs: A MAVID Randomized Controlled Trial

PubMed Central

Czech-Kowalska, Justyna; Latka-Grot, Julita; Bulsiewicz, Dorota; Jaworski, Maciej; Pludowski, Pawel; Wygledowska, Grazyna; Chazan, Bogdan; Pawlus, Beata; Zochowska, Anna; Borszewska-Kornacka, Maria K.; Karczmarewicz, Elzbieta; Czekuc-Kryskiewicz, Edyta; Dobrzanska, Anna

2014-01-01

Objective The optimal vitamin D intake for nursing women is controversial. Deterioration, at least in bone mass, is reported during lactation. This study evaluated whether vitamin D supplementation during lactation enhances the maternal and infant’s vitamin D status, bone mass and body composition. Design and Methods After term delivery, 174 healthy mothers were randomized to receive 1200 IU/d (800 IU/d+400 IU/d from multivitamins) or 400 IU/d (placebo+400 IU/d from multivitamins) of cholecalciferol for 6 months while breastfeeding. All infants received 400 IU/d of cholecalciferol. Serum 25-hydroxyvitamin D [25(OH)D], iPTH, calcium, urinary calcium, and densitometry were performed in mother-offspring pairs after delivery, and at 3 and 6 months later. Results A total of 137 (79%) (n = 70; 1200 IU/d, n = 67; 400 IU/d) completed the study. 25(OH)D was similar in both groups at baseline (13.7 ng/ml vs. 16.1 ng/ml; P = 0.09) and at 3 months (25.7 ng/ml vs. 24.5 ng/ml; P = 0.09), but appeared higher in the 1200 IU/d group at 6 months of supplementation (25.6 ng/ml vs. 23.1 ng/ml; P = 0.009). The prevalence of 25(OH)D <20 ng/ml was comparable between groups at baseline (71% vs. 64%, P = 0.36) but lower in the 1200 IU/d group after 3 months (9% vs. 25%, P = 0.009) and 6 months (14% vs. 30%, P = 0.03). Maternal and infants’ iPTH, calciuria, bone mass and body composition as well as infants’ 25(OH)D levels were not significantly different between groups during the study. Significant negative correlations were noted between maternal 25(OH)D and fat mass (R = −0.49, P = 0.00001), android fat mass (R = −0.53, P = 0.00001), and gynoid fat mass (R = −0.43, P = 0.00001) after 6 months of supplementation. Conclusions Vitamin D supplementation at a dose of 400 IU/d was not sufficient to maintain 25(OH)D >20 ng/ml in nursing women, while 1200 IU/d appeared more effective, but had no effect on breastfed offspring vitamin D status, or changes in the bone mass and the body composition observed in both during breastfeeding. Trial Registration ClinicalTrials.gov NCT01506557 PMID:25232839

Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia

PubMed Central

Wu, Carolyn M Yu; Noska, Amanda

2016-01-01

Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians’ high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control. PMID:26965406

Intrauterine device infection causing concomitant streptococcal toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus bacteraemia.

PubMed

Wu, Carolyn M Yu; Noska, Amanda

2016-03-10

Intrauterine devices (IUDs) are rarely associated with serious infections. We report an unusual concomitant infection of group A Streptococcus (GAS) causing toxic shock syndrome and pelvic abscess with Actinomyces odontolyticus associated with an IUD in a healthy 50-year-old patient. The IUD was subsequently removed and the patient recovered on the appropriate antibiotics. This case highlights the importance of clinicians' high index of suspicion of an IUD infection and prompt removal of the infected foreign body to obtain source control. 2016 BMJ Publishing Group Ltd.

IUD users may have higher risk of contracting PID, studies find; pill may have protective effect.

PubMed

1980-01-01

The incidence of pelvic inflammatory disease (PID), which can lead to serious reproductive impairment, infertility, or ectopic pregnancy, is increasing worldwide. About 500,000 women in their childbearing years contract PID for the first time each year in the U.S., and the incidence among young women appears to be increasing. Sexually transmitted diseases are responsible for many PID cases worldwide, while in developing countries postpartum and postabortion sepsis and endemic diseases such as filariasis and schistosomiasis may also be implicated. Some increase of PID is associated with legal abortion and IUD insertion, while pill use appears to protect women from PID. A worldwide review of medical literature indicates that the risk of PID is 3.5 times greater for IUD users than for nonusers, although several variables other than IUD use affect PID risk, such as age, race, socioeconomic status, and sexual activity. The risk for never pregnant IUD users in a Swedish study was 11.8 per 100 woman years, compared to 3.4 for ever-pregnant IUD users. There was no difference in relative risk for users of the pill or barrier methods, or for non-contraceptors. Another study reported a higher relative risk of PID related to duration of IUD use.

Development of a smart IUD launcher for prevention of uterine perforation.

PubMed

Al-Ashwal, Rania Hussein; Aziz, Noor Afatin Che; Nooh, Syed Mohd

2016-10-01

Intrauterine contraception is a widely used, highly effective and reversible means of birth control. One potential disadvantage with the use of intrauterine devices (IUDs) is the risk of uterine perforation. During the process of IUD insertion, there is a possibility to perforate the wall of the uterus during which health workers might injure the fundus of the uterus, due to inadequate knowledge or insufficient training. This paper discusses the development of a smart IUD launcher insertion system that would be used to prevent perforation of the uterine wall by detecting a specific distance to the wall for the safe release of the IUD using a sensor. Several launcher prototypes were developed prior to the final version of the IUD launcher. The results from testing experiments, that have been conducted to evaluate the performance of the proposed device, show that the sensor is able to detect a distance up to 5 mm and is also capable of detecting the distance to the target even in high viscosity liquid. The developed prototype promises a solution for more accurate IUD insertion that could be used as a training module for health care providers, helping remove fear from using this long-lasting contraceptive method and promote an affordable modern contraceptive method to society.

Ortho stops marketing Lippes Loop; cites economic factors.

PubMed

1985-11-01

Ortho Pharmaceutical Corporation has stopped marketing the Lippes Loop IUD, the only inert IUD currently available in the US. The firm cited "economic considerations" as its reason. Linda Organ, company spokeswoman, told Contraceptive Technology Update (CTU) that the number of women using IUDs has declined in the past few years and, as a result, Ortho's Lippes Loop sales dropped. Most physicians, according to Organ, currently prescribe copper-bearing IUDs. Few devices have been studied as thoroughly before marketing as the Lippes Loop, according to its developer, Dr. Jack Lippes. Lippes told CTU that the Population Council analyzed 40,000 women from 1962 to 1968 and "found no trouble with the Loop." Lippes attributes Ortho's recent decision to 2 factors: the IUD has been only "marginally profitable" and the problems of A.H. Robins with the Dalkon Shield has most likely had an effect; and the US Food and Drug Administration (FDA) published a proposed rule in August 1985 that would require any company wanting to manufacture and market IUDs like the Lippes Loop to submit a premarketing approval application to that agency. In effect, the FDA's rule would only apply to the Lippes Loop. Under the proposed rule, any company wanting to market Lippes Loops, or any nondrug IUD, would have to submit an application to the FDA with a detailed discussion and supporting clinical studies addressing the following concerns: pelvic actinomycosis; tubal infertility; duration that the IUD should remain in situ; and safety of leaving the IUD in situ when contraception is no longer indicated. According to Lillian Yin, FDA device evaluation, the clinical effectiveness and most of the safety issues regarding inert IUDs have been thoroughly covered in published data. She told CTU that "most of the information needed is straightforward, but the part that's new involves the long term use infection rate." Yin indicated that the FDA received a letter from Ortho advising the agency of the company's decision to discontinue selling the loop. That decision, according to Organ, is not based on new study information about inert versus copper bearing IUDs. The company sent a letter to physicians on April 15 advising them of revisions in Lippes Loop patient and physician information materials. The added information is cited.

Zn(2+) release behavior and surface characteristics of Zn/LDPE nanocomposites and ZnO/LDPE nanocomposites in simulated uterine solution.

PubMed

Yang, Zhihong; Xie, Changsheng; Xia, Xianping; Cai, Shuizhou

2008-11-01

To decrease the side effects of the existing copper-bearing intrauterine devices, the zinc/low-density polyethylene (Zn/LDPE) nanocomposite and zinc-oxide/low-density polyethylene (ZnO/LDPE) nanocomposite have been developed in our research for intrauterine devices (IUDs). In this study, the influences of preparation methods of nanocomposites and particle sizes of zinc and zinc oxide on Zn(2+) release from composites incubated in simulated uterine solution were investigated. All release profiles are biphasic: an initial rapid release phase is followed by a near zero-order release period. Zn(2+) release rates of nanocomposites prepared by compressing moulding are higher than those of the nanocomposites prepared by hot-melt extrusing. Compared with Zn(2+) release from the microcomposites, the release profiles of the nanocomposites exhibit a sharp decrease in Zn(2+) release rate in the first 18 days, an early onset of the zero-order release period and a high release rate of Zn(2+) at the later stage. The microstructure of the Zn/LDPE sample and the ZnO/LDPE sample after being incubated for 200 days was characterized by SEM, XRD and EDX techniques. The results show that the dissolution depth of ZnO/LDPE nanocomposite is about 60 mum. Lots of pores were formed on the surface of the Zn/LDPE sample and ZnO/LDPE sample, indicating that these pores can provide channels for the dissolution of nanoparticles in the matrix. The undesirable deposits that are composed of ZnO are only detected on the surface of Zn/LDPE nanocomposite, which may increase the risk of side effects associated with IUDs. It can be expected that ZnO/LDPE nanocomposite is more suitable for IUDs than Zn/LDPE nanocomposite.

IUD discontinuation rates, switching behavior, and user satisfaction: findings from a retrospective analysis of a mobile outreach service program in Pakistan

PubMed Central

Azmat, Syed Khurram; Hameed, Waqas; Mustafa, Ghulam; Hussain, Wajahat; Ahmed, Aftab; Bilgrami, Mohsina

2013-01-01

Background In Pakistan, the uptake rate for the intrauterine device (IUD) is very low at 2.5%. The most popular modern contraceptive methods in Pakistan are female sterilization and use of condoms. The Marie Stopes Society established its mobile outreach service delivery program with the aim of increasing use of modern quality contraceptive services, including the long-term reversible IUD, by women living in hard-to-reach areas. The present study attempts to assess IUD discontinuation rates and associated factors, including switching behavior and level of satisfaction with this type of service delivery. Methods Using a cross-sectional approach, we contacted 681 women who had received an IUD from the Marie Stopes Society mobile outreach program during July and August 2009. Successful interviews were conducted with 639 of these women using a structured questionnaire. The data were analyzed with Stata 11.2 using simple descriptive Chi-square and Cox proportional techniques. Results Analysis revealed that 19.4% (95% confidence interval 16.3–22.5) of the women discontinued use of their IUD at 10 months and, of these women, the majority (69.4%) cited side effects as the main reason for discontinuation. Other factors, such as geographical catchment province, age of the woman, history of contraceptive use before IUD insertion, and side effects following insertion of the device, were found to be significantly associated with IUD. Amongst the women who had their IUD removed, 56.5% did not switch to any other contraceptive method, while 36.3% switched to either short-term or traditional methods, such as withdrawal, rhythm, and folk methods. Degree of satisfaction with the device was also significantly associated with discontinuation. Conclusion Early discontinuation and not switching to another contraceptive method increases the risk of unplanned pregnancy. Health care workers should be trained in managing clients’ concerns about the IUD to prevent discontinuation and providing counseling services for clients to select an alternative contraceptive method if they decide to discontinue. PMID:23359788

Tubal infertility and the intrauterine device.

PubMed

Cramer, D W; Schiff, I; Schoenbaum, S C; Gibson, M; Belisle, S; Albrecht, B; Stillman, R J; Berger, M J; Wilson, E; Stadel, B V

1985-04-11

To study the association between intrauterine devices (IUDs) and pelvic inflammatory disease, we compared contraceptive histories in 4185 while women--283 nulliparous women with primary tubal infertility, 69 women with secondary tubal infertility, and 3833 women admitted for delivery at seven collaborating hospitals from 1981 to 1983. The relative risk of tubal infertility associated with IUD use was calculated by means of multivariate logistic regression to control for confounding factors, including region, year of menarche, religion, education, smoking, and reported number of sexual partners. The adjusted risk of primary tubal infertility associated with any IUD use before a first live birth was 2.0 (95 per cent confidence limits, 1.5 to 2.6) relative to nonuse. Users of the Dalkon Shield had an adjusted risk of 3.3 (1.7 to 6.1), users of the Lippes Loop or Saf-T-Coil had a risk of 2.9 (1.7 to 5.2), and users of copper IUDs had a risk of 1.6 (1.1 to 2.4). Women who reported having only one sexual partner had no increased risk of primary tubal infertility associated with IUD use. The adjusted risk of secondary tubal infertility associated with use of a copper IUD after a first live birth was not statistically significant (1.5; 95 per cent confidence limits, 0.8 to 3.0), whereas the risk from similar use of noncopper devices was significant (2.8; 1.3 to 5.9). We conclude that tubal infertility is associated with IUD use, but less so with copper IUDs.

Continuation of a Levonorgestrel Intrauterine Device During Hematopoietic Stem Cell Transplant: A Case Report.

PubMed

Brady, Paula C; Soiffer, Robert J; Ginsburg, Elizabeth S

2017-04-01

During treatment of hematologic malignancies in premenopausal women, both menstrual suppression and contraception are crucial. Continuation of hormonal intrauterine devices (IUDs) - widely used and highly effective contraceptives that also decrease menstrual flow - is controversial during hematopoietic stem cell transplants (SCTs) due to infectious and vaginal bleeding concerns. A 23-year-old nulligravid female was diagnosed with acute myeloid leukemia (AML, positive for FLT3-ITD, DNMT3A and RUNX1, with normal cytogenetics). She elected to retain her existing levonorgestrel-containing IUD during chemotherapy and SCT. During and following treatment, she remained amenorrheic without infection, despite severe neutropenia and thrombocytopenia. Eight months later, she remains in remission without IUD-related complications. This is the first report of levonorgestrel IUD retention during hematopoietic SCT. Despite severe neutropenia and thrombocytopenia, the patient developed neither pelvic infection by retaining her IUD nor significant vaginal bleeding. Future studies are needed to confirm the safety of levonorgestrel IUDs in women undergoing SCT. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

Intrauterine contraception.

PubMed

Reinprayoon, D

1992-08-01

Currently 85 million women use an intrauterine device (IUD), making it the most widely used, reliable, reversible contraceptive method worldwide. Although the exact mechanisms by which copper-bearing IUDs produce contraceptive action are not completely defined, recent evidence indicates that they act primarily to prevent sperm from fertilizing ova. The future of the IUD is brighter than it has been for the past 20 years. The latest generation of IUDs, such as the TCu 380A (Paragard, GynoPharma, Somerville, NJ), are safer and more effective than ever. In World Health Organization large, multicenter trials, pregnancy rates for the TCu 380A are 1.0, 1.4, 1.6, and 1.8 at 3, 5, 7, and 9 years of use, respectively. The ectopic pregnancy rates and removal for pelvic inflammatory disease are very low. The device may soon be the major IUD available in most countries. The acceptability of IUD use can be increased by good clinical management, sympathetic counseling, careful client selection, proper device selection, careful insertion, timing of insertion, and regular follow-up with quick access to medical care.

The levonorgestrel-releasing intrauterine device potentiates stress reactivity.

PubMed

Aleknaviciute, Jurate; Tulen, Joke H M; De Rijke, Yolanda B; Bouwkamp, Christian G; van der Kroeg, Mark; Timmermans, Mirjam; Wester, Vincent L; Bergink, Veerle; Hoogendijk, Witte J G; Tiemeier, Henning; van Rossum, Elisabeth F C; Kooiman, Cornelis G; Kushner, Steven A

2017-06-01

The levonorgestrel-releasing intrauterine device (LNG-IUD) is currently recommended as a first-line contraceptive with an exclusively local intrauterine influence. However, recent clinical trials have identified side effects of LNG-IUD that appear to be systemically mediated, including depressed mood and emotional lability. We performed two experimental studies and a cross-sectional study. For each study, women were included from three groups: LNG-IUD (0.02mg/24h), oral ethinylestradiol/levonorgestrel (0.03mg/0.15mg; EE30/LNG) and natural cycling (NC). Study 1-Salivary cortisol was measured at baseline and at defined intervals following the Trier Social Stress Test (TSST). Heart rate was monitored continuously throughout the TSST. Study 2-Salivary cortisol and serum total cortisol were evaluated relative to low-dose (1μg) adrenocorticotropic hormone (ACTH) administration. Study 3-Hair cortisol was measured as a naturalistic index of long-term cortisol exposure. Women using LNG-IUD had an exaggerated salivary cortisol response to the TSST (24.95±13.45 nmol/L, 95% CI 17.49-32.40), compared to EE30/LNG (3.27±2.83 nmol/L, 95% CI 1.71-4.84) and NC (10.85±11.03nmol/L, 95% CI 6.30-15.40) (P<0.0001). Heart rate was significantly potentiated during the TSST in women using LNG-IUD (P=0.047). In response to ACTH challenge, women using LNG-IUD and EE30/LNG had a blunted salivary cortisol response, compared to NC (P<0.0001). Women using LNG-IUD had significantly elevated levels of hair cortisol compared to EE30/LNG or NC (P<0.0001). Our findings suggest that LNG-IUD contraception induces a centrally-mediated sensitization of both autonomic and hypothalamic-pituitary-adrenal (HPA) axis responsivity. LNG-IUD sensitization of HPA axis responsivity was observed acutely under standardized laboratory conditions, as well as chronically under naturalistic conditions. Copyright © 2017 Elsevier Ltd. All rights reserved.

Lack of insurance and parity influence choice between long-acting reversible contraception and sterilization in women postpregnancy.

PubMed

Baldwin, Maureen K; Rodriguez, Maria I; Edelman, Alison B

2012-07-01

Disparities in postpregnancy contraception utilization exist, with low-income women disproportionately undergoing sterilization. We assessed the impact of increased intrauterine device (IUD) availability on rates of female sterilization. Hospital billing records were used to identify women with an IUD placement or sterilization within 1 year of a pregnancy at a university hospital between Oct 2005 and Jun 2007. Demographic data were compared between women receiving either an IUD or sterilization. There were 365 sterilizations and 223 IUD placements during the study period. IUD placements doubled over the study period from 6% to 12% of all deliveries, while sterilizations remained stable at 11% (p<.001). Demographic variables were examined for women with either public or private insurance who had financial access to both sterilization (n=253) and IUD (n=223). Women receiving sterilization were slightly older (mean age 31 years versus 30 years, p=.03), of higher parity (median three versus two, p<.01), more likely to have had cesarean delivery (69% versus 31%, p<.001) and more likely to have public insurance (77% versus 23%, p<.001) than women who received IUD. Approximately 45% of women delivering in Oregon in 2007 were publicly insured (2010 Maternal and Child Health Update: States Make Progress Towards Improving Systems of Care. National Governor's Association, Table 6. Available at http://www.nga.org/files/live/sites/NGA/files/pdf/MCHUPDATE2010.PDF, accessed Nov 2011). After adjusting for age, parity and type of delivery, women choosing sterilization were more likely to have public insurance than women choosing IUD (odds ratio 8.4, 95% confidence interval 4.7-14.9, p<.0001). Women choosing sterilization are more likely to have public insurance than women choosing IUD and may represent a continued trend toward nonreversible contraception among women of lower socioeconomic status despite available long-acting reversible methods. Copyright © 2012 Elsevier Inc. All rights reserved.

Comparison of the analgesic effects of oral tramadol and naproxen sodium on pain relief during IUD insertion.

PubMed

Karabayirli, Safinaz; Ayrim, Aylin Aker; Muslu, Bunyamin

2012-01-01

To compare the analgesic efficacy of oral tramadol and naproxen sodium on pain during insertion of an intrauterine device (IUD). Randomized, double-blinded, clinical trial (Canadian Task Force classification I). University-affiliated hospital. Single-center. One hundred three patients scheduled for insertion of an IUD. Patients were randomly assigned to receive oral tramadol 50 mg capsules (n = 35) or naproxen sodium 550 mg tablets (n = 34) or placebo (n = 34) 1 hour before insertion of the IUD. After insertion of the IUD, pain intensity was evaluated using a visual analog scale (VAS, 0-10). Adverse effects, patient satisfaction with the medication, and preference for using it during future insertions were also recorded. The VAS scores were significantly different during IUD insertion among the 3 groups (p = .001). Pain scores in the tramadol group were significantly lower than in the naproxen group (p = .003), and the scores in the naproxen group was significantly lower than in the control group (p = .001). Patient satisfaction with the medication and preference for its future use were significantly lower in the control group than in the other 2 groups (p = .001). Prophylactic analgesia using 50 mg tramadol and 550 mg naproxen, delivered orally, can be used to relieve pain during IUD insertion. However, tramadol capsules were found to be more effective than naproxen tablets. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

WE-E-BRE-08: Impact of IUdR in Rat 9L Glioma Cell Survival for 25–35 KeV Photo-Activated Auger Electron Therapy

DOE Office of Scientific and Technical Information (OSTI.GOV)

Alvarez, D; Hogstrom, K; Mary Bird Perkins Cancer Center, Baton Rouge, LA

2014-06-15

Purpose: To determine the biological effect from Auger electrons with 9% and 18% iododeoxyuridine (IUdR) incorporated into the DNA of rat 9L glioma cells at photon energies above and below the K-edge of iodine (33.2 keV). Methods: Rat 9L glioma cell survival versus dose curves with 0%, 9%, and 18% thymidine replacement with IUdR were measured using four irradiation energies (4 MV x-rays; monochromatic 35, 30, and 25 keV synchrotron photons). For each of 11 conditions (Energy, %IUdR) survival curves were fit to the data (826 cell cultures) using the linear-quadratic model. The ratio of doses resulting in 10% survivalmore » gave sensitization enhancement ratios (SER10) from which contributions due to linear-energy transfer (LET), radiosensitization (RS), and Auger effect (AE) were extracted. Results: At 35, 30, and 25 keV, SER10,LET values were 1.08±0.03, 1.22±0.02, and 1.37±0.02, respectively. At 4 MV SER10,RS values for 9% and 18% IUdR were 1.28±0.02 and 1.40±0.02, respectively. Assuming LET effects are independent of %IUdR and radiosensitization effects are independent of energy, SER10,AE values for 18% IUdR at 35, 30, and 25 keV were 1.35±0.05, 1.06±0.03, and 0.98±0.03, respectively; values for 9% IUdR at 35 and 25 keV were 1.01±0.04 and 0.82±0.02, respectively. Conclusion: For 18% IUdR the radiosensitization effect of 1.40 and the Auger effect of 1.35 at 35 keV are equally important to the combined effect of 1.90. No measureable Auger effect was observed for energies below the K-edge at 20 and 25 keV, as expected. The insignificant Auger effect at 9% IUdR was not expected. Additional data (40–70 keV) and radiobiological modeling are being acquired to better understand the energy dependence of Auger electron therapy with IUdR. Funding support in part by the National Science Foundation Graduate Research Fellowship Program and in part by Contract No. W81XWH-10-1-0005 awarded by the U.S. Army Research Acquisition Activity. This paper does not necessarily reflect the position or policy of the Government, and no official endorsement should be inferred.« less

Routine counseling about intrauterine contraception for women seeking emergency contraception.

PubMed

Schwarz, E Bimla; Papic, Melissa; Parisi, Sara M; Baldauf, Erin; Rapkin, Rachel; Updike, Glenn

2014-07-01

To compare contraceptive knowledge and use among women seeking emergency contraception (EC) before and after an inner-city clinic began providing structured counseling and offering same-day intrauterine device (IUD) or implant placement to all women seeking EC. For 8 months before and 21 months after this change in clinic policy, women aged 15-45 who wanted to avoid pregnancy for at least 6 months were asked to complete surveys immediately, 3 and 12 months after their clinic visit. In addition, we abstracted electronic medical record (EMR) data on all women who sought EC (n=328) during this period. We used chi-squared tests to assess pre/post differences in survey and EMR data. Surveys were completed by 186 women. After the clinic began offering structured counseling, more women had accurate knowledge of the effectiveness of IUDs, immediately and 3 months after their clinic visit. In addition, more women initiated IUD or implant use (survey: 40% vs. 17% preintervention, p=0.04; EMR: 22% vs. 10% preintervention, p=0.01), and fewer had no contraceptive use (survey: 3% vs. 17% preintervention, p<0.01; EMR: 32% vs. 68%, p<0.01) in the 3 months after seeking EC. EMR data indicate that when same-day placement was offered, 11.0% of women received a same-day IUD. Of those who received a same-day IUD, 88% (23/26) reported IUD use at 3-months and 80% (12/15) at 12 months. Routine provision of structured counseling with the offer of same-day IUD placement increases knowledge and use of IUDs 3 months after women seek EC. Women seeking EC from family planning clinics should be offered counseling about highly effective reversible contraceptives with the option of same-day contraceptive placement. Copyright © 2014 Elsevier Inc. All rights reserved.

Lidocaine-Prilocaine Cream as Analgesia for IUD Insertion: A Prospective, Randomized, Controlled, Triple Blinded Study

PubMed Central

Tavakolian, Samira; Doulabi, Mahbobeh Ahmadi; Baghban, Alireza Akbarzade; Mortazavi, Alireza; Ghorbani, Maryam

2015-01-01

Introduction: Copper IUD is a long term and reversible contraception which equals tubal ligation in terms of sterilization. One of the barriers to using this contraception method is the fear and the pain associated with its insertion. Eutectic mixture of local anesthetics (EMLA) 5% is a local anesthetic that contains 25 mg lidocaine and 25 mg of prilocaine per gram. Application of topical analgesic cream to the cervix for laser surgery, hysteroscopy and hysterosalpingography is known Aims: this study aimed to determine the effect of EMLA on IUD insertion pain. Methods: This triple blind clinical trial was conducted on 92 women in a clinic in Hamedan in 2012. After applying the cream on the cervix, pain in three steps, after using Tenaculum, after inserting hystrometr and after inserting IUD and removing IUD insertion tube were assessed with visual analog scale and were compared in EMLA group and placebo group Statistical analysis used to determine and compare the pain of independent t tests, Mann-Whitney U test and repeated measures analysis of variance and chi-square tests to determine the homogeneity of variables and Fisher’s exact test was used Results: Insertion hystrometr was determined as the most painful IUD insertion. The mean pain at step 2 (inserting hystrometr) was (3/11±2/53) in EMLA group, (5/23±2/31) in placebo group. EMLA cream significantly reduced the pain after using tenaculum (P<0/001), pain inserting Hystrometr (P< 0/001) and pain at IUD insertion and removing insertion tube (P< 0/001) Conclusions: Topical Application of EMLA 5% cream as a topical anesthetic on the cervix before insertion IUD reduced the pain during this procedure. PMID:25946948

Influences on women's decision making about intrauterine device use in Madagascar.

PubMed

Gottert, Ann; Jacquin, Karin; Rahaivondrafahitra, Bakoly; Moracco, Kathryn; Maman, Suzanne

2015-04-01

We explored influences on decision making about intrauterine device (IUD) use among women in the Women's Health Project (WHP), managed by Population Services International in Madagascar. We conducted six small group photonarrative discussions (n=18 individuals) and 12 individual in-depth interviews with women who were IUD users and nonusers. All participants had had contact with WHP counselors in three sites in Madagascar. Data analysis involved creating summaries of each transcript, coding in Atlas.ti and then synthesizing findings in a conceptual model. We identified three stages of women's decision making about IUD use, and specific forms of social support that seemed helpful at each stage. During the first stage, receiving correct information from a trusted source such as a counselor conveys IUD benefits and corrects misinformation, but lingering fears about the method often appeared to delay method adoption among interested women. During the second stage, hearing testimony from satisfied users and receiving ongoing emotional support appeared to help alleviate these fears. During the third stage, accompaniment by a counselor or peer seemed to help some women gain confidence to go to the clinic to receive the IUD. Identifying and supplying the types of social support women find helpful at different stages of the decision-making process could help program managers better respond to women's staged decision-making process about IUD use. This qualitative study suggests that women in Madagascar perceive multiple IUD benefits but also fear the method even after misinformation is corrected, leading to a staged decision-making process about IUD use. Programs should identify and supply the types of social support that women find helpful at each stage of decision making. Copyright © 2015 Elsevier Inc. All rights reserved.

Adaptation of Laser Microdissection Technique for the Study of a Spontaneous Metastatic Mammary Carcinoma Mouse Model by NanoString Technologies

PubMed Central

Saylor, Karen L.; Anver, Miriam R.; Salomon, David S.; Golubeva, Yelena G.

2016-01-01

Laser capture microdissection (LCM) of tissue is an established tool in medical research for collection of distinguished cell populations under direct microscopic visualization for molecular analysis. LCM samples have been successfully analyzed in a number of genomic and proteomic downstream molecular applications. However, LCM sample collection and preparation procedure has to be adapted to each downstream analysis platform. In this present manuscript we describe in detail the adaptation of LCM methodology for the collection and preparation of fresh frozen samples for NanoString analysis based on a study of a model of mouse mammary gland carcinoma and its lung metastasis. Our adaptation of LCM sample preparation and workflow to the requirements of the NanoString platform allowed acquiring samples with high RNA quality. The NanoString analysis of such samples provided sensitive detection of genes of interest and their associated molecular pathways. NanoString is a reliable gene expression analysis platform that can be effectively coupled with LCM. PMID:27077656

Counseling by epileptologists affects contraceptive choices of women with epilepsy.

PubMed

Espinera, Alyssa R; Gavvala, Jay; Bellinski, Irena; Kennedy, Jeffrey; Macken, Micheal P; Narechania, Aditi; Templer, Jessica; VanHaerents, Stephen; Schuele, Stephan U; Gerard, Elizabeth E

2016-12-01

There are several important interactions between antiepileptic drugs (AEDs) and hormonal contraception that need to be carefully considered by women with epilepsy (WWE) and their practitioners. Many AEDs induce hepatic enzymes and decrease the efficacy of hormonal contraception. In addition, estrogen-containing hormonal contraception can increase the metabolism of lamotrigine, the most commonly prescribed AED in women of childbearing age. The intrauterine device (IUD) is a highly effective form of reversible contraception without AED drug interactions that is considered by many to be the contraceptive of choice for WWE. Women with epilepsy not planning pregnancy require effective contraceptive counseling that should include discussion of an IUD. There are no guidelines, however, on who should deliver these recommendations. The objective of this study was to explore the hypothesis that contraceptive counseling by a neurologist can influence the contraceptive choices of WWE. In particular, we explored the relationship between contraceptive counseling in the epilepsy clinic and the likelihood that patients would obtain an IUD. We conducted a retrospective chart review of female patients age 18-45 seen at our institution for an initial visit between 2010 and 2014 to ascertain the type of contraceptive counseling each patient received as well as AED use and contraceptive methods. Patients who were pregnant or planning pregnancy at the first visit were excluded from further analyses as were patients with surgical sterilization. We also examined a subgroup of 95 patients with at least 4 follow-up visits to evaluate the efficacy of epileptologists' counseling. Specifically, we looked at the likelihood a patient obtained an IUD based on the type of counseling she had received. Fisher exact tests assessed associations between counseling type and whether patients had obtained an IUD. Three hundred and ninety-seven women met criteria for inclusion. Only 35% of female patients were counseled about contraception at the first visit. If women were not counseled at the first visit, they were unlikely to be counseled at subsequent visits; only 37% had ever received counseling by their fourth visit. Of the 95 patients who completed 4 visits, 28.4% were counseled about an IUD as an optimal contraceptive choice, 38.9% were generally counseled about contraceptive interactions, and 32.6% were not counseled about contraception. Women with epilepsy who received IUD-specific counseling were significantly more likely to switch to an IUD (44.4%) compared with women who received no contraceptive counseling (6.5%; p=0.0009). Women with epilepsy who received IUD-specific counseling also tended to switch to an IUD more often than those women receiving general counseling about AEDs and contraceptive interactions (18.9%; p=0.027). There was no significant difference in the likelihood of acquiring an IUD between the general counseling and no counseling groups. Contraceptive counseling by epileptologists and specific mention of an IUD is significantly associated with patient selection of an IUD as a contraceptive method. This suggests that neurologists can play an important role in patients' contraceptive choices. Copyright © 2016 Elsevier Inc. All rights reserved.

[Suspension of IUD sales in the United States: what are the international implications?].

PubMed

Ramirez, F J; Starrs, A M

1987-01-01

The decisions by Ortho Pharmaceutical in 1985 to suspend manufacture and sale of the Lippes Loop IUD and by G.D. Searle and Co. to suspend sales of the copper 7 and copper T 200 IUDs in the US have virtually eliminated the IUD as a potential contraceptive method for American women. The only remaining IUD on the US market is the little used Progestasert hormone-releasing IUD, which accounted for only 3% of the US market at the time of Searle's decision. The decisions were made as a direct result of the liability insurance crisis and the high cost of lawsuits in the US. The US legal system, unlike those of many countries, permits individuals who believe they have been injured by actions, inactions, or products of individuals, companies, or governmental organizations to sue. The number of such lawsuits rose by 680% in US federal courts between 1974-84, and the average damages awarded now exceed US $1 million. The phenomenon of joint responsibility, in which the plaintiff can sue all parties who can be defined as having had responsibility for the alleged injury, is particularly worrisome for industry. In practice this often means that plaintiffs concentrate their efforts on the party able to pay the greatest amount in damages. As the volume of lawsuits and damages awarded have skyrocketed, so has the cost of liability insurance. Some insurance companies simply refuse to insure high risk ventures at any price. Causes of the insurance crisis in the US are multiple, but one important factor is the new unwillingness of much of the public to accept any risks in return for benefits such as control of fertility. The Lippes loop has been the object of about 200 lawsuits and the Searle IUDs of about 800, 400 of which have been dismissed or settled out of court. Of those going to court, Searle won 9 and lost 2. Legal fees in 4 recent cases won by Searle exceeded $1.5 million. Alza Corp., manufacturer of the Progestasert, is now making the device available to all physicians requesting it, but Alza urges physicians to obtain informed consent and includes a 7-page pamphlet with each device. Each unit costs $84 compared to the $25 or so for copper IUDs, and each must be replaced annually. Many satisfied users and family planning personnel in the US are dismayed by the disappearance of an effective method from the market. Although there is no objective reason for the termination of IUD use in the US to affect the availability of IUDs in other countries, the continued distribution of IUDs elsewhere has aroused suspicion. The International Planned Parenthood Federation, Family Health International, other family planning organizations, and the US Agency for International Development have examined the records of the IUD and have reiterated their conviction that the method is safe and effective for appropriately selected users. They emphasize that the IUD has the unqualified approval of the US Food and Drug Administration.

Satisfied IUD acceptors as family planning motivators in Sri Lanka.

PubMed

Fisher, A A; de Silva, V

1986-01-01

In this study, government midwives were teamed with currently satisfied IUD acceptors to strengthen field motivational and recruitment efforts. The objective was to increase the number of new IUD acceptors. In the experimental study areas, a total of 3,019 new IUD acceptors were recruited. Time series regression analysis revealed a significant difference between the experimental and comparison areas that was over and above what might be expected on the basis of the past history of differences between these two areas. These and other findings suggest that teaming currently satisfied acceptors with government field-workers can have a substantial impact on the recruitment of new family planning users.

[Intrauterine device: about a rare complication and literature review].

PubMed

Kallat, Adil; Ibrahimi, Ahmed; Fahsi, Otheman; El Sayegh, Hachem; Iken, Ali; Benslimane, Lounis; Nouini, Yassine

2017-01-01

The intrauterine device (IUD) is the most common contraceptive method used in the world. Transuterine migration is a rare complication, accounting for 1/350 - 1/10000 insertions in the literature. We report the case of a 40-year old patient, who had had an IUD insertion 12-year before, presenting with pelvic and right lower back pain associated with intermittent hematuria and burning during urination. Radiological assessment showed calcific deposits on intra bladder IUD. The patient underwent cystostomy, without any difficulty, allowing stone and IUD extraction. A urinary catheter was left in place for 5 days and then withdrawn. The postoperative course was uneventful.

Primary uterine diffuse large B-cell lymphoma (DLBCL) in a patient with prolonged insertion of intrauterine device (IUD).

PubMed

Shimizu, Takuya; Hatanaka, Kazuo; Kaneko, Hitomi; Shimada, Toshihide; Imada, Kazunori

2017-07-01

A 49-year-old female from China was referred to our hospital after endocervical polypectomy. Twenty years before admission, after the birth of her first child, an intrauterine device (IUD) had been inserted due to the one-child policy in China. She had noticed abnormal vaginal bleeding with a foul smell 3 years before admission. Then the IUD was removed and a polyp was found at the IUD contact site. Two months before admission, endocervical polypectomy was performed. Lymphoma was suspected by histological examination and she was referred to our hospital. Further examination confirmed the diagnosis of primary uterine diffuse large B-cell lymphoma (DLBCL). Subsequently, a combination of three cycles of R-CHOP regimen and involved-field radiation therapy was performed, followed by maintenance therapy with five cycles of rituximab. She has remained in complete remission for over 1 year. This case suggests that chronic inflammation induced by prolonged IUD insertion may contribute to the development of primary uterine lymphoma. To the best of our knowledge, this is the first reported case of DLBCL associated with prolonged IUD insertion.

Naproxen Sodium for Pain Control With Intrauterine Device Insertion: A Randomized Controlled Trial.

PubMed

Ngo, Lynn L; Braaten, Kari P; Eichen, Eva; Fortin, Jennifer; Maurer, Rie; Goldberg, Alisa B

2016-12-01

To evaluate whether 550 mg oral naproxen sodium given 1 hour before intrauterine device (IUD) insertion is effective for pain relief as compared with placebo. This was a randomized, double-blind, placebo-controlled trial. The primary outcome was pain with IUD insertion measured on a 100-mm visual analog scale (VAS). Our sample size was calculated to detect a 15-mm difference in VAS scores with 80% power (α=0.05). Secondary outcomes included pain with tenaculum placement, uterine sounding, and 5 and 15 minutes postinsertion. A total of 118 women were enrolled and analyzed (58 in the naproxen sodium arm, 60 in the placebo arm, 97% nulliparous) between May 11, 2015, and March 25, 2016. There were no differences in baseline demographics or reproductive characteristics between arms. There were no differences in median VAS pain scores for the primary outcome of pain with IUD insertion between the naproxen sodium arm compared with the placebo arm (69 compared with 66 mm, P=.89). There were no differences in the secondary outcomes of median VAS pain scores with tenaculum placement (37 compared with 32 mm, P=.97) or uterine sounding (60 compared with 58 mm, P=.66). However, median pain scores postprocedure were lower in the naproxen arm as compared with the placebo arm: 17 compared with 26 mm (P=.01) at 5 minutes and 13 compared with 24 mm (P=.01) at 15 minutes postinsertion. Oral naproxen sodium does not reduce pain with IUD insertion but does reduce pain after insertion and should be considered as a premedication. ClinicalTrials.gov, http://clinicaltrials.gov, NCT02388191.

Decrease in cytotoxicity of copper-based intrauterine devices (IUD) pretreated with 6-mercaptopurine and pterin as biocompatible corrosion inhibitors.

PubMed

Alvarez, Florencia; Grillo, Claudiaa; Schilardi, Patricial; Rubert, Aldo; Benítez, Guillermo; Lorente, Carolina; de Mele, Mónica Fernández Lorenzo

2013-01-23

The copper intrauterine device (IUD) based its contraceptive action on the release of cupric ions from a copper wire. Immediately after the insertion, a burst release of copper ions occurs, which may be associated to a variety of side effects. 6-Mercaptopurine (6-MP) and pterin (PT) have been proposed as corrosion inhibitors to reduce this harmful release. Pretreatments with 1 × 10(-4) M 6-MP and 1 × 10(-4) M PT solutions with 1h and 3h immersion times were tested. Conventional electrochemical techniques, EDX and XPS analysis, and cytotoxicity assays with HeLa cell line were employed to investigate the corrosion behavior and biocompatibility of copper with and without treatments. Results showed that copper samples treated with PT and 6-MP solutions for 3 and 1 h, respectively, are more biocompatible than those without treatment. Besides, the treatment reduces the burst release effect of copper in simulated uterine solutions during the first week after the insertion. It was concluded that PT and 6-MP treatments are promising strategies able to reduce the side effects related to the "burst release" of copper-based IUD without altering the contraceptive action.

Profile of long-acting reversible contraception users in Europe.

PubMed

Haimovich, Sergio

2009-06-01

To assess the profile of long-acting reversible contraceptives (LARCs) users in Europe. A random sample of women aged 15-49 years in 14 European countries (Germany, France, UK, Spain, Italy, Russian Federation, Estonia, Latvia, Lithuania, Austria, Czech Republic, Denmark, Norway, and Sweden) underwent web-based or computer-aided face-to-face interviews in June 2006. In this paper data pertaining to a subgroup of women using LARCs are presented. A total of 11,490 women participated in the full study. Of these, 1,188 (10%) women were LARC (hormonal implant, injectables, levonorgestrel-releasing intrauterine system [LNG-IUS], copper intrauterine device [Cu-IUD]) users. The age of the LARC users exceeded 30 years for 57-91% of them. Furthermore, more than half of them found convenience an extremely important factor when selecting the LARC as a contraceptive method. As compared to those wearing a Cu-IUD, women using hormonal LARCs experienced fewer physical and emotional symptoms that appeared or worsened during menstruation. LARCs have their place in the contraceptive market in Europe. The most popular LARCs among European women were the LNG-IUS and the Cu-IUD; both were mainly used by women who had children and had no wish to have more in the future.

A survey on abnormal uterine bleeding among radiographers with frequent MRI exposure using intrauterine contraceptive devices.

PubMed

Huss, A; Schaap, K; Kromhout, H

2018-02-01

Based on a previous case report of menometrorrhagia (prolonged/excessive uterine bleeding, occurring at irregular and/or frequent intervals) in MRI workers with intrauterine devices (IUDs), it was evaluated whether this association could be confirmed. A survey was performed among 381 female radiographers registered with their national association. Logistic regression was used to analyze associations of abnormal uterine bleeding with the frequency of working with MRI scanners, presence near the scanner/in the scanner room during image acquisition, and with scanner strength or type. A total of 68 women reported using IUDs, and 72 reported abnormal uterine bleeding. Compared with unexposed women not using IUDs, the odds ratio in women with IUDs working with MRI scanners was 2.09 (95% confidence interval 0.83-3.66). Associations were stronger if women working with MRI reported being present during image acquisition (odds ratio 3.43, 95% CI 1.26-9.34). Associations with scanner strength or type were not consistent. Radiographers using IUDs who are occupationally exposed to stray fields from MRI scanners report abnormal uterine bleeding more often than their co-workers without an IUD, or nonexposed co-workers with an IUD. In particular, radiographers present inside the scanner room during image acquisition showed an increased risk. Magn Reson Med 79:1083-1089, 2018. © 2017 International Society for Magnetic Resonance in Medicine. © 2017 International Society for Magnetic Resonance in Medicine.

Exploring Trends in Intrauterine Device (IUD) Usage among Women in the United States: A Literature Review

ERIC Educational Resources Information Center

Nobiling, Brandye; Drolet, Judy C.

2012-01-01

Intrauterine devices (IUDs) have not been popular contraceptives in the US for the past 40 years. Recent evidence, however, has shown a slight rebirth in use, from a rate of approximately 2% in 2002 to over 5% in 2008 (Guttmacher Institute, 2010). Empirical evidence is favorable of IUD use in most women, but the still-low usage rate suggests…

Success Providing Postpartum Intrauterine Devices in Private-Sector Health Care Facilities in Nigeria: Factors Associated With Uptake.

PubMed

Eluwa, George Ie; Atamewalen, Ronke; Odogwu, Kingsley; Ahonsi, Babatunde

2016-06-20

Use of modern contraceptive methods in Nigeria remained at 10% between 2008 and 2013 despite substantive investments in family planning services. Many women in their first postpartum year, in particular, have an unmet need for family planning. We evaluated use of postpartum intrauterine device (IUD) insertion and determined factors associated with its uptake in Nigeria. Data were collected between May 2014 and February 2015 from 11 private health care facilities in 6 southern Nigerian states. Women attending antenatal care in participating facilities were counseled on all available contraceptive methods including the postpartum IUD. Data were abstracted from participating facility records and evaluated using a cross-sectional analysis. Categorical variables were calculated as proportions while continuous variables were calculated as medians with the associated interquartile range (IQR). Multivariate logistic regression analysis was used to identify factors associated with uptake of the postpartum IUD while controlling for potential confounding factors, including age, educational attainment, marital status, parity, number of living children, and previous use of contraception. During the study period, 728 women delivered in the 11 facilities. The median age was 28 years, and most women were educated (73% had completed at least the secondary level). The majority (96%) of the women reported they were married, and the median number of living children was 3 (IQR, 2-4). Uptake of the postpartum IUD was 41% (n = 300), with 8% (n = 25) of the acceptors experiencing expulsion of the IUD within 6 weeks post-insertion. After controlling for potential confounding factors, several characteristics were associated with greater likelihood of choosing the postpartum IUD, including lower education, having a higher number of living children, and being single. Women who had used contraceptives previously were less likely to choose the postpartum IUD than women who had not previously used contraception (adjusted odds ratio, 0.68; 95% confidence interval, 0.55 to 0.84). A high percentage (41%) of women delivering in private health care facilities in southern Nigeria accepted immediate postpartum IUD insertion. Scale-up of postpartum IUD services is a promising approach to increasing uptake of long-acting reversible contraceptives among women in Nigeria. © Eluwa et al.

Response of Vitamin D Concentration to Vitamin D3 Administration in Older Adults without Sun Exposure: A Randomized Double-Blind Trial.

PubMed

Schwartz, Janice B; Kane, Lynn; Bikle, Daniel

2016-01-01

To determine the dose-response relationship between 25-hydroxyvitamin D (25(OH)D) and supplemental vitamin D3 in elderly nursing home residents. Randomized double-blind investigation. Nursing home. Of 81 women (n=51) and men (n=30) (mean age 87.4±8) enrolled, 72 completed the study. Sixteen weeks of oral vitamin D3 at 800, 2,000, or 4,000 IU/d or 50,000 IU/wk. The main outcome was 25(OH)D concentrations (tandem mass spectrometry) after 16 weeks. Free 25(OH)D and intact parathyroid hormone (iPTH) were also analyzed. Safety monitoring of calcium and estimated glomerular filtration rate was performed, and adherence and clinical status were measured. 25(OH)D concentrations increased with dose (P<.001) and were higher with 50,000 IU/wk (P<.001) than other doses and with 4,000 IU/d than 800 or 2,000 IU/d, but 800 IU and 2,000 IU/d did not differ. One subject receiving 800 IU/d had concentrations less than 20 ng/mL. All subjects receiving more than 2000 IU/d had concentrations of 20 ng/mL and greater. Free 25(OH)D concentrations rose with total 25(OH) vitamin D. Total and free 25(OH)D were related to calcium concentrations; only free 25(OH)D was related to iPTH. 25(OH)D increased linearly with 800 to 4,000 IU/d and 50,000 IU/wk of vitamin D3, without a ceiling effect. Data suggest that some elderly adults will require more than 800 IU/d of vitamin D3 to ensure adequate vitamin D levels. Changes in 25(OH)D with vitamin D3 were related to starting concentrations (greatest with the lowest concentrations and unchanged with 800 and 2,000 IU/d if 20-40 ng/mL). Relationships between serum calcium and iPTH and free 25(OH)D suggest the potential for free 25(OH)D in defining optimal 25(OH)D concentrations. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

[Contraception and sexology].

PubMed

Black, J S

1991-01-01

This work argues that contraceptive education urgently requires a new approach that will take into account the client's sexuality at the time the choice of method is made. Emotional factors such as a conscious or unconscious desire for pregnancy or motherhood, family pressures to produce a grandchild, or shame and distrust of contraception may contribute to contraceptive failure. Methods applied at the time of coitus such as condoms or spermicides may not be appropriate for clients for who contraception is a source of anxiety or guilt. The more effective, noncoital-dependent methods including oral contraceptives (OCs), IUDs, and sterilization may generate anxiety over infertility. Their efficacy may lack appeal for clients who enjoy an element of risk. The practitioner's attitude and knowledge may be further influences on the counseling over method choice. Among reversible methods, OCs are ideal for most women as long as they individually prescribed. OCs may be particularly important to the sexual expression of specific groups such as those over 35 with no risk factors other than age. Low-dose progestin-only OCs may be prescribed for this group, although about 10% of users change methods because of menstrual problems. IUDs are usually successfully used by women who have been carefully selected to exclude contraindications. In some cases the partner may be annoyed by the string, which can be rolled up and pushed out of the way or shortened by the practitioner. IUDs are often the best alternative for women with contraindications to OCs or who tolerate their side effects poorly. Spermicides may cause dermatoses or allergies that cause the woman to avoid intercourse. Some women dislike using spermicides because they must be applied prior to each use. Their bad taste is a disadvantage for some couples. Involving the male partner in application of the spermicide may remove some objections. The Billings or cervical mucus method should be avoided by women with irregular cycles and those who are reluctant to touch their genitalia. Diaphragms and cervical caps can be inserted by the male partner is desired. Menstrual extraction, insertion of an IUD within 72 hours of unprotected intercourse, or use of sufficiently high dose of oral hormones prevent pregnancy in most cases, but should not be relied upon for routine contraception. Much misinformation persists about the side effects of female sterilization, which is said to cause weight gain or sexual problems or to be followed inevitably by total hysterectomy. Most women are satisfied with the operation and express no regrets. Although reversal rates are improving, sterilization should be considered definitive. Condom use remains limited despite some increases related to fear of HIV infection. Condoms may increase performance anxiety in some men. Couples should be taught to use condoms in a more sensual manner. Withdrawal is still widely used throughout the world despite lack of esthetics appeal and high failure rate.

Scanning electron microscopy as an analytical tool for the study of calcified intrauterine contraceptive devices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khan, S.R.; Wilkinson, E.J.

Within the endometrial cavity intrauterine contraceptive devices (IUDs) become encrusted with cellular, acellular, and fibrillar substances. Scanning electron microscopy was used to study the crust. Cellular material consisted mainly of blood cells and various types of bacteria. The fibrillar material appeared to be fibrin which was omnipresent in the crust and formed a thin layer immediately over the IUD surface. X-ray microanalysis of the acellular component of the crust revealed the presence of calcium. No other major peaks were identified. Near the IUD surface characteristic calcium phosphate crystals were present. Their microanalysis showed peaks for calcium and phosphorus. X-ray diffractionmore » of the crust however, showed it to contain only calcite. It is through the use of scanning electron microscopy that calcium phosphate has been detected in the IUD crust and a fibrillar layer has been visualized on the IUD surface. This study further demonstrates the effectiveness of SEM analytical techniques in the area of biomedical research.« less

Actinomyces-like organisms in the cervical smears of IUCD users.

PubMed

Farida Jamal; Mohd Salleh Mohd Yasin; Zooraidah Zainal; Hamid Arshat

1983-01-01

Pelvic inflammatory disease (PID) is a well-documented complication of IUD use. The presence of tails on the IUDs appears to facilitate ascent of bacteria from the vagina into the uterus. In this study, cervical smears of 128 IUD users were stained by Gram's stain and screened for the presence of Actinomyces-like organisms. 5.5% of the smears were positive for these organisms. Pus was seen in 20.1% of the smears, and yeast cells were seen in 10.2%. The average duration of IUD insertion was 8 months. Smears of 103 controls were negative for Actinomyces-like organisms, pus cells were present in 8.7%, and yeast cells in 4.8%. Of the 7 smears positive for the organisms, only 1 was from the user of a plastic device. All cases included were asymptomatic and were visiting the clinic for routine follow-up. These data suggest that colonization by Actinomyces-like organisms does not appear to be a significant problem in IUD users in Malaysia.

A multicenter randomized clinical trial of one-rod etonogestrel and two-rod levonorgestrel contraceptive implants with nonrandomized copper-IUD controls: methodology and insertion data.

PubMed

Meirik, Olav; Brache, Vivian; Orawan, Kiriwat; Habib, Ndema Abu; Schmidt, Johannes; Ortayli, Nuriye; Culwell, Kelly; Jackson, Emily; Ali, Moazzam

2013-01-01

Comparative data on etonogestrel and two-rod levonorgestrel contraceptive implants are lacking. A multicenter, open, parallel-group trial with random allocation of implants was performed. For every second implant user, an age-matched woman choosing an intrauterine device (IUD) (TCu380A) was admitted. Methods and data on implant/IUD insertion and 6-week follow-up are reported. A total of 2008 women were randomized to an implant, and 974 women were enrolled in the IUD group. Results from 997 etonogestrel implant users, 997 levonorgestrel implant users and 971 IUD users were analyzed. In the etonogestrel and levonorgestrel groups, respectively, mean insertion durations were 51 (SD 50.2) s and 88 (SD 60.8) s; complication rates at insertion were 0.8% and 0.2%; and at follow-up, 27.2% and 26.7% of women, respectively, had signs or symptoms at the insertion site. At follow-up within 6 weeks after insertion, all implants were in situ, while 2.1% of IUDs were expelled. Performance of etonogestrel and levonorgestrel implants at insertion and within the first 6 weeks is similar. Short-term (6 weeks) continuation rates appear higher for implants than TCu380A. Copyright © 2013 Elsevier Inc. All rights reserved.

Scanning electron microscopy, x-ray diffraction, and electron microprobe analysis of calcific deposits on intrauterine contraceptive devices

DOE Office of Scientific and Technical Information (OSTI.GOV)

Khan, S.R.; Wilkinson, E.J.

Deposits found on intrauterine contraceptive devices (IUDs) were studied by scanning electron microscopy, x-ray diffraction, and energy dispersive x-ray microanalysis. All seven devices, including five plastic and two copper IUDs, were coated with a crust containing cellular, acellular, and fibrillar material. The cellular material was composed of erythrocytes, leukocytes, cells of epithelial origin, sperm, and bacteria. Some of the bacteria were filamentous, with acute-angle branching. The fibrillar material appeared to be fibrin. Most of the acellular material was amorphous; calcite was identified by x-ray diffraction, and x-ray microanalysis showed only calcium. Some of the acellular material, particularly that on themore » IUD side of the crust, was organized in spherulitic crystals and was identified as calcium phosphate by x-ray microanalysis. The crust was joined to the IUD surface by a layer of fibrillar and amorphous material. It is suggested that the initial event in the formation of calcific deposits on IUD surfaces is the deposition of an amorphous and fibrillar layer. Various types of cells present in the endometrial environment adhere to this layer and then calcify. Thus, the deposition of calcific material on the IUDs is a calcification phenomenon, not unlike the formation of plaque on teeth.« less

New intrauterine technologies for contraception and treatment in -nulliparous/adolescent and parous women.

PubMed

Wildemeersch, D

2009-01-01

The IUD (intra uterine device) is a highly effective method of contraception that is underused. New developments in intrauterine technology, smaller frameless copper and levonorgestrel-releasing devices, could help increase the prevalence-- of use in adolescents and nulliparous women. Because adolescents and young nulliparous women contribute disproportionately to the epidemic of unintended pregnancies, long-acting methods of contraception, particularly IUDs, should be considered as first-line choices for interval, emergency and immediate post-abortal contraception in this population of women. As the uterine cavity is generally much smaller in this group than in older women, adapted IUDs may be very useful. Compatibility of the IUD with the small uterine cavity leads to high acceptability and continuation of use, a prerequisite to reduce unintended pregnancies. A strategic advantage of IUDs is that, unlike the Pill, they are genuinely 'fit-and-forget'. In use, they are much more effective than Pills in this age group. However, copper intrauterine devices do not offer protection against sexually transmitted infections (STIs) and, therefore, they are not always the methods of first choice for teenagers and nulliparous women. New evidence, however, from the World Health -Organization and the American College of Obstetricians and Gynecologists, shows that IUDs can be used and that they are safe for most women, including adolescents.

Postplacental or delayed levonorgestrel intrauterine device insertion and breastfeeding duration

PubMed Central

Chen, Beatrice A.; Reeves, Matthew F.; Creinin, Mitchell D.; Schwarz, E. Bimla

2011-01-01

BACKGROUND The objective was to assess the effect of timing of postpartum levonorgestrel-releasing IUD insertion on breastfeeding continuation. STUDY DESIGN Women interested in using a levonorgestrel IUD postpartum were randomized to immediate postplacental insertion (postplacental group) or insertion 6–8 weeks after vaginal delivery (delayed group). Duration and exclusivity of breastfeeding were assessed at 6–8 weeks, 3 months, and 6 months postpartum. Only women who received an IUD were included in this analysis. RESULTS Breastfeeding was initiated by 32/50 (64%) of women receiving a postplacental IUD and 27/46 (58.7%) of women receiving a delayed IUD (p=0.59). More women in the delayed group compared to the postplacental group continued to breastfeed at 6–8 weeks (16/46 vs 15/50, p=0.62), 3 months (13/46 vs 7/50, p=0.13), and 6 months postpartum (11/46 vs 3/50, p=0.02). The results did not differ when only women who initiated breastfeeding or only primiparous women with no prior breastfeeding experience were analyzed. CONCLUSIONS Immediate postplacental insertion of the levonorgestrel IUD is associated with shorter duration of breastfeeding and less exclusive breastfeeding. Further studies are needed of the effects of early initiation of progestin-only methods on women’s lactation experience. PMID:22018124

Evaluation of placenta in foetal demise and foetal growth restriction.

PubMed

Ch, Ujwala; Guruvare, Shyamala; Bhat, Sudha S; Rai, Lavanya; Rao, Sugandhi

2013-11-01

The study objective was to evaluate the pathological changes of the placenta in foetal death and foetal growth restriction and to find correlation of the findings with clinical causes. Prospective study at a tertiary care hospital. Gross and histopathological examinations of the placentae were carried out in pregnancies with foetal demise (IUD) and Foetal Growth Restriction (FGR). SPSS, version 11.5. Placentae of twenty seven women with foetal demise and of equal number of women with foetal growth restriction were studied. Placental weight was less than 10(th) percentile in 61.5% women in IUD group and in 93% women in the FGR group. Gross examination of placentae showed abnormalities in 12 (44%) women of IUD group and in 16 (59%) women of FGR group. Histopathological abnormalities were observed in 74.1% women of the IUD group and in 66.7% women of FGR group. Placental histopathology correlated with clinical risk factors in 60% women of IUD group and in 40% women of FGR group. Among the women with no clinically explainable cause for IUD and FGR, 86% and 57% had placental histopathological abnormalities respectively. The histopathological abnormalities of the placenta can be used to document the clinical causes of foetal demise and growth restriction; it may explain the causes in cases of clinically unexplained foetal demise and foetal growth restriction.

The effect of nitroglycerin on the IUD insertion experience in nulliparous women: a pilot study.

PubMed

Micks, Elizabeth A; Jensen, Jeffrey T; Bednarek, Paula H

2014-07-01

Concern about pain during placement of an intrauterine device (IUD) represents a barrier to use, especially among nulliparous women. We hypothesized that nitroglycerin gel applied vaginally 30 min prior to IUD placement would reduce insertion-related pain. We designed a randomized, double-blinded, placebo-controlled pilot study to evaluate the efficacy and tolerability of 0.5-mg nitroglycerin gel (1 mL) or identical placebo gel applied vaginally in nulliparous women 30 min prior to IUD placement. The study was limited to women who opted for the levonorgestrel-releasing intrauterine system. Subjects completed a series of 100-mm visual analogue scales at several time points. The primary outcome was subject-reported pain with passage of the IUD through the cervix. Secondary outcomes included subject-reported pain at other time points, provider-reported ease of insertion, side effects, adverse events and need for additional dilation. A total of 24 women were randomized. Baseline characteristics were similar between groups. The mean pain score with IUD deployment was 55.0 mm [standard deviation (SD) = 29.7 mm] in the placebo group and 57.4 mm (SD 22.1 mm) in the nitroglycerin group (p=.82). There was no difference in ease of insertion reported by providers. Two subjects required dilation, one in each group. Vaginal administration of 0.5-mg nitroglycerin gel 30 min prior to IUD placement does not appear to decrease patient-reported procedural pain among nulliparous women or ease of insertion for providers. Copyright © 2014 Elsevier Inc. All rights reserved.

[The role of intrauterine contraceptive devices in the development of inflammatory processes in the small pelvis].

PubMed

Batar, I

1986-08-10

The incidence of pelvic inflammatory disease (PID) attributable to IUD use has been increasing, especially after the removal of the Dalkon shield from the market, but this relationship has not been settled conclusively. In recent decades PID included a variety of infections, but lately the definition of PID has meant acute ascending infections of the female genital tract. Its most common risk factors include promiscuity of IUD use, although this can be reduced to one fourth by regular checkups and proper hygiene. The frequency of PID is estimated at 2-5% of IUD users. Microorganisms contributing to PID include Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Escherichia coli, Proteus, Staphylococcus epidermis, Haemophilus influenzae, Bacteroides, Peptococcus, Peptostreptococcus, Clostridium, and Actinomyces israelii, The differentiation of actinomycosis (AC) and pseudoactinomycosis (PAC) is well advised. The potential of IUD use in increasing the risk of AIDS should not be discounted. The clinical picture of PID is varied, it can be mild requiring conservative drug therapy; with medium severity requiring removal of the IUD and drug therapy; severe necessitating removal, antibiotics and sulfonamide treatment and laparotomy; and very severe with potentially fatal generalized sepsis. In addition to antibiotics, e.g., penicillin, treatment can include the so called catastrophy combination of Mandokef- Metronidazol-Gentamycin. An analysis of the data of 8536 IUD fittings in Debrecen, Hungary showed 1.4% removals due to PID after 4 years, 694 patients (8.1%) had lower abdominal pain 73 of which (0.9%) had palpable resistance, and suppuration occurred in only 30 cases (0.4%). Treatment included Semicillin or Tetran, or removal of the IUD, and even surgery if no improvement resulted. Prevention of PID include elimination of risk factors, the careful selection of IUD users, regular checkups, the use of copper (Cu) T device, and strict adherence to professional standards.

Evaluation of The Combined Effects of Hyperthermia, Cobalt-60 Gamma Rays and IUdR on Cultured Glioblastoma Spheroid Cells and Dosimetry Using TLD-100

PubMed Central

Neshasteh-Riz, Ali; Rahdani, Rozhin; Mostaar, Ahmad

2014-01-01

Objective In radiation treatment, the irradiation which is effective enough to control the tumors far exceeds normal-tissues tolerance. Thus to avoid such unfavourable outcomes, some methods sensitizing the tumor cells to radiation are used. Iododeoxyuridine (IUdR) is a halogenated thymidine analogue that known to be effective as a radiosensitizer in human cancer therapy. Improving the potential efficacy of radiation therapy after combining to hyperthermia depends on the magnitude of the differential sensitization of the hyperthermic effects or on the differential cytotoxicity of the radiation effects on the tumor cells. In this study, we evaluated the combined effects of IUdR, hyperthermia and gamma rays of 60Co on human glioblastoma spheroids culture. Materials and Methods In this experimental study,the cultured spheroids with 100µm diameter were treated by 1 µM IUdR, 43°C hyperthermia for an hour and 2 Gy gamma rays, respectively. The DNA damages induced in cells were compared using alkaline comet assay method, and dosimetry was then performed by TLD-100. Comet scores were calculated as mean ± standard error of mean (SEM) using one-way ANOVA. Results Comparison of DNA damages induced by IUdR and hyperthermia + gamma treatment showed 2.67- and 1.92-fold enhancement, respectively, as compared to the damages induced by radiation alone or radiation combined IUdR. Dosimetry results showed the accurate dose delivered to cells. Conclusion Analysis of the comet tail moments of spheroids showed that the radiation treatments combined with hyperthermia and IUdR caused significant radiosensitization when compared to related results of irradiation alone or of irradiation with IUdR. These results suggest a potential clinical advantage of combining radiation with hyperthermia and indicate effectiveness of hyperthermia treatment in inducing cytotoxicity of tumor cells. PMID:24611138

Comparison of spontaneous and idoxuridine-induced micronuclei by chromosome painting.

PubMed

Fauth, E; Zankl, H

1999-04-06

Fluorescence in situ hybridisation (FISH) technique with chromosome specific library (CSL) DNA probes for all human chromosomes were used to study about 9000 micronuclei (MN) in normal and idoxuridine (IUdR)-treated lymphocyte cultures of female and male donors. In addition, MN rates and structural chromosome aberrations were scored in Giemsa-stained chromosome spreads of these cultures. IUdR treatment (40 microg/ml) induced on the average a 12-fold increase of the MN rate. Metaphase analysis revealed no distinct increase of chromosome breaks but a preferential decondensation at chromosome 9q12 (28-79%) and to a lower extend at 1q12 (8-21%). Application of FISH technique with CSL probes to one male and one female untreated proband showed that all human chromosomes except chromosome 12 (and to a striking high frequency chromosomes 9, X and Y) occurred in spontaneous MN. In cultures containing IUdR, the chromosomal spectrum found in MN was reduced to 10 chromosomes in the male and 13 in the female proband. Eight chromosomes (2, 6, 12, 13, 14, 15, 17 and 18) did not occur in MN of both probands. On the contrary chromosomes 1 and especially 9 were found much more frequently in the MN of IUdR-treated cultures than in MN of control cultures. DAPI-staining revealed heterochromatin signals in most of the IUdR-induced MN. In an additional study, spontaneous and IUdR-induced MN were investigated in lymphocytes of another female donor using CSL probes only for chromosomes 1, 6, 9, 15, 16 and X. The results confirmed the previous finding that chromosomes 1 and 9 occur very often in MN after IUdR-treatment. The results indicate that decondensation of heterochromatic regions on chromosomes 1 and 9 caused by IUdR treatment strongly correlates with MN formation by these chromosomes. Copyright 1999 Elsevier Science B.V.

Intrauterine levonorgestrel delivery with frameless fibrous delivery system: review of clinical experience

PubMed Central

Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman D; Hasskamp, Thomas; Jackers, Geert

2017-01-01

The concept of using a frameless intrauterine device (IUD) instead of the conventional plastic framed IUD is not new. Frameless copper IUDs have been available since the late 1990s. They rely on an anchoring system to retain in the uterine cavity. The clinical experience with these IUDs suggests that frameless IUDs fit better as they are thin and, therefore, do not disturb or irritate the uterus. High tolerance and continuation rates have been achieved as complaints of pain are virtually nonexistent and the impact on menstrual blood loss is minimal. Conventional levonorgestrel-releasing intrauterine systems (LNG-IUSs) are very popular as they significantly reduce menstrual bleeding and provide highly effective contraception. However, continuation of use remains problematic, particularly in young users. Total or partial expulsion and displacement of the LNG-IUS also occur too often due to spatial incompatibility within a small uterine cavity, as strong uterine contractions originate, attempting to get rid of the bothersome IUD/IUS. If not expelled, embedment ensues, often leading to chronic pain and early removal of the IUD/IUS. Several studies conducted recently have requested attention to the relationship between the LNG-IUS and the endometrial cavity. Some authors have proposed to measure the cavity width prior to inserting an IUD, as many uterine cavities are much smaller than the currently existing LNG-IUSs. A frameless fibrous drug delivery system fits, in principle, in all uterine cavities and may therefore be preferable to framed drug delivery systems. This review examines the clinical performance, acceptability, and potential of the frameless LNG-IUS (FibroPlant®) when used for contraception, treatment of heavy menstrual bleeding, dysmenorrhea, and endometrial suppression in women using estrogen replacement therapy, endometrial hyperplasia, and other gynecological conditions. The review concludes that FibroPlant LNG-IUS offers unique advantages in reducing side effects. PMID:28176932

US Industrial Base Dependence/Vulnerability. Phase 2. Analysis

DTIC Science & Technology

1987-11-01

widest range of prospec- tive bidders on his program--ino IudIng Japanese, Israeli, Korean, Brazilian, et cetera. The program manager clearly cannot...nuclear weapons did not do away with the previous force structure), or 2) a major war (we did get rid of the horse cavalry in WWII). However, it is...ion arrangements with NATO Allies. a program manager would seek the bidders on his program--I no Iuding Mian, et cetera. The program

CCR5 Expression Levels in HIV-Uninfected Women Receiving Hormonal Contraception

PubMed Central

Sciaranghella, Gaia; Wang, Cuiwei; Hu, Haihong; Anastos, Kathryn; Merhi, Zaher; Nowicki, Marek; Stanczyk, Frank Z.; Greenblatt, Ruth M.; Cohen, Mardge; Golub, Elizabeth T.; Watts, D. Heather; Alter, Galit; Young, Mary A.; Tsibris, Athe M. N.

2015-01-01

Human immunodeficiency virus (HIV) infectivity increases as receptor/coreceptor expression levels increase. We determined peripheral CD4, CCR5, and CXCR4 expression levels in HIV-uninfected women who used depot medroxyprogesterone acetate (DMPA; n = 32), the levonorgestrel-releasing intrauterine device (LNG-IUD; n = 27), oral contraceptive pills (n = 32), or no hormonal contraception (n = 33). The use of LNG-IUD increased the proportion of CD4+ and CD8+ T cells that expressed CCR5; increases in the magnitude of T-cell subset CCR5 expression were observed with DMPA and LNG-IUD use (P < .01 for all comparisons). LNG-IUD and, to a lesser extent, DMPA use were associated with increased peripheral T-cell CCR5 expression. PMID:25895986

The copper-7 intrauterine contraceptive device: 5-year evaluation.

PubMed Central

Sellors, J. W.

1981-01-01

Over a 5-year period a family practitioner inserted copper-7 (Cu-7 intrauterine contraceptive devices (IUDs) in 134 women. The rates of continued use after 2 years, 53.0% for the women's first IUD and 63.9% for all their IUDs, and of accidental pregnancy, 2.4%, are comparable to those in the literature. However, in this series the rate of expulsion was 0.8%, much lower than that in the literature. Fertility did not appear to be reduced in women who planned to have pregnancies after the device was removed. A carefully scrutinized technique of insertion and conscientious follow-up make the Cu-7 IUD an acceptable form of contraception for many patients in a family practice. PMID:7326653

Success Providing Postpartum Intrauterine Devices in Private-Sector Health Care Facilities in Nigeria: Factors Associated With Uptake

PubMed Central

Eluwa, George IE; Atamewalen, Ronke; Odogwu, Kingsley; Ahonsi, Babatunde

2016-01-01

ABSTRACT Background: Use of modern contraceptive methods in Nigeria remained at 10% between 2008 and 2013 despite substantive investments in family planning services. Many women in their first postpartum year, in particular, have an unmet need for family planning. We evaluated use of postpartum intrauterine device (IUD) insertion and determined factors associated with its uptake in Nigeria. Methods: Data were collected between May 2014 and February 2015 from 11 private health care facilities in 6 southern Nigerian states. Women attending antenatal care in participating facilities were counseled on all available contraceptive methods including the postpartum IUD. Data were abstracted from participating facility records and evaluated using a cross-sectional analysis. Categorical variables were calculated as proportions while continuous variables were calculated as medians with the associated interquartile range (IQR). Multivariate logistic regression analysis was used to identify factors associated with uptake of the postpartum IUD while controlling for potential confounding factors, including age, educational attainment, marital status, parity, number of living children, and previous use of contraception. Results: During the study period, 728 women delivered in the 11 facilities. The median age was 28 years, and most women were educated (73% had completed at least the secondary level). The majority (96%) of the women reported they were married, and the median number of living children was 3 (IQR, 2–4). Uptake of the postpartum IUD was 41% (n = 300), with 8% (n = 25) of the acceptors experiencing expulsion of the IUD within 6 weeks post-insertion. After controlling for potential confounding factors, several characteristics were associated with greater likelihood of choosing the postpartum IUD, including lower education, having a higher number of living children, and being single. Women who had used contraceptives previously were less likely to choose the postpartum IUD than women who had not previously used contraception (adjusted odds ratio, 0.68; 95% confidence interval, 0.55 to 0.84). Conclusion: A high percentage (41%) of women delivering in private health care facilities in southern Nigeria accepted immediate postpartum IUD insertion. Scale-up of postpartum IUD services is a promising approach to increasing uptake of long-acting reversible contraceptives among women in Nigeria. PMID:27353620

Synergistic effect of amphotericin B and tyrosol on biofilm formed by Candida krusei and Candida tropicalis from intrauterine device users.

PubMed

Shanmughapriya, Santhanam; Sornakumari, Haridevvenkatesan; Lency, Arumugam; Kavitha, Senthil; Natarajaseenivasan, Kalimuthusamy

2014-11-01

The presence of intrauterine contraceptive devices (IUDs) provides a solid surface for attachment of microorganisms and an ideal niche for the biofilm to form and flourish. Vaginal candidiasis is often associated with the use of IUDs. Treatment of vaginal candidiasis that develops in connection with IUD use requires their immediate removal. Here, we present in vitro evidence to support the use of combination therapy to inhibit Candida biofilm. Twenty-three clinical Candida isolates (10 C. krusei and 13 C. tropicalis) recovered from endocervical swabs obtained from IUD and non-IUD users were assessed for biofilm-formation ability. The rate of isolation of Candida did not differ significantly among IUD and non-IUD users (P = 0.183), but the biofilm-formation ability of isolates differed significantly (P = 0.02). An in vitro biofilm model with the obtained isolates was subjected to treatment with amphotericin B, tyrosol, and a combination of amphotericin B and tyrosol. Inhibition of biofilm by amphotericin B or tyrosol was found to be concentration dependent, with 50% reduction (P < 0.05) at 4 mg/l and 80 μM, respectively. Hence, a combination effect of tyrosol and amphotericin B was studied. Interestingly, approximately 90% reduction in biofilm was observed with use of 80 μM tyrosol combined with 4 mg/l amphotericin B (P < 0.001). This represents a first step in establishing an appropriate antibiofilm therapy when yeasts are present. © The Author 2014. Published by Oxford University Press on behalf of The International Society for Human and Animal Mycology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Pediatricians' Attitudes and Beliefs about Long-Acting Reversible Contraceptives Influence Counseling.

PubMed

Berlan, Elise D; Pritt, Nicole M; Norris, Alison H

2017-02-01

Adolescents are at high risk for unintended pregnancy. Because of pediatricians' potential role in contraceptive counseling, understanding their attitudes and beliefs and counseling practices about use of long-acting reversible contraceptives (LARC; ie, etonogestrel implant and intrauterine devices [IUDs]) is vital. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We interviewed primary care pediatricians (N = 23) in a Midwestern city in June-August 2014. We transcribed the interviews, developed a coding schema, and analyzed these qualitative data using a priori and open coding of transcripts. Few pediatricians had favorable views on adolescent IUD use and most did not include IUDs in routine contraception counseling. Pediatricians perceived IUDs to impose significant risks for adverse reproductive outcomes and to be poorly tolerated by adolescents. Poor and/or outdated knowledge influenced inaccurate beliefs and unsupportive attitudes. Whereas some pediatricians were advocates for adolescent use of IUDs, many others had concerns that IUDs were not appropriate and not favored by adolescents. In contrast, participants viewed the etonogestrel implant more favorably and often included it in routine counseling. Some pediatricians focused on the familiar and readily available methods (injectable and oral contraceptives) or assumed patients had predetermined expectations for those methods. Time spent counseling on LARC was also perceived as a barrier. Pediatricians described how education and increased familiarity with LARC changed viewpoints. A variety of beliefs and attitudes, as well as factors such as time and personal habits, influence pediatricians' contraceptive counseling practices. Until knowledge deficits are addressed, uninformed viewpoints and unfavorable attitudes will limit adolescents' access to LARC, especially IUDs. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

The T 380A intrauterine device: a retrospective 5-year evaluation.

PubMed

de Araujo, Fabio Fernando; Barbieri, Márcia; Guazzelli, Cristina Aparecida Falho; Lindsey, Prescilla Chow

2008-12-01

The undue resistance to intrauterine device (IUD) use seen in several settings does not seem to occur in the Family Planning Unit of UNIFESP-EPM (São Paulo Federal University, Brazil). In fact, the Copper T 380A IUD in this clinic has reached an outstanding importance and this motivated us to present our differing experience. The prevalence of this method in this clinic is as high as 40%. This contrasts to the low use in the rest of the country, where tubal ligation is by far the most used contraceptive method (40%) and where IUD is inexpressive (1.1%). This is a retrospective study of the records of 118 users of Copper T 380A IUD inserted at the clinic and who were followed during 5 years. The cumulative pregnancy rate was 0.8%. The main cause for discontinuation of the study was loss to follow-up (21.3%). Other reasons for the withdrawal of the device were personal option (13.6%), dislocation (11.7%) and pregnancy wish (3.4%). There was no withdrawal by pelvic inflammatory disease. Bleeding (0.8%) was not an important cause for withdrawal, and there were no withdrawals due to pain. The continuation rate at 5 years was 46.7%. The structured service and an adequate educative program perhaps could explain at least partially the good performance of IUD use in this clinic. There was an amazing prevalence of the components of the metabolic syndrome. This could represent contraindications for hormonal contraception, and, in consequence, it could influence the increased option for and continuation of the IUD. These data show a good performance of the IUD for long duration, in relation to other studies, and this should be considered as a reliable alternative to the high prevalence of female sterilization in this country.

A randomized efficacy trial of a cognitive-behavioral group intervention to prevent Internet Use Disorder onset in adolescents: The PROTECT study protocol.

PubMed

Lindenberg, Katajun; Halasy, Katharina; Schoenmaekers, Sophie

2017-06-01

The reduction of prevalence rates of Internet Use Disorder (IUD) and its effective treatment are at high priority in both public health and educational policies. School-based preventive interventions facilitate a low-threshold approach for individuals with IUD, who are typically characterized by high therapy avoidance. Moreover, indicated approaches which target adolescents at high-risk show larger effects than universal prevention programs. Simultaneously, they reduce unnecessary burden for the majority of high-school students that is not at-risk. The PROTECT group intervention for indicated prevention of IUD in school settings was developed based on these preventive strategies. Three-hundred and forty adolescents, aged 12-18 years, from 40 secondary schools in Germany, screened for high-risk of IUD onset, are randomly assigned to a) PROTECT preventive intervention group or b) assessment only control group. The tested intervention consists of a cognitive-behavioral 4-session brief-protocol. Follow-up assessments are at 1, 4 and 12 months after admission. Primary outcome is the 12-months incidence rate of IUD. Secondary outcomes are the reduction of IUD and comorbid symptoms as well as the promotion of problem solving, cognitive restructuring and emotion regulation skills. The indicated preventive intervention PROTECT follows the APA-guidelines for psychological prevention, i.e., it is theory- and evidence-based and addresses both risk-reduction and strength-promotion, it considers current research and epidemiology and ethical standards such as professional secrecy and is designed as a systemic intervention at the school-level. It is expected that the intervention decreases risk of IUD onset (incidence rate). ClinicalTrials.gov: NCT02907658.

Risk-based screening for Chlamydia trachomatis and Neisseria gonorrhoeae prior to intrauterine device insertion.

PubMed

Grentzer, Jaclyn M; Peipert, Jeffrey F; Zhao, Qiuhong; McNicholas, Colleen; Secura, Gina M; Madden, Tessa

2015-10-01

The objective was to compare three strategies for Chlamydia trachomatis and Neisseria gonorrhoeae screening prior to intrauterine device (IUD) insertion. This was a secondary analysis of the Contraceptive CHOICE Project. We measured the prevalence of C. trachomatis and/or N. gonorrhoeae at the time of IUD insertion. We then compared sensitivity, specificity, negative and positive predictive values, and likelihood ratios for three screening strategies for C. trachomatis and N. gonorrhoeae prior to IUD insertion: (a) "age-based" — age ≤25 years alone; (b) "age/partner-based" — age ≤25 and/or multiple sexual partners; and (c) "risk-based" — age ≤25, multiple sexual partners, inconsistent condom use and/or history of prior sexually transmitted infection (STI). Among 5087 IUD users, 140 (2.8%) tested positive for C. trachomatis, 16 (0.3%) tested positive for N. gonorrhoeae, and 6 (0.1%) were positive for both at the time of IUD insertion. The "risk-based" screening strategy had the highest sensitivity (99.3%) compared to "age-based" and "age/partner-based" screening (80.7% and 84.7%, respectively.) Only one (0.7%) woman with a chlamydia or gonorrhea infection would not have been screened using "risk-based" screening. A risk-based strategy to screen for C. trachomatis and N. gonorrhoeae prior to IUD insertion has higher sensitivity than screening based on age alone or age and multiple sexual partners. Using a risk-based screening strategy (age≤25, multiple sexual partners, inconsistent condom use and/or history of an STI) to determine who should be screened for C. trachomatis and N. gonorrhoeae prior to IUD insertion will miss very few cases of infection and obviates the need for universal screening. Copyright © 2015 Elsevier Inc. All rights reserved.

California Family Planning Health Care Providers' Challenges to Same-Day Long-Acting Reversible Contraception Provision.

PubMed

Biggs, M Antonia; Harper, Cynthia C; Brindis, Claire D

2015-08-01

To assess the extent to which practices offering family planning services are able to offer intrauterine devices (IUDs) and implants in one visit and to identify the reasons why multiple visits may be required. In the fall of 2011, 1,000 California family planning providers were asked about their long-acting reversible contraception delivery practices in a probability survey. We used multivariable logistic regression to examine practice characteristics associated with same-day provision of IUDs and implants. Among the 636 responding practices, 67% offered an IUD and 40% offered a contraceptive implant onsite. Among those with onsite provision, the majority required two or more visits to place an IUD (58%); almost half required two visits to place an implant (47%). Nearly all Planned Parenthood practices could place an IUD (95%) or implant (95%) at the initial visit, whereas the majority of all other practice types could not. The main reasons for delaying IUD and contraceptive implant provision included the need to screen and wait for test results (68% and 24%, respectively) and clinic flow and scheduling issues (50% and 64%, respectively). Multivariable analyses indicated that Planned Parenthood practices were significantly more likely than private practices to have same-day insertion protocols. Most of the family planning providers surveyed have not adopted same-day long-acting reversible contraception insertion protocols and face barriers to same-day provision. III.

Comparison of copper intrauterine device with levonorgestrel-bearing intrauterine system for post-abortion contraception.

PubMed

Bilgehan, Fatma; Dilbaz, Berna; Karadag, Burak; Deveci, Canan Dura

2015-09-01

The aim of this study was to compare the safety, bleeding pattern, effects, side-effects, complications and 6-month continuity rates of levonorgestrel-bearing intrauterine system (LNG-IUS) with conventional copper intrauterine device (Cu-IUD) inserted immediately after voluntary termination of pregnancy up to 10 weeks of gestation. One hundred women who underwent voluntary pregnancy termination and preferred IUD insertion as a contraceptive method after counseling were enrolled. The patients were randomly allocated to Cu-IUD or LNG-IUS and followed up at 10 days, and at 1, 3 and 6 months. The expulsion rates, continuation rates, side-effects, and bleeding patterns were compared. Fifty women in the Cu-IUD group and 44 women in the LNG-IUS group were followed up. The continuity and expulsion rate for Cu-IUD and LNG-IUS at the end of 6 months was 74%, 12%, and 75%, 11.3%, respectively. In LNG-IUS users, the incidence of amenorrhea and the number of spotting days were higher and hemoglobin increased throughout the follow-up period. The side-effects related to both methods were not different from interval insertions. Immediate post-abortion intrauterine contraception with Cu-IUD or LNG-IUS is a safe, reliable method. The incidence of side-effects is similar, and there is only a slightly higher rate of expulsion but an acceptable rate of method continuation. © 2015 Japan Society of Obstetrics and Gynecology.

[Intrauterine device, the best method for spacing births in breastfeeding mothers].

PubMed

Blum, M; Kaplan, B

1992-11-01

Twenty-nine breastfeeding women, with a mean age of 36.5 years, were fitted with an IUD, Nova T or Multi load 375, at an average time of 3.6 months after delivery. Insertion at this time was easy, without dilatation, pain or bleeding. During a follow up of 18 months, the IUD has to be discontinued in one woman (3.4%) because of excessive menstrual bleeding, at a time when she was no more fully breastfeeding. The continuation rate was 96.56%, as compared to only 82% for a general population of 216 women fitted with IUD at the same period after delivery and followed up for the same period of time. The IUD is in our opinion the birthspacing method of choice for breastfeeding mothers.

Intrauterine device (image)

MedlinePlus

... uses copper as the active contraceptive, others use progesterone in a plastic device. IUDs are very effective ... less than 2% chance per year for the progesterone IUD, less than 1% chance per year for ...

[The applied of computer for analysis on contraceptive efficacy of IUD of rural women in Guangdong province].

PubMed

Jia, G H

1989-12-01

This paper discussed the usage and effect of IUD-type O use for rural married women in Guangdong province. The continuation rate of IUD-type O is 71.7 per cent 100 women in one year. The main problem for failure was expulsion. This paper have used a combination of univariate and multivariate analytic methods. On the whole, the important factors were number of gravid and parity, number of induced abortion and medical technical level etc.

Levonorgestrel Intrauterine Device Placement in a Premenopausal Breast Cancer Patient with a Bicornuate Uterus.

PubMed

Eskew, Ashley M; Crane, Erin K

2016-01-01

Young women with breast cancer face contraceptive challenges. Data are limited and conflicting on the use of the levonorgestrel intrauterine device (LNG-IUD) in this patient population. A 32-year-old nulligravid woman with a history of breast cancer on tamoxifen presented with new-onset vaginal bleeding. Further workup revealed a previously undiagnosed bicornuate uterus. She underwent hysteroscopy, dilation and curettage, and LNG-IUD placement in each uterine horn. Postoperative follow-up confirmed retention and proper placement of both IUDs. Pathology from the dilation and curettage was benign, and the abnormal uterine bleeding abated. LNG-IUD placement in a young patient with a personal history of breast cancer on tamoxifen and a bicornuate uterus is a safe and feasible alternative for contraception. Copyright © 2016 AAGL. Published by Elsevier Inc. All rights reserved.

Budget impact analysis of 8 hormonal contraceptive options.

PubMed

Crespi, Simone; Kerrigan, Matthew; Sood, Vipan

2013-07-01

To develop a model comparing costs of 8 hormonal contraceptives and determine whether acquisition costs for implants and intrauterine devices (IUDs) were offset by decreased pregnancy-related costs over a 3-year time horizon from a managed care perspective. A model was developed to assess the budget impact of branded or generic oral contraceptives (OCs), quarterly intramuscular depot medroxyprogesterone, etonogestrel/ethinyl estradiol vaginal ring, etonogestrel implant, levonorgestrel IUD, norelgestromin/ethinyl estradiol transdermal contraceptive, and ethinyl estradiol/levonorgestrel extended-cycle OC. Major variables included drug costs, typical use failure rates, discontinuation rates, and pregnancy costs. The base case assessed costs for 1000 women initiating each of the hormonal contraceptives. The etonogestrel implant and levonorgestrel IUD resulted in the fewest pregnancies, 63 and 85, respectively, and the least cost, $1.75 million and $2.0 million, respectively. In comparison, generic OC users accounted for a total of 243 pregnancies and $3.4 million in costs. At the end of year 1, costs for the etonogestrel implant ($800,471) and levonorgestrel IUD ($949,721) were already lower than those for generic OCs ($1,146,890). Sensitivity analysis showed that the cost of pregnancies, not product acquisition cost, was the primary cost driver. Higher initial acquisition costs for the etonogestrel implant and levonorgestrel IUD were offset within 1 year by lower contraceptive failure rates and consequent pregnancy costs. Thus, after accounting for typical use failure rates of contraceptive products, the etonogestrel implant and levonorgestrel IUD emerged as the least expensive hormonal contraceptives.

Attitudes of physicians providing family planning services in Egypt about recommending intrauterine device for family planning clients.

PubMed

Aziz, Mirette; Ahmed, Sabra; Ahmed, Boshra

2017-12-01

To assess the attitudes of physicians providing family planning services at the public sector in Egypt about recommending intrauterine device (IUD) for family planning clients, and to identify the factors that could affect their attitudes. A descriptive cross sectional study, in which all the physicians providing family planning services in Assiut Governorate were invited to complete self-administered questionnaires. The study participants were recruited at the family planning sector monthly meetings of the 13 health directorates of Assiut Governorate, Upper Egypt. 250 physicians accepted to participate in the study. Bivariate and Multivariate regression analyses were performed to identify the most important predictors of recommending IUD to family planning clients when appropriate. Less than 50% of physicians would recommend IUD for clients with proper eligibility criteria; women younger than 20 years old (49.2%), women with history of ectopic pregnancy (34%), history of pelvic inflammatory diseases (40%) or sexually transmitted diseases (18.4%) and nulliparous women (22.8%). Receiving family planning formal training within the year preceding data collection and working in urban areas were the significant predictors of recommending IUD insertion for appropriate clients. Physicians providing family planning services in Upper Egypt have negative attitudes about recommending IUD for family planning clients. Continuous education and in-service training about the updated medical eligibility criteria, especially for physicians working in rural areas may reduce the unfounded medical restrictions for IUD use. Copyright © 2017 Elsevier B.V. All rights reserved.

Treatment of Low-Risk Endometrial Cancer and Complex Atypical Hyperplasia With the Levonorgestrel-Releasing Intrauterine Device.

PubMed

Pal, Navdeep; Broaddus, Russell R; Urbauer, Diana L; Balakrishnan, Nyla; Milbourne, Andrea; Schmeler, Kathleen M; Meyer, Larissa A; Soliman, Pamela T; Lu, Karen H; Ramirez, Pedro T; Ramondetta, Lois; Bodurka, Diane C; Westin, Shannon N

2018-01-01

To assess efficacy of the levonorgestrel-releasing intrauterine device (LNG-IUD) for treatment of complex atypical hyperplasia or low-grade endometrial cancer. This retrospective case series included all patients treated with the LNG-IUD for complex atypical hyperplasia or early-grade endometrial cancer from January 2003 to June 2013. Response rates were calculated and the association of response with clinicopathologic factors, including age, body mass index, and uterine size, was determined. Forty-six patients diagnosed with complex atypical hyperplasia or early-grade endometrial cancer were treated with the LNG-IUD. Of 32 evaluable patients at the 6-month time point, 15 had complex atypical hyperplasia (47%), nine had G1 endometrial cancer (28%), and eight had grade 2 endometrial cancer (25%). Overall response rate was 75% (95% CI 57-89) at 6 months; 80% (95% CI 52-96) in complex atypical hyperplasia, 67% (95% CI 30-93) in grade 1 endometrial cancer, and 75% (CI 35-97) in grade 2 endometrial cancer. Of the clinicopathologic features evaluated, there was a trend toward the association of lack of exogenous progesterone effect in the pathology specimen with nonresponse to the IUD (P=.05). Median uterine diameter was 1.3 cm larger in women who did not respond to the IUD (P=.04). Levonorgestrel-releasing IUD therapy for the conservative treatment of complex atypical hyperplasia or early-grade endometrial cancer resulted in return to normal histology in a majority of patients.

Limited Uptake of Planned Intrauterine Devices During the Postpartum Period.

PubMed

Salcedo, Jennifer; Moniaga, Natalie; Harken, Tabetha

2015-08-01

The primary objective of this study was to determine the percentage of women with a documented plan for postpartum intrauterine device (IUD) insertion who had a device inserted within 8 weeks of delivery. The secondary objective was to determine factors associated with successful initiation of postpartum IUDs as planned. We conducted a retrospective chart review of women who had at least one prenatal visit and delivered a viable pregnancy at our academic medical center. Methods of planned and established postpartum contraceptive methods were recorded, as well as demographic information and documented reasons for failure to initiate planned intrauterine contraception. A total of 110 women planned postpartum IUD placement. Of these women, 84 (76%) presented for at least one postpartum appointment. Only 22.6% (95% confidence interval 13.7-31.5) of those presenting for postpartum follow-up underwent IUD placement within 8 weeks of delivery. Women planning postpartum IUD insertion were just as likely as women with no planned postpartum contraceptive method to fail to establish contraception within 8 weeks (P = 0.55). Failure to establish planned postpartum intrauterine contraception occurs frequently, even in a setting with a high rate of postpartum follow-up.

The power of information and contraceptive choice in a family planning setting in Mexico

PubMed Central

Ponce, E; Sloan, N; Winikoff, B; Langer, A; Coggins, C; Heimburger, A; Conde-Glez, C; Salmeron, J

2000-01-01

Objectives: This study measured the effect of information about family planning methods and STD risk factors and prevention, together with personal choice on the selection of intrauterine devices (IUDs) by clients with cervical infection. Methods: We conducted a randomised, controlled trial in which family planning clients were assigned to one of two groups, the standard practice (control) group in which the provider selected the woman's contraceptive and the information and choice (intervention) group. The study enrolled 2107 clients in a family planning clinic in Mexico City. Results: Only 2.1% of the clients had gonorrhoea or chlamydial infections. Significantly fewer women in the intervention group selected the IUD than the proportion for whom the IUD was recommended in the standard care group by clinicians (58.2% v 88.2%, p=0.0000). The difference was even more pronounced among infected women: 47.8% v 93.2% (intervention v control group, p=0.0006). Conclusions: The intervention increased the selection of condoms and reduced the selection of IUDs, especially among women with cervical infections, for whom IUD insertion is contraindicated. Key Words: reproductive health; sexually transmitted diseases; contraception PMID:11026883

The promotion of intrauterine contraception in low- and middle-income countries: a narrative review.

PubMed

Cleland, John; Ali, Moazzam; Benova, Lenka; Daniele, Marina

2017-06-01

The contribution of copper-bearing intrauterine devices (IUDs) to overall contraceptive protection has declined in many countries, despite their well-known advantages. In response, initiatives to promote this method have been undertaken. To review and interpret the experience of interventions to promote use of IUDs in low- and middle-income countries in order to provide strategic guidance for policies and programs. We conducted a systematic search of Medline, Popline, Embase and Global Health electronic databases for relevant journal papers, reports and gray literature since 2010. Telephone interviews were held with two donors and six international family planning organizations. We identified a total of 31 publications. Four reported the results of randomized control trials and three were derived from quasi-experiments. The majority were based on service statistics. Eight publications concerned interventions for HIV-positive women or couples, nine for postpartum or postabortion cases and 14 for general populations. Intervention approaches included vouchers, franchising of private practitioners, mobile outreach services, placement of dedicated staff in high-volume facilities and demand creation. Most publications adduced evidence of a positive impact and some reported impressively large numbers of IUD insertions. Results to date on the uptake of IUDs in postpartum interventions are modest. There is also almost no evidence of effects on IUD use at national levels. Implant uptake generally exceeded IUD uptake when both were offered. The evidence base is weak and offers few lessons on what strategies are most effective. The overall impression is that IUD use can be increased in a variety of ways but that progress is hampered by persistent adverse perceptions by both providers and potential clients. Provider enthusiasm is a key to success. The lack of a population impact stems in part from the fact that nearly all interventions are initiated by international organizations, with limited national reach except in small countries, rather than by government agencies. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

A randomized trial of three copper IUDs (MLCu250, MLCu375 and Nova-T).

PubMed

Bratt, H; Skjeldestad, F E; Cullberg Valentin, K

1988-01-01

A randomized prospective trial of three copper IUDs, Nova-T, MLCu375 and MLCu250, including 200 of each, is presented. Insertion was done at the hospital outpatient clinic on normally menstruating women and on women in puerperio. Follow-up was scheduled after 12, 24 and 36 months. Pregnancy rates were low for all 3 models. Pearl indices after 3 years were 0.5, 0.9 and 0.8 for Nova-T, MLCu375 and MLCu250 respectively (NS). Abnormal bleeding and/or pain was the most frequent termination cause. Minor differences in the termination rates because of abnormal bleeding and/or pain were found and are discussed. The continuation rates based on all medically relevant IUD removals were 74%, 73% and 81% after 3 years for Nova-T, MLCu375 and MLCu250 respectively. No important difference in clinical performance between the three copper IUDs could be demonstrated.

SR-XRD in situ monitoring of copper-IUD corrosion in simulated uterine fluid using a portable spectroelectrochemical cell.

PubMed

Grayburn, Rosie A; Dowsett, Mark G; Sabbe, Pieter-Jan; Wermeille, Didier; Anjos, Jorge Alves; Flexer, Victoria; De Keersmaecker, Michel; Wildermeersch, Dirk; Adriaens, Annemie

2016-08-01

The objective of this work is to study the initial corrosion of copper in the presence of gold when placed in simulated uterine fluid in order to better understand the evolution of active components of copper-IUDs. In order to carry out this study, a portable cell was designed to partially simulate the uterine environment and provide a way of tracking the chemical changes occurring in the samples in situ within a controlled environment over a long period of time using synchrotron spectroelectrochemistry. The dynamically forming crystalline corrosion products are determined in situ for a range of copper-gold surface ratios over the course of a 10-day experiment in the cell. It is concluded that the insoluble deposits forming over this time are not the origin of the anticonception mechanism. Copyright © 2016 Elsevier B.V. All rights reserved.

[Ethical Aspects of the Use of Mirena(r) Iud in the Treatment of Heavy Menstrual Bleeding].

PubMed

Turiel Miranda, Miriam; Agulles Simó, Pau

2018-01-01

The levonorgestrel-releasing intrauterine device known as Mirena IUD(r) (20mcg/24h) is nowadays considered among the leading resources in the treatment of heavy menstrual bleeding. Nonetheless, due to either its effect of prevention of conception and especially to the possibility that it may also have an anti-implantation effect, there is a founded concern on whether its therapeutic use may be ethically licit. This article engages in an exhaustive literature review in order to ascertain the mechanism of action of Mirena(r) IUD, in view of an ethical evaluation of its therapeutic use, keeping in mind those two unwanted effects. According to the most recent bibliography, the modification of the cervical mucus in patients carrying Mirena(r) IUD seems to consistently impede the spermatozoa penetration through the cervix, thus keeping down the probability of conception. Therefore, the likelihood of inducing an embryonic loss that can be ascribed to the device seems to be virtually nil. Given that there are no therapeutic alternatives that respect fertility as they address the pathology once the first-line treatments have failed, the prevention of fertilization effect of Mirena(r) IUD may be judged as ethically acceptable. Moreover one cannot conclude that the embryonic loss that might aggravate the moral evaluation of its use actually takes place.

Comparison of DSB effects of the beta particles of iodine-131 and 6 MV X-ray at a dose of 2 Gy in the presence of 2-Methoxyestradiol, IUdR, and TPT in glioblastoma spheroids

NASA Astrophysics Data System (ADS)

Neshasteh-Riz, Ali; Eyvazzadeh, Nazila; Koosha, Fereshteh; Cheraghi, Susan

2017-02-01

Glioblastoma is one of the lethal brain tumors and one of the resistant tumors against radiotherapy. Multiple treatment methods and different types of radiation and Radiosensitizers drugs have been combined to optimize the efficacy of radiotherapy. Radiosensitizers are employed to reinforce tumor cell killing and have much fewer effects on the normal tissue. Inducing DNA double strand break in tumoral cells is a major goal of radiation sensitivity. In this study, the level of DNA double strand break in glioblastoma spheroids irradiated by 2 Gy beta particles of iodine-131 and 6 MV X-rays in the presence of 2-Methoxyestradiol (2ME2), iodo-deoxy-uridine (IUdR) and Topotecan (TPT) was measured using the PicoGreen method. Spheroids of the U87MG cell line were cultured to reach a 300 μm diameter. In the phase one of the study, the spheroids were treated in four groups individually, including 2 Gy of iodine-131, TPT+iodine-131, IUdR+iodine-131, IUdR+2ME2+iodine-131. In the next phase, the cells were treated with 2 Gy of 6 MV X-ray, TPT+6 MV X-ray, IUdR+6 MV X-ray, TPT+IUdR+6 MV X-ray. DSB lesions were measured by the Pico Green assay. The amount of DSB lesions in groups irradiated with iodine-131 individually was greater than the group irradiated with 6 MV X-ray (p<0.05). DNA double strand breaks became more significant in combination with TPT. However, the amount of DSBs in the two independent groups of TPT+IUdR+2ME2+iodine-131 and TPT+IUdR+2ME2+6 MV X-ray was approximately in the same range (P>0.05). The level of DNA double strand breaks in cells irradiated with Iodine-131 was higher than cells irradiated with 6 MV X-ray at the same dose and Topotecan had a positive effect on inducing the damage. The role of 2ME2+IUdR in increasing the damage caused by beta particles of iodine-131 was not significant. Iodine-131 could lead to major DSB damage than 6 MV X-ray at the same dose due to its cross fire effect and spatial distribution of energy in different angels. This study showed that a combination of chemotherapy and iodine-131 had better efficacy than radiotherapy with 6 MV X-ray in the treatment of glioblastoma.

“I don’t know enough to feel comfortable using them:” Women’s knowledge of and perceived barriers to long acting reversible contraceptives on a college campus

PubMed Central

Ela, Elizabeth; Zochowski, Melissa K.; Caldwell, Amy; Moniz, Michelle; McAndrew, Laura; Steel, Monique; Challa, Sneha; Dalton, Vanessa K.; Ernst, Susan

2016-01-01

Objective To assess multiple dimensions of long acting reversible contraception (LARC) knowledge and perceived multi-level barriers to LARC use among a sample of college women. Study Design We conducted an internet-based study of 1,982 female undergraduates at a large mid-western university. Our 55-item survey used a multi-level framework to measure young women’s understanding of, experiences with intrauterine devices (IUD) and implants and their perceived barriers to LARC at individual, health systems, and community levels. The survey included a 20-item knowledge scale. We estimated and compared LARC knowledge scores and barriers using descriptive, bivariate, and linear regression statistics. Results Few college women had used (5%) or heard of (22%) LARC, and most self-reported “little” or “no” knowledge of IUDs (79%) and implants (88%). Women answered 50% of LARC knowledge items correctly (mean 10.4, range 0–20), and scores differed across sociodemographic groups (p-values<0.04). Factors associated with scores in multivariable models included race/ethnicity, program year, sorority participation, religious affiliation and service attendance, employment status, sexual orientation, and contraceptive history. Perceived barriers to IUDs included: not wanting a foreign object in body (44%); not knowing enough about the method (42%); preferring a “controllable” method (42%); cost (27%); and not being in a long-term relationship (23%). Implant results were similar. “Not knowing enough” was women’s primary reason for IUD (18%) and implant (22%) nonuse. Conclusion Lack of knowledge (both perceived and actual) was the most common barrier among many perceived individual, systems, and community-level factors precluding these college women’s LARC use. Findings can inform innovative, multi-level interventions to improve understanding, acceptability, and uptake of LARC on campuses. PMID:26879627

NanoString, a novel digital color-coded barcode technology: current and future applications in molecular diagnostics.

PubMed

Tsang, Hin-Fung; Xue, Vivian Weiwen; Koh, Su-Pin; Chiu, Ya-Ming; Ng, Lawrence Po-Wah; Wong, Sze-Chuen Cesar

2017-01-01

Formalin-fixed, paraffin-embedded (FFPE) tissue sample is a gold mine of resources for molecular diagnosis and retrospective clinical studies. Although molecular technologies have expanded the range of mutations identified in FFPE samples, the applications of existing technologies are limited by the low nucleic acids yield and poor extraction quality. As a result, the routine clinical applications of molecular diagnosis using FFPE samples has been associated with many practical challenges. NanoString technologies utilize a novel digital color-coded barcode technology based on direct multiplexed measurement of gene expression and offer high levels of precision and sensitivity. Each color-coded barcode is attached to a single target-specific probe corresponding to a single gene which can be individually counted without amplification. Therefore, NanoString is especially useful for measuring gene expression in degraded clinical specimens. Areas covered: This article describes the applications of NanoString technologies in molecular diagnostics and challenges associated with its applications and the future development. Expert commentary: Although NanoString technology is still in the early stages of clinical use, it is expected that NanoString-based cancer expression panels would play more important roles in the future in classifying cancer patients and in predicting the response to therapy for better personal therapeutic care.

EEG based topography analysis in string recognition task

NASA Astrophysics Data System (ADS)

Ma, Xiaofei; Huang, Xiaolin; Shen, Yuxiaotong; Qin, Zike; Ge, Yun; Chen, Ying; Ning, Xinbao

2017-03-01

Vision perception and recognition is a complex process, during which different parts of brain are involved depending on the specific modality of the vision target, e.g. face, character, or word. In this study, brain activities in string recognition task compared with idle control state are analyzed through topographies based on multiple measurements, i.e. sample entropy, symbolic sample entropy and normalized rhythm power, extracted from simultaneously collected scalp EEG. Our analyses show that, for most subjects, both symbolic sample entropy and normalized gamma power in string recognition task are significantly higher than those in idle state, especially at locations of P4, O2, T6 and C4. It implies that these regions are highly involved in string recognition task. Since symbolic sample entropy measures complexity, from the perspective of new information generation, and normalized rhythm power reveals the power distributions in frequency domain, complementary information about the underlying dynamics can be provided through the two types of indices.

Factors Associated With Contraceptive Method Choice and Initiation in Adolescents and Young Women.

PubMed

Cohen, Rebecca; Sheeder, Jeanelle; Kane, Meghan; Teal, Stephanie B

2017-10-01

The purpose of the study was to identify factors associated with uptake of contraceptive implants or intrauterine devices (IUDs) by adolescents and young women. For this prospective cohort study, we recruited English-speaking female contraceptive initiators aged 14-24 years attending a Title X-supported, youth-focused clinic. Immediately prior to their visits, participants completed surveys assessing demographic and reproductive characteristics and awareness of, interest in, and intent to initiate specific contraceptive methods. Participants also answered questions about their social contacts' contraceptive experiences. Following the visit, participants reported the method initiated and the perceived importance of provider counseling. We used a multivariable regression model to ascertain factors associated with initiation of an IUD, an implant, or a short-acting reversible method. We enrolled 1,048 contraceptive initiators: 277 initiated short-acting methods, 384 IUDs, and 387 implants. High previsit personal acceptability of the method was associated with choosing that method for both implants and IUDs. Knowing someone who uses a specific method and likes it was predictive of personal acceptability of that method (IUD adjusted odds ratio: 10.9, 95% confidence interval: 3.8-31.1; implant adjusted odds ratio: 7.0, 95% confidence interval: 2.3-21.0). However, 10.4% of those initiating IUDs and 14.2% of those initiating implants had never heard of the method before their appointment. Even women with previsit intent to initiate a specific method found importance in contraceptive counseling. Previsit personal acceptability, which was associated with social contacts' experiences, was the strongest predictor of specific method uptake in our study. However, counseling informed the decisions of those with low previsit awareness and supported patients with formed intent. Copyright © 2017 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Actinomyces-Related Tubo-Ovarian Abscess in a Poorly Controlled Type II Diabetic With a Copper Intrauterine Device.

PubMed

Sawtelle, Ashley L; Chappell, Nicole P; Miller, Caela R

2017-03-01

The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings. After she was treated with intravenous and outpatient antibiotics with clinical improvement, repeat imaging 1 month later revealed a persistent complex left adnexal mass. Tumor markers were negative but given the persistence and complex nature of the mass, surgical management was recommended. A robotic-assisted hysterectomy with bilateral salpingo-oophorectomy was performed. Adhesiolysis, profuse irrigation, and ureteral stenting were required. Pathology revealed bilateral tubo-ovarian abscesses with actinomyces species identified on intraoperative culture. The patient had a total of 10 days of postoperative antibiotics and improved glucose control with no further signs of infection. Although actinomyces-related IUD PID is considered an outdated diagnosis, there are intermittent case reports of bizarre presentations in older women, often mimicking malignancy. Actinomyces should be a consideration in tubo-ovarian abscesses or pelvic inflammatory disease in patients with an IUD in place, particularly those who have poor glucose control or are otherwise immunosuppressed. Early identification and treatment of actinomyces tubo-ovarian abscesses may reduce surgical morbidity and overall improve patient outcomes and safety. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Evaluation of vitamin D3 intakes up to 15,000 international units/day and serum 25-hydroxyvitamin D concentrations up to 300 nmol/L on calcium metabolism in a community setting.

PubMed

Kimball, S M; Mirhosseini, N; Holick, M F

2017-01-01

Supplementation by the general public with vitamin D at doses above the Tolerable Upper Level of Intake (UL) is becoming quite common. The objective of the current analysis was to characterize the effect of vitamin D supplementation at doses up to 15,000 IU/d in a community-based program on vitamin D status, calcium homeostasis as well as on kidney, liver and immune function. We evaluated data collected for 3,882 participants in a community program for whom there were blood measurements at program entry and at follow-up within 6-18 months between 2013 and 2015. Participants were supplemented with a wide range of vitamin D doses (1,000 - 15,000 IU/d) aimed at achieving serum 25-hydroxyvitamin D [25(OH)D] levels of at least 100 nmol/L. Serum 25(OH)D concentrations up to 300 nmol/L were achieved without perturbation of calcium homeostasis or incidence of toxicity. Hypercalcemia and hypercalciuria were not related to an increase in 25(OH)D concentrations nor vitamin D dose. To achieve serum 25(OH)D levels >100 nmol/L on average, required vitamin D intakes of 6,000 IU/d for normal Body Mass Index (BMI), 7,000 IU/d for overweight and 8,000 IU/d for obese. Doses of vitamin D in excess of 6,000 IU/d were required to achieve serum 25(OH)D concentrations above 100 nmol/L, especially in individuals who were overweight or obese without any evidence of toxicity. Serum 25(OH)D concentrations up to 300 nmol/L were found to be safe.

Validation of the Complexity INdex in SARComas prognostic signature on formalin-fixed, paraffin-embedded, soft tissue sarcomas.

PubMed

Le Guellec, S; Lesluyes, T; Sarot, E; Valle, C; Filleron, T; Rochaix, P; Valentin, T; Pérot, G; Coindre, J-M; Chibon, F

2018-05-31

Prediction of metastatic outcome in sarcomas is challenging for clinical management since they are aggressive and carry a high metastatic risk. A 67-gene expression signature, the Complexity INdex in SARComas (CINSARC), has been identified as a better prognostic factor than the reference pathological grade. Since it cannot be applied easily in standard laboratory practice, we assessed its prognostic value using nanoString on formalin-fixed, paraffin-embedded (FFPE) blocks to evaluate its potential in clinical routine practice and guided therapeutic management. A code set consisting of 67 probes derived from the 67 genes of the CINSARC signature was built and named NanoCind®. To compare the performance of RNA-seq and nanoString (NanoCind®), we used expressions of various sarcomas (n=124, frozen samples) using both techniques and compared predictive values based on CINSARC risk groups and clinical annotations. We also used nanoString on FFPE blocks (n=67) and matching frozen and FFPE samples (n=45) to compare their level of agreement. Metastasis-free survival and agreement values in classification groups were evaluated. CINSARC strongly predicted metastatic outcome using nanoString on frozen samples (HR = 2.9, 95% CI 1.23-6.82) with similar risk-group classifications (86%). While more than 50% of FFPE blocks were not analyzable by RNA-seq owing to poor RNA quality, all samples were analyzable with nanoString. When similar (risk-group) classifications were measured with frozen tumors (RNA-seq) compared to FFPE blocks (84% agreement), the CINSARC signature was still a predictive factor of metastatic outcome with nanoString on FFPE samples (HR = 4.43, 95% CI 1.25-15.72). CINSARC is a material-independent prognostic signature for metastatic outcome in sarcomas and outperforms histological grade. Unlike RNA-seq, nanoString is not influenced by the poor quality of RNA extracted from FFPE blocks. The CINSARC signature can potentially be used in combination with nanoString (NanoCind®) in routine clinical practice on FFPE blocks to predict metastatic outcome.

Unanswered questions on ectopic pregnancy.

PubMed

Jonas, E G

1980-07-19

In a previous article (3 May, p. 1127), the British Medical Journal attempted to assess the demography of ectopic pregnancy and noted that a rise in incidence might lead to a better diagnosis of the condition. Cited as possible causes of ectopic pregnancy are pelvic sepsis and IUD usage. There is clinical confirmation of the relationship between pelvic sepsis and IUD usage. A review of the records of 325 consecutive patients diagnosed as having ectopic pregnancy in 4 large London Hospitals during the period 1967-79 revealed that PID (Pelvic Inflammatory Disease) was uncommon (11%). 12% of the remaining patients had IUDs and a further 2% were progestogen-only contraceptive failures. As regards the role of IUDs in ectopic pregnancy, failed intrauterine contraception is hypothesized to result in pregnancy, but with an incidence of ectopic, mainly tubal, implantation by reasons of disturbed ovum migration along the oviduct. The physiology of the human oviduct is not well known. Further research should be done on the many common aberations of human reproduction, iatrogenic and spontaneous.

The effect of intra-uterine devices on the reproductive physiology and behaviour of pony mares.

PubMed

Argo, C M; Turnbull, E B

2010-10-01

Spherical (35 mm diameter) glass intra-uterine devices (IUDs) are commonly understood to modify sexual behaviour in performance mares. The effect of IUDs on the endocrinology (luteinising hormone, oestradiol, progesterone, testosterone), ovarian and uterine function, sexual and social behaviours associated with the ovarian cycle were evaluated during the natural breeding season in nine, nuliparous pony mares (4.6±0.5 years old, 230±12 kg bodyweight). Age and weight-matched groups were allocated to sham-treatment (n=5) or IUD-implantation (n=4) groups. Fifty complete ovarian cycles were evaluated, with 26 ovarian cycles monitored for the nine mares prior to treatment and a further 12 cycles were evaluated for mares in each of the groups post-treatment. Detailed characterisation of cyclic reproductive changes in the pony may be of value for controlled breeding programmes. The presence of an IUD was well-tolerated, but failed to modify any recorded aspect of reproductive physiology or behaviour. Crown Copyright © 2009. Published by Elsevier Ltd. All rights reserved.

[Contraception: yes, but at what cost?].

PubMed

Grenon-Plante, D

1982-11-01

This article, arguing that consumers have a right to be informed about the dangers of health care measures, discusses the health risks of oral contraceptives (OCs) and IUDs. In a brief review of the history of contraceptive development and use, it is stated that the 1st OC was tested on only 132 women in Puerto Rico before being approved for commercial use. OCs, which inhibit ovulation, sperm penetration, and implantation of the egg, represent the surest and most convenient contraceptive yet developed. Despite their advantages, pills may cause various secondary effects such as spotting, water retention, irritability, nervousness, nausea, vaginitis, migraine headaches, hypertension, and others, whose alleviation is responsible for large additional profits to the pharmaceutical industry. Although results are difficult to interpret and the passage of time may not have been sufficient, disquieting indications of a possible carcinogenic effect of OCs have been noted. The pill has been implicated in an elevated incidence of thromboembolism and is known to influence the metabolism of some substances, and the list of contraindications for pill use is long. Women wishing to use pills should consult a conscientious physician who will take a complete medical history, perform a thorough physical, and furnish complete information on the risks of pill use. IUD mode of action is incompletely understood. Fewer than 2/3 of women accepting IUDS are able to tolerate them for more than 1 year, from 7 to 20% of IUDs are spontaneously expelled, and from 3-35% are removed at the request of the client for pelvic pain and bleeding. Another 4-15% are removed each year for other medical reasons. IUD related mortality is less than that related to OCs, but a series of secondary effects and contraindications are associated with their use. If a woman chooses to use an IUD despite everything, she should choose a physician experienced in IUD insertion who is not experimenting with a new type of device. The preference for powerful contraceptives has caused women to excuse men from sharing in the responsibility for birth control, among other deleterious effects.

Current status of contraceptive use among rural married women in Anhui Province of China.

PubMed

Zhang, X-J; Wang, G-Y; Shen, Q; Yu, Y-L; Sun, Y-H; Yu, G-B; Zhao, D; Ye, D-Q

2009-11-01

This study aims to explore the current status of married women in regard of their use of contraceptive methods (permanent methods versus non-permanent methods) and to find out factors that affect the use of contraceptive methods in rural areas of Anhui Province of China. Survey. Anhui, China. A total of 53,652 married women aged 18-49 years. A multistage probability sampling method was used to identify a representative sample of 53,652 married women aged 18-49 years. All women were asked to provide detailed information by completing detailed questionnaires. Contraceptive prevalence and influence factors. The total birth control rate of the sample was 95.2%. Samples choosing the permanent and nonpermanent contraceptive methods have taken up 46.7 and 48.5% respectively. Female sterilisation was the first choice with a usage rate of 43.6%, followed by intrauterine device (IUD), which was used by 41.1% of samples. Single-variable analysis showed that the choice of contraceptive methods was associated with age, education level, parity, frequency of sex intercourses in a month, contraceptive knowledge, RTI symptom and the gender of the last child of rural married women. A significant increase in contraceptive use of rural married women in Anhui Province of China. Female sterilisation and IUD still play the dominant role. Effective family planning methods should be advocated through adequate counselling on the correct use and proper management, with consideration of the background of custom and belief.

Will ethylene oxide sterilization influence the application of novel Cu/LDPE nanocomposite intrauterine devices?

PubMed

Xia, Xianping; Wang, Yun; Cai, Shuizhou; Xie, Changsheng; Zhu, Changhong

2009-01-01

Copper/low-density polyethylene (Cu/LDPE) nanocomposite intrauterine device (IUD) is an implanted medicinal device that must be sterilized before use. Sterilization processes act either chemically or physically, leading to a lethal change in the structure or function of organic macromolecules in microorganisms. Given the nature of their action, sterilization might also attack the macromolecules of polymers by the same mechanisms, resulting in changes in surface functional groups and in the internal structure of the polymer. If sterilization leads to changes in surface functional groups and in the internal structure of the LDPE matrix, which will influence the mechanical property and cupric ions release rate of novel Cu/LDPE nanocomposite IUDs, potential clinical application will be limited. Therefore, it is necessary to study the influence of ethylene oxide sterilization on the potential clinical application of novel Cu/LDPE nanocomposite IUDs. The influence of ethylene oxide sterilization on the internal structure, surface functional groups, mechanical property and cupric ions release rate of novel Cu/LDPE nanocomposite IUDs was studied using differential scanning calorimetry, attenuated total reflection Fourier transform infrared spectroscopy, tensile testing and absorbance measurement. Ethylene oxide sterilization did not have any influence on the internal structure, surface functional groups, mechanical property and cupric ions release rate of novel Cu/LDPE nanocomposite intrauterine devices. Ethylene oxide sterilization will not affect the potential application of novel Cu/LDPE nanocomposite IUDs.

Changes in out-of-pocket costs for hormonal IUDs after implementation of the Affordable Care Act: an analysis of insurance benefit inquiries.

PubMed

Bearak, Jonathan M; Finer, Lawrence B; Jerman, Jenna; Kavanaugh, Megan L

2016-02-01

The Affordable Care Act (ACA) requires that privately insured women can obtain contraceptive services and supplies without cost sharing. This may substantially affect women who prefer an intrauterine device (IUD), a long-acting reversible contraceptive, because of high upfront costs that they would otherwise face. However, imperfect enforcement of and exceptions to this provision could limit its effect. We analyzed administrative data for 417,221 women whose physicians queried their insurance plans from January 2012 to March 2014 to determine whether each woman had insurance coverage for a hormonal IUD and the extent of that coverage. In January 2012, 58% of women would have incurred out-of-pocket costs for an IUD, compared to only 13% of women in March 2014. Differentials by age and region virtually dissolved over the period studied, which suggests that the ACA reduced inequality among insured women. Our findings suggest that the cost of hormonal IUDs fell to US$0 for most insured women following the implementation of the ACA. Financial barriers to one of the most effective methods of contraception fell substantially following the ACA. If more women interested in this method can access it, this may contribute to a decline in unintended pregnancies in the United States. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

Parental Acceptability of Contraceptive Methods Offered to their Teen During a Confidential Health Care Visit

PubMed Central

Hartman, Lauren B; Shafer, Mary-Ann; Pollack, Lance M; Wibbelsman, Charles; Chang, Fay; Tebb, Kathleen P

2013-01-01

Purpose To examine parental acceptability of contraceptive methods offered confidentially to their adolescent daughter. Methods A random sample of 261 parents/guardians with a daughter between 12–17 completed a telephone survey examining the relationship between parental acceptability of seven contraceptive methods with adolescents’ likelihood to have sex, parenting beliefs, parents’ sexual health as teens, sexually transmitted infection (STI) knowledge, and demographic factors. Results Acceptability was highest for oral contraceptive pills (59%), and lowest for intrauterine device (IUD) (18%). Parental acceptance of teens’ autonomy was significantly associated with increased acceptability of all methods. Parental knowledge of STIs was poor and 51% found it acceptable for clinicians to provide their sexually active teen with condoms. Conclusion Conclusions: Parents were more accepting of OCPs and condoms, compared to IUDs and implants. Parental recognition of their teen’s autonomy was associated with greater parental acceptability of clinicians providing their adolescent with contraceptives (regardless of the specific type of method being offered). PMID:23332493

Efficacy and Safety of Long-Acting Reversible Contraception

PubMed Central

Stoddard, Amy; McNicholas, Colleen; Peipert, Jeffrey F.

2013-01-01

Long-acting reversible contraception (LARC) includes intrauterine devices (IUDs) and the subdermal implant. These methods are the most effective reversible methods of contraception, and have the additional advantages of being long-lasting, convenient, well liked by users and cost effective. Compared with other user-dependent methods that increase the risk of noncompliance-related method failure, LARC methods can bring ‘typical use’ failure rates more in line with ‘perfect use’ failure rates. LARC methods are ‘forgettable’; they are not dependent on compliance with a pill-taking regimen, remembering to change a patch or ring, or coming back to the clinician for an injection. LARC method failure rates rival that of tubal sterilization at <1% for IUDs and the subdermal implant. For these reasons, we believe that IUDs and implants should be offered as first-line contraception for most women. This article provides a review of the LARC methods that are currently available in the US, including their effectiveness, advantages, disadvantages and contraindications. Additionally, we dispel myths and misconceptions regarding IUDs, and address the barriers to LARC use. PMID:21668037

Barriers and enablers to adoption of intrauterine device as a contraceptive method: A multi-stakeholder perspective.

PubMed

Mishra, Namita; Panda, Meely; Pyne, Souvik; Srinivas, Nallala; Pati, Sandipana; Pati, Sanghamitra

2017-01-01

Promoting family planning practices aid considerably in attaining Millennium Development Goals by various mechanisms. Despite concerted health system efforts, adoption of especially reversible contraceptive methods such as intrauterine devices (IUDs) has remained negatively skewed in India, which is the pioneer country to implement Family Planning programme way back in 1952. Although few studies in India have looked into the reasons for its nonacceptance, literature from Odisha was scant and hence the study was undertaken. A cross-sectional study using qualitative methods was done in the Mahanga Tehsil of Cuttack district. In-depth interviews were conducted with women of reproductive age (WRA) and focused group discussions (FGDs) among health workers and health professionals were held separately. Data analysis was done using thematic framework approach supported by Atlas Ti software. There were 31 in-depth interviews with WRA, two FGDs with health workers, and one FGD with health professionals. Availability of IUD services was low and wherever available, being located far away affected its physical accessibility. Most women were reluctant to ask health workers about services owing to their shyness while many women felt using IUDs breached their autonomy and privacy. The existence of fear and misconceptions regarding its use rooting from lack of knowledge and poor service quality also impeded its adoption by women. There is a pressing need to enhance the demand of IUDs by dispelling the myths among women through effective information, education, and communication and also to improve the availability of IUDs.

What we've learned about IUDs from the Women's Health Study.

PubMed

Lee, N C

1989-01-01

A new look at data from the Women's Health Study, done in 1976-1978, focuses on the outcomes of pelvic inflammatory disease (PID) and its determinants, and ectopic pregnancy, in IUD users. The advantage of this data set is that it does not suffer from bias resulting from the bad publicity that IUDs have since received. 657 cases of PID ascertained by discharge diagnosis were compared to 2566 sexually active controls with non-gynecological conditions. The overall data showed that the Dalkon shield conferred a relative risk of 8.3, and the risk was slightly elevated for Progestasert and Copper-7, compared to women using no method of contraception. Broken down by duration of use, most of the risk was limited to the 1st 4 months of use, and the highest risk was in the 1st month, 3.8. Regarding aspects of sexual behavior, the risks were computed for women claiming only one sexual partner. Single and previously married women had about twice the risk of married or cohabiting women. It is likely that this can be explained by a higher proportion of women whose partners were monogamous among married and cohabiting women, than among single or divorced women. The risk of ectopic pregnancy was 0.4 for IUD and traditional method users, and 0.1 for pill users, compared to non-contracepting women. Thus IUDs put women at a slightly higher risk of ectopic pregnancy, but at a low absolute risk, since they lower the overall change of pregnancy.

Water absorption characteristics of novel Cu/LDPE nanocomposite for use in intrauterine devices.

PubMed

Xia, Xianping; Cai, Shuizhou; Hu, Junhui; Xie, Changsheng

2006-11-01

Intrauterine devices (IUDs), especially the copper-containing IUDs (Cu-IUDs), are one of the worldwide used forms for birth control, owing to their advantages of long-lasting and high efficacy, economy, safety, and reversibility. However, it is not perfect for the existing Cu-IUDs; some shortcomings related to its side effects have not been overcome yet. For this reason, a new Cu-IUDs material, the copper/low-density polyethylene (Cu/LDPE) nanocomposite, has been developed in our research team. The structure and water uptake characteristics of this new Cu-IUDs material have been investigated by using X-ray diffraction (XRD), Scanning electron microscopy (SEM), X-ray energy dispersive spectroscopy (EDS), Fourier transform infrared spectroscopy (FT-IR), and gravimetric analysis in this paper. The results of XRD, SEM, EDS, and FT-IR show three important outcomes associated with the structure of the nanocomposite. First, the nanocomposite is hybrid of the polymer and the copper nanoparticles (nano-Cu). Second, porosities, nano-Cu aggregates, and primary alcohol (R--CH(2)--OH) are existed in the nanocomposite. Third, the nano-Cu aggregates are distributed uniformly in the polymer matrix in general. The results of Gravimetric analysis, which associated with the water uptake characteristics of the nanocomposite, exhibit that the water absorption behavior of the nanocomposite obeys the classical diffusion theory very well, the water uptake of the nanocomposite increases with the increasing of the nano-Cu loading, and that the water uptake ability of the nanocomposite with 15.0 wt % nano-Cu (50 nm in diameter) is about 150 times larger than that of the base resin and about 45 times higher than that of the Cu/LDPE microcomposite with 15.0 wt % copper microparticles (5 microm in diameter). These water uptake characteristics are mainly attributed to the structure of the Cu/LDPE composites and the size effect of the nano-Cu. (c) 2006 Wiley Periodicals, Inc.

Familiarity with Long-acting Reversible Contraceptives among Obstetrics and Gynecology, Family Medicine, and Pediatrics Residents: Results of a 2015 National Survey and Implications for Contraceptive Provision for Adolescents.

PubMed

Davis, Susan A; Braykov, Nikolay P; Lathrop, Eva; Haddad, Lisa B

2018-02-01

To assess familiarity with long-acting reversible contraceptives (LARC) among current obstetrics and gynecology (OB/GYN), family medicine (FM), and pediatrics senior residents in the United States. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We selected 156 OB/GYN, FM, and pediatrics residency programs using the American Medical Association Freida database. Senior residents completed a survey addressing any training they had received on LARC, and rated their comfort level counseling about and inserting LARC. Residents rated their likelihood of recommending LARC to an adolescent, nulliparous patient, and indicated whether they would like additional training on LARC. Descriptive and analytic statistics were generated using R statistical software (The R Project for Statistical Computing; https://www.r-project.org). The survey was completed by 326 of 1,583 residents (20.6% response rate); at least 1 resident completed the survey at 105 (67.3%) of the residency programs contacted. Most programs (84.8%) provided some training on LARC. Residents in OB/GYN programs were comfortable counseling about and inserting contraceptive implants (97%, 83%), copper intrauterine devices (IUDs; 100%, 86%), and levonorgestrel (LNG) IUDs (100%, 86%). In FM programs, fewer residents were comfortable counseling about and inserting contraceptive implants (71%, 47%), copper IUDs (68%, 21%), and LNG IUDs (79%, 18%). Residents in pediatrics programs had low comfort levels counseling about contraceptive implants (14%), copper IUDs (14%), and LNG IUDs (25%); no pediatrics residents were comfortable inserting LARC. OB/GYN residents were significantly more likely to recommend a LARC to an adolescent, nulliparous patient (P = .019). Most pediatric and FM residents desired additional training on LARC (82.7% and 60.7%, respectively). This study shows that knowledge gaps exist regarding LARC among FM and pediatrics residents. Copyright © 2017 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Levels and determinants of switching following intrauterine device discontinuation in 14 developing countries.

PubMed

Ali, Mohamed M; Park, Min Hae; Ngo, Thoai D

2014-07-01

To examine the levels and determinants of switching to any reversible modern contraceptive method following intrauterine device (IUD) discontinuation due to method-related reasons among women in developing countries. We analysed 5-year contraceptive calendar data from 14 Demographic and Health Surveys, conducted in 1993-2008 (n=218,092 women; 17,151 women contributed a total of 18,485 IUD episodes). Life-table methods were used to determine overall and cause-specific probabilities of IUD discontinuation at 12 months of use. For IUD episodes discontinued due to method-related reasons, the probability of switching to another reversible modern method within 3 months was estimated, overall and by place of residence, education level, motivation for use, age category and wealth tertiles. Country-specific rate ratios (RR) were estimated using generalized linear models, and pooled RRs using meta-analyses. The median duration of uninterrupted IUD use was 37 months. At 12 months, median probability of discontinuation was 13.2% and median probability of discontinuation due to method-related reasons was 8.9%. Within 3 months of discontinuation due to method-related reasons, half of the women had switched to another reversible modern method, 12% switched to traditional methods, 12% became pregnant, and 25% remained at risk for pregnancy. More educated women were more likely to switch to another reversible modern method than women with primary education or less (pooled RR 1.47; 95% CI 1.10-1.96), as were women in the highest wealth tertile (pooled RR 1.38; 95% CI 1.04-1.83) and women who were limiting births (pooled RR 1.35; 95% CI 1.08-1.68). Delays to switching and switching to less reliable methods following IUD discontinuation remain a problem, exposing women to the risk of unwanted pregnancy. Family planning programmes should aim to improve quality of services through strengthening of counselling and follow-up services to support women's continuation of effective methods. The risk of unintended pregnancy following IUD discontinuation remains high in developing countries. The quality of family planning services may be an important factor in switching to alternative modern contraceptive methods. Service providers should focus on counselling services and follow-up of women to support the continued use of effective methods. Copyright © 2014 The Authors. Published by Elsevier Inc. All rights reserved.

[A comparative study of three types of IUD].

PubMed

Lai, K R; Chen, Q B

1991-11-01

In Zhejiang Province, China, there are 2.7 million IUD users. 90% of them use stainless steel single ring. In order to evaluate the effectiveness of the IUDs, the Provincial Family Planning Commission organized a prospective comparative study on 3 kinds of IUDs: the single ring made in Wuxi, the metal ring with plastic core made in Beijing, and the copper TCU 220c made in Tianjin. Between October 1985 and March 1986 1199 healthy women aged 20-39 who had 2 or fewer normal deliveries and without previous history of ectopic pregnancy were screened and recruited to the study. They were randomly assigned to be inserted with the IUDs. 400 women had single ring, 402 women had metal with plastic core, and 397 had TCu 220c. 8 postinsertion follow-up visits were conducted up to 3 years, and menstruations were recorded every month. During the study, 4 cases were lost to follow-up. In the single-ring group, the cumulative continuation rates at 12, 24, and 36 months were 73.4, 66.7, and 65.7% respectively. For the metal-plastic ring group, it was 80.9, 72.3, and 69.3% and for the TCu 220c group, it was 94.5, 88.4, and 83.1%, respectively. The expulsion rates among the 3 kinds of IUDs were statistically significant at 12, 24, and 36 months. The highest expulsion rates were the single ring and TCu 220c were the lowest. The pregnancy rates were highest among metal-plastic ring users and lowest among TCu 220c users. The differences were not statistically significant between single ring and metal-plastic ring users. Discontinuation due to excessive menstrual bleeding were similar among the 3 methods probably due to treatment of the users who experienced excessive bleeding. Younger women and women who experienced fewer pregnancies were found to have higher expulsion and pregnancy rates. But the occurrence of side effects such as prolonged menstrual periods, spotting, and back pain were highest among TCu 220c users. It was recommended that the more effective TCu 220c should be promoted to replace the single ring. Since different sizes of TCu IUDs have been developed, it would be possible to reduce excessive menstrual bleeding and its side effects.

Characterizing string-of-pearls colloidal silica by multidetector hydrodynamic chromatography and comparison to multidetector size-exclusion chromatography, off-line multiangle static light scattering, and transmission electron microscopy.

PubMed

Brewer, Amandaa K; Striegel, André M

2011-04-15

The string-of-pearls-type morphology is ubiquitous, manifesting itself variously in proteins, vesicles, bacteria, synthetic polymers, and biopolymers. Characterizing the size and shape of analytes with such morphology, however, presents a challenge, due chiefly to the ease with which the "strings" can be broken during chromatographic analysis or to the paucity of information obtained from the benchmark microscopy and off-line light scattering methods. Here, we address this challenge with multidetector hydrodynamic chromatography (HDC), which has the ability to determine, simultaneously, the size, shape, and compactness and their distributions of string-of-pearls samples. We present the quadruple-detector HDC analysis of colloidal string-of-pearls silica, employing static multiangle and quasielastic light scattering, differential viscometry, and differential refractometry as detection methods. The multidetector approach shows a sample that is broadly polydisperse in both molar mass and size, with strings ranging from two to five particles, but which also contains a high concentration of single, unattached "pearls". Synergistic combination of the various size parameters obtained from the multiplicity of detectors employed shows that the strings with higher degrees of polymerization have a shape similar to the theory-predicted shape of a Gaussian random coil chain of nonoverlapping beads, while the strings with lower degrees of polymerization have a prolate ellipsoidal shape. The HDC technique is contrasted experimentally with multidetector size-exclusion chromatography, where, even under extremely gentle conditions, the strings still degraded during analysis. Such degradation is shown to be absent in HDC, as evidenced by the fact that the molar mass and radius of gyration obtained by HDC with multiangle static light scattering detection (HDC/MALS) compare quite favorably to those determined by off-line MALS analysis under otherwise identical conditions. The multidetector HDC results were also comparable to those obtained by transmission electron microscopy (TEM). Unlike off-line MALS or TEM, however, multidetector HDC is able to provide complete particle analysis based on the molar mass, size, shape, and compactness and their distributions for the entire sample population in less than 20 min. © 2011 American Chemical Society

Melanoma-targeted delivery system (part 2): Synthesis, radioiodination and biological evaluation in B16F0 bearing mice.

PubMed

El Aissi, Radhia; Miladi, Imen; Chezal, Jean-Michel; Chavignon, Olivier; Miot-Noirault, Elisabeth; Moreau, Emmanuel

2016-09-14

Here we report the synthesis and radiolabelling with iodine-125 of a melanoma-selective prodrug (17a*) and its parent drug IUdR. The in vivo and ex vivo biodistributions of [(125)I](17a*) and [(125)I]IUdR were evaluated in a model of melanoma B16F0-bearing mice. The pharmacokinetic profile of [(125)I](17a*) suggests rapid release of the active drug [(125)I]IUdR after i.v. administration of [(125)I](17a*). Preliminary metabolism studies in dedicated compartments (i.e. blood, urine and tumour) yielded results consistent with this hypothesis. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Expanding contraceptive options for PMTCT clients: a mixed methods implementation study in Cape Town, South Africa

PubMed Central

2014-01-01

Background Clients of prevention of mother-to-child transmission (PMTCT) services in South Africa who use contraception following childbirth rely primarily on short-acting methods like condoms, pills, and injectables, even when they desire no future pregnancies. Evidence is needed on strategies for expanding contraceptive options for postpartum PMTCT clients to include long-acting and permanent methods. Methods We examined the process of expanding contraceptive options in five health centers in Cape Town providing services to HIV-positive women. Maternal/child health service providers received training and coaching to strengthen contraceptive counseling for postpartum women, including PMTCT clients. Training and supplies were introduced to strengthen intrauterine device (IUD) services, and referral mechanisms for female sterilization were reinforced. We conducted interviews with separate samples of postpartum PMTCT clients (265 pre-intervention and 266 post-intervention) to assess knowledge and behaviors regarding postpartum contraception. The process of implementing the intervention was evaluated through systematic documentation and interpretation using an intervention tracking tool. In-depth interviews with providers who participated in study-sponsored training were conducted to assess their attitudes toward and experiences with promoting voluntary contraceptive services to HIV-positive clients. Results Following the intervention, 6% of interviewed PMTCT clients had the desired knowledge about the IUD and 23% had the desired knowledge about female sterilization. At both pre- and post-intervention, 7% of clients were sterilized and IUD use was negligible; by comparison, 75% of clients used injectables. Intervention tracking and in-depth interviews with providers revealed intervention shortcomings and health system constraints explaining the failure to produce intended effects. Conclusions The intervention failed to improve PMTCT clients’ knowledge about the IUD and sterilization or to increase use of those methods. To address the family planning needs of postpartum PMTCT clients in a way that is consistent with their fertility desires, services must expand the range of contraceptive options to include long-acting and permanent methods. In turn, to ensure consistent access to high quality family planning services that are effectively linked to HIV services, attention must also be focused on resolving underlying health system constraints weakening health service delivery more generally. PMID:24410922

NanoStringNormCNV: pre-processing of NanoString CNV data.

PubMed

Sendorek, Dorota H; Lalonde, Emilie; Yao, Cindy Q; Sabelnykova, Veronica Y; Bristow, Robert G; Boutros, Paul C

2018-03-15

The NanoString System is a well-established technology for measuring RNA and DNA abundance. Although it can estimate copy number variation, relatively few tools support analysis of these data. To address this gap, we created NanoStringNormCNV, an R package for pre-processing and copy number variant calling from NanoString data. This package implements algorithms for pre-processing, quality-control, normalization and copy number variation detection. A series of reporting and data visualization methods support exploratory analyses. To demonstrate its utility, we apply it to a new dataset of 96 genes profiled on 41 prostate tumour and 24 matched normal samples. NanoStringNormCNV is implemented in R and is freely available at http://labs.oicr.on.ca/boutros-lab/software/nanostringnormcnv. paul.boutros@oicr.on.ca. Supplementary data are available at Bioinformatics online.

Asynchronous sampling of speech with some vocoder experimental results

NASA Technical Reports Server (NTRS)

Babcock, M. L.

1972-01-01

The method of asynchronously sampling speech is based upon the derivatives of the acoustical speech signal. The following results are apparent from experiments to date: (1) It is possible to represent speech by a string of pulses of uniform amplitude, where the only information contained in the string is the spacing of the pulses in time; (2) the string of pulses may be produced in a simple analog manner; (3) the first derivative of the original speech waveform is the most important for the encoding process; (4) the resulting pulse train can be utilized to control an acoustical signal production system to regenerate the intelligence of the original speech.

Enhancement of IUdR Radiosensitization by Low-Energy Photons Results from Increased and Persistent DNA Damage.

PubMed

Bayart, Emilie; Pouzoulet, Frédéric; Calmels, Lucie; Dadoun, Jonathan; Allot, Fabien; Plagnard, Johann; Ravanat, Jean-Luc; Bridier, André; Denozière, Marc; Bourhis, Jean; Deutsch, Eric

2017-01-01

Low-energy X-rays induce Auger cascades by photoelectric absorption in iodine present in the DNA of cells labeled with 5-iodo-2'-deoxyuridine (IUdR). This photoactivation therapy results in enhanced cellular sensitivity to radiation which reaches its maximum with 50 keV photons. Synchrotron core facilities are the only way to generate such monochromatic beams. However, these structures are not adapted for the routine treatment of patients. In this study, we generated two beams emitting photon energy means of 42 and 50 keV respectively, from a conventional 225 kV X-ray source. Viability assays performed after pre-exposure to 10 μM of IUdR for 48h suggest that complex lethal damage is generated after low energy photons irradiation compared to 137Cs irradiation (662KeV). To further decipher the molecular mechanisms leading to IUdR-mediated radiosensitization, we analyzed the content of DNA damage-induced foci in two glioblastoma cell lines and showed that the decrease in survival under these conditions was correlated with an increase in the content of DNA damage-induced foci in cell lines. Moreover, the follow-up of repair kinetics of the induced double-strand breaks showed the maximum delay in cells labeled with IUdR and exposed to X-ray irradiation. Thus, there appears to be a direct relationship between the reduction of radiation survival parameters and the production of DNA damage with impaired repair of these breaks. These results further support the clinical potential use of a halogenated pyrimidine analog combined with low-energy X-ray therapy.

Will new IUD debate lower Dalkon Shield settlements?

PubMed

1991-07-01

A recent study challenging the risk associated with the use of IUDs will have little impact on the settlements of claims against the maker of the Dalkon Shield, an IUD believed to have caused pelvic inflammatory disease (PID) and other medical problems among its users. Recently, Richard Kronmal, a biostatistician from the University of Washington in Seattle, questioned the data from the Women's Health Study, an investigation sponsored by the National Institutes of Health, which found that the relative risk of PID among IUD users is 1.6. According to Kronmal, the actual relative risk is only 1.2. While other scientists came to the defense of the Women's Health Study, the press reported that Kronmal's report would lead to lower damage settlements for former Dalkon Shield users who have filed a claim against A.H. Robins Corp., the maker of the IUD. But according to Georgene Vairo, chair of the trust for the Dalkon Shield Claims Resolution Facility, the Kronmal study will have no impact on the settlements. Vairo says that the settlements will continue to be based on past offers, which range anywhere from %725 to 6-figure settlements, depending the amount of documentation and proof of injury. So far, the trust has settled some 137,000 claims. Furthermore, Vairo says that the trust still has $2.3 billion with which to settle claims, and has no incentive to reduce payments. The trust was set up by American Home Products Co., which acquired A.H. Robins after the maker of the Dalkon Shield filed for bankruptcy following increasing litigation claims from former Dalkon Shield users.

Chemical stratigraphy of the Apollo 17 deep drill cores 70009-70007

NASA Technical Reports Server (NTRS)

Ehmann, W. D.; Ali, M. Z.

1977-01-01

A description is presented of an analysis of a total of 26 samples from three core segments (70009, 70008, 70007) of the Apollo 17 deep drill string. The deep drill string was taken about 700 m east of the Camelot Crater in the Taurus-Littrow region of the moon. Three core segments have been chemically characterized from the mainly coarse-grained upper portion of the deep drill string. The chemical data suggest that the entire 70007-70009 portion of the deep drill string examined was not deposited as a single unit, but was formed by several events sampling slightly different source materials which may have occurred over a relatively short period of time. According to the data from drill stem 70007, there were at least two phases of deposition. Core segment 70009 is probably derived from somewhat different source material than 70008. It seems to be a very well mixed material.

Wireline system for multiple direct push tool usage

DOEpatents

Bratton, Wesley L.; Farrington, Stephen P.; Shinn, II, James D.; Nolet, Darren C.

2003-11-11

A tool latching and retrieval system allows the deployment and retrieval of a variety of direct push subsurface characterization tools through an embedded rod string during a single penetration without requiring withdrawal of the string from the ground. This enables the in situ interchange of different tools, as well as the rapid retrieval of soil core samples from multiple depths during a single direct push penetration. The system includes specialized rods that make up the rod string, a tool housing which is integral to the rod string, a lock assembly, and several tools which mate to the lock assembly.

In vitro release of cupric ion from intrauterine devices: influence of frame, shape, copper surface area and indomethacin.

PubMed

Zhang, Shuangshuang; Li, Ying; Yu, Panpan; Chen, Tong; Zhou, Weisai; Zhang, Wenli; Liu, Jianping

2015-02-01

The release of cupric ion from copper intrauterine device (Cu-IUD) in human uterus is essential for contraception. However, excessive cupric ion will cause cytotoxic effect. In this paper, we investigated the influence of device characteristics (frame, copper surface area, shape, copper type and indomethacin) on copper release for the efficacy and adverse effects vary with IUD types which may correlate to their different release behaviors. Nine types of Cu-IUDs were selected and incubated in simulated uterine fluid. They were paired for comparison based on the device properties and the release of cupric ion was determined by flame atomic absorption spectrometer for about 160 days. The result showed that there was a burst release during the first month and the release rate tends to slow down and become steady afterwards. In addition, the copper release was mainly influenced by frame, indomethacin and copper type (copper wire and copper sleeve) while the shape variation had little effect on copper release throughout the experiment. Moreover, the influence of copper surface area was only noticeable during the first month. These findings were seldom reported before and may provide some useful information for the design of Cu-IUDs.

[I.U.D. in Greenland].

PubMed

Berg, O

1971-11-05

In the past few decades, Greenland has experienced a population explosion, due mainly to a significant decrease in death from tuberculosis and an increase in the birthrate. 50% of the population of Greenland is younger than 16 years of age. The condom and diaphragm were the main methods of contraception used in Greenland, but neither was used extensively; in the case of the diaphragm, the lack of privacy in larger families (where contraception is most needed) because of cramped living conditions makes difficult the necessary hygiene which accompanies the use of the diaphragm. A campaign was undertaken to introduce the IUD in Greenland. In the district of Narssaq 152 women, approximately 33% of the women 15-44 years of age, had IUDs inserted over a period of 20 months. 48% of the women were unmarried, 40% were married. 16% of the women were between 15-19 years old, 51% between 20-29. IUDs are preferred over oral contraceptives because of mass media public relations advertising and the social and cultural demand for a nonregimented form of contraception. The birthrate in Greenland dropped from 40 to 30% and in Narssaq from approximately 40 to 20% during the campaign.

The safety of available and emerging options for emergency contraception.

PubMed

Lee, Jessica K; Schwarz, Eleanor Bimla

2017-10-01

Emergency contraception (EC) is a way to significantly reduce the chance of becoming pregnant after an episode of unprotected intercourse. Considerable data support the safety of all available and emerging options for EC. Areas covered: This review presents a comprehensive summary of the literature regarding the safety of EC as well as directions for further study. PubMed was searched for all relevant studies published prior to June 2017. Expertopinion: All available methods of EC (i.e., ulipristal acetate pills, levonorgestrel pills, and the copper-IUD), carry only mild side effects and serious adverse events are essentially unknown. The copper IUD has the highest efficacy of EC methods. Given the excellent safety profiles of mifepristone and the levonorgestrel IUD, research is ongoing related to use of these products for EC.

Intrauterine device use, cervical infection with human papillomavirus, and risk of cervical cancer: a pooled analysis of 26 epidemiological studies.

PubMed

Castellsagué, Xavier; Díaz, Mireia; Vaccarella, Salvatore; de Sanjosé, Silvia; Muñoz, Nubia; Herrero, Rolando; Franceschi, Silvia; Meijer, Chris J L M; Bosch, F Xavier

2011-10-01

Intrauterine device (IUD) use has been shown to reduce the risk of endometrial cancer, but little is known about its association with cervical cancer risk. We assessed whether IUD use affects cervical human papillomavirus (HPV) infection and the risk of developing cervical cancer. We did a pooled analysis of individual data from two large studies by the International Agency for Research on Cancer and Institut Català d'Oncologia research programme on HPV and cervical cancer; one study included data from ten case-control studies of cervical cancer done in eight countries, and the other included data from 16 HPV prevalence surveys of women from the general population in 14 countries. 2205 women with cervical cancer and 2214 matched control women without cervical cancer were included from the case-control studies, and 15,272 healthy women from the HPV surveys. Information on IUD use was obtained by personal interview. HPV DNA was tested by PCR-based assays. Odds ratios and 95% CIs were estimated using multivariate unconditional logistic regression for the associations between IUD use, cervical HPV DNA, and cervical cancer. After adjusting for relevant covariates, including cervical HPV DNA and number of previous Papanicolaou smears, a strong inverse association was found between ever use of IUDs and cervical cancer (odds ratio 0·55, 95% CI 0·42-0·70; p<0·0001). A protective association was noted for squamous-cell carcinoma (0·56, 0·43-0·72; p<0·0001), adenocarcinoma and adenosquamous carcinoma (0·46, 0·22-0·97; p=0·035), but not among HPV-positive women (0·68, 0·44-1·06; p=0·11). No association was found between IUD use and detection of cervical HPV DNA among women without cervical cancer. Our data suggest that IUD use might act as a protective cofactor in cervical carcinogenesis. Cellular immunity triggered by the device might be one of several mechanisms that could explain our findings. Instituto de Salud Carlos III; Agència de Gestió d'Ajuts Universitaris i Recerca; Marató TV3 Foundation; Bill & Melinda Gates Foundation; International Agency for Research on Cancer; European Community; Fondo de Investigaciones Sanitarias, Spain; Preventiefonds, Netherlands; Programa Interministerial de Investigación y Desarrollo, Spain; Conselho Nacional de Desenvolvimiento Cientifico e Tecnologico, Brazil; and Department of Reproductive Health & Research, WHO. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Serum immunoglobulin levels in women fitted with a copper T intrauterine contraceptive device (author's transl)].

PubMed

Tatra, G; Beck, A; Prunner, Ch; Breitenecker, G

1975-10-31

Serum concentrations of the immunoglobulins IgG, IgM and IgA were assayed by single radial immunodiffusion in 37 women before insertion of Copper T IUD and 6 to 12 months subsequently. There was a tendency towards an increase in immuno-globulin levels with the IUD in situ, but the results were not of statistical significance.

CUP: contraceptive users pamphlet.

PubMed

1986-02-01

This pamphlet, edited by an ad hoc committee of several consultants, scientists, theologians, public health and family planning directors, and an international attorney, covers the following topics: contra-conception; choices of contraceptives; contraceptive package information; copper IUDs; pelvic inflammatory disease (PID); sexually transmitted diseases; and acquired immunodeficiency syndrome. It includes a questionnaire for sexually transmitted diseases (STDs). Professor Joseph Goldzieher describes the "Contra-Conception" database as "a synthesis of up-to-date literature and contemporary guidelines, designed to provide ready access for practicing physicians and medical students." It contains data on several types of hormonal contraception. "Contra-Conceptions" is designed to allow the physician to set his or her own pace when working with the computer, and no previous computer experience is required. 1 of the program's many innovative features is the patient-profiling/decisionmaking section which can be used in the doctor's office to help decide what type of hormonal contraceptive is appropriate for a particular patient. The program permits the doctor to evaluate the significance of patient variables such as parity, smoking, menstrual difficulties and helps the doctor to identify the risks and benefits of the various methods and, ultimately, to make a balanced decision in the context of the most recent data. Contraceptive drugs and devices should include detailed information on the following: description of formula or device; indication, usage, and contraindications, clinical pharmacology and toxicology; dose-related risk; pregnancies per 100 women year; and detailed warning. The sequence of major pathophysiological reactions associated with copper IUDs is identified as are special problems of pelvic infections in users of copper IUDs. Those women who use oral contraceptives (OCs) or a barrier method of contraception or whose partners use a condom have a lower frequency of PID than women not employing any protection. It is well established that copper IUDs cause different types and different degrees of PID. Women using copper IUDs are more at risk for pelvic infection. There is a higher frequency of salpingitis and PID when copper IUDs are employed especially when the population is nulligravidas under the age of 25. The pamphlet lists criteria for the diagnosis of salpingo-oophoritis and actue salpingitis.

From Feline Idiopathic Ulcerative Dermatitis to Feline Behavioral Ulcerative Dermatitis: Grooming Repetitive Behaviors Indicators of Poor Welfare in Cats

PubMed Central

Titeux, Emmanuelle; Gilbert, Caroline; Briand, Amaury; Cochet-Faivre, Noëlle

2018-01-01

Feline idiopathic head-and-neck dermatitis—also named feline idiopathic ulcerative dermatitis (IUD)—is considered as a rare skin disease of unknown origin. It is usually associated with a crusted, non-healing, self-induced ulcer occurring most commonly on the dorsal or lateral neck or between the scapula where self-grooming by scratching occurs. Usually, IUD is diagnosed after exclusion of other causes of pruritus. In feline medicine, self-induced alopecia is recognized as a behavioral disorder (abnormal repetitive behavior) due to excessive licking, which is an amplification of a normal maintenance behavior. Such repetitive behaviors, like self-induced alopecia or self-induced wounds, are named stereotypies and considered as indicators of poor welfare. The objectives of our study were to determine, first, if the repetitive behavior associated with self-induced wounds was related to a poor welfare, and, second, if improving the welfare in the cat’s environment would lead to healing, thanks to environmental enrichment. We recruited 13 cats diagnosed with IUD by a dermatologist. These cats were referred to a behaviorist for welfare evaluation. A welfare score was attributed using a new 21-point welfare scale. The median score of the 13 IUD cats was 16, while the median score of 35 healthy cats was 7 (significant difference, p < 0.001). Major modifications of the cat’s environment and the human–cat relationship were then recommended for IUD cats. Within 15 days after environment modifications, ulcerative lesions were healed and welfare scores improved significantly (median score of 6, significantly different from the score before environmental modifications), being similar to healthy cats (no significant differences). Only one cat was treated with a psychotropic drug, owners being reluctant to improve environmental modifications. These results suggest that feline IUD is a behavioral disorder indicative of poor welfare and that it requires management by behavior specialists, proposing environmental modifications. We hence propose to rename this affection to “behavioral ulcerative dermatitis,” given that welfare scores were significantly different from healthy cats, and that environmental modifications modified welfare scores and lead to successful healing in all cases. PMID:29713639

Side effects unrelated to disease activity and acceptability of highly effective contraceptive methods in women with systemic lupus erythematosus: a randomized, clinical trial.

PubMed

Cravioto, María-del-Carmen; Jiménez-Santana, Luisa; Mayorga, Julio; Seuc, Armando H

2014-08-01

To assess the side effects unrelated to disease activity and the acceptability of combined oral contraceptives (COCs), progestin-only pills (POPs) and copper-releasing intrauterine devices (IUDs) in women with systemic lupus erythematosus (SLE). A randomized clinical trial including 162 women with SLE, assigned to COC (n=54), POP (n=54) or IUD (n=54). Follow-up visits were conducted after 1, 2, 3, 6, 9 and 12 months of treatment to monitor the presence of symptoms, changes in body weight and blood pressure as well as the development of health problems other than those relating to lupus. Reasons for discontinuation and satisfaction with the use of the assigned method were recorded at the end of treatment. Statistical analysis included descriptive statistics, repeated measure analyses and Kaplan-Meier curves. Significantly different discontinuation rates due to any reason [35%, 55%, 29% (p<0.01)] or nonmedical reasons [(11%, 31%, 4% (p<0.05)] were observed among the COC, POP and IUD groups. Nausea was most frequent among COC users, dysmenorrhea among IUD users and acne and hirsutism among POP users. Mean blood pressures remained unchanged. Mild increases in body weight were observed over time in all treatment groups. Most women were satisfied with the use of the assigned contraceptive method. Oral contraceptives and IUD are acceptable birth control methods for patients with lupus, when counseling and specialized health attention are provided; however, the acceptability of POP appears to be inferior. Side effects unrelated to lupus disease activity are not frequent reasons to discontinue the contraceptive methods. This study delves into an area that has not been explored among patients with lupus. Our findings on the associated side effects and reasons for discontinuing COCs, POPs or copper-bearing IUDs may be useful in improving contraceptive counseling for women with lupus. Furthermore, they also heighten our knowledge on the reasons that may preclude the widespread use of effective contraceptives among lupus patients. Copyright © 2014. Published by Elsevier Inc.

Preparing high-adhesion silver coating on APTMS modified polyethylene with excellent anti-bacterial performance

NASA Astrophysics Data System (ADS)

Li, Wenfei; Chen, Yunxiang; Wu, Song; Zhang, Jian; Wang, Hao; Zeng, Dawen; Xie, Changsheng

2018-04-01

Silver coating as a broad-spectrum antimicrobial agent was considered to alleviate the inflammation caused by intrauterine device (IUD) in endometrium. In this work, to avoid the damage of silver coating and ensure its antibacterial properties, 3-aminopropyltrimethoxysilane (APTMS) was introduced to modify the polyethylene (PE) substrate for the purpose of improving the adhesion of the silver coating. From the 90° peel test, it could be found that the adhesive strength of silver coating on the APTMS modified PE substrate was nearly 23 times stronger than the silver coating on substrate without surface modification. The dramatically enhanced adhesive strength could be attributed to the formation of continuous chemical bonds between the silver coatings and substrates after surface modification, which had been confirmed by the XPS. Moreover, the standard antibacterial test revealed that the silver coated samples against Staphylococcus aureus (S. aureus) exhibit excellent antibacterial efficacy. Considering the largely enhanced adhesion and the effective antibacterial property, it is reasonable to believe that the silver coating could be considered as a potential candidate for the antibacterial agent in IUD.

An exploratory analysis of contraceptive method choice and symptoms of depression in adolescent females initiating prescription contraception.

PubMed

Francis, Jenny; Presser, Liandra; Malbon, Katherine; Braun-Courville, Debra; Linares, Lourdes Oriana

2015-04-01

We examine the association between depressive symptoms and contraceptive method choice among adolescents initiating prescription contraception. This cross-sectional study analyzes baseline data of 220 urban, minority adolescent females (ages 15-19 years) presenting for prescription contraceptive initiation at a comprehensive, free-of-cost, adolescent health center in New York City. All participants met with a health care provider who provided standard contraception counseling before initiating contraception. Each participant then selected a short- or long-acting contraceptive: a 3-month supply of the pill, patch, ring or a medroxyprogesterone acetate depot injection (short-acting), or placement/referral for an intrauterine device (IUD; long-acting). We assess the independent association between contraceptive method selection and symptoms of depression [assessed by the Center for Epidemiological Studies - Depression (CES-D) scale]. Ten percent (n=21/220) of adolescent females selected an IUD. Bivariate analysis revealed that those with elevated levels of depressive symptoms were more likely to select an IUD as compared to those with minimal symptoms (mean CES-D score 20 vs. 13; t=3.052, p=.003). In multivariate logistic regressions, adolescent females had increased odds of selecting an IUD if they reported moderate to severe depressive symptoms (adjusted odds ratio=4.93; confidence interval, 1.53-15.83; p=.007) after controlling for ethnicity/race, education, number of lifetime partners and gravidity. Inner-city, minority adolescents with elevated symptoms of depression who present for prescription contraceptive initiation may be more likely to select an IUD rather than shorter-acting methods. By recognizing adolescent females with depressive symptoms, providers can strategize their approach to effective contraception counseling. Copyright © 2015 Elsevier Inc. All rights reserved.

[Impact of intrauterine device insertion surgery on women's mental state].

PubMed

Chu, Guang-hua; Zou, Yan; Wang, Xiao-ye; Li, Su-xia; Huang, Zi-rong; Fang, Ai-hua; Tian, Ai-ping

2013-06-01

To evaluate the impact of the intrauterine device (IUD) insertion on the mental state of women. From Jan. 2009 to Jun. 2010, a multi-center clinical observational study was performed. Totally 641 women were selected in the six provinces' 18 family planning service stations and hospitals for IUD insertion surgery study. Analysis of the change of women's mental state which was evaluated by symptom checklist-90 (SCL-90) scale before and after IUD insertion surgery. Before and after IUD insertion surgery, 10 factors' scores in SCL-90 of the observed objects were between 1.1 to 1.2, total scores were 107±27 and 105±25, respectively. Before and after surgery, total average score both were 1.2, the average score of positive items both were 2.1. The difference of the above results were not statistically significance (all P>0.05). Preoperative and postoperative, the rate of positive items was 9.2%-19.6% and 7.7%-17.6%, respectively.In addition to anxiety and fear, the rate of other factors' positive items postoperative was significantly lower than those in the preoperative (all P<0.05). The incidence of the observed objects postoperative of each factor score, "deteriorated" was in the range of 4.9% to 23.0%, "improved" was in the range of 26.3%-50.1%. The incidence of total scores, "deterioration" was 28.8% (166/575), "improved" was 45.6% (262/575). The incidence of the average score of positive items, "deterioration" was 3.7% (21/575), "improved" was 52.3% (301/575). Logistic analysis showed that, in addition to unit level, there were no other significant influencing factors for women' mental state of postoperative (all P>0.05). IUD insertion surgery has no adverse effect on women's mental state.

Egypt's FOF shifts into high gear.

PubMed

1983-01-01

Family of the Future (FOF), a private Egyptian family planning organization, is implementing a number of new activities in its 4 year old contraceptive social marketing program. These changes, in part, are a response to the recommendations made in a 1982 audit of the program. New activities include television advertising of contraceptives, implementation of a physician training program, and expansion of the program's product line. In 1980, FOF initiated a televised promotional campaign for several of its products. Television advertising is generally not approved of in Arab countries. The FOF television ads generated some religious controversy but spurred lagging sales of the program's condoms and vaginal foam tablets (Annan). Prior to the campaign, sales of Annan averaged 35,000 tablets/month. During the 1st month following the television campaign, sales reached 660,000 and during the 2nd month, more than 1 million tablets were sold. An IUD insertion training program for physicians was implemented in October, 1983. Contraceptive training in Egyptian medical shools is inadequate. As a result physicians are hesitant about recommending IUDs to their patients. IUDs are popular among poor urban women, and IUDs acoount for more than 1/2 of the couple years of protection provided by the FOF program. Another training program is currently being developed for the purpose of improving the marketing skills of FOF managers. The program's product line is expected to increase. A low dose oral contraceptive will be introducted in late 1983 or early 1984, and plans are being developed for the introduction of an ultra-thin condom. The program is also considering selling several noncontraceptive items. Products udner consideration are surgical gloves as a supplemental item for the program's IUD kits, pregnancy test kits, and vitamin supplements for pregnant women.

Advances in Integrating Autonomy with Acoustic Communications for Intelligent Networks of Marine Robots

DTIC Science & Technology

2013-02-01

Sonar AUV #Environmental Sampling Environmental AUV +name : string = OEX Ocean Explorer +name : string = Hammerhead Iver2 +name : string = Unicorn ...executable» Google Earth Bluefin 21 AUV ( Unicorn ) MOOS Computer GPS «serial» Bluefin 21 AUV (Macrura) MOOS Computer «acoustic» Micro-Modem «wired...Computer Bluefin 21 AUV ( Unicorn ) MOOS Computer NURC AUV (OEX) MOOS Computer Topside MOOS Computer «wifi» 5.0GHz WiLan «acoustic» Edgetech GPS

Intrauterine devices: learning from the past and looking to the future.

PubMed

Petta, C A; McPheeters, M; Chi, I C

1996-04-01

This paper reviews the historical development of the IUD, describing the challenges and successes, and attempts to offer a balanced perspective for family planning service workers today. Modern IUDs are an important component of family planning services and an excellent contraceptive choice for properly screened women, providing contraception that is safe, effective, long lasting and cost effective. Potential research strategies for the future are also discussed.

Update on emergency contraception.

PubMed

Fok, Wing Kay; Blumenthal, Paul D

2016-12-01

Emergency contraception provides a critical and time-sensitive opportunity for women to prevent undesired pregnancy after intercourse. Both access and available options for emergency contraception have changed over the last several years. Emergency contraceptive pills can be less effective in obese women. The maximum achieved serum concentration of levonorgestrel (LNG) is lower in obese women than women of normal BMI, and doubling the dose of LNG (3 mg) increases its concentration maximum, approximating the level in normal BMI women receiving one dose of LNG. Repeated use of both LNG and ulipristal acetate (UPA) is well tolerated. Hormonal contraception can be immediately started following LNG use, but should be delayed for 5 days after UPA use to avoid dampening the efficacy of UPA. The copper intrauterine device (IUD) is the only IUD approved for emergency contraception (and the most effective method of emergency contraception), but use of LNG IUD as emergency contraception is currently being investigated. Accurate knowledge about emergency contraception remains low both for patients and healthcare providers. Emergency contraception is an important yet underutilized tool available to women to prevent pregnancy. Current options including copper IUD and emergency contraceptive pills are safe and well tolerated. Significant gaps in knowledge of emergency contraception on both the provider and user level exist, as do barriers to expedient access of emergency contraception.

Serum copper levels in users of multiload intra-uterine contraceptive devices.

PubMed

Arowojolu, A O; Otolorin, E O; Ladipo, O A

1989-12-01

The systemic absorption of copper incorporated into multiload intra-uterine contraceptive devices (IUDs), as indicated by serum copper levels in users of such devices, was assessed in a prospective longitudinal study. One hundred and ten healthy Nigerian women using either multiload copper 250 (MLCU 250) or multiload copper 375 (MLCU 375) IUDs participated in the study. Their serum copper levels were estimated serially during 12 months of continuous use of the devices. The mean (+/- s.e.m.) pre-insertion serum copper levels of our subjects using MLCU 250 (17.0 +/- 3 mumol/l) and MLCU 375 (16.7 +/- 0.5 mumol/l) were found to be lower than those reported in Americans (22.2 mumol/l) and in Germans (20.2 mumol/l), although similar to levels in Indians (17.0 mumol/l). There was no significant difference in the mean serum copper levels estimated before and after 1 month of continuous use of the device. Serial estimations of the serum copper levels in users showed that there was no alteration in these levels after a period of 12 months of continuous IUD use. We therefore conclude that the copper incorporated into multiload IUDs appears not to influence the concentration of serum copper of users.

A 3-year multicentre randomized controlled trial of etonogestrel- and levonorgestrel-releasing contraceptive implants, with non-randomized matched copper-intrauterine device controls.

PubMed

Bahamondes, Luis; Brache, Vivian; Meirik, Olav; Ali, Moazzam; Habib, Ndema; Landoulsi, Sihem

2015-11-01

Is there any difference in the clinical performance of the 3-year one-rod etonogestrel (ENG)- and the 5-year two-rod levonorgestrel (LNG)-releasing contraceptive implants during 3 years of insertion, and between implant and intrauterine device (IUD) contraception, in particular complaints possibly related to hormonal contraceptives? The cumulative contraceptive effectiveness after 3 years and method continuation through 2.5 years were not significantly different between ENG and LNG implants, but both outcomes were significantly worse in the non-randomized age-matched group of IUD users than in the combined implant group. ENG- and LNG-releasing implants are safe and highly efficacious contraceptives with pregnancy rates reported to be 0.0-0.5 per 100 women-years (W-Y). No head-to-head comparative study of the two implants has been undertaken, and little information is available on comparisons of complaints of side effects of implant and copper IUD users. This was an open parallel group RCT with 1:1 allocation ratio of the ENG and the LNG implants with non-randomized control group of women choosing TCu380A IUD to address lack of reliable data on common side effects typically attributed to the use of progestogen-only contraceptives. After device(s) placement, follow-ups were at 2 weeks, 3 and 6 months, and semi-annually thereafter for 3 years or until pregnancy, removal or expulsion of the implant/IUD occurred. The study took place in family planning clinics in Brazil, Chile, Dominican Republic, Hungary, Thailand, Turkey and Zimbabwe. Women seeking long-term contraception were enlisted after an eligibility check and informed consent, and 2982 women were enrolled: 1003, 1005 and 974 in the ENG-implant, LNG-implant and IUD groups, respectively; 995, 997 and 971, respectively, were included in the per protocol analysis reported here. ENG and LNG implants each had the same 3-year cumulative pregnancy rate of 0.4 per 100 W-Y [95% confidence interval (CI) 0.1-1.4]. A weight of ≥70 kg at admission was unrelated to pregnancy. Method continuation rates for ENG and LNG implants at 2.5 years were 69.8 (95% CI 66.8-72.6) and 71.8 per 100 W-Y (68.8-74.5), and at 3 years 12.1 (95% CI 5.2-22.0) and 52.0 per 100 W-Y (95% CI 41.8-61.2), respectively. Bleeding disturbances, the most frequent reason for method discontinuation, were significantly more common in the ENG group [16.7 (95% CI 14.4-19.3)] than in the LNG group [12.5 (95% CI 10.5-14.9)] (P 0.019). The 3-year cumulative loss to follow-up was lower in the ENG- than in the LNG-implant group, 8.1 (95% CI 6.4-10.2) and 14.4 per 100 W-Y (95% CI 12.1-17.1), respectively. The median duration of implant removal was 50 s shorter among women with ENG than among women with LNG implant (P < 0.0001). In the observational comparison between IUD and implant users, the 3-year relative risk for pregnancy in IUD group compared with the combined implant group was 5.7 per 100 W-Y (95% CI 4.4-7.3) (P = 0.0003). The 3-year expulsion rate of the IUD was 17.8 per 100 W-Y (95% CI 14.5-21.9), while the discontinuation rate for bleeding disturbances was 8.5 (95% CI 6.7-10.9). Frequency of complaints of headache and dizziness was not significantly different between implant and IUD users (P = 0.16 and 0.77, respectively), acne and bleeding irregularities were more frequent among implant users (P < 0.0001), while heavy bleeding and lower abdominal pain occurred more often among IUD than implant users (P < 0.0001). Few women were ≤19 years old or nulligravida, the proportion of implant users ≥70 kg was <20% and <8% were obese. Findings of the study can inform policy makers and clinicians about choice of implant, but also about TCu380A IUD in relation to implants. UNDP/UNFPA/WHO/UNICEF/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research (RHR), World Health Organization (WHO). This report contains the views of an international expert group and does not necessarily represent the decisions or the stated policy of the WHO. ISRCTN33378571 registered on 22 March 2004. The first participant was enrolled on 12 May 2003. © The Author 2015. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

The copper intrauterine device for emergency contraception: an opportunity to provide the optimal emergency contraception method and transition to highly effective contraception.

PubMed

Dermish, Amna I; Turok, David K

2013-07-01

Worldwide, 40% of all pregnancies are unintended. Widespread, over-the-counter availability of oral emergency contraception (EC) has not reduced unintended pregnancy rates. The EC visit presents an opportunity to initiate a highly effective method of contraception in a population at high risk of unintended pregnancy who are actively seeking to avoid pregnancy. The copper intrauterine device (IUD), the most effective method of EC, continues to provide contraception as effective as sterilization for up to 12 years, and it should be offered as the first-line method of EC wherever possible. Increased demand for and supply of the copper IUD for EC may have an important role in reducing rates of unintended pregnancy. The EC visit should include access to the copper IUD as optimal care but should ideally include access to all highly effective methods of contraception.

Dietary vitamin D dose-response in healthy children 2 to 8 y of age: a 12-wk randomized controlled trial using fortified foods.

PubMed

Brett, Neil R; Lavery, Paula; Agellon, Sherry; Vanstone, Catherine A; Maguire, Jonathon L; Rauch, Frank; Weiler, Hope A

2016-01-01

Vitamin D is fundamental for bone health. A high proportion of Canadian 2- to 8-y-olds do not meet the Estimated Average Requirement (EAR) of 400 IU/d. The objective was to determine whether vitamin D intakes consistent with the EAR or Recommended Dietary Allowance (RDA), through fortification of additional dairy products, would result in higher vitamin D status in young children. Participants aged 2-8 y (n = 77; Montreal, Canada) were randomly assigned to 1 of 3 dietary vitamin D targets (control; EAR: 400 IU/d; or RDA: 600 IU/d) for 12 wk (January to April 2014). Anthropometric measurements, demographic characteristics, dietary intakes, fasting serum parathyroid hormone, 25-hydroxyvitamin D [25(OH)D], and ionized calcium were compared by using mixed-model ANOVA. Participants' mean ± SD age was 5.1 ± 1.9 y; 54.5% were boys with body mass index z scores of 0.50 ± 0.85. Compliance was 85% overall. No differences were observed in baseline dietary vitamin D intakes or serum 25(OH)D. At 12 wk, the EAR and RDA groups had significantly higher vitamin D intakes [median (IQR): control, 227 (184-305) IU/d; EAR, 410 (363-516) IU/d; and RDA, 554 (493-653) IU/d; P < 0.05] and serum 25(OH)D concentrations (control: 55.8 ± 12.3 nmol/L; EAR: 64.1 ± 10.0 nmol/L; and RDA: 63.7 ± 12.4 nmol/L; P < 0.05) than the control group. Ninety-six percent of children in the EAR and RDA groups and 67% of the control group had 25(OH)D concentrations ≥50 nmol/L. Increasing the vitamin D intakes of young children through fortification of alternative dairy products results in significantly higher serum concentrations of 25(OH)D and a significantly greater proportion of children with serum 25(OH)D ≥50 nmol/L during periods of minimal ultraviolet B radiation exposure. This trial was registered at clinicaltrials.gov as NCT02097160 and had Health Canada Temporary Marketing Authorization Letters for both products (TM-13-0432 and TM-13-0433). © 2016 American Society for Nutrition.

Body composition and bone mineral density in users of the etonogestrel-releasing contraceptive implant.

PubMed

Modesto, Waleska; Dal Ava, Natália; Monteiro, Ilza; Bahamondes, Luis

2015-12-01

There is scarce information about bone mineral density (BMD) and body composition (BC) among users of the etonogestrel (ENG)-releasing implant. To evaluate BC and BMD in ENG-releasing implant users as compared to copper intrauterine device (Cu-IUD)-users. A prospective study was conducted on 75 users of both contraceptive methods. BMD was evaluated at femoral neck (FN) and lumbar spine (LS) (L1-L4) and BC at baseline and at 12 months after insertion. The mean (±SD) age was 30.4 ± 6.8 and 29.8 ± 8.4 years and body mass index (kg/m(2)) was 24.9 ± 4.1 and 24.6 ± 3.5 in ENG-releasing implant- and Cu-IUD-users, respectively. ENG-releasing implant users did not show significant differences on BMD at the LS and FN at 12 months of use. Furthermore, ENG-implant users had an increase in body weight at 12 months (p < 0.001) and an increase of 2 % in the percentage of body fat, when compared with Cu-IUD users. There was a significant increase in lean mass in ENG-implant users at 12 months (p = 0.020). No significant changes of BMD were seen after the first year of use among the ENG-releasing implant-users, albeit an increase of weight and fat mass was seen when compared to Cu-IUD users.

Three-dimensional versus two-dimensional ultrasound for assessing levonorgestrel intrauterine device location: A pilot study.

PubMed

Andrade, Carla Maria Araujo; Araujo Júnior, Edward; Torloni, Maria Regina; Moron, Antonio Fernandes; Guazzelli, Cristina Aparecida Falbo

2016-02-01

To compare the rates of success of two-dimensional (2D) and three-dimensional (3D) sonographic (US) examinations in locating and adequately visualizing levonorgestrel intrauterine devices (IUDs) and to explore factors associated with the unsuccessful viewing on 2D US. Transvaginal 2D and 3D US examinations were performed on all patients 1 month after insertion of levonorgestrel IUDs. The devices were considered adequately visualized on 2D US if both the vertical (shadow, upper and lower extremities) and the horizontal (two echogenic lines) shafts were identified. 3D volumes were also captured to assess the location of levonorgestrel IUDs on 3D US. Thirty women were included. The rates of adequate device visualization were 40% on 2D US (95% confidence interval [CI], 24.6; 57.7) and 100% on 3D US (95% CI, 88.6; 100.0). The device was not adequately visualized in all six women who had a retroflexed uterus, but it was adequately visualized in 12 of the 24 women (50%) who had a nonretroflexed uterus (95% CI, -68.6; -6.8). We found that 3D US is better than 2D US for locating and adequately visualizing levonorgestrel IUDs. Other well-designed studies with adequate power should be conducted to confirm this finding. © 2015 Wiley Periodicals, Inc.

[Historical survey of modern reversible contraceptive methods].

PubMed

Mbabajende, V

1986-04-01

Because of contraception, pregnancy need not be viewed by women as punishment for sexual activity but as a planned and desired event. Most of the contraceptive methods used in developing countries at present were introduced during the 1960s, but use of contraception has a long history and some methods date back to antiquity. Contraceptive pills were already used around 2000 BC in the form of mercury and arsenic tablets. Their effectiveness was questionable. The role of hormones in human reproduction began to be understood only in the early 1900s. The discovery of progesterone in a Mexican iguana in the 1940s permitted production of progesterone on a large scale. Estrogens had been identified around 1930. Human trials of a contraceptive pill beginning in 1956 in Puerto Rico demonstrated that progestins could prevent pregnancy by suppressing ovulation. Later on, estrogen was added to reduce menstrual irregularities. The 1st generation of combined oral contraceptives contained very high levels of hormones associated with high rates of side effects. Numerous formulations with lower hormonal contents became available beginning around 1970 and constitute the principal formulations in use today. A number of long acting hormonal methods based on progestins have been developed, including injectables, some IUDs and vaginal rings, and implants. The 1st commercially available injectable, norethisterone enanthate, did not acquire the wide distribution of medroxyprogesterone acetate, sold as Depo Provera and used to treat various pathological conditions as well as for contraception. The 1st true IUDs were small stones placed within the uteri of camels by nomads to prevent pregnancy during long caravans. An IUD was developed in 1909 by Richter, and the 2 most widely used models before 1960 were the Grafenberg and Ota silver rings. Use of the 2 rings became rare for medical reasons after 1935 despite their efficacy. Safe plastic IUDs which appeared beginning in the early 1960s were flexible and capable of returning to their original shape after insertion. The Lippes loop was the 1st highly successful IUD. Bioactive IUDs containing copper were developed in the 1970s. Research is underway to develop IUDs which will resist expulsion, reduce bleeding, be more appropriate for multiparas, and last longer. IUDs are used to treat intrauterine adhesions as well as for contraception. A gummy substance used to block the cervix was described in Egypt in 1850 BC. Japanese and Chinese prostitutes of antiquity placed oiled bamboo paper at the cervical opening for contraception. Diaphragms and cervical caps were developed in the 19th century in Germany. Large scale production became possible after 1880 with the development of better, more durable, and cheaper rubber. An Egyptian writing in 3500 BC began the study of spermicides. Numerous substances such as lemon juice and honey have been placed in the vagina to avoid pregnancy. Such substances are available to all women and some were reasonably effective. Current research is directed toward development of spermicides which will also prevent sexually transmitted diseases. The 1st condoms were made of animal skins by an English physician to prevent transmission of venereal diseases. Rubber condoms appeared in the early 20th century and are widely utilized in some family planning programs. Pregnancy vaccines and a reversible hormonal method for men are among methods under development.

Trajectory Design for a Single-String Impactor Concept

NASA Technical Reports Server (NTRS)

Dono Perez, Andres; Burton, Roland; Stupl, Jan; Mauro, David

2017-01-01

This paper introduces a trajectory design for a secondary spacecraft concept to augment science return in interplanetary missions. The concept consist of a single-string probe with a kinetic impactor on board that generates an artificial plume to perform in-situ sampling. The trajectory design was applied to a particular case study that samples ejecta particles from the Jovian moon Europa. Results were validated using statistical analysis. Details regarding the navigation, targeting and disposal challenges related to this concept are presented herein.

Use of the Etonogestrel Implant and Levonorgestrel Intrauterine Device Beyond the U.S. Food and Drug Administration–Approved Duration

PubMed Central

McNicholas, Colleen; Maddipati, Ragini; Zhao, Qiuhong; Swor, Erin; Peipert, Jeffrey F.

2014-01-01

Objective To evaluate the effectiveness of the contraceptive implant and the 52mg hormonal intrauterine device (IUD) in women using the method beyond the current U.S. Food and Drug Administration–approved duration of 3 and 5 years respectively. Methods Women willing to continue using their implant or 52mg levonorgestrel IUD (LNG-IUD) beyond the FDA-approved duration were followed prospectively for contraceptive effectiveness. Unintended pregnancy rate per 100 women-years was calculated. Implant users are offered periodic venipuncture for analysis of serum etonogestrel levels. The Kruskal-Wallis test was used to compare the etonogestrel levels across BMI groups. Results Implant users (n=237) have contributed 229.4 women-years of follow-up, with 123 using the etonogestrel implant for 4 years, and 34 using it for 5 years. Zero pregnancies have been documented, for a failure rate of 0 (one-sided 97.5% CI: 0, 1.61) per 100 women-years. Among 263 LNG-IUD users, 197.7 women-years of follow-up have been completed. One pregnancy was confirmed, for a failure rate of 0.51 (95% CI: 0.01, 2.82) per 100 women-years. Among implant users with serum etonogestrel results, the median and range of etonogestrel level at 3 years of use was 188.8 pg/mL (range 63.8, 802.6) and 177.0 pg/mL (67.9, 470.5) at 4 years of use. Etonogestrel levels did not differ by BMI at either time point (3 years: p=0.79; 4 years: p=0.47). Conclusion Preliminary findings indicate the contraceptive implant and 52mg hormonal IUD continue to be highly-effective for an additional year, beyond the FDA approved 3 and 5 years.. Serum etonogestrel levels indicate the implant contains adequate hormone for ovulation suppression at the end of both 3 and 4 years of use. PMID:25730221

Perceived Musculoskeletal Discomfort among Elementary, Middle, and High School String Players

ERIC Educational Resources Information Center

Russell, Joshua A.; Benedetto, Rachel L.

2014-01-01

The purposes of this study were to identify the body regions where young string players report experiencing musculoskeletal discomfort and explore factors that may impact their perceived discomfort. A purposive yet nonprobability sample of elementary (n = 101), middle school (n = 97), and high school (n = 159) students participated in the study by…

Evaluation of Microscopic Observation Drug Susceptibility (MODS) and the string test for rapid diagnosis of pulmonary tuberculosis in HIV/AIDS patients in Bolivia.

PubMed

Lora, Meredith H; Reimer-McAtee, Melissa J; Gilman, Robert H; Lozano, Daniel; Saravia, Ruth; Pajuelo, Monica; Bern, Caryn; Castro, Rosario; Espinoza, Magaly; Vallejo, Maya; Solano, Marco; Challapa, Roxana; Torrico, Faustino

2015-06-06

Tuberculosis (TB) is the most common opportunistic infection and the leading cause of death in HIV-positive people worldwide. Diagnosing TB is difficult, and is more challenging in resource-scarce settings where culture-based diagnostic methods rely on poorly sensitive smear microscopy by Ziehl-Neelsen stain (ZN). We performed a cross-sectional study examining the diagnostic utility of Microscopic Observation Drug Susceptibility liquid culture (MODS) versus traditional Ziehl-Neelsen staining (ZN) and Lowenstein Jensen culture (LJ) of pulmonary tuberculosis (TB) and multidrug-resistant tuberculosis (MDRTB) in HIV-infected patients in Bolivia. For sputum scarce individuals we assessed the value of the string test and induced sputum for TB diagnosis. The presence of Mycobacterium tuberculosis (Mtb) in the sputum of 107 HIV-positive patients was evaluated by ZN, LJ, and MODS. Gastric secretion samples obtained by the string test were evaluated by MODS in 102 patients. The TB-HIV co-infection rate of HIV patients with respiratory symptoms by sputum sample was 45 % (48/107); 46/48 (96 %) were positive by MODS, 38/48 (79 %) by LJ, and 30/48 (63 %) by ZN. The rate of MDRTB was 9 % (4/48). Median time to positive culture was 10 days by MODS versus 34 days by LJ (p < 0.0001). In smear-negative patients, MODS detected TB in 17/18 patients, compared to 11/18 by LJ (94.4 % vs 61.0 %, p = 0.03 %). In patients unable to produce a sputum sample without induction, the string test cultured by MODS yielded Mtb in of 9/11 (82 %) TB positive patients compared to 11/11 (100 %) with induced sputum. Of the 10 patients unable to produce a sputum sample, 4 were TB-positive by string test. MODS was faster and had a higher Mtb detection yield compared to LJ, with a greater difference in yield between the two in smear-negative patients. The string test is a valuable diagnostic technique for HIV sputum-scarce or sputum-absent patients, and should be considered as an alternative test to induced sputum to obtain sample for Mtb in resource-limited settings. Nine percent of our TB+ patients had MDRTB, which reinforces the need for rapid detection with direct drug susceptibility testing in HIV patients in Bolivia.

Body weight and composition in users of levonorgestrel-releasing intrauterine system.

PubMed

Dal'Ava, Natália; Bahamondes, Luis; Bahamondes, M Valeria; de Oliveira Santos, Allan; Monteiro, Ilza

2012-10-01

There is little information about body weight and body composition (BC) among users of the levonorgestrel-releasing intrauterine system (LNG-IUS). The aim of this study was to evaluate body weight and BC in LNG-IUS users compared to users of the TCu380A intrauterine device (IUD). A prospective study was done with 76 new users of both contraceptive methods. Women were paired by age (±2 years) and body mass index (BMI, kg/m², ±2). Body weight and BC (% lean mass and % fat mass) were evaluated by a trained professional at baseline and at 1 year of contraceptive use. The BC measurements were obtained using Lunar DXA equipment. Weight and BC were evaluated in each woman at baseline and at 12 months and analyzed as the mean change within each woman. Then, the changes in weight and BC for each woman were calculated and then compared between LNG-IUS and TCu380A IUD users (paired data for each woman). The central-to-peripheral fat ratio was calculated by dividing trunk fat by the upper and lower limb fat. There were no significant differences at time of IUD insertion between LNG-IUS and TCu380A IUD users regarding age (mean±SD) (34.4±7.5 vs. 33.9±8.0 years), BMI (25.3±4.1 vs. 25.9±4.1) and number of pregnancies (1.9±0.2 vs. 1.7±0.2), respectively. Mean body weight gain of 2.9 kg was observed among LNG-IUS users at 12 months (p=.0012), whereas the body weight of TCu380A IUD users only increased by 1.4 kg (p=.067). There was no significant difference in body weight change between the two groups of users at 12 months. The variation in the central-to-peripheral fat ratio was the same between the two groups (-1.6% vs. -0.2%; p=.364). LNG-IUS users showed a 2.5% gain in fat mass (p=.0009) and a 1.4% loss of lean mass, whereas TCu380A IUD users showed a loss of 1.3% of fat mass (p=.159) and gain of 1.0% of lean mass (p=.120). TCu380A IUD users gained more lean mass than LNG-IUS users (p=.0270), although there was no significant difference between the two groups after 12 months of use. Although an increase in mean fat mass among LNG-IUS users at 12 months of use was observed, it should be noted that an increase of body weight was also observed in both groups after 1 year of insertion of the device. However, a study with a larger number of women and long-term evaluation is necessary to evaluate these body changes. Copyright © 2012 Elsevier Inc. All rights reserved.

Levonorgestrel-releasing intrauterine device versus dydrogesterone for management of endometrial hyperplasia without atypia.

PubMed

El Behery, Manal M; Saleh, Hend S; Ibrahiem, Moustafa A; Kamal, Ebtesam M; Kassem, Gamal A; Mohamed, Mohamed El Sayed

2015-03-01

To compare the efficacy and safety of the levonorgestrel-releasing intrauterine device (LNG-IUD) with dydrogesterone applied for the same duration in patients having endometrial hyperplasia (EH) without atypia. One hundred thirty eight women aged between 30 and 50 years with abnormal uterine bleeding and diagnosed as EH by transvaginal ultrasound were randomized to receive either LNG-IUD or dydrogesterone for 6 months. Primary outcome measures were regression of hyperplasia after 6 months of therapy. Secondary outcome measures were occurrence of side effects during treatment or recurrence of hyperplasia during follow-up period. After 6 months of treatment, regression of EH occurs in 96% of women in the levonorgestrel-releasing intrauterine system (LNG-IUS) group versus 80% of women in the oral group (P < .001). Adverse effects were relatively common with minimal differences between the 2 groups. Intermenstrual vaginal spotting and amenorrhea were more common in the LNG-IUD group (P value .01 and .0001). Patient satisfaction was significantly higher in the LNG-IUS group (P value .0001). Hysterectomy rates were lower in the LNG-IUS group than in the oral group (P = .001). Recurrence rate was 0% in the LNG-IUD group compared to 12.5% in the oral group. In management of EH without atypia, LNG-IUS achieves a higher regression and a lower hysterectomy rate than oral progesterone and could be used as a first-line therapy. © The Author(s) 2014.

Comprehensive Safety Monitoring of 12-Month Daily 7000-IU Vitamin D3 Supplementation in Human Immunodeficiency Virus-Infected Children and Young Adults.

PubMed

Schall, Joan I; Hediger, Mary L; Zemel, Babette S; Rutstein, Richard M; Stallings, Virginia A

2016-09-01

There is uncertainty whether long-term daily dosing with vitamin D3 (cholecalciferol) supplementation (vitD3) above the 4000-IU/d dietary reference intake upper tolerable limit in children and adults is safe. As part of a randomized placebo-controlled trial, we determined if supplementation with 7000-IU/d vitD3 for 12 months in human immunodeficiency virus (HIV)-Infected subjects was safe and/or associated with metabolic outcomes. A total of 58 HIV-infected subjects-aged 9-24.9 years and stratified by mode of HIV acquisition (perinatal or behavioral)-were recruited, randomized to 7000-IU/d vitD3 or placebo, and followed at 3, 6, and 12 months with physical examinations, blood and urine sampling for measures of 25(OH)D (serum 25-hydroxyvitamin D), metabolic status, safety measures, and HIV immune status. Safety was defined by a low incidence (<5%) of the study-defined serious adverse events-that is, elevated serum calcium plus 25(OH)D >160 ng/mL-and no changes in hematologic, liver, renal, metabolic, lipid, or inflammatory status. Randomization groups did not differ in demographic characteristics, vitamin D status, or HIV disease status at baseline. Over the 12 months, serum 25(OH)D increased with supplementation. No subject experienced a serious adverse safety event; none had 25(OH)D >80 ng/mL at any time. There were no clinically significant changes in hematologic, liver, renal, metabolic, lipid, or inflammatory status. Safety of daily 7000-IU vitD3 supplementation in children and young adults with HIV was comprehensively monitored over 12 months. High-dose daily vitD3 supplementation was efficacious in improving vitamin D status, and there were no safety events. © 2015 American Society for Parenteral and Enteral Nutrition.

Cooperative strings and glassy interfaces

PubMed Central

Salez, Thomas; Salez, Justin; Dalnoki-Veress, Kari; Raphaël, Elie; Forrest, James A.

2015-01-01

We introduce a minimal theory of glass formation based on the ideas of molecular crowding and resultant string-like cooperative rearrangement, and address the effects of free interfaces. In the bulk case, we obtain a scaling expression for the number of particles taking part in cooperative strings, and we recover the Adam–Gibbs description of glassy dynamics. Then, by including thermal dilatation, the Vogel–Fulcher–Tammann relation is derived. Moreover, the random and string-like characters of the cooperative rearrangement allow us to predict a temperature-dependent expression for the cooperative length ξ of bulk relaxation. Finally, we explore the influence of sample boundaries when the system size becomes comparable to ξ. The theory is in agreement with measurements of the glass-transition temperature of thin polymer films, and allows quantification of the temperature-dependent thickness hm of the interfacial mobile layer. PMID:26100908

Diagnosis of sputum-scarce HIV-associated pulmonary tuberculosis in Lima, Peru

PubMed Central

Vargas, Daniel; García, Luis; Gilman, Robert H; Evans, Carlton; Ticona, Eduardo; Ñavincopa, Marcos; Luo, Robert F; Caviedes, Luz; Hong, Clemens; Escombe, Rod; Moore, David A J

2010-01-01

Sputum induction, bronchoalveolar lavage, or gastric aspiration are often needed to produce adequate diagnostic respiratory samples from people with HIV in whom tuberculosis is suspected. Since these procedures are rarely appropriate in less-developed countries, we compared the performances of a simple string test and the gold-standard sputum induction. 160 HIV-positive adults under investigation for tuberculosis, and 52 asymptomatic HIV-positive control patients underwent the string test followed by sputum induction. The string test detected tuberculosis in 14 patients in whom this disease was suspected; sputum induction detected only eight of them (McNemar's test, p=0·03). These preliminary data suggest that the string test is safe and effective for retrieval of useful clinical specimens for diagnosis of pulmonary tuberculosis, and is at least as sensitive as sputum induction. PMID:15639297

Vitamin D Replacement in Children, Adolescents and Pregnant Women in the Middle East and North Africa

PubMed Central

Chakhtoura, M; El Ghandour, S; Shawwa, K; Akl, EA; Arabi, A; Mahfoud, Z; Habib, RH; Hoballah, H; El Hajj Fuleihan, G

2017-01-01

Introduction Hypovitaminosis D affects one-third to two-thirds of children and pregnant women from the Middle East and North Africa (MENA) region. Objective To evaluate in infants, children, adolescents and pregnant women, from the MENA region, the effect of supplementation with different vitamin D doses on the change in 25-hydroxyvitamin D [25(OH)D] level reached, and other skeletal and non-skeletal outcomes. Methods This is a systematic review of randomized controlled trials of vitamin D supplementation conducted in the MENA region. We conducted a comprehensive literature search in 7 databases, without language or time restriction, until November 2016. Two reviewers abstracted data from the included studies, independently and in duplicate. We calculated the mean difference (MD) and 95% CI of 25(OH)D level reached when at least 2 studies were eligible in each comparison (low (< 800 IU), intermediate (800–2,000 IU) or high (> 2,000 IU) daily dose of vitamin D, or placebo). We pooled data using RevMan version 5.3. Results We identified a total of 15 eligible trials: one in infants, 4 in children and adolescents and 10 in pregnant women. In children and adolescents, an intermediate vitamin D dose (1,901 IU/d), resulted in a mean difference in 25(OH)D level of 13.5 (95% Confidence Interval (CI) 8.1;18.8) ng/ml, compared to placebo, favoring the intermediate dose (p < 0.001). The proportion of children and adolescents reaching a 25(OH)D level ≥ 20 ng/ml was 74% in the intermediate dose group. In pregnant women, four trials started supplementation at 12–16 weeks of gestation and continued until delivery, and six trials started supplementation at 20–28 weeks gestation and stopped it at delivery. The MD in 25(OH)D level reached was 8.6 (95% CI 5.3–11.9) ng/ml (p <0.001) comparing the high dose (3,662 IU/d) to the intermediate dose (1,836 IU/d), and 12.3 (95% CI 6.4–18.2) ng/ml (p <0.001), comparing the high dose (3,399 IU/d) to the low dose (375 IU/d). Comparing the intermediate (1,832 IU/d) to the low dose (301 IU/d), the MD in 25(OH)D level achieved was 7.8 (95% CI 4.5–10.8) ng/ml (p < 0.001). The proportion of pregnant women reaching a 25(OH)D level ≥ 20 ng/ml was 80–90%, 73% and 27–43% in the high, intermediate, and low dose groups, respectively. The risk of bias in the included studies, for children, adolescents and pregnant women, ranged from low to high. Conclusion In children, adolescents and pregnant women from the MENA, an intermediate vitamin D dose of 1,000–2,000 IU seems necessary to allow for the majority of the population to reach a desirable 25(OH)D level of 20 ng/ml. Further high quality RCTs are required to confirm/refute the beneficial impact of vitamin D supplementation on various clinically important outcomes. PMID:28403940

Long-Acting Reversible Contraceptive Placement Among Active-Duty U.S. Army Servicewomen.

PubMed

Erickson, Anne K; Nelson, D Alan; Shaw, Jonathan G; Loftus, Pooja D; Kurina, Lianne M; Shaw, Kate A

2017-05-01

To quantify uptake of long-acting reversible contraceptives (LARC)-intrauterine devices (IUDs) and hormonal implants-among U.S. Army active-duty female soldiers and identify characteristics associated with uptake. This retrospective cohort study used the Stanford Military Data Repository, which includes all digitally recorded health encounters for active-duty U.S. Army soldiers from 2011 to 2014. We analyzed data from women aged 18-44 years to assess rates of LARC initiation using medical billing codes. We then evaluated predictors of LARC initiation using multivariable regression. Among 114,661 servicewomen, 14.5% received a LARC method; among those, 60% received an IUD. Intrauterine device insertions decreased over the study period (38.7-35.9 insertions per 1,000 women per year, β=0.14, 95% confidence interval [CI] -0.23 to -0.05, P<.05), whereas LARC uptake increased, driven by an increase in implant insertions (20.3-35.4/1,000 women per year, β=0.41, CI 0.33-0.48, P<.001). Younger age was a positive predictor of LARC uptake: 32.4% of IUD users and 62.6% of implant users were in the youngest age category (18-22 years) compared with 9.6% and 2.0% in the oldest (36-44 years). The likelihood of uptake among the youngest women (compared with oldest) was most marked for implants (adjusted relative risk 7.12, CI 5.92-8.55; P<.001). A total of 26.2% of IUD users had one child compared with 13.2% among non-LARC users (adjusted relative risk 1.94, CI 1.85-2.04, P<.001). The majority (52.2%) of those initiating IUDs were married, which was predictive of uptake over never-married women (adjusted relative risk 1.52, CI 1.44-1.59, P<.001). Among servicewomen, we observed low but rising rates of LARC insertion, driven by increasing implant use. Unmarried and childless soldiers were less likely to initiate LARC. These findings are consistent with potential underutilization and a need for education about LARC safety and reversibility in a population facing unique consequences for unintended pregnancies.

[Abnormal uterine bleeding in women with IUDs submitted to magnetotherapy].

PubMed

Semeraro, A; De Castro, G

1985-01-01

IUDs are now 1 of the cornerstones of modern contraception. Blood loss, in the form of hemorrhage or spotting, is the most common complication. Between 10%-20% of users exhibit this symptom, which is also the most frequent reason for mandatory removal. The explanations given by various authors to justify the connection between uterine hemorrhage and the IUD are many and often conflicting. In a clinical case in Italy, a 32-year-old patient came in complaining of uterine bleeding. In the long term pathological case history nothing appeared which indicated pathology in the genital region. However, it reported a vertebral fracture for which reason she was fitted with a 2nd copper IUD, which was well tolerated, and caused no intermenstrual spotting. 5 days before her appointment she had started a cycle of magnetotherapy for the vertebral fracture and 3 days later she noticed mild spotting. This is why she sought medical care. It is known that during this therapy, metals found within the magnetic field can become hot. Copper is an excellent electrical conductor, and if it is within a magnetic field it can also become hot. There are 2 possible hypotheses: 1) direct action of the magnetic field on the metal; in fact, a metal immersed in a variable magnetic field acts as if it were made up of many small magnets which modify their orientation at the fringes of the magnetic field, generating internal friction which may alter its temperature; and 2) direct action of the magnetic field on the copper wiring by way of parasite currents, setting up the Joule effect. In this patient, the symptom disappeared 6 days after the termination of physiotherapy. Therefore, it is thought that when there is a uterine hemorrhage for which no plausible explanation can be found, it is advisable to verify whether there has been any magnetotherapy involving the pelvic region. The IUD is the most widely used contraceptive among patients 40 years of age and older and it is mostly this group that may need this type of physiotherapy.

What Are Women Told When Requesting Family Planning Services at Clinics Associated with Catholic Hospitals? A Mystery Caller Study.

PubMed

Guiahi, Maryam; Teal, Stephanie B; Swartz, Maryke; Huynh, Sandy; Schiller, Georgia; Sheeder, Jeanelle

2017-12-01

Catholic Church directives restrict family planning service provision at Catholic health care institutions. It is unclear whether obstetrics and gynecology clinics that are owned by or have business affiliations with Catholic hospitals offer family planning appointments. Mystery callers phoned 144 clinics nationwide that were found on Catholic hospital websites between December 2014 and February 2016, and requested appointments for birth control generally, copper IUD services specifically, tubal ligation and abortion. Chi-square and Fisher's exact tests assessed potential correlates of appointment availability, and multivariable logistic regressions were computed if bivariate testing suggested multiple correlates. Although 95% of clinics would schedule birth control appointments, smaller proportions would schedule appointments for copper IUDs (68%) or tubal ligation (58%); only 2% would schedule an abortion. Smaller proportions of Catholic-owned than of Catholic-affiliated clinics would schedule appointments for birth control (84% vs. 100%), copper IUDs (4% vs. 97%) and tubal ligation (29% vs. 72%); for birth control and copper IUD services, no other clinic characteristics were related to appointment availability. Multivariable analysis confirmed that tubal ligation appointments were less likely to be offered at Catholic-owned than at Catholic-affiliated clinics (odds ratio. 0.1); location and association with one of the top 10 Catholic health care systems also were significant. Adherence to church directives is inconsistent at Catholic-associated clinics. Women visiting such clinics who want highly effective methods may need to rely on less effective methods or delay method uptake while seeking services elsewhere. Copyright © 2017 by the Guttmacher Institute.

Dimensional analysis of the endometrial cavity: how many dimensions should the ideal intrauterine device or system have?

PubMed

Goldstuck, Norman D

2018-01-01

The geometrical shape of the human uterus most closely approximates that of a prolate ellipsoid. The endometrial cavity itself is more likely to also have the shape of a prolate ellipsoid especially when the extension of the cervix is omitted. Using this information and known endometrial cavity volumes and lateral and vertical dimensions, it is possible to calculate the anteroposterior (AP) dimensions and get a complete evaluation of all possible dimensions of the endometrial cavity. These are singular observations and not part of any other study. The AP dimensions of the endometrial cavity of the uterus were calculated using the formula for the volume of the prolate ellipsoid to complete a three-dimensional picture of the endometrial cavity. Calculations confirm ultrasound imaging which shows large variations in cavity size and shape. Known cavity volumes and length and breadth measurements indicate that the AP diameter may vary from 6.29 to 38.2 mm. These measurements confirm the difficulty of getting a fixed-frame intrauterine device (IUD) to accommodate to a space of highly variable dimensions. This is especially true of three-dimension IUDs. A one-dimensional frameless IUD is most likely to be able to conform to this highly variable space and shape. The endometrial cavity may assume many varied prolate ellipsoid configurations where one or more measurements may be too small to accommodate standard IUDs. A one-dimensional device is most likely to be able to be accommodated by most uterine cavities as compared to two- and three-dimensional devices.

[Intrauterine devices in the immediate, early and late postabortion period].

PubMed

Nun, S

1971-01-01

2146 cases of IUD insertions after hospitalization for abortion at a hospital in Chile were studied. In 1514 cases the IUDs were inserted immediately after abortion, in 430 cases between 1-5 days after the operation, and in 202 cases between 5-40 days after. It is concluded that immediate or early insertion results in a somewhat lower retention rate, but offers the advantage of making it possible to treat a greater number of patients, many of whom would not return later to have the IUD inserted. The incidence of removal for medical causes was very low and immediate insertion was found to be harmless. The medical causes of removal were the usual ones of bleeding, pain, and infection; the most frequent cause of interruption of use was expulsion, which tends to occur during the 1st few months of use and among younger women. The probability of failure due to pregnancy was somewhat higher than in the case of insertion during the intermenstrual period. Cases of voluntary removal tend to increase after prolonged use, and a study to analyze the actual reasons for this fact is necessary.

[Activities of a family planning clinic incorporated to a public medical service over a 4-year period].

PubMed

Blum, M; Benaim, J

1991-05-01

Over a period of four years, 1769 women, all of whom were married with at least 2 children, agreed to use an intra-uterine contraceptive device (IUD), 1199 women (predominantly unmarried) preferred to use an oral contraceptive (in most cases, two- or three-phase, low-estrogen pills) and 62 a local contraceptive (spermicide or diaphragm). The period of use was 89.65% for the IUDs, with a single case of acute inflammation of the genital tract. As expected, we diagnosed a large number of cases of asymptomatic Chlamydia trachomatis infections in 24% of the women using oral contraceptives and in 15% of the women fitted with an IUD. Symptomatic cases took the form of abdominal discomfort, vaginal discharge and metrorrhagia. In the opinion of the authors, the successful results obtained were due to the cooperation between the GP and the gynecologist and to a clear and firm policy towards the choice of the optimum method of contraception. In this article, the authors describe the principles behind this policy.

Expression profiles of antimicrobial peptides in the genital tract of women using progesterone intrauterine devices versus combined oral contraceptives.

PubMed

Introini, Andrea; Kaldensjö, Tove; Hirbod, Taha; Röhl, Maria; Tjernlund, Annelie; Andersson, Sonia; Broliden, Kristina

2014-11-01

Sex hormones can influence the immune defenses of the female genital tract (FGT) and its susceptibility to infections. Here we investigated the effect of different hormonal contraceptives on the production of antimicrobial peptides (AMPs) in different compartments of the female genital mucosa (FGM), secretions and tissue. Cervicovaginal secretions (CVS) and ectocervical tissue samples obtained from women using progesterone intrauterine devices (pIUD) (n = 23) and combined oral contraceptives (COC) (n = 23) were analyzed for the expression and in situ localization of HNP1-3, BD-2, LL-37, SLPI and trappin-2 by ELISA, real-time PCR and immunohistochemistry. Women using COC had significantly lower mRNA levels of BD-2 and trappin-2 in ectocervical tissue than pIUD users. The two groups showed no differences in CVS concentration, as well as similar in situ expression patterns in ectocervical tissue, of all five AMPs. The use of hormonal contraceptives influences AMP expression differently in genital secretions compared to ectocervical tissue. This suggests that the impact of sex hormones on local immune defenses varies in different compartments of the FGM, and likely in different locations across the FGT. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Multiplexed color-coded probe-based gene expression assessment for clinical molecular diagnostics in formalin-fixed paraffin-embedded human renal allograft tissue.

PubMed

Adam, Benjamin; Afzali, Bahman; Dominy, Katherine M; Chapman, Erin; Gill, Reeda; Hidalgo, Luis G; Roufosse, Candice; Sis, Banu; Mengel, Michael

2016-03-01

Histopathologic diagnoses in transplantation can be improved with molecular testing. Preferably, molecular diagnostics should fit into standard-of-care workflows for transplant biopsies, that is, formalin-fixed paraffin-embedded (FFPE) processing. The NanoString(®) gene expression platform has recently been shown to work with FFPE samples. We aimed to evaluate its methodological robustness and feasibility for gene expression studies in human FFPE renal allograft samples. A literature-derived antibody-mediated rejection (ABMR) 34-gene set, comprised of endothelial, NK cell, and inflammation transcripts, was analyzed in different retrospective biopsy cohorts and showed potential to molecularly discriminate ABMR cases, including FFPE samples. NanoString(®) results were reproducible across a range of RNA input quantities (r = 0.998), with different operators (r = 0.998), and between different reagent lots (r = 0.983). There was moderate correlation between NanoString(®) with FFPE tissue and quantitative reverse transcription polymerase chain reaction (qRT-PCR) with corresponding dedicated fresh-stabilized tissue (r = 0.487). Better overall correlation with histology was observed with NanoString(®) (r = 0.354) than with qRT-PCR (r = 0.146). Our results demonstrate the feasibility of multiplexed gene expression quantification from FFPE renal allograft tissue. This represents a method for prospective and retrospective validation of molecular diagnostics and its adoption in clinical transplantation pathology. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Emergency contraception review: evidence-based recommendations for clinicians

PubMed Central

Cleland, Kelly; Raymond, Elizabeth G.; Westley, Elizabeth; Trussell, James

2014-01-01

Several options for emergency contraception are available in the United States. This article describes each method, including efficacy, mode of action, safety, side effect profile and availability. The most effective emergency contraceptive is the copper IUD, followed by ulipristal acetate and levonorgestrel pills. Levonorgestrel is available for sale without restrictions, while ulipristal acetate is available with prescription only, and the copper IUD must be inserted by a clinician. Although EC pills have not been shown to reduce pregnancy or abortion rates at the population level, they are an important option for individual women seeking to prevent pregnancy after sex. PMID:25254919

Contraception Use among Egyptian Women: Results from Egypt Demographic and Health Survey in 2005

PubMed Central

Awadalla, Hala Ibrahim

2012-01-01

Background The reports of a rise in contraceptive practices have not been matched by a similar decrease in population: therefore, there is a need to look into the causes of this discrepancy. The objectives of this study were to determine the prevalence of different methods of contraception used by Egyptian women, to compare different contraception methods used among various socio-demographic groups and, finally, to identify the main decision makers of contraception use within Egyptian families. Methods The 2005 Egypt Demographic and Health Survey (EDHS) is a nationally representative household survey of 18134 married women aged 15–49 years. The 2005 EDHS provides a wealth of information on fertility, family planning, maternal and child health and nutrition, and violence against women. The study sample was selected using a multistage sampling technique. A face-to-face structured interview was conducted with each of the selected women. The response rate was 99.5% for completing the questionnaires. Results The prevalence of contraception was 57.5%, nearly one third of the participants (33.1%) used IUD as a method of contraception. Both male and female were responsible for decision making regarding the use of contraception among different educational levels. Most women reporting use of contraceptive methods were 30–39 years old, were employed, were rich, educated and belonged to urban governorates. Conclusion More than half of the participants used contraception while IUDs and pills were the most commonly used methods. Whatever the level of education, the majority of women thought that family planning decisions should be made by both partners. PMID:23926542

Permuting input for more effective sampling of 3D conformer space

NASA Astrophysics Data System (ADS)

Carta, Giorgio; Onnis, Valeria; Knox, Andrew J. S.; Fayne, Darren; Lloyd, David G.

2006-03-01

SMILES strings and other classic 2D structural formats offer a convenient way to represent molecules as a simplistic connection table, with the inherent advantages of ease of handling and storage. In the context of virtual screening, chemical databases to be screened are often initially represented by canonicalised SMILES strings that can be filtered and pre-processed in a number of ways, resulting in molecules that occupy similar regions of chemical space to active compounds of a therapeutic target. A wide variety of software exists to convert molecules into SMILES format, namely, Mol2smi (Daylight Inc.), MOE (Chemical Computing Group) and Babel (Openeye Scientific Software). Depending on the algorithm employed, the atoms of a SMILES string defining a molecule can be ordered differently. Upon conversion to 3D coordinates they result in the production of ostensibly the same molecule. In this work we show how different permutations of a SMILES string can affect conformer generation, affecting reliability and repeatability of the results. Furthermore, we propose a novel procedure for the generation of conformers, taking advantage of the permutation of the input strings—both SMILES and other 2D formats, leading to more effective sampling of conformation space in output, and also implementing fingerprint and principal component analyses step to post process and visualise the results.

Comparison of quantitative real-time polymerase chain reaction with NanoString® methodology using adipose and liver tissues from rats fed seaweed.

PubMed

Bentley-Hewitt, Kerry L; Hedderley, Duncan I; Monro, John; Martell, Sheridan; Smith, Hannah; Mishra, Suman

2016-05-25

Experimental methods are constantly being improved by new technology. Recently a new technology, NanoString®, has been introduced to the market for the analysis of gene expression. Our experiments used adipose and liver samples collected from a rat feeding trial to explore gene expression changes resulting from a diet of 7.5% seaweed. Both quantitative real-time polymerase chain reaction (qPCR) and NanoString methods were employed to look at expression of genes related to fat and glucose metabolism and this paper compares results from both methods. We conclude that NanoString offers a valuable alternative to qPCR and our data suggest that results are more accurate because of the reduced sample handling and direct quantification of gene copy number without the need for enzymatic amplification. However, we have highlighted a potential challenge for both methods, which needs to be addressed when designing primers or probes. We suggest a literature search for known splice variants of a particular gene to be completed so that primers or probes can be designed that do not span exons which may be affected by alternative gene sequences. Copyright © 2016 Elsevier B.V. All rights reserved.

Using PubMed search strings for efficient retrieval of manual therapy research literature.

PubMed

Pillastrini, Paolo; Vanti, Carla; Curti, Stefania; Mattioli, Stefano; Ferrari, Silvano; Violante, Francesco Saverio; Guccione, Andrew

2015-02-01

The aim of this study was to construct PubMed search strings that could efficiently retrieve studies on manual therapy (MT), especially for time-constrained clinicians. Our experts chose 11 Medical Subject Heading terms describing MT along with 84 additional potential terms. For each term that was able to retrieve more than 100 abstracts, we systematically extracted a sample of abstracts from which we estimated the proportion of studies potentially relevant to MT. We then constructed 2 search strings: 1 narrow (threshold of pertinent articles ≥40%) and 1 expanded (including all terms for which a proportion had been calculated). We tested these search strings against articles on 2 conditions relevant to MT (thoracic and temporomandibular pain). We calculated the number of abstracts needed to read (NNR) to identify 1 potentially pertinent article in the context of these conditions. Finally, we evaluated the efficiency of the proposed PubMed search strings to identify relevant articles included in a systematic review on spinal manipulative therapy for chronic low back pain. Fifty-five search terms were able to extract more than 100 citations. The NNR to find 1 potentially pertinent article using the narrow string was 1.2 for thoracic pain and 1.3 for temporomandibular pain, and the NNR for the expanded string was 1.9 and 1.6, respectively. The narrow search strategy retrieved all the randomized controlled trials included in the systematic review selected for comparison. The proposed PubMed search strings may help health care professionals locate potentially pertinent articles and review a large number of MT studies efficiently to better implement evidence-based practice. Copyright © 2015 National University of Health Sciences. Published by Elsevier Inc. All rights reserved.

Intrauterine contraception in nulliparous women: a prospective survey.

PubMed

Hall, Alexandra M; Kutler, Beth A

2016-01-01

Intrauterine contraception is a first-line option for young women, yet relatively few prospective studies have been performed in nulliparous women using currently available devices, and many providers are still reluctant to provide this option. Between January 2012 and June 2014, 109 nulliparous women, aged 18-30 years, who had an intrauterine device (IUD) placed at a student health clinic [88 levonorgestrel-intrauterine system (LNG-IUS) users and 21 Cu T 380A (IUD) users] were surveyed at 1, 6, 12 and 18 months after insertion. Overall satisfaction was high; at follow-up survey 83% of 100 women (mean use 13.4 months) were 'happy' or 'very happy' with their IUD, and there were no differences in satisfaction between the two IUD types. Some 75% of participants stated that the insertion procedure went 'very well', despite 78% rating insertion pain as moderate to severe, and 46% experiencing vasovagal symptoms. The 12-month continuation rate was 89%, with discontinuations for expulsion (3%), side effects (6%), lack of anticipated benefit (1%) and pregnancy (1%). Users of the Cu T 380A were more likely to have heavy menses (74% vs 2%; p<0.0001) or moderate to severe cramping (68% vs 20%; p=0.0002) compared with LNG-IUS users. There were no uterine perforations or diagnoses of pelvic inflammatory disease. The rate of failed insertions during the study period was 6.2%. Despite significant symptoms with insertion, intrauterine contraception is safe, effective and ultimately well tolerated in nulliparous women and should be provided to this population in both university and community health settings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Family planning and maternal and child health services.

PubMed

Singh, A

1975-12-01

Considerable effort has been made in the area of family planning in the State of Punjab. Family planning personnel has been recruited and trained at the State Family Planning Training and Research Center in Kharar; supplies of Nirodh, IUDs, oral contraceptives, and hospital equipment along with transportation facilities have been made available; and there has been some building construction. The State Health Education Bureau has worked to produce publicity material and has also used the mass media to create awareness of family planning among the people. As many as 120 rural and 49 urban Family Welfare Planning Centers are providing family planning services along with 856 subcenters in rural areas. 1123 other institutions are also doing family planning work in addition to the efforts of 34 mobile sterilization and IUD units attached to the District Family Planning Bureau and the contributions of some voluntary organizations. Although the state has adopted the cafeteria approach to family planning and the focus is on provision of family planning services on routine days in the various institutions to well-motivated couples, mass family planning camps for vasectomy, tubal ligations, and IUD insertions have been held with considerable success. Additionally, the State has integrated family planning programs with maternal and child health care in order to provide a totality of service. This precedes the total integration of this national program w ith general health services. Punjab has done well in achieving its targets for 1974-1975. Sterilization targets were set at 38,300 and 36,460 sterilizations, 95.2% of the target, were performed. IUD targets were 27,000, and the number achieved was 39,637 or 109.4%. The conventional contraceptive user target was 99,800, and 151,976 or 152.3% of the target figure became conventional contraceptive users.

Intrauterine contraception in nulliparous women: a prospective survey

PubMed Central

Kutler, Beth A

2016-01-01

Background Intrauterine contraception is a first-line option for young women, yet relatively few prospective studies have been performed in nulliparous women using currently available devices, and many providers are still reluctant to provide this option. Methods Between January 2012 and June 2014, 109 nulliparous women, aged 18–30 years, who had an intrauterine device (IUD) placed at a student health clinic [88 levonorgestrel-intrauterine system (LNG-IUS) users and 21 Cu T 380A (IUD) users] were surveyed at 1, 6, 12 and 18 months after insertion. Results Overall satisfaction was high; at follow-up survey 83% of 100 women (mean use 13.4 months) were ‘happy’ or ‘very happy’ with their IUD, and there were no differences in satisfaction between the two IUD types. Some 75% of participants stated that the insertion procedure went ‘very well’, despite 78% rating insertion pain as moderate to severe, and 46% experiencing vasovagal symptoms. The 12-month continuation rate was 89%, with discontinuations for expulsion (3%), side effects (6%), lack of anticipated benefit (1%) and pregnancy (1%). Users of the Cu T 380A were more likely to have heavy menses (74% vs 2%; p<0.0001) or moderate to severe cramping (68% vs 20%; p=0.0002) compared with LNG-IUS users. There were no uterine perforations or diagnoses of pelvic inflammatory disease. The rate of failed insertions during the study period was 6.2%. Conclusions Despite significant symptoms with insertion, intrauterine contraception is safe, effective and ultimately well tolerated in nulliparous women and should be provided to this population in both university and community health settings. PMID:25854550

[Contraception during the perimenopause: indications, security, and non contraceptive benefits].

PubMed

Cantero Pérez, P; Klingemann, J; Yaron, M; Irion, N Fournet; Streuli, I

2015-10-28

Although patients' fertility is diminished in the period of perimenopause, they still need efficient contraception. Thorough knowledge of the physiological changes occuring during this period of transition is essential in order to provide optimal care. Until the age of 50, no contraceptive method is specifically considered unsuitable due to age alone. The choice of contraceptive needs to be adapted to the patient, assessing the individual risk factors and favouring the potential non-contraceptive advantages of the method selected. Long-term contraceptive methods (e.g., the copper intrauterine device (IUD), the Mirena IUD or a subcutaneous implant) offer an excellent solution on both levels.

[Exercise-induced oedema due to hormone-containing intrauterine device].

PubMed

Franssen, Laurens E; Bos, Willem-Jan W

2012-01-01

Oedema is a known adverse effect of the levonorgestrel-containing intrauterine device (Mirena IUD). However, exercise-induced oedema has not been described before. A 38-year-old woman presented with symptoms of diffuse, exercise-induced oedema and dyspnoea. Tests for heart failure and other causes of oedema showed no abnormalities. All symptoms resolved spontaneously after the patient initiated removal of the IUD. The pathophysiology of exercise-induced oedema is still poorly understood. When confronted with a patient with oedema (induced by exercise or other cause), the most common causes must first be excluded. If no explanation can be found, then the effects of medication must not be overlooked.

Group B streptococci in women fitted with intrauterine devices.

PubMed Central

Mitchell, R G; Guillebaud, J; Day, D G

1977-01-01

A survey was made of group B streptococcal carriage at various sites in 100 women attending a clinic for the insertion of an intrauterine contraceptive device (IUD). Twenty-three women carried streptococci at one or more sites at the preinsertion visit, the vaginal carriage rate being 16%. Six months after insertion changes in carrier status were noted and there was evidence of a change of strain in four patients. Twenty-nine women were carriers at one or more sites at some stage of the study. There was no evidence that symptoms attributable to infection in patients fitted with an IUD were caused by group B streptococci. PMID:338639

Intrauterine device insertion in the postpartum period: a systematic review.

PubMed

Sonalkar, Sarita; Kapp, Nathalie

2015-02-01

Given new research on postpartum placement of levonorgestrel and copper intrauterine devices (IUDs), our objective was to update a prior systematic review of the safety and expulsion rates of postpartum IUDs. We searched MEDLINE, CENTRAL, LILACS, POPLINE, Web of Science, and ClinicalTrials.gov databases for articles between the database inception until July 2013. We included studies that compared IUD insertion time intervals and routes during the postpartum period. We used standard abstract forms and the United States Preventive Services Task Force grading system to summarise and assess the quality of the evidence. We included 18 articles. New evidence suggests that a levonorgestrel releasing-intrauterine system (LNG-IUS) insertion within 48 hours of delivery is safe. Postplacental insertion and insertion between 10 minutes and 48 hours after delivery result in higher expulsion rates than insertion 4 to 6 weeks postpartum, or non-postpartum insertion. Insertion at the time of caesarean section is associated with lower expulsion rates than postplacental insertion at the time of vaginal delivery. This review supports the evidence that insertion of an intrauterine contraceptive within the first 48 hours of vaginal or caesarean delivery is safe. Expulsion rates should be further studied in larger randomised controlled trials.

Survey of the attitude to, the knowledge and the practice of contraception and medical abortion in women who attended a family planning clinic.

PubMed

K M, Umashankar; M N, Dharmavijaya; Kumar D E, Jayanta; K, Kala; Nagure, Abed Gulab; Ramadevi

2013-03-01

To assess the attitude to, the knowledge and practice of contraception and medical abortion in women attending the family planning clinic at the mvj medical college , hosakote , Bangalore, India. Between 1(st) of August, 2011 and 31st of July, 2012 200 women attending family planning clinic of the mvj medical college, hosakote, Bangalore India of which 105 requested for medical termination of pregnancy (mtp), 95 for family planning advice, were interrogated on a structured questionnaire. The age of women ranged in between 20-45 years, 71 (35.5%) were illiterate, 30 (15%) had primary school education and 99 (49.5%) had diplomas from high school and above. Patients were grouped into low and high socio-economic status according to modified kuppuswamy socio-economic status scale: (i). upper class, (ii). Upper middle class, (iii). Middle class, (iv). Lower middle class, (v). lower class.consent of both husband and wife was taken. They were counseled about the various contraceptives available and allowed to choose whichever suited them best. Among the 200 women 85 (42%) did not use contraception; 51 (25.5 %) were on the barrier method; 49 (18.31%) used intrauterine devices (iud); 12 (6%) used oral pills and and 3 (1.5%) used other methods. the request for mtp was on grounds of unplanned pregnancy in 55.25% cases or failure of contraception in 44.7%. there was no eugenic indication of the women, 3 (1.5%) had heard about emergency contraceptives, however none had used them; 20 (10%) had heard of medical abortion and 12 (6%) had previously undergone mtp with satisfaction. the various methods of contraception accepted by the women post abortion were ocps by 11 (10.47%), iuds by 54 (51.5%) and female sterilization by 26 (24.71%). in the other group, 23 (24.2%) had iuds removed and reinserted; 37.8% had iuds inserted; 26 (27.36%) women underwent sterilization operation; and 6 (6.31%) had iuds removed opting for pregnancy. statistical analysis was done using spss software (Chicago) with χ(2) test taking p value of 0.05 as significant. There is lack of awareness of emergency contraception and medical abortion in the women community under study.

Contraceptive Use and the Risk of Ectopic Pregnancy: A Multi-Center Case-Control Study.

PubMed

Li, Cheng; Zhao, Wei-Hong; Meng, Chun-Xia; Ping, Hua; Qin, Guo-Juan; Cao, Shu-Jun; Xi, Xiaowei; Zhu, Qian; Li, Xiao-Cui; Zhang, Jian

2014-01-01

To evaluate the association between the risk of ectopic pregnancy (EP) and the use of common contraceptives during the previous and current conception/menstrual cycle. A multi-center case-control study was conducted in Shanghai. Women diagnosed with EP were recruited as the case group (n = 2,411). Women with intrauterine pregnancy (IUP) (n = 2,416) and non-pregnant women (n = 2,419) were matched as controls at a ratio of 1∶1. Information regarding the previous and current use of contraceptives was collected. Multivariate logistic regression analyses were performed to calculate odds ratios (ORs) and the corresponding 95% confidential intervals (CIs). Previous use of intrauterine devices (IUDs) was associated with a slight risk of ectopic pregnancy (AOR1 = 1.87 [95% CI: 1.48-2.37]; AOR2 = 1.84 [1.49-2.27]), and the risk increased with the duration of previous use (P1 for trend <10-4, P2 for trend <10-4). The current use of most contraceptives reduced the risk of both unwanted IUP (condom: AOR = 0.04 [0.03-0.05]; withdrawal method: AOR = 0.10 [0.07-0.13]; calendar rhythm method: AOR = 0.54 [0.40-0.73]; oral contraceptive pills [OCPs]: AOR = 0.03 [0.02-0.08]; levonorgestrel emergency contraception [LNG-EC]: AOR = 0.22 [0.16-0.30]; IUDs: AOR = 0.01 [0.005-0.012]; tubal sterilization: AOR = 0.01 [0.001-0.022]) and unwanted EP (condom: AOR1 = 0.05 [0.04-0.06]; withdrawal method: AOR1 = 0.13 [0.09-0.19]; calendar rhythm method: AOR1 = 0.66 [0.48-0.91]; OCPs: AOR1 = 0.14 [0.07-0.26]; IUDs: AOR1 = 0.17 [0.13-0.22]; tubal sterilization: AOR1 = 0.04 [0.02-0.08]). However, when contraception failed and pregnancy occurred, current use of OCPs (AOR2 = 4.06 [1.64-10.07]), LNG-EC (AOR2 = 4.87 [3.88-6.10]), IUDs (AOR2 = 21.08 [13.44-33.07]), and tubal sterilization (AOR2 = 7.68 [1.69-34.80]) increased the risk of EP compared with the non-use of contraceptives. Current use of most contraceptives reduce the risk of both IUP and EP. However, if the contraceptive method fails, the proportions of EP may be higher than those of non-users. In the case of contraceptive failure in the current cycle, EP cases should be differentiated according to current use of OCPs, LNG-EC, IUDs, and tubal sterilization. In addition, attention should be paid to women with previous long-term use of IUDs.

Top-down analysis of protein samples by de novo sequencing techniques

DOE Office of Scientific and Technical Information (OSTI.GOV)

Vyatkina, Kira; Wu, Si; Dekker, Lennard J. M.

MOTIVATION: Recent technological advances have made high-resolution mass spectrometers affordable to many laboratories, thus boosting rapid development of top-down mass spectrometry, and implying a need in efficient methods for analyzing this kind of data. RESULTS: We describe a method for analysis of protein samples from top-down tandem mass spectrometry data, which capitalizes on de novo sequencing of fragments of the proteins present in the sample. Our algorithm takes as input a set of de novo amino acid strings derived from the given mass spectra using the recently proposed Twister approach, and combines them into aggregated strings endowed with offsets. Themore » former typically constitute accurate sequence fragments of sufficiently well-represented proteins from the sample being analyzed, while the latter indicate their location in the protein sequence, and also bear information on post-translational modifications and fragmentation patterns.« less

Dataset of breath research manuscripts curated using PubMed search strings from 1995-2016.

PubMed

Geer Wallace, M Ariel; Pleil, Joachim D

2018-06-01

The data contained in this article are PubMed search strings and search string builders used to curate breath research manuscripts published from 1995-2016 and the respective number of articles found that satisfied the search requirements for selected categories. Breath sampling represents a non-invasive technique that has gained usefulness for public health, clinical, diagnostic, and environmental exposure assessment applications over the years. This data article includes search strings that were utilized to retrieve publications through the PubMed database for different breath research-related topics that were related to the analysis of exhaled breath, exhaled breath condensate (EBC), and exhaled breath aerosol (EBA) as well as the analysis of cellular headspace. Manuscripts were curated for topics including EBC, EBA, Direct MS, GC-MS, LC-MS, alcohol, and sensors. A summary of the number of papers published per year for the data retrieved using each of the search strings is also included. These data can be utilized to discern trends in the number of breath research publications in each of the different topics over time. A supplementary Appendix A containing the titles, author lists, journal names, publication dates, PMID numbers, and EntrezUID numbers for each of the journal articles curated using the finalized search strings for the seven breath research-related topics can also be found within this article. The selected manuscripts can be used to explore the impact that breath research has had on expanding the scientific knowledge in each of the investigated topics.

Meteorological Sensor Array (MSA)-Phase I. Volume 2 (Data Management Tool: Proof of Concept)

DTIC Science & Technology

2014-10-01

directory of next hourly file to read *** utcString = CStr (CInt(utcString) + 1) utcString = String(2 - Len(utcString), Ŕ...hourly file to read *** utcString = CStr (CInt(utcString) + 1) utcString = String(2 - Len(utcString), Ŕ") & utcString

Greenhouse gas emissions from integrated urban drainage systems: Where do we stand?

NASA Astrophysics Data System (ADS)

Mannina, Giorgio; Butler, David; Benedetti, Lorenzo; Deletic, Ana; Fowdar, Harsha; Fu, Guangtao; Kleidorfer, Manfred; McCarthy, David; Steen Mikkelsen, Peter; Rauch, Wolfgang; Sweetapple, Chris; Vezzaro, Luca; Yuan, Zhiguo; Willems, Patrick

2018-04-01

As sources of greenhouse gas (GHG) emissions, integrated urban drainage systems (IUDSs) (i.e., sewer systems, wastewater treatment plants and receiving water bodies) contribute to climate change. This paper, produced by the International Working Group on Data and Models, which works under the IWA/IAHR Joint Committee on Urban Drainage, reviews the state-of-the-art and modelling tools developed recently to understand and manage GHG emissions from IUDS. Further, open problems and research gaps are discussed and a framework for handling GHG emissions from IUDSs is presented. The literature review reveals that there is a need to strengthen already available mathematical models for IUDS to take GHG into account.

Current concepts on the use of IUDs.

PubMed

McCarthy, T

1989-08-01

IUDs have been used in Singapore since the mid 1960's but acceptance of this contraceptive method has fluctuated widely as a result of misconceptions regarding possible complications. The current generation of copper bearing devices have pregnancy rates below 1 per 100 women per year and this rate falls further with continued use. New developments which hold promise include a device releasing 20 mcg levonorgestrel per day and a copper device without a plastic frame which may reduce menstrual blood loss and dysmenorrhoea. In addition to the well established contra-indications to use, a past history of pelvic inflammatory disease or ectopic pregnancy, promiscuity, nulliparity and age less than 25 are now considered relative contraindications.

The formation of topological defects in phase transitions

NASA Technical Reports Server (NTRS)

Hodges, Hardy M.

1989-01-01

It was argued, and fought through numerical work that the results of non-dynamical Monte Carlo computer simulations cannot be applied to describe the formation of topological defects when the correlation length at the Ginzburg temperature is significantly smaller than the horizon size. To test the current hypothesis that infinite strings at formation are essentially described by Brownian walks of size the correlation length at the Ginzburg temperature, fields at the Ginzburg temperature were equilibrated. Infinite structure do not exist in equilibrium for reasonable definitions of the Ginzburg temperature, and horizons must be included in a proper treatment. A phase transition, from small-scale to large-scale string or domain wall structure, is found to occur very close to the Ginzburg temperature, in agreement with recent work. The formation process of domain walls and global strings were investigated through the breaking of initially ordered states. To mimic conditions in the early Universe, cooling times are chosen so that horizons exist in the sample volume when topological structure formation occurs. The classical fields are evolved in real-time by the numerical solution of Langevin equations of motion on a three dimensional spatial lattice. The results indicate that it is possible for most of the string energy to be in small loops, rather than in long strings, at formation.

Divergent endometrial inflammatory cytokine expression at peri-implantation period and after the stimulation by copper intrauterine device.

PubMed

Chou, Chia-Hung; Chen, Shee-Uan; Shun, Chia-Tung; Tsao, Po-Nien; Yang, Yu-Shih; Yang, Jehn-Hsiahn

2015-10-15

Endometrial inflammation has contradictory effects. The one occurring at peri-implantation period is favourable for embryo implantation, whereas the other occurring after the stimulation by copper intrauterine device (Cu-IUD) prevents from embryo implantation. In this study, 8 week female ICR mice were used to investigate the endometrial inflammation, in which they were at proestrus stage (Group 1), at peri-implantation period (Group 2), and had a copper wire implanted into right uterine horn (Group 3). Cytokine array revealed that two cytokines were highly expressed in Group 2 and Group 3 as compared with Group 1, and seven cytokines, including tumour necrosis factor α (TNF-α), had selectively strong expression in Group 3. Immunohistochemistry demonstrated prominent TNF-α staining on the endometrium after Cu-IUD stimulation, and in vitro culture of human endometrial glandular cells with Cu induced TNF-α secretion. The increased TNF-α concentration enhanced in vitro THP-1 cells chemotaxis, and reduced embryo implantation rates. These results suggest that inflammatory cytokine profiles of endometrium are different between those at peri-implantation period and after Cu-IUD stimulation, and TNF-α is the one with selectively strong expression in the latter. It might account for the contradictory biological effects of endometrial inflammation.

Chitosan/alginate multilayer film for controlled release of IDM on Cu/LDPE composite intrauterine devices.

PubMed

Tian, Kuan; Xie, Changsheng; Xia, Xianping

2013-09-01

To reduce such side effects as pain and bleeding caused by copper-containing intrauterine device (Cu-IUD), a novel medicated intrauterine device, which is coated with an indomethacin (IDM) delivery system on the surface of copper/low-density polyethylene (Cu/LDPE) composite intrauterine device, has been proposed and developed in the present work. The IDM delivery system is a polyelectrolyte multilayer film, which is composed of IDM containing chitosan and alginate layer by layer, is prepared by using self-assembled polyelectrolyte multilayer method, and the number of the layers of this IDM containing chitosan/alginate multilayer film can be tailored by controlling the cyclic repetition of the deposition process. After the IDM containing chitosan/alginate multilayer film is obtained on the surface of Cu/LDPE composite intrauterine device, its release behavior of both IDM and cupric ion has been studied in vitro. The results show that the release duration of IDM increase with the increasing of thickness of the IDM containing chitosan/alginate multilayer film, and the initial burst release of cupric ion cannot be found in this novel medicated Cu/LDPE composite IUD. These results can be applied to guide the design of novel medicated Cu-IUD with minimal side effects for the future clinical use. Copyright © 2013 Elsevier B.V. All rights reserved.

Consistent Condom Use Increases the Colonization of Lactobacillus crispatus in the Vagina

PubMed Central

Ma, Liyan; Lv, Zhi; Su, Jianrong; Wang, Jianjie; Yan, Donghui; Wei, Jingjuan; Pei, Shuang

2013-01-01

Background Non-hormonal contraception methods have been widely used, but their effects on colonization by vaginal lactobacilli remain unclear. Objective To determine the association between non-hormonal contraception methods and vaginal lactobacilli on women’s reproductive health. Methods The cross-sectional study included 164 healthy women between 18–45 years of age. The subjects were divided into different groups on the basis of the different non-hormonal contraception methods used by them. At the postmenstrual visit (day 21 or 22 of the menstrual cycle), vaginal swabs were collected for determination of Nugent score, quantitative culture and real-time polymerase chain reaction (PCR) of vaginal lactobacilli. The prevalence, colony counts and 16S rRNA gene expression of the Lactobacillus strains were compared between the different groups by Chi-square and ANOVA statistical analysis methods. Results A Nugent score of 0–3 was more common in the condom group (93.1%) than in the group that used an interuterine device(IUD) (75.4%), (p = 0.005). The prevalence of H2O2-producing Lactobacillus was significantly higher in the condom group (82.3%) than in the IUD group (68.2%), (p = 0.016). There was a significant difference in colony count (mean ± standard error (SE), log10colony forming unit (CFU)/ml) of H2O2-producing Lactobacillus between condom users (7.81±0.14) and IUD users (6.54±0.14), (p = 0.000). The 16S rRNA gene expression (mean ± SE, log10copies/ml) of Lactobacillus crispatus was significantly higher in the condom group (8.09±0.16) than in the IUD group (6.03±0.18), (p = 0.000). Conclusion Consistent condom use increases the colonization of Lactobacillus crispatus in the vagina and may protect against both bacterial vaginosis (BV) and human immunodeficiency virus (HIV). PMID:23894682

Status of fertility control in Egypt.

PubMed

Hefnawi, F I

1982-01-01

The concern for fertility control is not alien to the cultural and religious heritage of Egypt. Historically, Egyptian interest in fertility dates to the Pharoahs. Contraceptive recipes written at least 15-18 centuries B.C. have been found. Romans may have borrowed some of the more effective methods from Egypt when it became part of the Roman Empire as evidenced by the decline in size of aristocratic Roman families at the beginning of the Christian era. Muslim conquerors of Egypt encouraged fertility control. In the 9th century differences of opinion about the legality of contraception appeared among the interpreters of Islamic law. Some methods found in the writings of Muslim doctors as al-Razi and Avicenna still survive in the folk medicine of Egypt. In modern times use of barrier methods of contraception were encouraged by family planning organizations in Egypt. The medical profession was not deeply involved since these methods did not require much medical assistance. In 1936 a religiouss verdict declared contraception to be a lawful act of Islam. National programs in family planning in the 1960's encouraged the use of the Lippes Loop IUD. The medical problem of blood loss associated with the IUD caused anxiety because of the high incidence of anemia in the female Egyptian population. There was also a cultural limitation on the wide use of the IUD. "Spotting" due to the IUD resulted in females being ritually unclean and therefore unfit to pray or observe the Islamic fast. The Pill, initially favored caused complications due to its effect on breast milk which is the universal source of nutrition for infants in Egypt. Replacement of the Pill by depo-provera injections during the post partum period of lactation is a practical solution. Permanent sterilization is limited to females and only performed when medically indicated. Abortion is illegal and permitted only as a therapeutic measure.

Melanoma-targeted delivery system (part 1): design, synthesis and evaluation of releasable disulfide drug by glutathione.

PubMed

El Aissi, Radhia; Chezal, Jean-Michel; Tarrit, Sébastien; Chavignon, Olivier; Moreau, Emmanuel

2015-08-28

Here we describe the design and synthesis of a prodrug developed for pigmented melanoma therapy, consisting of a Melanin-Targeting Probe (MTP) conjugated to 5-iodo-2'-deoxyuridine (IUdR) with a reduction-sensitive pre-determined breaking point. Compared with the non-cleavable conjugate (17b), prodrug (17a) bearing a self-immolative disulfide linker achieved complete release of IUdR within 20 min in the presence of reducing agents such as DTT or glutathione. Analytical results also showed that prodrug (17a) was more sensitive than parent non-cleavable conjugate (17b) for a concentration range of glutathione similar to that found in the intracellular compartment of tumours. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Crater Morphology in the Phoenix Landing Ellipse: Insights Into Net Erosion and Ice Table Depth

NASA Technical Reports Server (NTRS)

Noe Dobrea, E. Z.; Stoker, C. R.; McKay, C. P.; Davila, A. F.; Krco, M.

2015-01-01

Icebreaker [1] is a Discovery class mission being developed for future flight opportunities. Under this mission concept, the Icebreaker payload is carried on a stationary lander, and lands in the same landing ellipse as Phoenix. Samples are acquired from the subsurface using a drilling system that penetrates into materials which may include loose or cemented soil, icy soil, pure ice, rocks, or mixtures of these. To avoid the complexity of mating additional strings, the drill is single-string, limiting it to a total length of 1 m.

A randomized controlled trial of nitrous oxide for intrauterine device insertion in nulliparous women.

PubMed

Singh, Rameet H; Thaxton, Lauren; Carr, Shannon; Leeman, Lawrence; Schneider, Emily; Espey, Eve

2016-11-01

To evaluate the effectiveness of inhaled nitrous oxide for pain management among nulliparous women undergoing intrauterine device (IUD) insertion. A double-blind, randomized controlled trial was conducted among nulliparous women aged 13-45years who underwent IUD insertion at a US center between October 1, 2013, and August 31, 2014. Using a computer-generated randomization sequence, participants were randomly assigned to inhale either oxygen (O 2 ) or a mixture of 50% nitrous oxide and 50% oxygen (N 2 O/O 2 ) through a nasal mask for 2minutes before insertion. Only the person administering the inhalation agent was aware of group assignment. The primary outcome was maximum pain assessed 2minutes after insertion via a 100-mm visual analog scale. Analyses were by intention to treat. Forty women were assigned to each group. Mean maximum pain score at the time of insertion was 54.3±24.8mm for the N 2 O/O 2 group and 55.3±20.9mm for the O 2 group (P=0.86). Adverse effects were reported for 6 (15%) women in the N 2 O/O 2 group and 7 (18%) in the O 2 group (P=0.32). N 2 O/O 2 did not reduce the pain of IUD insertion among nulliparous women. ClinicalTrials.gov: NCT02391714. Published by Elsevier Ireland Ltd.

Surgical removal of intra-abdominal intrauterine devices at one center in a 20-year period.

PubMed

Ertopcu, Kenan; Nayki, Cenk; Ulug, Pasa; Nayki, Umit; Gultekin, Emre; Donmez, Aysegul; Yildirim, Yusuf

2015-01-01

To review 20 years of experience of the removal of intra-abdominal intrauterine devices (IUDs) and to compare the surgical methods used. In a retrospective study, charts dating from between September 1, 1992, and August 31, 2012, were reviewed. Patients were eligible for inclusion when they had an IUD surgically removed by minilaparotomy or laparoscopy at a tertiary referral center in Izmir, Turkey. Among the 36 eligible women, 18 (50%) had undergone laparoscopy and 18 (50%) had undergone minilaparotomy. Mean operation length was 55.3±6.3 minutes in the laparoscopy group and 29.1±4.2 minutes in the minilaparotomy group (P=0.008). Conversion to full laparotomy was necessary in 4 (22%) women in the laparoscopy group and 1 (6%) in the minilaparotomy group (P=0.02). Perioperative complications were observed in 5 (14%) women, with no difference in frequency between groups (P=0.09). Total cost of medical/surgical procedures was US$436.4±35.4 for the laparoscopy group and $323.4±21.3 for the minilaparotomy group (P=0.04). Minilaparotomy seems to be an important alternative to laparoscopy for the removal of intra-abdominal IUDs. This procedure should be an integral part of gynecologic surgical training. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Infant of a substance-abusing mother

MedlinePlus

... up in homes that do not promote healthy emotional and mental growth. Alternative Names IUDE; Intrauterine drug exposure; Maternal drug abuse; Maternal substance use; Maternal drug use; Narcotic exposure - ...

Endometritis

MedlinePlus

... is more likely to occur after miscarriage or childbirth. It is also more common after a long ... biopsy Hysteroscopy Placement of an intrauterine device (IUD) Childbirth (more common after C-section than vaginal birth) ...

String scattering amplitudes and deformed cubic string field theory

NASA Astrophysics Data System (ADS)

Lai, Sheng-Hong; Lee, Jen-Chi; Lee, Taejin; Yang, Yi

2018-01-01

We study string scattering amplitudes by using the deformed cubic string field theory which is equivalent to the string field theory in the proper-time gauge. The four-string scattering amplitudes with three tachyons and an arbitrary string state are calculated. The string field theory yields the string scattering amplitudes evaluated on the world sheet of string scattering whereas the conventional method, based on the first quantized theory brings us the string scattering amplitudes defined on the upper half plane. For the highest spin states, generated by the primary operators, both calculations are in perfect agreement. In this case, the string scattering amplitudes are invariant under the conformal transformation, which maps the string world sheet onto the upper half plane. If the external string states are general massive states, generated by non-primary field operators, we need to take into account carefully the conformal transformation between the world sheet and the upper half plane. We show by an explicit calculation that the string scattering amplitudes calculated by using the deformed cubic string field theory transform into those of the first quantized theory on the upper half plane by the conformal transformation, generated by the Schwarz-Christoffel mapping.

Covariant open bosonic string field theory on multiple D-branes in the proper-time gauge

NASA Astrophysics Data System (ADS)

Lee, Taejin

2017-12-01

We construct a covariant open bosonic string field theory on multiple D-branes, which reduces to a non-Abelian group Yang-Mills gauge theory in the zero-slope limit. Making use of the first quantized open bosonic string in the proper time gauge, we convert the string amplitudes given by the Polyakov path integrals on string world sheets into those of the second quantized theory. The world sheet diagrams generated by the constructed open string field theory are planar in contrast to those of the Witten's cubic string field theory. However, the constructed string field theory is yet equivalent to the Witten's cubic string field theory. Having obtained planar diagrams, we may adopt the light-cone string field theory technique to calculate the multi-string scattering amplitudes with an arbitrary number of external strings. We examine in detail the three-string vertex diagram and the effective four-string vertex diagrams generated perturbatively by the three-string vertex at tree level. In the zero-slope limit, the string scattering amplitudes are identified precisely as those of non-Abelian Yang-Mills gauge theory if the external states are chosen to be massless vector particles.

E(lementary)-strings in six-dimensional heterotic F-theory

NASA Astrophysics Data System (ADS)

Choi, Kang-Sin; Rey, Soo-Jong

2017-09-01

Using E-strings, we can analyze not only six-dimensional superconformal field theories but also probe vacua of non-perturabative heterotic string. We study strings made of D3-branes wrapped on various two-cycles in the global F-theory setup. We claim that E-strings are elementary in the sense that various combinations of E-strings can form M-strings as well as heterotic strings and new kind of strings, called G-strings. Using them, we show that emissions and combinations of heterotic small instantons generate most of known six-dimensional superconformal theories, their affinizations and little string theories. Taking account of global structure of compact internal geometry, we also show that special combinations of E-strings play an important role in constructing six-dimensional theories of D- and E-types. We check global consistency conditions from anomaly cancellation conditions, both from five-branes and strings, and show that they are given in terms of elementary E-string combinations.

Gravitational Scattering Amplitudes and Closed String Field Theory in the Proper-Time Gauge

NASA Astrophysics Data System (ADS)

Lee, Taejin

2018-01-01

We construct a covariant closed string field theory by extending recent works on the covariant open string field theory in the proper-time gauge. Rewriting the string scattering amplitudes generated by the closed string field theory in terms of the Polyakov string path integrals, we identify the Fock space representations of the closed string vertices. We show that the Fock space representations of the closed string field theory may be completely factorized into those of the open string field theory. It implies that the well known Kawai-Lewellen-Tye (KLT) relations of the first quantized string theory may be promoted to the second quantized closed string theory. We explicitly calculate the scattering amplitudes of three gravitons by using the closed string field theory in the proper-time gauge.

Hot string soup: Thermodynamics of strings near the Hagedorn transition

NASA Astrophysics Data System (ADS)

Lowe, David A.; Thorlacius, Lárus

1995-01-01

Above the Hagedorn energy density closed fundamental strings form a long string phase. The dynamics of weakly interacting long strings is described by a simple Boltzmann equation which can be solved explicitly for equilibrium distributions. The averge total number of long strings grows logarithmically with total energy in the microcanonical ensemble. This is consistent with calculations of the free single string density of states provided the thermodynamic limit is carefully defined. If the theory contains open strings the long string phase is suppressed.

Uterine fibroids

MedlinePlus

... symptoms of uterine fibroids are: Bleeding between periods Heavy bleeding during your period, sometimes with blood clots ... may include: Birth control pills to help control heavy periods. Intrauterine devices (IUDs) that release hormones to ...

Birth control methods (image)

MedlinePlus

... t allow egg implantation. The hormones in oral contraceptives and hormone implants fool the ovaries into refraining ... egg, pregnancy will not occur. IUDs and oral contraceptives and hormones may be used as emergency contraception ...

Living with uterine fibroids

MedlinePlus

... care provider for uterine fibroids. They can cause: Heavy menstrual bleeding and long periods Bleeding between periods ... effects, including: Birth control pills to help with heavy periods. Intrauterine devices (IUDs) that release hormones to ...

Provider and lay perspectives on intra-uterine contraception: a global review.

PubMed

Daniele, Marina A S; Cleland, John; Benova, Lenka; Ali, Moazzam

2017-09-26

Intra-uterine contraception (IUC) involves the use of an intra-uterine device (IUD), a highly effective, long-acting, reversible contraceptive method. Historically, the popularity of IUC has waxed and waned across different world regions, due to policy choices and shifts in public opinion. However, despite its advantages and cost-effectiveness for programmes, IUC's contribution to contraceptive prevalence is currently negligible in many countries. This paper presents the results of a systematic review of the global literature on provider and lay perspectives on IUC. It aims to shed light on the reasons for low use of IUC and reflect on potential opportunities for the method's promotion. A systematic search of the literature was conducted in four peer-reviewed journals and four electronic databases (MEDLINE, EMBASE, POPLINE, and Global Health). Screening resulted in the inclusion of 68 relevant publications. Most included studies were conducted in areas where IUD use is moderate or low. Findings are similar across these areas. Many providers have low or uneven levels of knowledge on IUC and limited training. Many wrongly believe that IUC entails serious side effects such as pelvic inflammatory disease (PID), and are reluctant to provide it to entire eligible categories, such as HIV-positive women. There is particular resistance to providing IUC to teenagers and nulliparae. Provider opinions may be more favourable towards the hormonal IUD. Some health-care providers choose IUC for themselves. Many members of the public have low knowledge and unfounded misconceptions about IUC, such as the fear of infertility. Some are concerned about the insertion and removal processes, and about its effect on menses. However, users of IUC are generally satisfied and report a number of benefits. Peers and providers exert a strong influence on women's attitudes. Both providers and lay people have inaccurate knowledge and misconceptions about IUC, which contribute to explaining its low use. However, many reported concerns and fears could be alleviated through correct information. Concerted efforts to train providers, combined with demand creation initiatives, could therefore boost the method's popularity. Further research is needed on provider and lay perspectives on IUDs in low- and middle-income countries.

Location and content of counselling and acceptance of postpartum IUD in Sri Lanka.

PubMed

Karra, Mahesh; Canning, David; Foster, Sorcha; Shah, Iqbal H; Senanayake, Hemantha; Ratnasiri, U D P; Pathiraja, Ramya Priyanwada

2017-03-14

The immediate postpartum IUD (PPIUD) is a long-acting, reversible method of contraception that can be used safely and effectively following a birth. To appropriately facilitate the immediate postpartum insertion of IUDs, women must be informed of the method's availability and must be counselled on its benefits and risks prior to entering the delivery room. We examine the relationship between the location and quality of antenatal counselling and women's acceptance of immediate postpartum IUD (PPIUD) in four hospitals in Sri Lanka. Data were collected between January 2015 and May 2015. Modified Poisson regressions with robust standard errors are used to assess the relationships between place of counselling, indicators of counselling quality, and PPIUD uptake following delivery. We find that women who were counselled in hospital antenatal clinics and admission wards were much more likely to have a PPIUD inserted than women who were counselled in field clinics or during home visits. Hospital-based counselling had higher quality indicators for providing information on PPIUD, and women were more likely to receive PPIUD information leaflets in hospital locations than in lower-tiered clinics or during home visits. Women who were counselled at hospital locations also reported a higher level of satisfaction with the counselling that they received. Receipt of hospital-based counselling was also linked to higher PPIUD uptake, in spite of the fact that women were more likely to be given information about the risks and alternatives to PPIUD in hospitals. The information about the risks of and alternatives to PPIUD, whether provided in hospital or in non-hospital settings, tended to lower the likelihood of acceptance to have a PPIUD insertion. Counselling in hospital admission wards was focused on women who had not been counselled at field clinics. The study findings call for efforts that improve the training of midwives who provide PPIUD counselling at field clinics and during the home visits. We also recommend that routine PPIUD counselling be conducted in hospitals, even if women have already been counselled elsewhere.

Knowledge of and concerns about long-acting reversible contraception among women in medication-assisted treatment for opioid use disorder.

PubMed

Matusiewicz, Alexis K; Melbostad, Heidi S; Heil, Sarah H

2017-11-01

To assess interest in, concerns about and knowledge of long-acting reversible contraceptives (LARC) among women in medication-assisted treatment (MAT) for opioid use disorder who were at risk for unintended pregnancy. Women in MAT completed a survey on contraceptive use, attitudes and knowledge, including LARC methods, as part of eligibility screening for an ongoing trial evaluating family planning interventions for this population. Eighty-three women at risk for unintended pregnancy completed the survey, and a subset of 51 completed supplemental questions about implants. All participants had heard of IUDs and 75/83 (90%) had heard of implants, but only 34/83 (41%) and 14/51 (27%) reported being likely to use IUDs and implants, respectively. Thirty-five women reported they were unlikely to use IUDs, with 29/35 (83%) citing unspecified "other reasons" for this position and 24/35 (69%) endorsing concerns about side effects. Seventeen women reported they were unlikely to use implants, with 8/17 (47%) citing "other reasons" and 9/17 (53%) and 10/17 (59%) reporting concerns about insertion and removal, respectively. Participants reported they knew "a little" about LARCs, but only their knowledge of implants was limited. Only 50/83 (60%) participants were aware of the superior effectiveness of IUDs and 26/51 (51%) were aware of the superior effectiveness of implants relative to other reversible methods. Participants reported relatively low interest in LARCs. Many women had unspecified reasons for not using LARCs. Participants also lacked information about LARC safety and effectiveness, especially with regard to implants. Women in medication-assisted treatment for opioid use disorder are at high risk of unintended pregnancy, yet contraceptive use is low and use of less effective methods is common. Women in MAT may benefit from efforts to increase knowledge about implants and assuage concerns about their insertion and removal as well as more general efforts to improve knowledge about the relative efficacy of LARCs. Many women in MAT endorsed unspecified "other reasons" for not using LARCs, which should be explored further. Copyright © 2017 Elsevier Inc. All rights reserved.

Panel discussion on vaccine development to meet U.S. and international needs. Strategies for reducing the disincentives to HIV vaccine development: description of a successful public-private sector international collaboration.

PubMed

Bronnenkant, L

1994-01-01

A representative of Finishing Enterprises, the world's largest manufacturer of intrauterine contraceptive devices (IUDs), discusses how to alter the balance of incentives-disincentives to expedite the development of HIV vaccines for international evaluation. Three main disincentives exist for private manufacturers in the United States to develop a new HIV vaccine to be used in developing countries, outside the profitable North American and western European markets: 1) low profit margin because of limited money, time, and resources. Medium and large-sized corporations are more concerned with a high return on their investment owing to stockholder pressure than with the human benefit of that investment. 2) Lengthy regulatory approval process. The current regulatory process in the US is tedious, time-consuming, and costly. 3) Liability risk. The United States is the most litigious society in the world. Suits filed against US corporations involved in drug manufacture incur legal defence costs, which make an already low profit margin HIV vaccine even lower. Finishing Enterprises' IUD program aimed at providing the safest and most effective IUD at an affordable price in a socially responsible way. The Population Council developed the Copper T and retained the patent rights. They and other international health authorities, such as the World Health Organization, conducted or monitored international clinical trials to determine safety and efficacy. Private foundations and public donor agencies funded these activities. When donor agencies committed to volume purchases for their commodity programs, Finishing Enterprises could commit to volume pricing. Whenever high-margin private sector sales occur, Population Council receives a royalty payment. Thus, the disincentives were overcome: 1) Low profit margin was less an issue for a small, private company created specifically to manufacture IUDs and guaranteed volume orders. 2) Lengthy regulatory approval processes were avoided by various international clinical trials, generating international interest in the product. 3) Liability risk was minimized by the variety of safety tests the product underwent.

A comparative analysis of the modification of sexual desire of users of oral hormonal contraceptives and intrauterine contraceptive devices.

PubMed

Martin-Loeches, M; Ortí, R M; Monfort, M; Ortega, E; Rius, J

2003-09-01

To compare the influence of oral hormonal contraceptives (OCs) and the use of intrauterine contraceptive devices (IUDs) on the modification of sexual desire. A prospective observational study of 1073 women using OCs or an IUD at the Family Planning Center 'Marina Alta' in Alicante, Spain. In order to evaluate the relative risk regarding the decrease in libido attributed to each contraceptive method, a logistic regression analysis was undertaken which considered the factors of age adjustment, level of studies, family planning information, relationship with partner, age when sexual relationships were initiated, parity, contraceptive method previously used and the duration of use of the contraceptive method. No differences in the decrease of sexual desire were observed between the use of the OC and IUD (odds ratio (OR) 1.32; 95% confidence interval (CI) 0.70-2.49), yet differences were noted, however, in relation to age (OR 1.05; 95% CI 1.01-1.10). Although these differences were not statistically significant, a high level of awareness regarding family planning was shown to increase sexual desire when compared to a lower level of information on this subject (OR 0.64; 95% CI 0.41-1.01). Sexual desire was seen to decrease if the quality of the relationship with the partner was average (OR 2.24; 95% CI 1.36-3.69) or poor (OR 4.69; 95% CI 1.93-11.4). Nulliparous women showed a greater decrease in sexual desire in relation to women who had already given birth (OR 1.57; 95% CI 1.00-2.47). Sexual desire was greater if the contraceptive method had already been in use for 6-12 months (OR 0.41; 95% CI 0.17-0.98). Sexual desire does not vary in relation to the use of OCs or IUDs, yet it does decrease with age, in nulliparous women and in those with an average or poor relationship with their partner. Furthermore, sexual desire shows an increase between the first 6 and 12 months of contraceptive treatment.

Cosmic strings and superconducting cosmic strings

NASA Technical Reports Server (NTRS)

Copeland, Edmund

1988-01-01

The possible consequences of forming cosmic strings and superconducting cosmic strings in the early universe are discussed. Lecture 1 describes the group theoretic reasons for and the field theoretic reasons why cosmic strings can form in spontaneously broken gauge theories. Lecture 2 discusses the accretion of matter onto string loops, emphasizing the scenario with a cold dark matter dominated universe. In lecture 3 superconducting cosmic strings are discussed, as is a mechanism which leads to the formation of structure from such strings.

Quantization of Gaussian samples at very low SNR regime in continuous variable QKD applications

NASA Astrophysics Data System (ADS)

Daneshgaran, Fred; Mondin, Marina

2016-09-01

The main problem for information reconciliation in continuous variable Quantum Key Distribution (QKD) at low Signal to Noise Ratio (SNR) is quantization and assignment of labels to the samples of the Gaussian Random Variables (RVs) observed at Alice and Bob. Trouble is that most of the samples, assuming that the Gaussian variable is zero mean which is de-facto the case, tend to have small magnitudes and are easily disturbed by noise. Transmission over longer and longer distances increases the losses corresponding to a lower effective SNR exasperating the problem. This paper looks at the quantization problem of the Gaussian samples at very low SNR regime from an information theoretic point of view. We look at the problem of two bit per sample quantization of the Gaussian RVs at Alice and Bob and derive expressions for the mutual information between the bit strings as a result of this quantization. The quantization threshold for the Most Significant Bit (MSB) should be chosen based on the maximization of the mutual information between the quantized bit strings. Furthermore, while the LSB string at Alice and Bob are balanced in a sense that their entropy is close to maximum, this is not the case for the second most significant bit even under optimal threshold. We show that with two bit quantization at SNR of -3 dB we achieve 75.8% of maximal achievable mutual information between Alice and Bob, hence, as the number of quantization bits increases beyond 2-bits, the number of additional useful bits that can be extracted for secret key generation decreases rapidly. Furthermore, the error rates between the bit strings at Alice and Bob at the same significant bit level are rather high demanding very powerful error correcting codes. While our calculations and simulation shows that the mutual information between the LSB at Alice and Bob is 0.1044 bits, that at the MSB level is only 0.035 bits. Hence, it is only by looking at the bits jointly that we are able to achieve a mutual information of 0.2217 bits which is 75.8% of maximum achievable. The implication is that only by coding both MSB and LSB jointly can we hope to get close to this 75.8% limit. Hence, non-binary codes are essential to achieve acceptable performance.

IUD (Intrauterine Device)

MedlinePlus

... Kids site Sitio para niños How the Body Works Puberty & Growing Up Staying Healthy Staying Safe Recipes & Cooking Health Problems Illnesses & Injuries Relax & Unwind People, Places & Things That Help Feelings Expert Answers Q&A ...

Effectiveness of Family Planning Methods

MedlinePlus

... women in a year Effectiveness of Family Planning Methods Implant Reversible Intrauterine Device (IUD) Permanent Male Sterilization ... 0.5 % Diaphragm 12 % How to make your method most effective After procedure, little or nothing to ...

Intrauterine devices (IUD)

MedlinePlus

... Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier ... Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

Magnetic resonance angiography

MedlinePlus

... your provider if you have: Brain aneurysm clips Artificial heart valve Heart defibrillator or pacemaker Inner ear (cochlear) implants Insulin or chemotherapy port Intrauterine device (IUD) Kidney ... artificial joints Vascular stent Worked with sheet metal in ...

A Randomized Trial of Vitamin D3 Supplementation in Children: Dose-Response Effects on Vitamin D Metabolites and Calcium Absorption

PubMed Central

Laing, E. M.; Hill Gallant, K. M.; Hall, D. B.; McCabe, G. P.; Hausman, D. B.; Martin, B. R.; Warden, S. J.; Peacock, M.; Weaver, C. M.

2013-01-01

Context: Changes in serum vitamin D metabolites and calcium absorption with varying doses of oral vitamin D3 in healthy children are unknown. Objective: Our objective was to examine the dose-response effects of supplemental vitamin D3 on serum vitamin D metabolites and calcium absorption in children living at two U.S. latitudes. Design: Black and white children (n = 323) participated in a multisite (U.S. latitudes 34° N and 40° N), triple-masked trial. Children were randomized to receive oral vitamin D3 (0, 400, 1000, 2000, and 4000 IU/d) and were sampled over 12 weeks in winter. Serum 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured using RIA and intact PTH (iPTH) by immunoradiometric assay. Fractional calcium absorption was determined from an oral stable isotope 44Ca (5 mg) in a 150-mg calcium meal. Nonlinear and linear regression models were fit for vitamin D metabolites, iPTH, and calcium absorption. Results: The mean baseline 25(OH)D value for the entire sample was 70.0 nmol/L. Increases in 25(OH)D depended on dose with 12-week changes ranging from −10 nmol/L for placebo to 76 nmol/L for 4000 IU. Larger 25(OH)D gains were observed for whites vs blacks at the highest dose (P < .01). Gains for 1,25(OH)2D were not significant (P = .07), and decreases in iPTH were not dose-dependent. There was no dose effect of vitamin D on fractional calcium absorption when adjusted for pill compliance, race, sex, or baseline 25(OH)D. Conclusion: Large increases in serum 25(OH)D with vitamin D3 supplementation did not increase calcium absorption in healthy children living at 2 different latitudes. Supplementation with 400 IU/d was sufficient to maintain wintertime 25(OH)D concentrations in healthy black, but not white, children. PMID:24092833

A randomized trial of vitamin D₃ supplementation in children: dose-response effects on vitamin D metabolites and calcium absorption.

PubMed

Lewis, R D; Laing, E M; Hill Gallant, K M; Hall, D B; McCabe, G P; Hausman, D B; Martin, B R; Warden, S J; Peacock, M; Weaver, C M

2013-12-01

Changes in serum vitamin D metabolites and calcium absorption with varying doses of oral vitamin D₃ in healthy children are unknown. Our objective was to examine the dose-response effects of supplemental vitamin D₃ on serum vitamin D metabolites and calcium absorption in children living at two U.S. latitudes. Black and white children (n = 323) participated in a multisite (U.S. latitudes 34° N and 40° N), triple-masked trial. Children were randomized to receive oral vitamin D₃ (0, 400, 1000, 2000, and 4000 IU/d) and were sampled over 12 weeks in winter. Serum 25-hydroxyvitamin D (25(OH)D) and 1,25-dihydroxyvitamin D (1,25(OH)₂D) were measured using RIA and intact PTH (iPTH) by immunoradiometric assay. Fractional calcium absorption was determined from an oral stable isotope ⁴⁴Ca (5 mg) in a 150-mg calcium meal. Nonlinear and linear regression models were fit for vitamin D metabolites, iPTH, and calcium absorption. The mean baseline 25(OH)D value for the entire sample was 70.0 nmol/L. Increases in 25(OH)D depended on dose with 12-week changes ranging from -10 nmol/L for placebo to 76 nmol/L for 4000 IU. Larger 25(OH)D gains were observed for whites vs blacks at the highest dose (P < .01). Gains for 1,25(OH)₂D were not significant (P = .07), and decreases in iPTH were not dose-dependent. There was no dose effect of vitamin D on fractional calcium absorption when adjusted for pill compliance, race, sex, or baseline 25(OH)D. Large increases in serum 25(OH)D with vitamin D₃ supplementation did not increase calcium absorption in healthy children living at 2 different latitudes. Supplementation with 400 IU/d was sufficient to maintain wintertime 25(OH)D concentrations in healthy black, but not white, children.

From decay to complete breaking: pulling the strings in SU(2) Yang-Mills theory.

PubMed

Pepe, M; Wiese, U-J

2009-05-15

We study {2Q+1} strings connecting two static charges Q in (2+1)D SU(2) Yang-Mills theory. While the fundamental {2} string between two charges Q=1/2 is unbreakable, the adjoint {3} string connecting two charges Q=1 can break. When a {4} string is stretched beyond a critical length, it decays into a {2} string by gluon pair creation. When a {5} string is stretched, it first decays into a {3} string, which eventually breaks completely. The energy of the screened charges at the ends of a string is well described by a phenomenological constituent gluon model.

Subterranean barriers, methods, and apparatuses for forming, inspecting, selectively heating, and repairing same

DOEpatents

Nickelson, Reva A.; Sloan, Paul A.; Richardson, John G.; Walsh, Stephanie; Kostelnik, Kevin M.

2009-04-07

A subterranean barrier and method for forming same are disclosed, the barrier including a plurality of casing strings wherein at least one casing string of the plurality of casing strings may be affixed to at least another adjacent casing string of the plurality of casing strings through at least one weld, at least one adhesive joint, or both. A method and system for nondestructively inspecting a subterranean barrier is disclosed. For instance, a radiographic signal may be emitted from within a casing string toward an adjacent casing string and the radiographic signal may be detected from within the adjacent casing string. A method of repairing a barrier including removing at least a portion of a casing string and welding a repair element within the casing string is disclosed. A method of selectively heating at least one casing string forming at least a portion of a subterranean barrier is disclosed.

Top-down analysis of protein samples by de novo sequencing techniques.

PubMed

Vyatkina, Kira; Wu, Si; Dekker, Lennard J M; VanDuijn, Martijn M; Liu, Xiaowen; Tolić, Nikola; Luider, Theo M; Paša-Tolić, Ljiljana; Pevzner, Pavel A

2016-09-15

Recent technological advances have made high-resolution mass spectrometers affordable to many laboratories, thus boosting rapid development of top-down mass spectrometry, and implying a need in efficient methods for analyzing this kind of data. We describe a method for analysis of protein samples from top-down tandem mass spectrometry data, which capitalizes on de novo sequencing of fragments of the proteins present in the sample. Our algorithm takes as input a set of de novo amino acid strings derived from the given mass spectra using the recently proposed Twister approach, and combines them into aggregated strings endowed with offsets. The former typically constitute accurate sequence fragments of sufficiently well-represented proteins from the sample being analyzed, while the latter indicate their location in the protein sequence, and also bear information on post-translational modifications and fragmentation patterns. Freely available on the web at http://bioinf.spbau.ru/en/twister vyatkina@spbau.ru or ppevzner@ucsd.edu Supplementary data are available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

What Are the Different Types of Contraception?

MedlinePlus

... certain diseases. Long-Acting Reversible Contraception (LARC) Intrauterine Methods An intrauterine device (IUD), also known as an ... in clinical development. Hormonal Methods Short-Acting Hormonal Methods Hormonal methods of birth control use hormones to ...

Condom

MedlinePlus

... couples use condoms along with another method of birth control, like birth control pills or an IUD . For condoms to have ... against STDs even when using another method of birth control. Abstinence (not having sex) is the only method ...

Sex and Sexuality and HIV

MedlinePlus

... Education Home HIV Meds Updates Online Courses (CME) Case Studies Journal Articles Glossary Quick References Quick References Home ... against HIV: oral contraceptive ("the pill") injectable contraceptive (shot) contraceptive implant IUD (intrauterine device) emergency contraception ("morning- ...

Deciding about an IUD

MedlinePlus

... Groot LJ, de Krester DM, et al, eds. Endocrinology: Adult and Pediatric . 7th ed. Philadelphia, PA: Elsevier ... Strauss JF, Barbieri RL, eds. Yen & Jaffe's Reproductive Endocrinology . 7th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

Should the recommended number of IUD revisits be reduced?

PubMed

Janowitz, B; Hubacher, D; Petrick, T; Dighe, N

1994-01-01

This study uses data from clinical trials of intrauterine devices to examine the effect of reducing the recommended number of IUD follow-up visits. Over 11,000 follow-up forms were analyzed to estimate the number of health problems that would have escaped detection if women with no or mild symptoms had not made recommended revisits. Less than one percent of woman-visits with no or only mild symptoms had an underlying health risk that could have gone undetected if the follow-up visits that were made in the clinic trial setting had not been made. The results from this analysis suggest that a reduction in the number of recommended follow-up visits is safe, when measured according to selected conditions. Additional research is necessary to determine whether any revisits should be recommended in the absence of signs or symptoms.

Depot-medroxyprogesterone acetate contraception use among Salvadoran women: an in-depth analysis of attitudes and experiences.

PubMed

Cremer, Miriam; Ditzian, Lauren; April, Ayana; Peralta, Ethel; Klausner, Dalia; Podolsky, Rebecca; Dierking, Elizabeth

2011-11-01

To survey a cross-section of reproductive-age Salvadoran women in order to assess the factors that influence their decision to use depot-medroxyprogesterone acetate (DMPA), an injectable form of contraception. Reproductive-age women at three rural Salvadoran health clinics were asked to participate in a study to assess their current and past experiences using DMPA contraception. Verbal informed consent was obtained, and research coordinators administered a 23-question survey. Surveys were completed in 425 women with an average age of 27.36 years. Average duration of DMPA contraception use was 2.89 years. The majority (84%) of past and present users were very satisfied with DMPA contraception, most commonly because they did not have to remember to use it daily (44.9%). The side effects of DMPA appear to be a significant indicator of whether women heard about and wanted to use other forms of long-term reversible contraception, such as an intrauterine device (IUD) or implant. The main reason Salvadoran women chose to use DMPA is because they do not have to think about it on a daily basis. However, many women do not like the side effects and may be open to explore using other long-term reversible methods of contraception, such as IUDs or implants. It is possible that with increased access to educational information about IUD use, safety, and effectiveness, more women would use this form of long-term contraception as opposed to sterilization.

Informing New String Programmes: Lessons Learned from an Australian Experience

ERIC Educational Resources Information Center

Murphy, Fintan; Rickard, Nikki; Gill, Anneliese; Grimmett, Helen

2011-01-01

Although there are many examples of notable string programmes there has been relatively little comparative analysis of these programmes. This paper examines three benchmark string programmes (The University of Illinois String Project, The Tower Hamlets String Teaching Project and Colourstrings) alongside Music4All, an innovative string programme…

[ital N]-string vertices in string field theory

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bordes, J.; Abdurrahman, A.; Anton, F.

1994-03-15

We give the general form of the vertex corresponding to the interaction of an arbitrary number of strings. The technique employed relies on the comma'' representation of string field theory where string fields and interactions are represented as matrices and operations between them such as multiplication and trace. The general formulation presented here shows that the interaction vertex of [ital N] strings, for any arbitrary [ital N], is given as a function of particular combinations of matrices corresponding to the change of representation between the full string and the half string degrees of freedom.

The Birth of String Theory

NASA Astrophysics Data System (ADS)

Cappelli, Andrea; Castellani, Elena; Colomo, Filippo; Di Vecchia, Paolo

2012-04-01

Part I. Overview: 1. Introduction and synopsis; 2. Rise and fall of the hadronic string G. Veneziano; 3. Gravity, unification, and the superstring J. H. Schwarz; 4. Early string theory as a challenging case study for philosophers E. Castellani; Part II. The Prehistory: The Analytic S-Matrix: 5. Introduction to Part II; 6. Particle theory in the sixties: from current algebra to the Veneziano amplitude M. Ademollo; 7. The path to the Veneziano model H. R. Rubinstein; 8. Two-component duality and strings P. G. O. Freund; 9. Note on the prehistory of string theory M. Gell-Mann; Part III. The Dual Resonance Model: 10. Introduction to Part III; 11. From the S-matrix to string theory P. Di Vecchia; 12. Reminiscence on the birth of string theory J. A. Shapiro; 13. Personal recollections D. Amati; 14. Early string theory at Fermilab and Rutgers L. Clavelli; 15. Dual amplitudes in higher dimensions: a personal view C. Lovelace; 16. Personal recollections on dual models R. Musto; 17. Remembering the 'supergroup' collaboration F. Nicodemi; 18. The '3-Reggeon vertex' S. Sciuto; Part IV. The String: 19. Introduction to Part IV; 20. From dual models to relativistic strings P. Goddard; 21. The first string theory: personal recollections L. Susskind; 22. The string picture of the Veneziano model H. B. Nielsen; 23. From the S-matrix to string theory Y. Nambu; 24. The analogue model for string amplitudes D. B. Fairlie; 25. Factorization in dual models and functional integration in string theory S. Mandelstam; 26. The hadronic origins of string theory R. C. Brower; Part V. Beyond the Bosonic String: 27. Introduction to Part V; 28. From dual fermion to superstring D. I. Olive; 29. Dual models with fermions: memoirs of an early string theorist P. Ramond; 30. Personal recollections A. Neveu; 31. Aspects of fermionic dual models E. Corrigan; 32. The dual quark models K. Bardakci and M. B. Halpern; 33. Remembering the dawn of relativistic strings J.-L. Gervais; 34. Early string theory in Cambridge: personal recollections C. Montonen; Part VI. The Superstring: 35. Introduction to Part VI; 36. Supersymmetry in string theory F. Gliozzi; 37. Gravity from strings: personal reminiscences of early developments T. Yoneya; 38. From the Nambu-Goto to the σ-model action L. Brink; 39. Locally supersymmetric action for superstring P. Di Vecchia; 40. Personal recollections E. Cremmer; 41. The scientific contributions of Joël Scherk J. H. Schwarz; Part VII. Preparing the String Renaissance: 42. Introduction to Part VII; 43. From strings to superstrings: a personal perspective M. B. Green; 44. Quarks, strings and beyond A. M. Polyakov; 45. The rise of the superstring theory A. Cappelli and F. Colomo; Appendices; Index.

[Women's behavior and knowledge concerning family planning in the region of the Park Health Center].

PubMed

Ozyurda, F; Durmusoglu, M

1989-01-01

1390 women aged 15-44 were surveyed between February-June 1988 in the vicinity of the Park Health Education Center by the Ankara University School of Medicine, Department of Public Health. Within this sample, the survey focused on the knowledge, attitude and behavior of the 1082 married women, regarding birth control. Birth control pills, IUDs, and condoms were classified as effective modern birth control methods. Other less effective traditional methods were classified as ineffective. Analysis of the data indicated 74.2% of the subjects resort to some form of birth control while 66.2% use an effective modern method. Age, education, work status, number of children and type and location of housing influence family planning decisions. In general, the women using birth control are primary school graduates aged between 25-39, living in urban areas for at least 5 years. Most have 2 to 3 children and have had an abortion. The most frequently used method of birth control is the IUD. It is notable that 29.5% use the ineffective withdrawal method. 58.62% of the women who do not use birth control, avoid family planning because of their husbands. These women have 2 or more children and are illiterate or primary school graduates between the ages of 25-35 when they are most likely to become pregnant. Family planning services should be geared towards educating these families, especially the husbands. Education services should also target families using the withdrawal method and the 35-44 age group of women who show a low percentage of contraceptive use.

String resistance detector

NASA Technical Reports Server (NTRS)

Hall, A. Daniel (Inventor); Davies, Francis J. (Inventor)

2007-01-01

Method and system are disclosed for determining individual string resistance in a network of strings when the current through a parallel connected string is unknown and when the voltage across a series connected string is unknown. The method/system of the invention involves connecting one or more frequency-varying impedance components with known electrical characteristics to each string and applying a frequency-varying input signal to the network of strings. The frequency-varying impedance components may be one or more capacitors, inductors, or both, and are selected so that each string is uniquely identifiable in the output signal resulting from the frequency-varying input signal. Numerical methods, such as non-linear regression, may then be used to resolve the resistance associated with each string.

String mediated phase transitions

NASA Technical Reports Server (NTRS)

Copeland, ED; Haws, D.; Rivers, R.; Holbraad, S.

1988-01-01

It is demonstrated from first principles how the existence of string-like structures can cause a system to undergo a phase transition. In particular, the role of topologically stable cosmic string in the restoration of spontaneously broken symmetries is emphasized. How the thermodynamic properties of strings alter when stiffness and nearest neighbor string-string interactions are included is discussed.

Black string in dRGT massive gravity

NASA Astrophysics Data System (ADS)

Tannukij, Lunchakorn; Wongjun, Pitayuth; Ghosh, Suchant G.

2017-12-01

We present a cylindrically symmetric solution, both charged and uncharged, which is known as a black string solution to the nonlinear ghost-free massive gravity found by de Rham, Gabadadze, and Tolley (dRGT). This "dRGT black string" can be thought of as a generalization of the black string solution found by Lemos. Moreover, the dRGT black string solution includes other classes of black string solution such as the monopole-black string ones since the graviton mass contributes to the global monopole term as well as the cosmological-constant term. To investigate the solution, we compute mass, temperature, and entropy of the dRGT black string. We found that the existence of the graviton mass drastically affects the thermodynamics of the black string. Furthermore, the Hawking-Page phase transition is found to be possible for the dRGT black string as well as the charged dRGT black string. The dRGT black string solution is thermodynamically stable for r>r_c with negative thermodynamical potential and positive heat capacity while it is unstable for r

Experimental Study of Arcing on High-voltage Solar Arrays

NASA Technical Reports Server (NTRS)

Vayner, Boris; Galofaro, Joel; Ferguson, Dale

2005-01-01

The main obstacle to the implementation of a high-voltage solar array in space is arcing on the conductor-dielectric junctions exposed to the surrounding plasma. One obvious solution to this problem would be the installation of fully encapsulated solar arrays which were not having exposed conductors at all. However, there are many technological difficulties that must be overcome before the employment of fully encapsulated arrays will turn into reality. An alternative solution to raise arc threshold by modifications of conventionally designed solar arrays looks more appealing, at least in the nearest future. A comprehensive study of arc inception mechanism [1-4] suggests that such modifications can be done in the following directions: i) to insulate conductor-dielectric junction from a plasma environment (wrapthrough interconnects); ii) to change a coverglass geometry (overhang); iii) to increase a coverglass thickness; iiii) to outgas areas of conductor-dielectric junctions. The operation of high-voltage array in LEO produces also the parasitic current power drain on the electrical system. Moreover, the current collected from space plasma by solar arrays determines the spacecraft floating potential that is very important for the design of spacecraft and its scientific apparatus. In order to verify the validity of suggested modifications and to measure current collection five different solar array samples have been tested in large vacuum chamber. Each sample (36 silicon based cells) consists of three strings containing 12 cells connected in series. Thus, arc rate and current collection can be measured on every string independently, or on a whole sample when strings are connected in parallel. The heater installed in the chamber provides the possibility to test samples under temperature as high as 80 C that simulates the LEO operational temperature. The experimental setup is described below.

Experimental Study of Arcing on High-Voltage Solar Arrays

NASA Technical Reports Server (NTRS)

Vayner, Boris; Galofaro, Joel; Ferguson, Dale

2003-01-01

The main obstacle to the implementation of a high-voltage solar array in space is arcing on the conductor-dielectric junctions exposed to the surrounding plasma. One obvious solution to this problem would be the installation of fully encapsulated solar arrays which were not having exposed conductors at all. However, there are many technological difficulties that must be overcome before the employment of fully encapsulated arrays will turn into reality. An alternative solution to raise arc threshold by modifications of conventionally designed solar arrays looks more appealing, at least in the nearest future. A comprehensive study of arc inception mechanism suggests that such modifications can be done in the following directions: 1) To insulate conductor-dielectric junction from a plasma environment (wrapthrough interconnects); 2) To change a coverglass geometry (overhang); 3) To increase a coverglass thickness; 4) To outgas areas of conductor-dielectric junctions. The operation of high-voltage array in LEO produces also the parasitic current power drain on the electrical system. Moreover, the current collected from space plasma by solar arrays determines the spacecraft floating potential that is very important for the design of spacecraft and its scientific apparatus. In order to verify the validity of suggested modifications and to measure current collection five different solar array samples have been tested in a large vacuum chamber. Each sample (36 silicon based cells) consists of three strings containing 12 cells connected in series. Thus, arc rate and current collection can be measured on every string independently, or on a whole sample when strings are connected in parallel. The heater installed in the chamber provides the possibility to test samples under temperature as high as 80 C that stimulates the LEO operational temperature. The experimental setup is described below.

Painful menstrual periods

MedlinePlus

... exercise. If these self-care measures do not work, your health care provider may offer you treatment such as: Birth control pills Mirena IUD Prescription anti-inflammatory medicines Prescription pain relievers (including narcotics, for brief periods) Antidepressants Antibiotics When ...

The "Magic" String

ERIC Educational Resources Information Center

Hoover, Todd F.

2010-01-01

The "Magic" String is a discrepant event that includes a canister with what appears to be the end of two strings protruding from opposite sides of it. Due to the way the strings are attached inside the canister, it appears as if the strings can magically switch the way they are connected. When one string end is pulled, the observer's expectation…

Automatic generation and analysis of solar cell IV curves

DOEpatents

Kraft, Steven M.; Jones, Jason C.

2014-06-03

A photovoltaic system includes multiple strings of solar panels and a device presenting a DC load to the strings of solar panels. Output currents of the strings of solar panels may be sensed and provided to a computer that generates current-voltage (IV) curves of the strings of solar panels. Output voltages of the string of solar panels may be sensed at the string or at the device presenting the DC load. The DC load may be varied. Output currents of the strings of solar panels responsive to the variation of the DC load are sensed to generate IV curves of the strings of solar panels. IV curves may be compared and analyzed to evaluate performance of and detect problems with a string of solar panels.

A sensitive NanoString-based assay to score STK11 (LKB1) pathway disruption in lung adenocarcinoma

PubMed Central

Chen, Lu; Engel, Brienne E.; Welsh, Eric A.; Yoder, Sean J.; Brantley, Stephen G.; Chen, Dung-Tsa; Beg, Amer A.; Cao, Chunxia; Kaye, Frederic J.; Haura, Eric B.; Schabath, Matthew B.; Cress, W. Douglas

2016-01-01

Introduction Serine/threonine kinase 11 (STK11), better known as LKB1, is a tumor-suppressor commonly mutated in lung adenocarcinoma (LUAD). Previous work has shown that mutational inactivation of the STK11 pathway may serve as a predictive biomarker for cancer treatments including phenformin and COX-2 inhibition. Although immunohistochemistry and diagnostic sequencing are employed to measure STK11 pathway disruption, there are serious limitations to these methods emphasizing the importance to validate a clinically useful assay. Methods An initial STK11 mutation mRNA signature was generated using cell line data and refined using three large, independent patient databases. The signature was validated as a classifier using The Cancer Genome Anatomy Project (TCGA) LUAD cohort as well as a 442-patient LUAD cohort developed at Moffitt. Finally, the signature was adapted into a NanoString -based format and validated using RNA samples isolated from FFPE tissue blocks corresponding to a cohort of 150 LUAD patients. For comparison, STK11 immunochemistry was also performed. Results The STK11 signature was found to correlate with null mutations identified by exon sequencing in multiple cohorts using both microarray and NanoString formats. While there was a statistically significant correlation between reduced STK11 protein expression by IHC and mutation status, the NanoString-based assay showed superior overall performance with a −0.1588 improvement in area under the curve in receiver-operator characteristic curve analysis (p<0.012). Conclusion The described NanoString-based STK11 assay is a sensitive biomarker to study emerging therapeutic modalities in clinical trials. PMID:26917230

The decision tree classifier - Design and potential. [for Landsat-1 data

NASA Technical Reports Server (NTRS)

Hauska, H.; Swain, P. H.

1975-01-01

A new classifier has been developed for the computerized analysis of remote sensor data. The decision tree classifier is essentially a maximum likelihood classifier using multistage decision logic. It is characterized by the fact that an unknown sample can be classified into a class using one or several decision functions in a successive manner. The classifier is applied to the analysis of data sensed by Landsat-1 over Kenosha Pass, Colorado. The classifier is illustrated by a tree diagram which for processing purposes is encoded as a string of symbols such that there is a unique one-to-one relationship between string and decision tree.

Charged string loops in Reissner-Nordström black hole background

NASA Astrophysics Data System (ADS)

Oteev, Tursinbay; Kološ, Martin; Stuchlík, Zdeněk

2018-03-01

We study the motion of current carrying charged string loops in the Reissner-Nordström black hole background combining the gravitational and electromagnetic field. Introducing new electromagnetic interaction between central charge and charged string loop makes the string loop equations of motion to be non-integrable even in the flat spacetime limit, but it can be governed by an effective potential even in the black hole background. We classify different types of the string loop trajectories using effective potential approach, and we compare the innermost stable string loop positions with loci of the charged particle innermost stable orbits. We examine string loop small oscillations around minima of the string loop effective potential, and we plot radial profiles of the string loop oscillation frequencies for both the radial and vertical modes. We construct charged string loop quasi-periodic oscillations model and we compare it with observed data from microquasars GRO 1655-40, XTE 1550-564, and GRS 1915+105. We also study the acceleration of current carrying string loops along the vertical axis and the string loop ejection from RN black hole neighbourhood, taking also into account the electromagnetic interaction.

Estimated disability-adjusted life years averted by long-term provision of long acting contraceptive methods in a Brazilian clinic.

PubMed

Bahamondes, Luis; Bottura, Bruna F; Bahamondes, M Valeria; Gonçalves, Mayara P; Correia, Vinicius M; Espejo-Arce, Ximena; Sousa, Maria H; Monteiro, Ilza; Fernandes, Arlete

2014-10-10

What is the contribution of the provision, at no cost for users, of long acting reversible contraceptive methods (LARC; copper intrauterine device [IUD], the levonorgestrel-releasing intrauterine system [LNG-IUS], contraceptive implants and depot-medroxyprogesterone [DMPA] injection) towards the disability-adjusted life years (DALY) averted through a Brazilian university-based clinic established over 30 years ago. Over the last 10 years of evaluation, provision of LARC methods and DMPA by the clinic are estimated to have contributed to DALY averted by between 37 and 60 maternal deaths, 315-424 child mortalities, 634-853 combined maternal morbidity and mortality and child mortality, and 1056-1412 unsafe abortions averted. LARC methods are associated with a high contraceptive effectiveness when compared with contraceptive methods which need frequent attention; perhaps because LARC methods are independent of individual or couple compliance. However, in general previous studies have evaluated contraceptive methods during clinical studies over a short period of time, or not more than 10 years. Furthermore, information regarding the estimation of the DALY averted is scarce. We reviewed 50 004 medical charts from women who consulted for the first time looking for a contraceptive method over the period from 2 January 1980 through 31 December 2012. Women who consulted at the Department of Obstetrics and Gynaecology, University of Campinas, Brazil were new users and users switching contraceptive, including the copper IUD (n = 13 826), the LNG-IUS (n = 1525), implants (n = 277) and DMPA (n = 9387). Estimation of the DALY averted included maternal morbidity and mortality, child mortality and unsafe abortions averted. We obtained 29 416 contraceptive segments of use including 25 009 contraceptive segments of use from 20 821 new users or switchers to any LARC method or DMPA with at least 1 year of follow-up. The mean (± SD) age of the women at first consultation ranged from 25.3 ± 5.7 (range 12-47) years in the 1980s, to 31.9 ± 7.4 (range 16-50) years in 2010-2011. The most common contraceptive chosen at the first consultation was copper IUD (48.3, 74.5 and 64.7% in the 1980s, 1990s and 2000s, respectively). For an evaluation over 20 years, the cumulative pregnancy rates (SEM) were 0.4 (0.2), 2.8 (2.1), 4.0 (0.4) and 1.3 (0.4) for the LNG-IUS, the implants, copper IUD and DMPA, respectively and cumulative continuation rates (SEM) were 15.1 (3.7), 3.9 (1.4), 14.1 (0.6) and 7.3 (1.7) for the LNG-IUS, implants, copper IUD and DMPA, respectively (P < 0.001). Over the last 10 years of evaluation, the estimation of the contribution of the clinic through the provision of LARC methods and DMPA to DALY averted was 37-60 maternal deaths; between 315 and 424 child mortalities; combined maternal morbidity and mortality and child mortality of between 634 and 853, and 1056-1412 unsafe abortions averted. The main limitations are the number of women who never returned to the clinic (overall 14% among the four methods under evaluation); consequently the pregnancy rate could be different. Other limitations include the analysis of two kinds of copper IUD and two kinds of contraceptive implants as the same IUD or implant, and the low number of users of implants. In addition, the DALY calculation relies on a number of estimates, which may vary in different parts of the world. LARC methods and DMPA are highly effective and women who were well-counselled used these methods for a long time. The benefit of averting maternal morbidity and mortality, child mortality, and unsafe abortions is an example to health policy makers to implement more family planning programmes and to offer contraceptive methods, mainly LARC and DMPA, at no cost or at affordable cost for the underprivileged population. This study received partial financial support from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), grant # 2012/12810-4 and from the National Research Council (CNPq), grant #573747/2008-3. B.F.B., M.P.G., and V.M.C. were fellows from the scientific initiation programme from FAPESP. Since the year 2001, all the TCu380A IUD were donated by Injeflex, São Paulo, Brazil, and from the year 2006 all the LNG-IUS were donated by the International Contraceptive Access Foundation (ICA), Turku, Finland. Both donations are as unrestricted grants. The authors declare that there are no conflicts of interest associated with this study. © The Author 2014. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Effect of Notched Strings on Tennis Racket Spin Performance: Ultrahigh-Speed Video Analysis of Spin Rate, Contact Time, and Post-Impact Ball Velocity

NASA Astrophysics Data System (ADS)

Kawazoe, Yoshihiko; Takeda, Yukihiro; Nakagawa, Masamichi

While some tennis racket strings have more grip than others do, this does not guarantee that they will impart more spin to a tennis ball. Experiments with hand-held rackets are required to determine the longstanding question of how players can discern that different strings behave differently when laboratory tests indicate that they should play the same. In a previous study, we clarified the top-spin mechanism of a tennis racket by using high-speed video analysis on a tennis court for the first time. Furthermore, we improved it by using lubricated notched nylon strings. These experiments revealed that the more the main strings stretch and bend laterally, the more spin is imparted to the ball. This is due to the restoring force being parallel to the string face when the main strings spring back and the ball is released from the strings. Notched strings reduce the spin rate, but this can be effectively counteracted by employing lubricants. Furthermore, we found that imparting more spin reduces shock vibrations on the wrist during impact. The present study revealed that a ball has a 40% lower spin rate when hit with a racket with notched strings than with one with unnotched strings in the case of nylon (it had to be determined whether new strings or lubricated used strings give more spin). The experiments also showed that 30% more spin is imparted to a ball when the string intersections are lubricated by oil than when notched used nylon strings are used. Furthermore, we found that used natural gut notched strings reduced the spin rate by 70% compared to when new natural gut unnotched strings are used. We also investigated different top-spin behaviors obtained when professional and amateur tennis players hit a ball.

Analysis of the Microstructure of Titles in the INSPEC Data-Base

ERIC Educational Resources Information Center

And Others; Lynch, Michael F.

1973-01-01

A high degree of constancy has been found in the microstructure of titles of samples of the INSPEC data base taken over a three-year period. Character and digram frequencies are relatively stable, while variable-length character-strings characterizing samples separated by three years in time show close similarities. (2 references) (Author/SJ)

Syntactic transfer in artificial grammar learning.

PubMed

Beesley, T; Wills, A J; Le Pelley, M E

2010-02-01

In an artificial grammar learning (AGL) experiment, participants were trained with instances of one grammatical structure before completing a test phase in which they were required to discriminate grammatical from randomly created strings. Importantly, the underlying structure used to generate test strings was different from that used to generate the training strings. Despite the fact that grammatical training strings were more similar to nongrammatical test strings than they were to grammatical test strings, this manipulation resulted in a positive transfer effect, as compared with controls trained with nongrammatical strings. It is suggested that training with grammatical strings leads to an appreciation of set variance that aids the detection of grammatical test strings in AGL tasks. The analysis presented demonstrates that it is useful to conceptualize test performance in AGL as a form of unsupervised category learning.

An Ada/SQL (Structured Query Language) Application Scanner.

DTIC Science & Technology

1988-03-01

Digital ...8217 (" DIGITS "), 46 new STRING’ ("DO"), new STRING’ ("ELSE"), new STRING’ ("ELSIF"), new STRING’ ("END"), new STRING’ ("ENTRY"), new STRING’ ("EXCEPTION...INTEGERPRINT; generic type NUM is digits <>; package FLOATPRINT is package txtprts.ada 18 prcdr PR (FL inFL %YE LINE n LINTYPE UNCLASSIFIED procedure

Pitch glide effect induced by a nonlinear string-barrier interaction

NASA Astrophysics Data System (ADS)

Kartofelev, Dmitri; Stulov, Anatoli; Välimäki, Vesa

2015-10-01

Interactions of a vibrating string with its supports and other spatially distributed barriers play a significant role in the physics of many stringed musical instruments. It is well known that the tone of the string vibrations is determined by the string supports, and that the boundary conditions of the string termination may cause a short-lasting initial fundamental frequency shifting. Generally, this phenomenon is associated with the nonlinear modulation of the stiff string tension. The aim of this paper is to study the initial frequency glide phenomenon that is induced only by the string-barrier interaction, apart from other possible physical causes, and without the interfering effects of dissipation and dispersion. From a numerical simulation perspective, this highly nonlinear problem may present various difficulties, not the least of which is the risk of numerical instability. We propose a numerically stable and a purely kinematic model of the string-barrier interaction, which is based on the travelling wave solution of the ideal string vibration. The model is capable of reproducing the motion of the vibrating string exhibiting the initial fundamental frequency glide, which is caused solely by the complex nonlinear interaction of the string with its termination. The results presented in this paper can expand our knowledge and understanding of the timbre evolution and the physical principles of sound generation of numerous stringed instruments, such as lutes called the tambura, sitar and biwa.

Constraint Reasoning Over Strings

NASA Technical Reports Server (NTRS)

Koga, Dennis (Technical Monitor); Golden, Keith; Pang, Wanlin

2003-01-01

This paper discusses an approach to representing and reasoning about constraints over strings. We discuss how many string domains can often be concisely represented using regular languages, and how constraints over strings, and domain operations on sets of strings, can be carried out using this representation.

Breakage of IUDs in utero. (Letter).

PubMed

Jackson, M C

1977-06-01

I was interested in the note in the February 1977 issue of the "IPPF MEdical Bulletin" by Biale et al. about the breakage of IUDs in utero. They do not say where and by whom their loops were made, and omit 1 highly important factor in their assessment, i.e., the quality of the plastic. I think we all know that there was a batch of loops produced in Hong Kong in the early 1970s which started, within months of insertion, breaking up in utero; I spent many anxious hours extracting the pieces, and Gladys Dodds must have spent weeks and months removing the thousands of "HK loops" she had inserted in Hong Kong. Conversely, not long ago I removed a Lippes Loop (given me by Jack Lippes) which I had inserted in 1962. It had been in situ for 14 years and it was as resilient as when it went in and was in perfect shape.

The physics of unwound and wound strings on the electric guitar applied to the pitch intervals produced by tremolo/vibrato arm systems.

PubMed

Kemp, Jonathan A

2017-01-01

The physics of wound and unwound strings on the electric guitar are presented here, and the pitch intervals produced by the movements of a Fender Stratocaster tremolo unit are explained. Predicted changes in pitch sensitivity of different strings are given, and experimentally verified, for changes in saddle height, the distance of string free to move behind the nut and ratio of diameters/masses of the core and windings of wound strings. Also, it is shown that changes to the gauge of strings (assuming the string tension is sufficient for linear behaviour and in absence of changes to other construction details) don't alter the pitch intervals produced by a given angle of tremolo arm use assuming the instrument is set up with the same sounding pitches and starting bridge angle. It is demonstrated that it not possible to equalise the relative sensitivity of unwound steel stings on a Fender Stratocaster type tremolo unit through string construction techniques. The ratio of core to winding mass in the string, on the other hand, was found to be a very powerful design parameter for choosing the sensitivity of the string to tremolo arm use and standard pitch bends. For instance, the pitch intervals produced by operation of tremolo arm for wound strings may be made to approximately match that for one of the unwound strings if they share very similar core gauges (assuming the winding masses are chosen to give approximately the same tension at their sounding pitches). Such a design, only available currently by custom order, also delivers the optimum equalisation in sensitivity of strings for standard string bends (due to these also being produced by altering the length of the string to generate changes in tension and therefore pitch).

Entanglement branes in a two-dimensional string theory

DOE PAGES

Donnelly, William; Wong, Gabriel

2017-09-20

What is the meaning of entanglement in a theory of extended objects such as strings? To address this question we consider the spatial entanglement between two intervals in the Gross-Taylor model, the string theory dual to two-dimensional Yang-Mills theory at large N. The string diagrams that contribute to the entanglement entropy describe open strings with endpoints anchored to the entangling surface, as first argued by Susskind. We develop a canonical theory of these open strings, and describe how closed strings are divided into open strings at the level of the Hilbert space. Here, we derive the modular Hamiltonian for themore » Hartle-Hawking state and show that the corresponding reduced density matrix describes a thermal ensemble of open strings ending on an object at the entangling surface that we call an entanglement brane, or E-brane.« less

String-driven inflation

NASA Technical Reports Server (NTRS)

Turok, Neil

1988-01-01

It is argued that, in fundamental string theories, as one traces the universe back in time a point is reached when the expansion rate is so fast that the rate of string creation due to quantum effects balances the dilution of the string density due to the expansion. One is therefore led into a phase of constant string density and an exponentially expanding universe. Fundamental strings therefore seem to lead naturally to inflation.

p-adic string theories provide lattice Discretization to the ordinary string worldsheet.

PubMed

Ghoshal, Debashis

2006-10-13

A class of models called p-adic strings is useful in understanding the tachyonic instability of string theory. These are found to be empirically related to the ordinary strings in the p-->1 limit. We propose that these models provide discretization for the string worldsheet and argue that the limit is naturally thought of as a continuum limit in the sense of the renormalization group.

Self-organization in a system of binary strings with spatial interactions

NASA Astrophysics Data System (ADS)

Banzhaf, W.; Dittrich, P.; Eller, B.

1999-01-01

We consider an artificial reaction system whose components are binary strings. Upon encounter, two binary strings produce a third string which competes for storage space with the originators. String types or species can only survive when produced in sufficient numbers. Spatial interactions through introduction of a topology and rules for distance-dependent reactions are discussed. We observe various kinds of survival strategies of binary strings.

p-adic String Theories Provide Lattice Discretization to the Ordinary String Worldsheet

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ghoshal, Debashis

2006-10-13

A class of models called p-adic strings is useful in understanding the tachyonic instability of string theory. These are found to be empirically related to the ordinary strings in the p{yields}1 limit. We propose that these models provide discretization for the string worldsheet and argue that the limit is naturally thought of as a continuum limit in the sense of the renormalization group.

Progress report for a research program in theoretical high energy physics

DOE Office of Scientific and Technical Information (OSTI.GOV)

Feldman, D.; Fried, H.M.; Jevicki, A.

This year's research has dealt with: superstrings in the early universe; the invisible axion emissions from SN1987A; quartic interaction in Witten's superstring field theory; W-boson associated multiplicity and the dual parton model; cosmic strings and galaxy formation; cosmic strings and baryogenesis; quark flavor mixing; p -- /bar p/ scattering at TeV energies; random surfaces; ordered exponentials and differential equations; initial value and back-reaction problems in quantum field theory; string field theory and Weyl invariance; the renormalization group and string field theory; the evolution of scalar fields in an inflationary universe, with and without the effects of gravitational perturbations; cosmic stringmore » catalysis of skyrmion decay; inflation and cosmic strings from dynamical symmetry breaking; the physic of flavor mixing; string-inspired cosmology; strings at high-energy densities and complex temperatures; the problem of non-locality in string theory; string statistical mechanics; large-scale structures with cosmic strings and neutrinos; the delta expansion for stochastic quantization; high-energy neutrino flux from ordinary cosmic strings; a physical picture of loop bremsstrahlung; cylindrically-symmetric solutions of four-dimensional sigma models; large-scale structure with hot dark matter and cosmic strings; the unitarization of the odderon; string thermodynamics and conservation laws; the dependence of inflationary-universe models on initial conditions; the delta expansion and local gauge invariance; particle physics and galaxy formation; chaotic inflation with metric and matter perturbations; grand-unified theories, galaxy formation, and large-scale structure; neutrino clustering in cosmic-string-induced wakes; and infrared approximations to nonlinear differential equations. 17 refs.« less

Knowledge and attitudes about long-acting reversible contraception among Latina women who desire sterilization

PubMed Central

White, Kari; Hopkins, Kristine; Potter, Joseph E.; Grossman, Daniel

2013-01-01

Background There is growing interest in increasing the use of long-acting reversible contraception (LARC), and suggestions that such methods may serve as an alternative to sterilization. However, there is little information about whether women who do not want more children would be interested in using LARC methods. Methods We conducted semi-structured interviews with 120 parous Latina women in El Paso, Texas who wanted a sterilization but had not obtained one. We assessed women’s awareness of and interest in using the copper intrauterine device (IUD), levonorgestrel intrauterine system (LNG-IUS), and etonogestrel implant. Findings Overall, 51%, 23% and 47% of women reported they had heard of the copper IUD, LNG-IUS and implant, respectively. More women stated they would use the copper IUD (24%) than the LNG-IUS (14%) or implant (9%). Among women interested in LARC, the most common reasons were that, relative to their current method, LARC methods were more convenient, effective, and provided longer-term protection against pregnancy. Those who had reservations about LARC were primarily concerned with menstrual changes. Women also had concerns about side effects and the methods' effectiveness in preventing pregnancy, preferring to use a familiar method. Conclusions Although these findings indicate many Latina women in this setting do not consider LARC an alternative to sterilization, they point to an existing demand among some who wish to end childbearing. Efforts are needed to improve women’s knowledge and access to a range of methods so they can achieve their childbearing goals. PMID:23816156

Comparing the effect of mefenamic Acid and vitex agnus on intrauterine device induced bleeding.

PubMed

Yavarikia, Parisa; Shahnazi, Mahnaz; Hadavand Mirzaie, Samira; Javadzadeh, Yousef; Lutfi, Razieh

2013-09-01

Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding. This was a double blinded randomized controlled clinical trial. It was conducted on 84 women with random allocation in to two groups of 42 treated with mefenamic acid and vitex agnus capsules taking three times a day during menstruation for four months. Data were collected by demographic questionnaire and Higham 5 stage chart (1 month before the treatment and 4 months during the treatment)., Paired t-test, independent t-test, chi-square test, analysis of variance (ANOVA) with repeated measurements, and SPSS software were used to determine the results. Mefenamic acid and vitex agnus significantly decreased bleeding. This decrease in month 4 was 52% in the mefenamic acid group and 47.6% in the vitex agnus group. The mean bleeding score changes was statistically significant between the two groups in the first three months and before the intervention. In the mefenamic acid group, the decreased bleeding was significantly more than the vitex agnus group. However, during the 4(th) month, the mean change was not statistically significant. Mefenamic acid and vitex agnus were both effective on IUD induced bleeding; however, mefenamic acid was more effective.

The Big Vitamin D Mistake.

PubMed

Papadimitriou, Dimitrios T

2017-07-01

Since 2006, type 1 diabetes in Finland has plateaued and then decreased after the authorities' decision to fortify dietary milk products with cholecalciferol. The role of vitamin D in innate and adaptive immunity is critical. A statistical error in the estimation of the recommended dietary allowance (RDA) for vitamin D was recently discovered; in a correct analysis of the data used by the Institute of Medicine, it was found that 8895 IU/d was needed for 97.5% of individuals to achieve values ≥50 nmol/L. Another study confirmed that 6201 IU/d was needed to achieve 75 nmol/L and 9122 IU/d was needed to reach 100 nmol/L. The largest meta-analysis ever conducted of studies published between 1966 and 2013 showed that 25-hydroxyvitamin D levels <75 nmol/L may be too low for safety and associated with higher all-cause mortality, demolishing the previously presumed U-shape curve of mortality associated with vitamin D levels. Since all-disease mortality is reduced to 1.0 with serum vitamin D levels ≥100 nmol/L, we call public health authorities to consider designating as the RDA at least three-fourths of the levels proposed by the Endocrine Society Expert Committee as safe upper tolerable daily intake doses. This could lead to a recommendation of 1000 IU for children <1 year on enriched formula and 1500 IU for breastfed children older than 6 months, 3000 IU for children >1 year of age, and around 8000 IU for young adults and thereafter. Actions are urgently needed to protect the global population from vitamin D deficiency.

Optimizing the delivery of contraceptives in low- and middle-income countries through task shifting: a systematic review of effectiveness and safety.

PubMed

Polus, Stephanie; Lewin, Simon; Glenton, Claire; Lerberg, Priya M; Rehfuess, Eva; Gülmezoglu, A Metin

2015-04-01

To assess the effectiveness and safety of task shifting for the delivery of injectable contraceptives, contraceptive implants, intrauterine devices (IUDs), tubal ligation and vasectomy in low- and middle-income countries. Multiple electronic databases were searched up to 25 May 2012 for studies which had assessed the delivery of contraceptives by health workers with lower levels of training, compared to delivery by health workers usually assigned this role, or compared to no organized provision of contraceptives. We included randomized controlled trials, non-randomized controlled trials, controlled before-after studies, and interrupted time series. Data were extracted using a standard form and the certainty of the evidence found was assessed using GRADE. We identified six randomized controlled trials published between 1977 and 1995 that assessed the safety and effectiveness of task shifting for the delivery of long-term contraceptives. Two studies assessed IUD insertion by nurses compared to doctors, two assessed IUD insertion by auxiliary nurse-midwives compared to doctors, one assessed tubal ligation by midwives compared to doctors, and one assessed the delivery of vasectomy by medical students compared to doctors. In general, little or no difference was found in contraceptive outcomes between cadres. Study design limitations and the low number of eligible studies, however, allow only limited conclusions to be drawn. The findings indicate that task shifting for the delivery of long-term contraceptives may be a safe and effective approach to increasing access to contraception. Further research is needed because the certainty of the evidence identified is variable.

C-reactive protein and fibrinogen of bedridden older patients in a six-month vitamin D supplementation trial.

PubMed

Bjorkman, M P; Sorva, A J; Tilvis, R S

2009-05-01

To elucidate the association between vitamin D status, C-reactive protein (CRP) and fibrinogen. Secondary analysis of a randomised double-blind placebo controlled trial. Four longterm care hospitals (1215 beds) in Helsinki, Finland. 218 long-term inpatients aged over 65 years. Eligible patients (n = 218) were randomized to receive 0 IU/d, 400 IU/d, or 1200 IU/d cholecalciferol for six months. Plasma 25-hydroxyvitamin D (25-OHD), parathyroid hormone (PTH), high sensitive CRP, fibrinogen, amino-terminal propeptide of type I procollagen (PINP), and carboxy-terminal telopeptide of type I collagen (ICTP) were measured. The patients were aged (84.5 +/- 7.5 years), vitamin D deficient (25-OHD = 23 +/- 10 nmol/l), chronically bedridden and in stable general condition. The mean baseline CRP and fibrinogen were 10.86 mg/l (0.12 mg/l - 125.00 mg/l) and 4,7 g/l (2.3 g/l - 8.6 g/l), respectively. CRP correlated with ICTP (r = 0.217, p = 0.001), but not with vitamin D status. Supplementation significantly increased 25-OHD concentrations, but the changes in CRP and fibrinogen were insignificant and inconsistent. The post-trial CRP concentrations (0.23 mg/l -138.00 mg/l) correlated with ICTP (r = 0.156, p < 0.001), but no association was found with vitamin D status. The baseline and post-trial fibrinogen correlated with CRP, only. CRP concentrations are associated with bone turnover, but not with vitamin D status, and vitamin D supplementation has no major effect on CRP or fibrinogen concentrations in bedridden older patients.

Contraceptive method switching in the United States.

PubMed

Grady, William R; Billy, John O G; Klepinger, Daniel H

2002-01-01

Switching among contraceptive method types is the primary determinant of the prevalence of use of specific contraceptive methods, and it has direct implications for women's ability to avoid unintended pregnancies. Yet, method switching among U.S. women has received little attention from researchers. Data from the 1995 National Survey of Family Growth were used to construct multiple-decrement life tables to explore the gross switching rates of married and unmarried women. Within each group, discrete-time hazard models were estimated to determine how women's characteristics affect their switching behavior. Overall rates of method switching are high among both married and unmarried women (40% and 61%, respectively). Married women's two-year switching rates vary from 30% among women who use the implant, injectable, IUD or other reversible methods to 43% among nonusers, while unmarried women's rates vary from 33% among women who use the implant, injectable or IUD to 70% among nonusers. Multivariate analyses of method switching according to women's characteristics indicate that among married women, women without children are less likely than other women to adopt sterilization or a long-term reversible contraceptive (the implant, injectable or IUD). Older married women have a higher rate than their younger counterparts of switching to sterilization, but are also more likely to continue using no method. Among unmarried women, younger and more highly educated women have high rates of switching to the condom and to dual methods. Women's method switching decisions may be driven primarily by concerns related to level and duration of contraceptive effectiveness, health risks associated with contraceptive use and, among single women, sexually transmitted disease prevention.

Biological Evaluation of the Copper/Low-density Polyethylene Nanocomposite Intrauterine Device

PubMed Central

Wang, Hong; Li, Jun; Xie, Changsheng; Duan, Zhuo; Sun, Li-Kui; Wang, Xin; Zhu, Changhong

2013-01-01

Devices and materials intended for clinical applications as medical and implant devices should be evaluated to determine their biocompatibility in physiological systems. This article presents results from cytotoxicity assay of L929 mouse fibroblasts culture, tests for skin irritation, intracutaneous reactivity and sensitization, and material implantation tests for the novel copper/low-density polyethylene nanocomposite intrauterine device (nano-Cu/LDPE IUD) with potential for future clinical utilization. Cytotoxicity test in vitro was conducted to evaluate the change in morphology, growth and proliferation of cultured L929 mouse fibroblasts, which in vivo examination for skin irritation (n = 6) and intracutaneous reactivity (n = 6) were carried out to explore the irritant behavior in New Zealand White rabbits. Skin sensitization was implemented to evaluate the potential skin sensitizing in Hartley guinea pigs (n = 35). The materials were implanted into the spinal muscle of rabbits (n = 9). The cytotoxicity grade of the nano-Cu/LDPE IUD was 0–1, suggested that the composite was nontoxic or mildly cytotoxic; no irritation reaction and skin sensitization were identified in any animals of specific extracts prepared from the material under test; similarly to the control sides, the inflammatory reaction was observed in the rabbits living tissue of the implanted material in intramuscular implantation assay. They indicated that the novel composite intrauterine device presented potential for this type of application because they meet the requirements of the standard practices recommended for evaluating the biological reactivity. The nano-Cu/LDPE IUD has good biocompatibility, which is biologically safe for the clinical research as a novel contraceptive device. PMID:24058521

Biological evaluation of the copper/low-density polyethylene nanocomposite intrauterine device.

PubMed

Hu, Li-Xia; He, Jing; Hou, Li; Wang, Hong; Li, Jun; Xie, Changsheng; Duan, Zhuo; Sun, Li-Kui; Wang, Xin; Zhu, Changhong

2013-01-01

Devices and materials intended for clinical applications as medical and implant devices should be evaluated to determine their biocompatibility in physiological systems. This article presents results from cytotoxicity assay of L929 mouse fibroblasts culture, tests for skin irritation, intracutaneous reactivity and sensitization, and material implantation tests for the novel copper/low-density polyethylene nanocomposite intrauterine device (nano-Cu/LDPE IUD) with potential for future clinical utilization. Cytotoxicity test in vitro was conducted to evaluate the change in morphology, growth and proliferation of cultured L929 mouse fibroblasts, which in vivo examination for skin irritation (n = 6) and intracutaneous reactivity (n = 6) were carried out to explore the irritant behavior in New Zealand White rabbits. Skin sensitization was implemented to evaluate the potential skin sensitizing in Hartley guinea pigs (n = 35). The materials were implanted into the spinal muscle of rabbits (n = 9). The cytotoxicity grade of the nano-Cu/LDPE IUD was 0-1, suggested that the composite was nontoxic or mildly cytotoxic; no irritation reaction and skin sensitization were identified in any animals of specific extracts prepared from the material under test; similarly to the control sides, the inflammatory reaction was observed in the rabbits living tissue of the implanted material in intramuscular implantation assay. They indicated that the novel composite intrauterine device presented potential for this type of application because they meet the requirements of the standard practices recommended for evaluating the biological reactivity. The nano-Cu/LDPE IUD has good biocompatibility, which is biologically safe for the clinical research as a novel contraceptive device.

Comparison of the Antiviral Effects of 5-Methoxymethyl-deoxyuridine with 5-Iododeoxyuridine, Cytosine Arabinoside, and Adenine Arabinoside

PubMed Central

Babiuk, Lorne A.; Meldrum, Blair; Gupta, V. Sagar; Rouse, Barry T.

1975-01-01

The antiviral activity of 5-methoxymethyl-2′-deoxyuridine (MMUdR) was compared with that of 5-iodo-2′-deoxyuridine (IUdR), cytosine arabinoside (Ara-C), and adenine arabinoside (Ara-A). At concentrations of 2 to 4 μg/ml, MMUdR was inhibitory to herpes simplex virus type 1, but concentrations as high as 128 μg/ml were not inhibitory to three other herpesviruses tested (equine rhinopneumonitis virus, murine cytomegalovirus, and feline rhinopneumonitis virus) or to vaccinia virus. The other nucleosides, in contrast, were inhibitory at similar concentrations (1 to 8 μg/ml) against all viruses tested. The inhibition of HSV-1 by MMUdR appeared to be the result of interference with virus replication rather than the result of drug toxicity to host cells. The drug was not toxic to host cells at 100 times the antiviral concentrations, and pretreatment of host cells with high concentrations of MMUdR had no effect on subsequent virus replication. Combination of MMUdR with either IUdR, Ara-A, or Ara-C gave an enhanced antiviral effect, suggesting that the mechanism of action of MMUdR is different from that of the other three drugs. Antiviral indexes were calculated for each compound and were found to be >250, 80, 40, and 8 for MMUdR, IUdR, Ara-A, and Ara-C, respectively. These were defined as the minimum dose at which toxicity was observed microscopically divided by the dose which reduced plaque numbers by 50%. PMID:1239978

Trait and state impulsivity in males with tendency towards Internet-pornography-use disorder.

PubMed

Antons, Stephanie; Brand, Matthias

2018-04-01

Impulsivity has been identified to be involved in the development and maintenance of specific Internet-use disorders (IUD). It can be differentiated between relatively stable trait impulsivity and state impulsivity which is dependent on environmental and affective factors such as craving. Following the I-PACE (Interaction of Person-Affect-Cognition-Execution) model, both trait and state impulsivity may play an interactive role in IUD. The present study aimed to investigate the relationship between trait and state impulsivity and symptom severity of Internet-pornography-use disorder (IPD) as one form of IUD. Fifty heterosexual males participated in this study. State impulsivity was measured with reaction times in a modified stop-signal task. Each participant conducted two blocks of this task which included neutral and pornographic pictures. Moreover, current subjective craving, trait impulsivity, and symptom severity of IPD were assessed using several questionnaires. Results indicate that trait impulsivity was associated with higher symptom severity of IPD. Especially those males with higher trait impulsivity and state impulsivity in the pornographic condition of the stop-signal task as well as those with high craving reactions showed severe symptoms of IPD. The results indicate that both trait and state impulsivity play a crucial role in the development of IPD. In accordance with dual-process models of addiction, the results may be indicative of an imbalance between the impulsive and reflective systems which might be triggered by pornographic material. This may result in loss of control over the Internet-pornography use albeit experiencing negative consequences. Copyright © 2017 Elsevier Ltd. All rights reserved.

Contraceptive use during the reproductive lifecycle as reported by 46-year-old women in Sweden.

PubMed

Sköld, Annelie; Larsson, Margareta

2012-03-01

The aim of this study was to investigate the contraceptive methods 46-year-old women in Sweden had chosen during different phases of their reproductive lifecycle and, the factors affecting their choice. The design was a retrospective cross-sectional study and targeted 46-year-old women. Five hundred Swedish women were randomly selected from a national population-based register and sent a questionnaire with 18 multiple response questions: the response rate was 47%. The women used different contraceptive methods during different phases of their reproductive lifecycle. Women mainly used oral contraceptive pills and condoms before pregnancy, copper-IUD between pregnancies and, hormonal- and copper IUD after pregnancy. Condoms were used during all phases of women's fertile period. Women with early sexual debut were more likely to have used condom as their first contraceptive method than women with late sexual debut, and women who had children were more likely to use IUD as current contraception than women without children. High efficacy, accessibility and advice from a counselor were the most cited reasons for choosing a particular method. The most common reasons for discontinuing contraceptive use were a wish to be pregnant and concerns about side effects. The partner had little or no influence on choice of method, but advice from a gynecologist or midwife was influential. 46-year-old women in Sweden had chosen different contraceptive methods during different phases of their reproductive lifecycle. Partners appear to have limited influence over this choice. Individualized counseling by health care providers seems important. Copyright © 2011 Elsevier B.V. All rights reserved.

Comparing the Effect of Mefenamic Acid and Vitex Agnus on Intrauterine Device Induced Bleeding

PubMed Central

Yavarikia, Parisa; Shahnazi, Mahnaz; Hadavand Mirzaie, Samira; Javadzadeh, Yousef; Lutfi, Razieh

2013-01-01

Introduction: Increased bleeding is the most common cause of intrauterine device (IUD) removal. The use of alternative therapies to treat bleeding has increased due to the complications of medications. But most alternative therapies are not accepted by women. Therefore, conducting studies to find the right treatment with fewer complications and being acceptable is necessary. This study aimed to compare the effect of mefenamic acid and vitex agnus castus on IUD induced bleeding. Methods: This was a double blinded randomized controlled clinical trial. It was conducted on 84 women with random allocation in to two groups of 42 treated with mefenamic acid and vitex agnus capsules taking three times a day during menstruation for four months. Data were collected by demographic questionnaire and Higham 5 stage chart (1 month before the treatment and 4 months during the treatment)., Paired t-test, independent t-test, chi-square test, analysis of variance (ANOVA) with repeated measurements, and SPSS software were used to determine the results. Results: Mefenamic acid and vitex agnus significantly decreased bleeding. This decrease in month 4 was 52% in the mefenamic acid group and 47.6% in the vitex agnus group. The mean bleeding score changes was statistically significant between the two groups in the first three months and before the intervention. In the mefenamic acid group, the decreased bleeding was significantly more than the vitex agnus group. However, during the 4th month, the mean change was not statistically significant. Conclusion: Mefenamic acid and vitex agnus were both effective on IUD induced bleeding; however, mefenamic acid was more effective. PMID:25276733

Comparison of contraceptive method chosen by women with and without a recent history of induced abortion.

PubMed

Madden, Tessa; Secura, Gina M; Allsworth, Jenifer E; Peipert, Jeffrey F

2011-12-01

Women undergoing induced abortion may be more motivated to choose long-acting reversible contraception (LARC), including the intrauterine device (IUD) and implant, than women without a history of abortion. Our objective was to determine whether the contraceptive method chosen is influenced by a recent history of induced abortion and access to immediate postabortion contraception. This was a subanalysis of the Contraceptive CHOICE Project. We compared contraception chosen by women with a recent history of abortion to women without a recent history. Participants with a recent history of abortion were divided into immediate postabortion contraception and delayed-start contraception groups. Data were available for 5083 women: 3410 women without a recent abortion history, 937 women who received immediate postabortion contraception and 736 women who received delayed-start postabortion contraception. Women offered immediate postabortion contraception were more than three times as likely to choose an IUD [adjusted relative risk (RR(adj)) 3.30, 95% confidence interval (CI) 2.67-4.85] and 50% more likely to choose the implant (RR(adj) 1.51, 95%CI 1.12-2.03) compared to women without a recent abortion. There was no difference in contraceptive method selected among women offered delayed-start postabortion contraception compared to women without a recent abortion. Women offered immediate postabortion contraception are more likely to choose the IUD and implant than women without a recent abortion history. Increasing access to immediate postabortion LARC is essential to preventing repeat unintended pregnancies. Copyright © 2011 Elsevier Inc. All rights reserved.

A study investigating obstetricians' and gynaecologists' management of women requesting an intrauterine device.

PubMed

Black, Kirsten I; Sakhaei, Tahereh; Garland, Suzanne M

2010-04-01

Intrauterine methods including the copper intrauterine device (Cu-IUD) and the levonorgestrel intrauterine system (LNG-IUS) provide highly effective long-term reversible contraception. The reasons for relative low use of these methods in Australia compared to many European countries are not clear, but may in part relate to provider reluctance because of outdated knowledge about their safety and efficacy. The aim of this study was to survey Australian Fellows of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists about their knowledge of the risks, benefits and mechanisms of action of intrauterine methods. In 2008, we undertook a cross-sectional survey of all Australian Fellows not registered as a subspecialist. The survey was mailed to 1050 practitioners and 701 were returned, comprising a response rate of 67%. Knowledge about the LNG-IUS was significantly better than for the Cu-IUD in terms of correct understanding about mechanism of action (89.3% vs. 30%; P < 0.001) and efficacy (63.2% vs. 33.5%; P < 0.001). According to the WHO, both methods are considered suitable for use in nulliparous women, yet only 39.1% of providers believed the Cu-IUD suitable compared to 69.4% for the LNG-IUS (P < 0.001). When responses were analysed according to time from graduation, many aspects of knowledge about these devices showed a linear trend, with greater accuracy in recent graduates (<10 years) compared with graduates of more than 30 years. Both methods are highly effective, non-user dependent and reversible and deserve greater understanding and consideration for use by Australian practitioners and women.

String Formatting Considered Harmful for Novice Programmers

ERIC Educational Resources Information Center

Hughes, Michael C.; Jadud, Matthew C.; Rodrigo, Ma. Mercedes T.

2010-01-01

In Java, "System.out.printf" and "String.format" consume a specialised kind of string commonly known as a format string. In our study of first-year students at the Ateneo de Manila University, we discovered that format strings present a substantial challenge for novice programmers. Focusing on their first laboratory we found…

Charting the landscape of supercritical string theory.

PubMed

Hellerman, Simeon; Swanson, Ian

2007-10-26

Special solutions of string theory in supercritical dimensions can interpolate in time between theories with different numbers of spacetime dimensions and different amounts of world sheet supersymmetry. These solutions connect supercritical string theories to the more familiar string duality web in ten dimensions and provide a precise link between supersymmetric and purely bosonic string theories. Dimension quenching and c duality appear to be natural concepts in string theory, giving rise to large networks of interconnected theories.

String solutions in spherically-symmetric f(R) gravity vacuum

NASA Astrophysics Data System (ADS)

Dil, Emre

Dynamical evolution of the cosmic string in a spherically symmetric f(R) gravity vacuum is studied for a closed and straight string. We first set the background spacetime metric for a constant curvature scalar R = R0, and obtain the Killing fields for it. Using the standard gauge coordinates and constraints for both closed and straight strings, we present the equation of motions and find the solutions of them. We then analyze the dynamics of the string by studying the behavior of the string radius and periastron radius, with respect to both proper time and azimuthal angle, for various values of f(R) functions. Consequently, we conclude that the value of f(R) dramatically affects the closed string collapse time and the straight string angular deviation.

Diffusion of massive particles around an Abelian-Higgs string

NASA Astrophysics Data System (ADS)

Saha, Abhisek; Sanyal, Soma

2018-03-01

We study the diffusion of massive particles in the space time of an Abelian Higgs string. The particles in the early universe plasma execute Brownian motion. This motion of the particles is modeled as a two dimensional random walk in the plane of the Abelian Higgs string. The particles move randomly in the space time of the string according to their geodesic equations. We observe that for certain values of their energy and angular momentum, an overdensity of particles is observed close to the string. We find that the string parameters determine the distribution of the particles. We make an estimate of the density fluctuation generated around the string as a function of the deficit angle. Though the thickness of the string is small, the length is large and the overdensity close to the string may have cosmological consequences in the early universe.

Remarks on entanglement entropy in string theory

NASA Astrophysics Data System (ADS)

Balasubramanian, Vijay; Parrikar, Onkar

2018-03-01

Entanglement entropy for spatial subregions is difficult to define in string theory because of the extended nature of strings. Here we propose a definition for bosonic open strings using the framework of string field theory. The key difference (compared to ordinary quantum field theory) is that the subregion is chosen inside a Cauchy surface in the "space of open string configurations." We first present a simple calculation of this entanglement entropy in free light-cone string field theory, ignoring subtleties related to the factorization of the Hilbert space. We reproduce the answer expected from an effective field theory point of view, namely a sum over the one-loop entanglement entropies corresponding to all the particle-excitations of the string, and further show that the full string theory regulates ultraviolet divergences in the entanglement entropy. We then revisit the question of factorization of the Hilbert space by analyzing the covariant phase-space associated with a subregion in Witten's covariant string field theory. We show that the pure gauge (i.e., BRST exact) modes in the string field become dynamical at the entanglement cut. Thus, a proper definition of the entropy must involve an extended Hilbert space, with new stringy edge modes localized at the entanglement cut.

A new experimental three-dimensional, reticular intrauterine device (3-DRIUD) composed of nitinol and silicone rubber.

PubMed

Qiu, Yi; Wang, Lei-Guang; Zhang, Mei-Hua; Zhang, Yan-Ping; Zhang, Ai-Dong; Yang, Dan-Tong

2013-07-01

The aim of this study was to explore a new three-dimensional, reticular intrauterine device (3-DRIUD) composed of nitinol and silicone rubber and to observe the contraceptive effect of the device in rats. Two contraceptive experiments were performed. In the first, female rats underwent bilateral placement of a 20.0-35.0-mm 3-DRUID (experimental group, n=30) via an abdominal incision or a sham operation with no IUD (control group, n=30). Two weeks after the operation was performed, the rats from either group were caged together with male rats. The contraceptive effects of the 3-DRIUD were observed at 1 to 3 months postoperation, after which the 3-DRIUDs were removed. One month after this second operation, the rats from the two groups were again coupled with fertile male rats. In a second experiment, female rats underwent bilateral placement of a 10.0-mm 3-DRUID (n=5) via an abdominal incision or a two-dimensional IUD (2-DIUD, n=20) and mated 1 month after surgery. The single-pipeline IUD was placed in 10 rats, while the enfolded-pipeline IUD was placed in 10 different rats. In the first experiment, none of the females in the experimental 3-DRIUD group became pregnant (0/30, 0%) after 3 months, compared to 28/30 (93.3%, p<.0001) rats in the control group. After the 3-DRIUDs were removed from the experimental group after 3 months, 27/30 (90%) became pregnant, compared with 29/30 (97%, p>.05). The litter size (mean±SD) did not differ between groups (10.9±1.5 3-DRUID, 11.2±1.1 control, p>.05). In the second experiment, five rats had a 10.0-mm 3-DRUID (which was one third the length of one uterine horn) inserted into the bilateral uterine horns, and three of the five rats became pregnant. All 20 rats were pregnant 1 month after the insertion of the 2-DIUD. Thus, the contraceptive rate for the 2-DIUD group was 0. The primary contraceptive mechanism effect of the new 3-DRIUD in rodents appears to be a result of occupying physical space in the uterus. Copyright © 2013 Elsevier Inc. All rights reserved.

Diagnostic Techniques for Semiconductor Materials Processing. Materials Research Society Symposium Proceedings Held in Boston, Massachusetts on November 29-December 2, 1993. Volume 324

DTIC Science & Technology

1994-05-01

phototransmittance (PT) to study PM-HEMTs with different electron densities and found that the first derivative of the ab- sorption coefficient with...circle before striking the sample. Samples are normally sealed into bags of FEP Teflon I and suspended in the beam between strings of PFA Teflon. Prompt

Cosmic string catalysis of skyrmion decay

NASA Technical Reports Server (NTRS)

Gregory, Ruth; Davis, Anne-Christine; Brandenberger, Robert

1988-01-01

The Callan-Witten picture is developed for monopole catalyzed skyrmion decay in order to analyze the corresponding cosmic string scenario. It is discovered that cosmic strings (both ordinary and superconducting) can catalyze proton decay, but that this catalysis only occurs on the scale of the core of the string. In order to do this we have to develop a vortex model for the superconducting string. An argument is also given for the difference in the enhancement factors for monopoles and strings.

Hydraulics Graphics Package. Users Manual

DTIC Science & Technology

1985-11-01

ENTER: VARIABLE/SEPARATOR/VALUE OR STRING GLBL, TETON DAM FAILURE ENTER: VARIABLE/SEPARATOR/VALUE OR STRING SLOC ,DISCHARGE HISTOGRAM ENTER: VARIABLE...ENTER: VARIABLE/SEPARATOR/VALUE OR STRING YLBL,FLOW IN 1000 CFS ENTER: VARIABLE/SEPARATORVA LUE OR STRING GLBL, TETON DAM FAILURE ENTER: VARIABLE...SEPARATOR/VALUE OR STRING SECNO, 0 ENTER: VARIABLE/SEPARATOR/VALUE OR STRING GO 1ee0. F go L 0 U I Goo. 200. TETON DAM FAILUPE N\\ rLOIJ Alr 4wi. fiNT. I .I

Impaired letter-string processing in developmental dyslexia: what visual-to-phonology code mapping disorder?

PubMed

Valdois, Sylviane; Lassus-Sangosse, Delphine; Lobier, Muriel

2012-05-01

Poor parallel letter-string processing in developmental dyslexia was taken as evidence of poor visual attention (VA) span, that is, a limitation of visual attentional resources that affects multi-character processing. However, the use of letter stimuli in oral report tasks was challenged on its capacity to highlight a VA span disorder. In particular, report of poor letter/digit-string processing but preserved symbol-string processing was viewed as evidence of poor visual-to-phonology code mapping, in line with the phonological theory of developmental dyslexia. We assessed here the visual-to-phonological-code mapping disorder hypothesis. In Experiment 1, letter-string, digit-string and colour-string processing was assessed to disentangle a phonological versus visual familiarity account of the letter/digit versus symbol dissociation. Against a visual-to-phonological-code mapping disorder but in support of a familiarity account, results showed poor letter/digit-string processing but preserved colour-string processing in dyslexic children. In Experiment 2, two tasks of letter-string report were used, one of which was performed simultaneously to a high-taxing phonological task. Results show that dyslexic children are similarly impaired in letter-string report whether a concurrent phonological task is simultaneously performed or not. Taken together, these results provide strong evidence against a phonological account of poor letter-string processing in developmental dyslexia. Copyright © 2012 John Wiley & Sons, Ltd.

Multiflavor string-net models

NASA Astrophysics Data System (ADS)

Lin, Chien-Hung

2017-05-01

We generalize the string-net construction to multiple flavors of strings, each of which is labeled by the elements of an Abelian group Gi. The same flavor of strings can branch, while different flavors of strings can cross one another and thus they form intersecting string nets. We systematically construct the exactly soluble lattice Hamiltonians and the ground-state wave functions for the intersecting string-net condensed phases. We analyze the braiding statistics of the low-energy quasiparticle excitations and find that our model can realize all the topological phases as the string-net model with group G =∏iGi . In this respect, our construction provides various ways of building lattice models which realize topological order G , corresponding to different partitions of G and thus different flavors of string nets. In fact, our construction concretely demonstrates the Künneth formula by constructing various lattice models with the same topological order. As an example, we construct the G =Z2×Z2×Z2 string-net model which realizes a non-Abelian topological phase by properly intersecting three copies of toric codes.

Search strings for the study of putative occupational determinants of disease

PubMed Central

Mattioli, Stefano; Zanardi, Francesca; Baldasseroni, Alberto; Schaafsma, Frederieke; Cooke, Robin MT; Mancini, Gianpiero; Fierro, Mauro; Santangelo, Chiara; Farioli, Andrea; Fucksia, Serenella; Curti, Stefania; Verbeek, Jos

2010-01-01

Objective To identify efficient PubMed search strategies to retrieve articles regarding putative occupational determinants of conditions not generally considered to be work related. Methods Based on MeSH definitions and expert knowledge, we selected as candidate search terms the four MeSH terms describing ‘occupational disease’, ‘occupational exposure’, ‘occupational health’ and ‘occupational medicine’ (DEHM) alongside 22 other promising terms. We first explored overlaps between the candidate terms in PubMed. Using random samples of abstracts retrieved by each term, we estimated the proportions of articles containing potentially pertinent information regarding occupational aetiology in order to formulate two search strategies (one more ‘specific’, one more ‘sensitive’). We applied these strategies to retrieve information on the possible occupational aetiology of meningioma, pancreatitis and atrial fibrillation. Results Only 20.3% of abstracts were retrieved by more than one DEHM term. The more ‘specific’ search string was based on the combination of terms that yielded the highest proportion (40%) of potentially pertinent abstracts. The more ‘sensitive’ string was based on the use of broader search fields and additional coverage provided by other search terms under study. Using the specific string, the numbers of abstracts needed to read to find one potentially pertinent article were 1.2 for meningioma, 1.9 for pancreatitis and 1.8 for atrial fibrillation. Using the sensitive strategy, the numbers needed to read were 4.4 for meningioma, 8.9 for pancreatitis and 10.5 for atrial fibrillation. Conclusions The proposed strings could help health care professionals explore putative occupational aetiology for diseases that are not generally thought to be work related. PMID:19819858

Photovoltaic power generation system with photovoltaic cells as bypass diodes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lentine, Anthony L.; Nielson, Gregory N.; Tauke-Pedretti, Anna

A photovoltaic power generation system that includes a solar panel is described herein. The solar panel includes a photovoltaic sub-module, which includes a group of microsystem enabled photovoltaic cells. The group includes a first string of photovoltaic cells, a second string of photovoltaic cells, and a differing photovoltaic cell. Photovoltaic cells in the first string are electrically connected in series, and photovoltaic cells in the second string are electrically connected in series. Further, the first string of photovoltaic cells, the second string of photovoltaic cells, and the differing photovoltaic cell are electrically connected in parallel. Moreover, the differing photovoltaic cellmore » is used as a bypass diode for the first string of photovoltaic cells and the second string of photovoltaic cells.« less

DOE Office of Scientific and Technical Information (OSTI.GOV)

Donnelly, William; Wong, Gabriel

What is the meaning of entanglement in a theory of extended objects such as strings? To address this question we consider the spatial entanglement between two intervals in the Gross-Taylor model, the string theory dual to two-dimensional Yang-Mills theory at large N. The string diagrams that contribute to the entanglement entropy describe open strings with endpoints anchored to the entangling surface, as first argued by Susskind. We develop a canonical theory of these open strings, and describe how closed strings are divided into open strings at the level of the Hilbert space. Here, we derive the modular Hamiltonian for themore » Hartle-Hawking state and show that the corresponding reduced density matrix describes a thermal ensemble of open strings ending on an object at the entangling surface that we call an entanglement brane, or E-brane.« less

Device for balancing parallel strings

DOEpatents

Mashikian, Matthew S.

1985-01-01

A battery plant is described which features magnetic circuit means in association with each of the battery strings in the battery plant for balancing the electrical current flow through the battery strings by equalizing the voltage across each of the battery strings. Each of the magnetic circuit means generally comprises means for sensing the electrical current flow through one of the battery strings, and a saturable reactor having a main winding connected electrically in series with the battery string, a bias winding connected to a source of alternating current and a control winding connected to a variable source of direct current controlled by the sensing means. Each of the battery strings is formed by a plurality of batteries connected electrically in series, and these battery strings are connected electrically in parallel across common bus conductors.

Aspects of some dualities in string theory

NASA Astrophysics Data System (ADS)

Kim, Bom Soo

AdS/CFT correspondence in string theory has changed landscape of the theoretical physics. Through this celebrated duality between gravity theory and field theory, one can investigate analytically strongly coupled gauge theories such as Quantum Chromodynamics (QCD) in terms of weakly coupled string theory such as supergravity theory and vice versa. In the first part of this thesis we used this duality to construct a new type of nonlocal field theory, called Puff Field Theory, in terms of D3 branes in type IIB string theory with a geometric twist. In addition to the strong-weak duality of AdS/CFT, there also exists a weak-weak duality, called Twistor String Theory. Twistor technique is successfully used to calculate the SYM scattering amplitude in an elegant fashion. Yet, the progress in the string theory side was hindered by a non-unitary conformal gravity. We extend the Twistor string theory by introducing mass terms, in the second part of the thesis. A chiral mass term is identified as a vacuum expectation value of a conformal supergravity field and is tied with the breaking of the conformal symmetry of gravity. As a prime candidate for a quantum theory of gravity, string theory revealed many promising successes such as counting the number of microstates in supersymmetric Black Holes thermodynamics and resolution of timelike and null singularities, to name a few. Yet, the fundamental string and M-theroy formulations are not yet available. Various string theories without gravity, such as Non-Commutative Open String (NCOS) and Open Membrane (OM) theories, are very nice playground to investigate the fundamental structure of string and M-theory without the complication of gravity. In the last part of the thesis, simpler Non-Relativistic String Theories are constructed and investigated. One important motivation for those theories is related to the connection between Non-Relativistic String Theories and Non-critical String Theories through the bosonization of betagamma CFT.

The physics of unwound and wound strings on the electric guitar applied to the pitch intervals produced by tremolo/vibrato arm systems

PubMed Central

2017-01-01

The physics of wound and unwound strings on the electric guitar are presented here, and the pitch intervals produced by the movements of a Fender Stratocaster tremolo unit are explained. Predicted changes in pitch sensitivity of different strings are given, and experimentally verified, for changes in saddle height, the distance of string free to move behind the nut and ratio of diameters/masses of the core and windings of wound strings. Also, it is shown that changes to the gauge of strings (assuming the string tension is sufficient for linear behaviour and in absence of changes to other construction details) don’t alter the pitch intervals produced by a given angle of tremolo arm use assuming the instrument is set up with the same sounding pitches and starting bridge angle. It is demonstrated that it not possible to equalise the relative sensitivity of unwound steel stings on a Fender Stratocaster type tremolo unit through string construction techniques. The ratio of core to winding mass in the string, on the other hand, was found to be a very powerful design parameter for choosing the sensitivity of the string to tremolo arm use and standard pitch bends. For instance, the pitch intervals produced by operation of tremolo arm for wound strings may be made to approximately match that for one of the unwound strings if they share very similar core gauges (assuming the winding masses are chosen to give approximately the same tension at their sounding pitches). Such a design, only available currently by custom order, also delivers the optimum equalisation in sensitivity of strings for standard string bends (due to these also being produced by altering the length of the string to generate changes in tension and therefore pitch). PMID:28934268

Formation of Electron Strings in Narrow Band Polar Semiconductors

NASA Astrophysics Data System (ADS)

Kusmartsev, F. V.

2000-01-01

We show that linear electron strings may arise in polar semiconductors. A single string consists of M spinless fermions trapped by an extended polarization well of a cigar shape. Inside the string the particles are free although they interact with each other via Coulomb forces. The strings arise as a result of an electronic phase separation associated with an instability of small adiabatic polarons. We have found the length of the string which depends on dielectric constants of semiconductors. The appearance of these electron strings may have an impact on the effect of stripe formation observed in a variety of high- Tc experiments.

Optimal management of batteries in electric systems

DOEpatents

Atcitty, Stanley; Butler, Paul C.; Corey, Garth P.; Symons, Philip C.

2002-01-01

An electric system including at least a pair of battery strings and an AC source minimizes the use and maximizes the efficiency of the AC source by using the AC source only to charge all battery strings at the same time. Then one or more battery strings is used to power the load while management, such as application of a finish charge, is provided to one battery string. After another charge cycle, the roles of the battery strings are reversed so that each battery string receives regular management.

The waiting time problem in a model hominin population.

PubMed

Sanford, John; Brewer, Wesley; Smith, Franzine; Baumgardner, John

2015-09-17

Functional information is normally communicated using specific, context-dependent strings of symbolic characters. This is true within the human realm (texts and computer programs), and also within the biological realm (nucleic acids and proteins). In biology, strings of nucleotides encode much of the information within living cells. How do such information-bearing nucleotide strings arise and become established? This paper uses comprehensive numerical simulation to understand what types of nucleotide strings can realistically be established via the mutation/selection process, given a reasonable timeframe. The program Mendel's Accountant realistically simulates the mutation/selection process, and was modified so that a starting string of nucleotides could be specified, and a corresponding target string of nucleotides could be specified. We simulated a classic pre-human hominin population of at least 10,000 individuals, with a generation time of 20 years, and with very strong selection (50% selective elimination). Random point mutations were generated within the starting string. Whenever an instance of the target string arose, all individuals carrying the target string were assigned a specified reproductive advantage. When natural selection had successfully amplified an instance of the target string to the point of fixation, the experiment was halted, and the waiting time statistics were tabulated. Using this methodology we tested the effect of mutation rate, string length, fitness benefit, and population size on waiting time to fixation. Biologically realistic numerical simulations revealed that a population of this type required inordinately long waiting times to establish even the shortest nucleotide strings. To establish a string of two nucleotides required on average 84 million years. To establish a string of five nucleotides required on average 2 billion years. We found that waiting times were reduced by higher mutation rates, stronger fitness benefits, and larger population sizes. However, even using the most generous feasible parameters settings, the waiting time required to establish any specific nucleotide string within this type of population was consistently prohibitive. We show that the waiting time problem is a significant constraint on the macroevolution of the classic hominin population. Routine establishment of specific beneficial strings of two or more nucleotides becomes very problematic.

The IMS Software Integration Platform

DTIC Science & Technology

1993-04-12

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Continuous glucose monitoring in hemodialyzed patients with type 2 diabetes: a multicenter pilot study.

PubMed

Képénékian, Lori; Smagala, Agnieszka; Meyer, Laurent; Imhoff, Olivier; Alenabi, Farideh; Serb, Liviu; Fleury, Dominique; Dorey, François; Krummel, Thierry; Le Floch, Jean-Pierre; Chantrel, François; Kessler, Laurence

2014-10-01

Hemodialyzed patients with diabetes face an increased cardiovascular risk. Optimal glycemic control can reduce morbidity and mortality, but it is difficult to achieve because of the alternation between dialysis and non-dialysis periods. This study evaluated the contribution of continuous glucose monitoring (CGM) to the management of insulin regimen. In this pilot prospective multicenter study, we performed CGM (Navigator®, Abbott, Rungis, France) for a total of 54 hours at baseline and for a 3-month follow-up period in a group of 28 hemodialyzed patients with type 2 diabetes treated by a basal-bolus detemir plus aspart insulin regimen. Insulin therapy was adapted to the CGM values. HbA1c and CGM parameters collected over the 3-month treatment period were compared using MANOVA for repeated measures. After 3 months, HbA1c significantly decreased from 8.4 ± 1.0% (65 ± 1 mmol/mol) to 7.6 ± 1.0% (60 ± 11 mmol/mol; p < 0.01). Similarly, mean CGM glucose values significantly decreased from 9.9 ± 1.9 to 8.9 ± 2.1 mmol/L (p = 0.05). The frequency of glucose values > 10 mmol/L significantly decreased from 41.3 ± 21.9% to 30.1 ± 22.4% (p < 0.05), without a significant increase in the frequency of glucose values < 3.3 mmol/L. Insulin requirements significantly increased from 70 ± 51 IU/d to 82 ± 77 IU/d (p < 0.001), without significant changes in body weight. CGM-adapted insulin regimen improves glycemic control without increasing hypoglycemic events in hemodialyzed diabetic patients. CGM could be a useful tool for the management of insulin therapy in these patients. These results need to be confirmed by long-term studies with larger sample sizes.

Private providers' knowledge, attitudes and misconceptions related to long-acting and permanent contraceptive methods: a case study in Bangladesh.

PubMed

Ugaz, Jorge; Banke, Kathryn; Rahaim, Stephen; Chowdhury, Wahiduzzaman; Williams, Julie

2016-11-01

In Bangladesh, use of long-acting and permanent methods of contraception (LAPMs) remains stagnant. Providers' limited knowledge and biases may be a factor. We assessed private providers' knowledge, misconceptions and general attitudes towards LAPM in two urban areas. The ultimate goal is to shape programs and interventions to overcome these obstacles and improve full method choice in Bangladesh. Trained data collectors interviewed a convenience sample of 235 female doctors (obstetricians-gynecologists and general practitioners) and 150 female nurses from 194 commercial (for-profit) health care facilities in Chittagong City Corporation and Dhaka district. Data were collected on the nature of the practice, training received, knowledge about modern contraceptives and attitudes towards LAPM [including intrauterine device (IUDs), implants, female and male sterilization]. All providers, and especially doctors, lacked adequate knowledge regarding side effects for all LAPMs, particularly female and male sterilization. Providers had misconceptions about the effectiveness and convenience of LAPMs compared to short-acting contraceptive methods. Implants and IUDs were generally perceived more negatively than other methods. The majority of providers believed that husbands favor short-acting methods rather than LAPMs and that women should not use a method that their husbands do not approve of. Our findings document knowledge and attitudinal barriers among private for-profit providers in urban areas affecting their provision of accurate information about LAPM choices. Practitioners should be offered the necessary tools to provide women full access to all modern methods, especially LAPMs, in order to contribute to decreasing unmet need and improving full method choice in Bangladesh. Copyright © 2016 Elsevier Inc. All rights reserved.

Contraception use and unplanned pregnancies among injection drug-using women in St Petersburg, Russia.

PubMed

Abdala, Nadia; Kershaw, Trace; Krasnoselskikh, Tatiana V; Kozlov, Andrei P

2011-07-01

This cross-sectional study estimated the prevalence of contraceptive methods and investigated whether abortion rates influence contraceptive behaviour among injection drug-using (IDU) women in St Petersburg, Russia. A self-administered questionnaire of behaviour in the last 3 months was applied to a convenient sample of IDU women. Of 80 sexually active participants, 67% had had an abortion. No participant reported using hormonal contraceptives or intrauterine devices (IUDs). The only valid method of contraception used was condoms, which was reported by half of the participants. Consistent condom use was reported by 22% of participants and was no more likely among those who had an abortion. Condom use was significantly associated with having multiple or casual sex partners [prevalence ratio (PR) 1.75, 95% (confidence interval) CI 1.11-2.78, p = 0.01], having an IDU sex partner (PR 0.55, 95% CI 0.36-0.85, p = 0.029) and with a negative attitude toward condoms (PR 0.53, 95% CI 0.33-0.84, p = 0.01). Abortions were less likely among those who had multiple or casual sex partners (PR 0.69, 95% CI 0.49-0.97, p = 0.03). Despite the high prevalence of abortions among IDU women, none reported the use of hormonal contraception or IUDs. Having had an abortion was not associated with greater likelihood of using condoms. Participants mostly used condoms with casual or multiple sex partners, suggesting that condoms were used mainly to prevent HIV/sexually transmitted infection transmission and not to prevent pregnancy. Programmes to prevent unwanted pregnancies and reduce abortion-related health risks among this understudied vulnerable group are needed.

Mars Sample Return mission utilizing in-situ propellant production

NASA Technical Reports Server (NTRS)

Zubrin, Robert; Price, Steve

1995-01-01

This report presents the results of a study examining the potential of in-situ propellant production (ISPP) on Mars to aid in achieving a low cost Mars Sample Return (MSR) mission. Two versions of such a mission were examined: a baseline version employing a dual string spacecraft, and a light weight version employing single string architecture with selective redundancy. Both systems employed light weight avionics currently being developed by Lockheed Martin, Jet Propulsion Lab and elsewhere in the aerospace community, both used a new concept for a simple, light weight parachuteless sample return capsule, both used a slightly modified version of the Mars Surveyor lander currently under development at Lockheed Martin for flight in 1998, and both used a combination of the Sabatier-electrolysis and reverse water gas shift ISPP systems to produce methane/oxygen propellant on Mars by combining a small quantity of imported hydrogen with the Martian CO2 atmosphere. It was found that the baseline mission could be launched on a Delta 7925 and return a 0.5 kg sample with 82 percent mission launch margin;over and beyond subsystem allocated contingency masses . The lightweight version could be launched on a Mid-Lite vehicle and return a 0.25 kg sample with 11 percent launch margin, over and above subsystem contingency mass allocations.

Cosmic superstrings: Observable remnants of brane inflation

NASA Astrophysics Data System (ADS)

Wyman, Mark Charles

Brane inflation provides a natural dynamical model for the physics which underlie the inflationary paradigm. Besides their inflationary predictions, brane models imply another observable consequence: cosmic strings. In this dissertation I outline the background of how cosmic strings arise in brane inflationary models and how the properties of the strings and the models are mutually tied (Chapter 2). I then use cosmological observations to put limits on the properties of any actually-existing cosmic string network (Chapter 3). Next, I study the question of how cosmic superstrings, as the cosmic strings arising from string theory are known, could be distinct from classical gauge- theory cosmic strings. In particular, I propose an analytical model for the cosmological evolution of a network of binding cosmic strings (Chapter 4); I also describe the distinctive gravitational lensing phenomena that are caused by binding strings (Chapter 5). Finally, I lay out the background for the numerical study of a gauge theory model for the dynamics of cosmic superstring binding (Chapter 6).

String theory--the physics of string-bending and other electric guitar techniques.

PubMed

Grimes, David Robert

2014-01-01

Electric guitar playing is ubiquitous in practically all modern music genres. In the hands of an experienced player, electric guitars can sound as expressive and distinct as a human voice. Unlike other more quantised instruments where pitch is a discrete function, guitarists can incorporate micro-tonality and, as a result, vibrato and sting-bending are idiosyncratic hallmarks of a player. Similarly, a wide variety of techniques unique to the electric guitar have emerged. While the mechano-acoustics of stringed instruments and vibrating strings are well studied, there has been comparatively little work dedicated to the underlying physics of unique electric guitar techniques and strings, nor the mechanical factors influencing vibrato, string-bending, fretting force and whammy-bar dynamics. In this work, models for these processes are derived and the implications for guitar and string design discussed. The string-bending model is experimentally validated using a variety of strings and vibrato dynamics are simulated. The implications of these findings on the configuration and design of guitars is also discussed.

PhD Thesis: String theory in the early universe

NASA Astrophysics Data System (ADS)

Gwyn, Rhiannon

2009-11-01

The intersection of string theory with cosmology is unavoidable in the early universe, and its exploration may shine light on both fields. In this thesis, three papers at this intersection are presented and reviewed, with the aim of providing a thorough and pedagogical guide to their results. First, we address the longstanding problem of finding a string theory realisation of the axion. Using warped compactifications in heterotic string theory, we show that the axion decay constant can be lowered to acceptable values by the warp factor. Next, we move to the subject of cosmic strings, whose network evolution could have important consequences for astrophysics and cosmology. In particular, there are quantitative differences between cosmic superstring networks and GUT cosmic string networks. We investigate the properties of cosmic superstring networks in warped backgrounds, giving the tension and properties of three-string junctions in these backgrounds. Finally, we examine the possibility that cosmic strings in heterotic string theory could be responsible for generating the galactic magnetic fields that seeded those observed today.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Ciuca, Razvan; Hernández, Oscar F., E-mail: razvan.ciuca@mail.mcgill.ca, E-mail: oscarh@physics.mcgill.ca

There exists various proposals to detect cosmic strings from Cosmic Microwave Background (CMB) or 21 cm temperature maps. Current proposals do not aim to find the location of strings on sky maps, all of these approaches can be thought of as a statistic on a sky map. We propose a Bayesian interpretation of cosmic string detection and within that framework, we derive a connection between estimates of cosmic string locations and cosmic string tension G μ. We use this Bayesian framework to develop a machine learning framework for detecting strings from sky maps and outline how to implement this frameworkmore » with neural networks. The neural network we trained was able to detect and locate cosmic strings on noiseless CMB temperature map down to a string tension of G μ=5 ×10{sup −9} and when analyzing a CMB temperature map that does not contain strings, the neural network gives a 0.95 probability that G μ≤2.3×10{sup −9}.« less

String Theory - The Physics of String-Bending and Other Electric Guitar Techniques

PubMed Central

Grimes, David Robert

2014-01-01

Electric guitar playing is ubiquitous in practically all modern music genres. In the hands of an experienced player, electric guitars can sound as expressive and distinct as a human voice. Unlike other more quantised instruments where pitch is a discrete function, guitarists can incorporate micro-tonality and, as a result, vibrato and sting-bending are idiosyncratic hallmarks of a player. Similarly, a wide variety of techniques unique to the electric guitar have emerged. While the mechano-acoustics of stringed instruments and vibrating strings are well studied, there has been comparatively little work dedicated to the underlying physics of unique electric guitar techniques and strings, nor the mechanical factors influencing vibrato, string-bending, fretting force and whammy-bar dynamics. In this work, models for these processes are derived and the implications for guitar and string design discussed. The string-bending model is experimentally validated using a variety of strings and vibrato dynamics are simulated. The implications of these findings on the configuration and design of guitars is also discussed. PMID:25054880

Minimal string theories and integrable hierarchies

NASA Astrophysics Data System (ADS)

Iyer, Ramakrishnan

Well-defined, non-perturbative formulations of the physics of string theories in specific minimal or superminimal model backgrounds can be obtained by solving matrix models in the double scaling limit. They provide us with the first examples of completely solvable string theories. Despite being relatively simple compared to higher dimensional critical string theories, they furnish non-perturbative descriptions of interesting physical phenomena such as geometrical transitions between D-branes and fluxes, tachyon condensation and holography. The physics of these theories in the minimal model backgrounds is succinctly encoded in a non-linear differential equation known as the string equation, along with an associated hierarchy of integrable partial differential equations (PDEs). The bosonic string in (2,2m-1) conformal minimal model backgrounds and the type 0A string in (2,4 m) superconformal minimal model backgrounds have the Korteweg-de Vries system, while type 0B in (2,4m) backgrounds has the Zakharov-Shabat system. The integrable PDE hierarchy governs flows between backgrounds with different m. In this thesis, we explore this interesting connection between minimal string theories and integrable hierarchies further. We uncover the remarkable role that an infinite hierarchy of non-linear differential equations plays in organizing and connecting certain minimal string theories non-perturbatively. We are able to embed the type 0A and 0B (A,A) minimal string theories into this single framework. The string theories arise as special limits of a rich system of equations underpinned by an integrable system known as the dispersive water wave hierarchy. We find that there are several other string-like limits of the system, and conjecture that some of them are type IIA and IIB (A,D) minimal string backgrounds. We explain how these and several other string-like special points arise and are connected. In some cases, the framework endows the theories with a non-perturbative definition for the first time. Notably, we discover that the Painleve IV equation plays a key role in organizing the string theory physics, joining its siblings, Painleve I and II, whose roles have previously been identified in this minimal string context. We then present evidence that the conjectured type II theories have smooth non-perturbative solutions, connecting two perturbative asymptotic regimes, in a 't Hooft limit. Our technique also demonstrates evidence for new minimal string theories that are not apparent in a perturbative analysis.

Dynamical AdS strings across horizons

DOE PAGES

Ishii, Takaaki; Murata, Keiju

2016-03-01

We examine the nonlinear classical dynamics of a fundamental string in anti-deSitter spacetime. The string is dual to the flux tube between an external quark-antiquark pair in $N = 4$ super Yang-Mills theory. We perturb the string by shaking the endpoints and compute its time evolution numerically. We find that with sufficiently strong perturbations the string continues extending and plunges into the Poincare´ horizon. In the evolution, effective horizons are also dynamically created on the string worldsheet. The quark and antiquark are thus causally disconnected, and the string transitions to two straight strings. The forces acting on the endpoints vanishmore » with a power law whose slope depends on the perturbations. Lastly, the condition for this transition to occur is that energy injection exceeds the static energy between the quark-antiquark pair.« less

Cosmic strings and the microwave sky. I - Anisotropy from moving strings

NASA Technical Reports Server (NTRS)

Stebbins, Albert

1988-01-01

A method is developed for calculating the component of the microwave anisotropy around cosmic string loops due to their rapidly changing gravitational fields. The method is only valid for impact parameters from the string much smaller than the horizon size at the time the photon passes the string. The method makes it possible to calculate the temperature pattern around arbitrary string configurations numerically in terms of one-dimensional integrals. This method is applied to temperature jump across a string, confirming and extending previous work. It is also applied to cusps and kinks on strings, and to determining the temperature pattern far from a strong loop. The temperature pattern around a few loop configurations is explicitly calculated. Comparisons with the work of Brandenberger et al. (1986) indicates that they have overestimated the MBR anisotropy from gravitational radiation emitted from loops.

The Development of a String Sight-Reading Pitch Skill Hierarchy

ERIC Educational Resources Information Center

Alexander, Michael L.; Henry, Michele L.

2012-01-01

This study was designed to determine a pitch skill hierarchy for string sight-reading, to determine the effects of key on string sight-reading achievement, and to determine the validity of a tonal pattern system as a measurement of melodic sight-reading skill for string players. High school string students (n = 94) obtained a mean score of 27.28…

Actomyosin purse strings: renewable resources that make morphogenesis robust and resilient

PubMed Central

Rodriguez-Diaz, Alice; Toyama, Yusuke; Abravanel, Daniel L.; Wiemann, John M.; Wells, Adrienne R.; Tulu, U. Serdar; Edwards, Glenn S.; Kiehart, Daniel P.

2008-01-01

Dorsal closure in Drosophila is a model system for cell sheet morphogenesis and wound healing. During closure two sheets of lateral epidermis move dorsally to close over the amnioserosa and form a continuous epidermis. Forces from the amnioserosa and actomyosin-rich, supracellular purse strings at the leading edges of these lateral epidermal sheets drive closure. Purse strings generate the largest force for closure and occur during development and wound healing throughout phylogeny. We use laser microsurgery to remove some or all of the purse strings from developing embryos. Free edges produced by surgery undergo characteristic responses as follows. Intact cells in the free edges, which previously had no purse string, recoil away from the incision and rapidly assemble new, secondary purse strings. Next, recoil slows, then pauses at a turning point. Following a brief delay, closure resumes and is powered to completion by the secondary purse strings. We confirm that the assembly of the secondary purse strings requires RhoA. We show that α-actinin alternates with nonmuscle myosin II along purse strings and requires nonmuscle myosin II for its localization. Together our data demonstrate that purse strings are renewable resources that contribute to the robust and resilient nature of closure. PMID:19404432

Physical cognition: birds learn the structural efficacy of nest material

PubMed Central

Bailey, Ida E.; Morgan, Kate V.; Bertin, Marion; Meddle, Simone L.; Healy, Susan D.

2014-01-01

It is generally assumed that birds’ choice of structurally suitable materials for nest building is genetically predetermined. Here, we tested that assumption by investigating whether experience affected male zebra finches’ (Taeniopygia guttata) choice of nest material. After a short period of building with relatively flexible string, birds preferred to build with stiffer string while those that had experienced a stiffer string were indifferent to string type. After building a complete nest with either string type, however, all birds increased their preference for stiff string. The stiffer string appeared to be the more effective building material as birds required fewer pieces of stiffer than flexible string to build a roofed nest. For birds that raised chicks successfully, there was no association between the material they used to build their nest and the type they subsequently preferred. Birds’ material preference reflected neither the preference of their father nor of their siblings but juvenile experience of either string type increased their preference for stiffer string. Our results represent two important advances: (i) birds choose nest material based on the structural properties of the material; (ii) nest material preference is not entirely genetically predetermined as both the type and amount of experience influences birds’ choices. PMID:24741011

Physical cognition: birds learn the structural efficacy of nest material.

PubMed

Bailey, Ida E; Morgan, Kate V; Bertin, Marion; Meddle, Simone L; Healy, Susan D

2014-06-07

It is generally assumed that birds' choice of structurally suitable materials for nest building is genetically predetermined. Here, we tested that assumption by investigating whether experience affected male zebra finches' (Taeniopygia guttata) choice of nest material. After a short period of building with relatively flexible string, birds preferred to build with stiffer string while those that had experienced a stiffer string were indifferent to string type. After building a complete nest with either string type, however, all birds increased their preference for stiff string. The stiffer string appeared to be the more effective building material as birds required fewer pieces of stiffer than flexible string to build a roofed nest. For birds that raised chicks successfully, there was no association between the material they used to build their nest and the type they subsequently preferred. Birds' material preference reflected neither the preference of their father nor of their siblings but juvenile experience of either string type increased their preference for stiffer string. Our results represent two important advances: (i) birds choose nest material based on the structural properties of the material; (ii) nest material preference is not entirely genetically predetermined as both the type and amount of experience influences birds' choices.

Text String Detection from Natural Scenes by Structure-based Partition and Grouping

PubMed Central

Yi, Chucai; Tian, YingLi

2012-01-01

Text information in natural scene images serves as important clues for many image-based applications such as scene understanding, content-based image retrieval, assistive navigation, and automatic geocoding. However, locating text from complex background with multiple colors is a challenging task. In this paper, we explore a new framework to detect text strings with arbitrary orientations in complex natural scene images. Our proposed framework of text string detection consists of two steps: 1) Image partition to find text character candidates based on local gradient features and color uniformity of character components. 2) Character candidate grouping to detect text strings based on joint structural features of text characters in each text string such as character size differences, distances between neighboring characters, and character alignment. By assuming that a text string has at least three characters, we propose two algorithms of text string detection: 1) adjacent character grouping method, and 2) text line grouping method. The adjacent character grouping method calculates the sibling groups of each character candidate as string segments and then merges the intersecting sibling groups into text string. The text line grouping method performs Hough transform to fit text line among the centroids of text candidates. Each fitted text line describes the orientation of a potential text string. The detected text string is presented by a rectangle region covering all characters whose centroids are cascaded in its text line. To improve efficiency and accuracy, our algorithms are carried out in multi-scales. The proposed methods outperform the state-of-the-art results on the public Robust Reading Dataset which contains text only in horizontal orientation. Furthermore, the effectiveness of our methods to detect text strings with arbitrary orientations is evaluated on the Oriented Scene Text Dataset collected by ourselves containing text strings in non-horizontal orientations. PMID:21411405

Text string detection from natural scenes by structure-based partition and grouping.

PubMed

Yi, Chucai; Tian, YingLi

2011-09-01

Text information in natural scene images serves as important clues for many image-based applications such as scene understanding, content-based image retrieval, assistive navigation, and automatic geocoding. However, locating text from a complex background with multiple colors is a challenging task. In this paper, we explore a new framework to detect text strings with arbitrary orientations in complex natural scene images. Our proposed framework of text string detection consists of two steps: 1) image partition to find text character candidates based on local gradient features and color uniformity of character components and 2) character candidate grouping to detect text strings based on joint structural features of text characters in each text string such as character size differences, distances between neighboring characters, and character alignment. By assuming that a text string has at least three characters, we propose two algorithms of text string detection: 1) adjacent character grouping method and 2) text line grouping method. The adjacent character grouping method calculates the sibling groups of each character candidate as string segments and then merges the intersecting sibling groups into text string. The text line grouping method performs Hough transform to fit text line among the centroids of text candidates. Each fitted text line describes the orientation of a potential text string. The detected text string is presented by a rectangle region covering all characters whose centroids are cascaded in its text line. To improve efficiency and accuracy, our algorithms are carried out in multi-scales. The proposed methods outperform the state-of-the-art results on the public Robust Reading Dataset, which contains text only in horizontal orientation. Furthermore, the effectiveness of our methods to detect text strings with arbitrary orientations is evaluated on the Oriented Scene Text Dataset collected by ourselves containing text strings in nonhorizontal orientations.

Families of FPGA-Based Accelerators for Approximate String Matching1

PubMed Central

Van Court, Tom; Herbordt, Martin C.

2011-01-01

Dynamic programming for approximate string matching is a large family of different algorithms, which vary significantly in purpose, complexity, and hardware utilization. Many implementations have reported impressive speed-ups, but have typically been point solutions – highly specialized and addressing only one or a few of the many possible options. The problem to be solved is creating a hardware description that implements a broad range of behavioral options without losing efficiency due to feature bloat. We report a set of three component types that address different parts of the approximate string matching problem. This allows each application to choose the feature set required, then make maximum use of the FPGA fabric according to that application’s specific resource requirements. Multiple, interchangeable implementations are available for each component type. We show that these methods allow the efficient generation of a large, if not complete, family of accelerators for this application. This flexibility was obtained while retaining high performance: We have evaluated a sample against serial reference codes and found speed-ups of from 150× to 400× over a high-end PC. PMID:21603598

How to simulate global cosmic strings with large string tension

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klaer, Vincent B.; Moore, Guy D., E-mail: vklaer@theorie.ikp.physik.tu-darmstadt.de, E-mail: guy.moore@physik.tu-darmstadt.de

Global string networks may be relevant in axion production in the early Universe, as well as other cosmological scenarios. Such networks contain a large hierarchy of scales between the string core scale and the Hubble scale, ln( f {sub a} / H ) ∼ 70, which influences the network dynamics by giving the strings large tensions T ≅ π f {sub a} {sup 2} ln( f {sub a} / H ). We present a new numerical approach to simulate such global string networks, capturing the tension without an exponentially large lattice.

Closed timelike curves produced by pairs of moving cosmic strings - Exact solutions

NASA Technical Reports Server (NTRS)

Gott, J. Richard, III

1991-01-01

Exact solutions of Einstein's field equations are presented for the general case of two moving straight cosmic strings that do not intersect. The solutions for parallel cosmic strings moving in opposite directions show closed timelike curves (CTCs) that circle the two strings as they pass, allowing observers to visit their own past. Similar results occur for nonparallel strings, and for masses in (2+1)-dimensional spacetime. For finite string loops the possibility that black-hole formation may prevent the formation of CTCs is discussed.

Coulomb string tension, asymptotic string tension, and the gluon chain

DOE PAGES

Greensite, Jeff; Szczepaniak, Adam P.

2015-02-01

We compute, via numerical simulations, the non-perturbative Coulomb potential and position-space ghost propagator in pure SU(3) gauge theory in Coulomb gauge. We find that that the Coulomb potential scales nicely in accordance with asymptotic freedom, that the Coulomb potential is linear in the infrared, and that the Coulomb string tension is about four times larger than the asymptotic string tension. We explain how it is possible that the asymptotic string tension can be lower than the Coulomb string tension by a factor of four.

Simulation of swimming strings immersed in a viscous fluid flow

NASA Astrophysics Data System (ADS)

Huang, Wei-Xi; Sung, Hyung Jin

2006-11-01

In nature, many phenomena involve interactions between flexible bodies and their surrounding viscous fluid, such as a swimming fish or a flapping flag. The intrinsic dynamics is complicate and not well understood. A flexible string can be regarded as a one-dimensional flag model. Many similarities can be found between the flapping string and swimming fish, although different wake speed results in a drag force for the flapping string and a propulsion force for the swimming fish. In the present study, we propose a mathematical formulation for swimming strings immersed in a viscous fluid flow. Fluid motion is governed by the Navier-Stokes equations and a momentum forcing is added in order to bring the fluid to move at the same velocity with the immersed surface. A flexible inextensible string model is described by another set of equations with an additional momentum forcing which is a result of the fluid viscosity and the pressure difference across the string. The momentum forcing is calculated by a feedback loop. Simulations of several numerical examples are carried out, including a hanging string which starts moving under gravity without ambient fluid, a swinging string immersed in a quiescent viscous fluid, a string swimming within a uniform surrounding flow, and flow over two side-by-side strings. The numerical results agree well with the theoretical analysis and previous experimental observations. Further simulation of a swimming fish is under consideration.

Noncommutative Field Theories and (super)string Field Theories

NASA Astrophysics Data System (ADS)

Aref'eva, I. Ya.; Belov, D. M.; Giryavets, A. A.; Koshelev, A. S.; Medvedev, P. B.

2002-11-01

In this lecture notes we explain and discuss some ideas concerning noncommutative geometry in general, as well as noncommutative field theories and string field theories. We consider noncommutative quantum field theories emphasizing an issue of their renormalizability and the UV/IR mixing. Sen's conjectures on open string tachyon condensation and their application to the D-brane physics have led to wide investigations of the covariant string field theory proposed by Witten about 15 years ago. We review main ingredients of cubic (super)string field theories using various formulations: functional, operator, conformal and the half string formalisms. The main technical tools that are used to study conjectured D-brane decay into closed string vacuum through the tachyon condensation are presented. We describe also methods which are used to study the cubic open string field theory around the tachyon vacuum: construction of the sliver state, "comma" and matrix representations of vertices.

Gravitational lensing effects of vacuum strings - Exact solutions

NASA Technical Reports Server (NTRS)

Gott, J. R., III

1985-01-01

Exact interior and exterior solutions to Einstein's field equations are derived for vacuum strings. The exterior solution for a uniform density vacuum string corresponds to a conical space while the interior solution is that of a spherical cap. For Mu equals 0-1/4 the external metric is ds-squared = -dt-squared + dr-squared + (1-4 Mu)-squared r-squared dphi-squared + dz-squared, where Mu is the mass per unit length in the string in Planck masses per Planck length. A maximum mass per unit length for a string is 6.73 x 10 to the 27th g/cm. It is shown that strings cause temperature fluctuations in the cosmic microwave background and produce equal brightness double QSO images separated by up to several minutes of arc. Formulae for lensing probabilities, image splittings, and time delays are derived for strings in a realistic cosmological setting. String searches using ST, the VLA, and the COBE satellite are discussed.

Fitting cosmic microwave background data with cosmic strings and inflation.

PubMed

Bevis, Neil; Hindmarsh, Mark; Kunz, Martin; Urrestilla, Jon

2008-01-18

We perform a multiparameter likelihood analysis to compare measurements of the cosmic microwave background (CMB) power spectra with predictions from models involving cosmic strings. Adding strings to the standard case of a primordial spectrum with power-law tilt ns, we find a 2sigma detection of strings: f10=0.11+/-0.05, where f10 is the fractional contribution made by strings in the temperature power spectrum (at l=10). CMB data give moderate preference to the model ns=1 with cosmic strings over the standard zero-strings model with variable tilt. When additional non-CMB data are incorporated, the two models become on a par. With variable ns and these extra data, we find that f10<0.11, which corresponds to Gmicro<0.7x10(-6) (where micro is the string tension and G is the gravitational constant).

Investigations of α-helix↔β-sheet transition pathways in a miniprotein using the finite-temperature string method

PubMed Central

Ovchinnikov, Victor; Karplus, Martin

2014-01-01

A parallel implementation of the finite-temperature string method is described, which takes into account the invariance of coordinates with respect to rigid-body motions. The method is applied to the complex α-helix↔β-sheet transition in a β-hairpin miniprotein in implicit solvent, which exhibits much of the complexity of conformational changes in proteins. Two transition paths are considered, one derived from a linear interpolant between the endpoint structures and the other derived from a targeted dynamics simulation. Two methods for computing the conformational free energy (FE) along the string are compared, a restrained method, and a tessellation method introduced by E. Vanden-Eijnden and M. Venturoli [J. Chem. Phys. 130, 194103 (2009)]. It is found that obtaining meaningful free energy profiles using the present atom-based coordinates requires restricting sampling to a vicinity of the converged path, where the hyperplanar approximation to the isocommittor surface is sufficiently accurate. This sampling restriction can be easily achieved using restraints or constraints. The endpoint FE differences computed from the FE profiles are validated by comparison with previous calculations using a path-independent confinement method. The FE profiles are decomposed into the enthalpic and entropic contributions, and it is shown that the entropy difference contribution can be as large as 10 kcal/mol for intermediate regions along the path, compared to 15–20 kcal/mol for the enthalpy contribution. This result demonstrates that enthalpic barriers for transitions are offset by entropic contributions arising from the existence of different paths across a barrier. The possibility of using systematically coarse-grained representations of amino acids, in the spirit of multiple interaction site residue models, is proposed as a means to avoid ad hoc sampling restrictions to narrow transition tubes. PMID:24811667

Investigations of α-helix↔β-sheet transition pathways in a miniprotein using the finite-temperature string method

NASA Astrophysics Data System (ADS)

Ovchinnikov, Victor; Karplus, Martin

2014-05-01

A parallel implementation of the finite-temperature string method is described, which takes into account the invariance of coordinates with respect to rigid-body motions. The method is applied to the complex α-helix↔β-sheet transition in a β-hairpin miniprotein in implicit solvent, which exhibits much of the complexity of conformational changes in proteins. Two transition paths are considered, one derived from a linear interpolant between the endpoint structures and the other derived from a targeted dynamics simulation. Two methods for computing the conformational free energy (FE) along the string are compared, a restrained method, and a tessellation method introduced by E. Vanden-Eijnden and M. Venturoli [J. Chem. Phys. 130, 194103 (2009)]. It is found that obtaining meaningful free energy profiles using the present atom-based coordinates requires restricting sampling to a vicinity of the converged path, where the hyperplanar approximation to the isocommittor surface is sufficiently accurate. This sampling restriction can be easily achieved using restraints or constraints. The endpoint FE differences computed from the FE profiles are validated by comparison with previous calculations using a path-independent confinement method. The FE profiles are decomposed into the enthalpic and entropic contributions, and it is shown that the entropy difference contribution can be as large as 10 kcal/mol for intermediate regions along the path, compared to 15-20 kcal/mol for the enthalpy contribution. This result demonstrates that enthalpic barriers for transitions are offset by entropic contributions arising from the existence of different paths across a barrier. The possibility of using systematically coarse-grained representations of amino acids, in the spirit of multiple interaction site residue models, is proposed as a means to avoid ad hoc sampling restrictions to narrow transition tubes.

Modal analysis of a nonuniform string with end mass and variable tension

NASA Technical Reports Server (NTRS)

Rheinfurth, M. H.; Galaboff, Z. J.

1983-01-01

Modal synthesis techniques for dynamic systems containing strings describe the lateral displacements of these strings by properly chosen shape functions. An iterative algorithm is provided to calculate the natural modes of a nonuniform string and variable tension for some typical boundary conditions including one end mass. Numerical examples are given for a string in a constant and a gravity gradient force field.

Self-energy and self-force in the space-time of a thick cosmic string

NASA Astrophysics Data System (ADS)

Khusnutdinov, N. R.; Bezerra, V. B.

2001-10-01

We calculate the self-energy and self-force for an electrically charged particle at rest in the background of Gott-Hiscock cosmic string space-time. We find the general expression for the self-energy which is expressed in terms of the S matrix of the scattering problem. The self-energy continuously falls down outward from the string's center with the maximum at the origin of the string. The self-force is repulsive for an arbitrary position of the particle. It tends to zero in the string's center and also far from the string and it has a maximum value at the string's surface. The plots of the numerical calculations of the self-energy and self-force are shown.

The implications of the COBE diffuse microwave radiation results for cosmic strings

NASA Technical Reports Server (NTRS)

Bennett, David P.; Stebbins, Albert; Bouchet, Francois R.

1992-01-01

We compare the anisotropies in the cosmic microwave background radiation measured by the COBE experiment to those predicted by cosmic string theories. We use an analytic model for the Delta T/T power spectrum that is based on our previous numerical simulations of strings, under the assumption that cosmic strings are the sole source of the measured anisotropy. This implies a value for the string mass per unit length of 1.5 +/- 0.5 x 10 exp -6 C-squared/G. This is within the range of values required for cosmic strings to successfully seed the formation of large-scale structures in the universe. These results clearly encourage further studies of Delta T/T and large-scale structure in the cosmic string model.

Identification of market trends with string and D2-brane maps

NASA Astrophysics Data System (ADS)

Bartoš, Erik; Pinčák, Richard

2017-08-01

The multidimensional string objects are introduced as a new alternative for an application of string models for time series forecasting in trading on financial markets. The objects are represented by open string with 2-endpoints and D2-brane, which are continuous enhancement of 1-endpoint open string model. We show how new object properties can change the statistics of the predictors, which makes them the candidates for modeling a wide range of time series systems. String angular momentum is proposed as another tool to analyze the stability of currency rates except the historical volatility. To show the reliability of our approach with application of string models for time series forecasting we present the results of real demo simulations for four currency exchange pairs.

Mechanism of Tennis Racket Spin Performance

NASA Astrophysics Data System (ADS)

Kawazoe, Yoshihiko; Okimoto, Kenji; Okimoto, Keiko

Players often say that some strings provide a better grip and more spin than others, but ball spin did not depend on string type, gauge, or tension in pervious laboratory experiments. There was no research work on spin to uncover what is really happening during an actual tennis impact because of the difficulty of performing the appropriate experiments. The present paper clarified the mechanism of top spin and its improvement by lubrication of strings through the use of high-speed video analysis. It also provided a more detailed explanation of spin behavior by comparing a racket with lubricated strings with the famous “spaghetti” strung racket, which was banned in 1978 by the International Tennis Federation because it used plastic spaghetti tubing over the strings to reduce friction, resulting in excessive ball spin. As the main strings stretch and slide sideways more, the ball is given additional spin due to the restoring force parallel to the string face when the main strings spring back and the ball is released from the strings. Herein, we also showed that the additional spin results in a reduction of shock vibrations of the wrist joint during impact.

Choice of birth control methods among European women and the role of partners and providers.

PubMed

de Irala, Jokin; Osorio, Alfonso; Carlos, Silvia; Lopez-del Burgo, Cristina

2011-12-01

The choice of a birth control method is influenced by sociocultural and personal factors. We explored the perceived influences in women's choice of a birth control method in five European countries (Germany, France, the UK, Romania and Sweden), where contraception is widely used. This is a cross-sectional study of 1137 randomly selected women aged 18-49 years. An anonymous, 31-item questionnaire related to birth control methods was used. Logistic regression was used to identify variables associated with partner participation in choice of a contraceptive. Oral contraceptives were mainly used in Germany (54.3%), France (50.5%) and Sweden (34.6%) and condoms in the UK (29.6%) and Romania (22.9%). Sweden showed the highest use of intrauterine devices (IUD, 19%). Romania had the lowest use of contraception. Oral contraceptives and IUDs use were frequently suggested by providers instead of by women. Choosing the method with the partner was associated with age [odds ratio (OR)=0.97, 95% confidence interval (CI) 0.94-0.99], being a university graduate (OR=1.59, 95% CI 1.01-2.29), married (OR=1.52, 95% CI 1.01-2.29) and with using a method that requires partner's cooperation (OR=8.18, 95% CI 5.46-12.27). Hormonal contraceptives and IUDs are commonly recommended by providers rather than requested by women. Partner preferences are taken into account when his cooperation in the use of the method is needed. As fertility care is a male and female issue, there is still more room for actively involving both women and men in their choice of a birth control method. Copyright © 2011 Elsevier Inc. All rights reserved.

Determinants of Contraceptive Availability at Medical Facilities in the Department of Veterans Affairs

PubMed Central

Cope, Jacqueline R; Yano, Elizabeth M; Lee, Martin L; Washington, Donna L

2006-01-01

OBJECTIVE To describe the variation in provision of hormonal and intrauterine contraception among Veterans Affairs (VA) facilities. DESIGN Key informant, cross-sectional survey of 166 VA medical facilities. Data from public use data sets and VA administrative databases were linked to facility data to further characterize their contextual environments. PARTICIPANTS All VA hospital-based and affiliated community-based outpatient clinics delivering services to at least 400 unique women during fiscal year 2000. MEASUREMENTS Onsite availability of hormonal contraceptive prescription and intrauterine device (IUD) placement. RESULTS Ninety-seven percent of facilities offered onsite prescription and management of hormonal contraception whereas 63% offered placement of IUDs. After adjusting for facility caseload of reproductive-aged women, 3 organizational factors were independently associated with onsite IUD placement: (1) onsite gynecologist (adjusted odds ratio [OR], 20.35; 95% confidence interval [CI], 7.02 to 58.74; P<.001); (2) hospital-based in contrast to community-based practice (adjusted OR, 5.49; 95% CI, 1.16 to 26.10; P=.03); and (3) availability of a clinician providing women's health training to other clinicians (adjusted OR, 3.40; 95% CI 1.19 to 9.76; P=.02). CONCLUSIONS VA's provision of hormonal and intrauterine contraception is in accordance with community standards, although onsite availability is not universal. Although contraception is a crucial component of a woman's health maintenance, her ability to obtain certain contraceptives from the facility where she obtains her primary care is largely influenced by the availability of a gynecologist. Further research is needed to determine how fragmentation of women's care into reproductive and nonreproductive services impacts access to contraception and the incidence of unintended pregnancy. PMID:16637943

Long-acting Reversible Contraception for Adolescents and Young Adults: Patient and Provider Perspectives

PubMed Central

Kavanaugh, Megan L.; Frohwirth, Lori; Jerman, Jenna; Popkin, Ronna; Ethier, Kathleen

2013-01-01

Study objective To describe and explore provider- and patient-level perspectives regarding long-acting reversible contraception (LARC) for teens and young adults (ages 16-24). Methods Data collection occurred between June – December 2011. We first conducted telephone interviews with administrative directors at 20 publicly funded facilities that provide family planning services. At six of these sites, we conducted a total of six focus group discussions (FGDs) with facility staff and forty-eight in-depth interviews (IDIs) with facility clients ages 16-24. Results Staff in the FGDs did not generally equate being a teen with ineligibility for IUDs. In contrast to staff, one quarter of the young women did perceive young age as rendering them ineligible. Clients and staff agreed that the “forgettable” nature of the methods and their duration were some of LARC’s most significant advantages. They also agreed that fear of pain associated with both insertion and removal and negative side effects were disadvantages. Some aspects of IUDs and implants were perceived as advantages by some clients but disadvantages by others. Common challenges to providing LARC-specific services to younger patients included extra time required to counsel young patients about LARC methods, outdated clinic policies requiring multiple visits to obtain IUDs, and a perceived higher removal rate among young women. The most commonly cited strategy for addressing many of these challenges was securing supplementary funding to support the provision of these services to young patients. Conclusion Incorporating young women’s perspectives on LARC methods into publicly funded family planning facilities’ efforts to provide these methods to a younger population may increase their use among young women. PMID:23287602

25-Hydroxyvitamin D response to graded vitamin D₃ supplementation among obese adults.

PubMed

Drincic, Andjela; Fuller, Eileen; Heaney, Robert P; Armas, Laura A G

2013-12-01

Guidelines have suggested that obese adults need 2 to 3 times more vitamin D than lean adults to treat vitamin D deficiency, but few studies have evaluated the vitamin D dose response in obese subjects. The purpose of this study was to characterize the pharmacokinetics of 25-hydroxyvitamin D [25(OH)D] response to 3 different doses of vitamin D₃ (cholecalciferol) in a group of obese subjects and to quantify the 25(OH)D dose-response relationship. DESIGN, SETTING, INTERVENTION, PATIENTS: This was a randomized, single-blind study of 3 doses of oral vitamin D₃ (1000, 5000, or 10,000 IU) given daily to 67 obese subjects for 21 weeks during the winter months. Serum 25(OH)D levels were measured at baseline and after vitamin D replacement, and 25(OH)D pharmacokinetic parameters were determined, fitting the 25(OH)D concentrations to an exponential model. Mean measured increments in 25(OH)D at week 21 were 12.4 ± 9.7 ng/mL in the 1000 IU/d group, 27.8 ± 10.2 ng/mL in the 5000 IU/d group, and 48.1 ± 19.6 ng/mL in the 10,000 IU/d group. Steady-state increments computed from the model were 20.6 ± 17.1, 35.2 ± 14.6, and 51.3 ± 22.0 ng/mL, respectively. There were no hypercalcuria or hypercalcemia events during the study. Our data show that in obese people, the 25(OH)D response to vitamin D₃ is directly related to dose and body size with ∼2.5 IU/kg required for every unit increment in 25(OH)D (nanograms per milliliter).

[Family planning in a suburban development of Mexico City].

PubMed

Gutiérrez Avila, J H; González Cortés, A; González Cortés, A

1982-01-01

To study the prevalence of contraceptive use among women in reproductive age, 15-50, and living in urban slums, the female population of Colonia Ajusco was surveyed. Colonia Ajusco is situated south of Mexico City; 70% of its population comes from the interior of the country; there is no drinkable water and no sewage system; housing conditions and urban services are very poor. 606 women were investigated; 58% of them were below age 36, and 53.5% were parity 4 and over. 56.4% used contraception; of these 36.7% used the IUD, 23.1% the pill, and 16.7% had been sterilized. The contraceptive method used seemed to be strictly related to the type of medical services used; women using the IUD were mostly patients of the Social Security medical services, while women using the pill were mostly clients of private physicians. There was no association between age and the method used. 88.4% of women not using contraception did not have easy availability of medical services. The percentage of women using contraception, 56.4% seems high in relation to other Latin American countries, but it is very low in relation to the percentage of contraceptive users in more developed countries (93% in England). The use of the IUD as the method of choice can be explained by several factors: the massive national advertising campaign, low cost, ease of insertion, and no need for sustained motivation to use contraception. From all studies on contraceptive prevalence in Mexico it appears that women start to regulate their fertility after the 1st child, or even after the 4th child. Women below 20 still tend to resort to illegal abortion.

Efficacy of contraceptive methods: A review of the literature.

PubMed

Mansour, Diana; Inki, Pirjo; Gemzell-Danielsson, Kristina

2010-02-01

To provide a comprehensive and objective summary of contraceptive failure rates for a variety of methods based on a systematic review of the literature. Medline and Embase were searched using the Ovid interface from January 1990 to February 2008, as well as the reference lists of published articles, to identify studies reporting contraceptive efficacy as a Pearl Index or life-table estimate. Reports that recruited less than 400 subjects per study group and those covering less than six cycles/six months were excluded. In addition, unlicensed products or those not internationally available, emergency contraception, and vasectomy studies were excluded. Information was identified and extracted from 139 studies. One-year Pearl Indices reported for short-acting user-dependent hormonal methods were generally less than 2.5. Gross life-table rates for long-acting hormonal methods (implants and the levonorgestrel releasing-intrauterine system [LNG-IUS]) generally ranged between 0-0.6 per 100 at one year, but wider ranges (0.1-1.5 per 100) were observed for the copper intrauterine devices (0.1-1.4 per 100 for Cu-IUDs with surface area > or =300 mm( 2 ) and 0.6-1.5 per 100 for those with surface area <300 mm( 2 )). Barrier and natural methods were the least effective. Our review broadly confirms the hierarchy of contraceptive effectiveness in descending order as: (1) female sterilisation, long-acting hormonal contraceptives (LNG-IUS and implants); (2) Cu-IUDs with > or =300 mm( 2 ) surface area; (3) Cu-IUDs with <300 mm( 2 ) surface area and short-acting hormonal contraceptives (injectables, oral contraceptives, the patch and vaginal ring), and (4) barrier methods and natural methods.

Pain perception during levonorgestrel-releasing intrauterine device insertion in nulliparous women: a systematic review.

PubMed

Anthoulakis, Christos; Iordanidou, Eirini; Vatopolou, Anastasia

2018-06-08

Intrauterine devices (IUDs) still remain underused in adolescents. Pain during insertion may prevent adolescents to opt for a levonorgestrel (LNG) - releasing IUD. This study aimed to conduct a systematic review, following the PRISMA guidelines, and critically appraise published data with respect to the efficacy of various substances (analgesics or not) in preventing pain during LNG-IUD insertion in nulliparous women as a proxy for adolescents. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: A comprehensive computerized systematic literature search of all English language studies between 2006 and 2016 was performed in PubMed, EMBASE, Scopus, Evidence Based Medicine Reviews (Cochrane Database and Cochrane Central Register of Controlled Trials), and Google Scholar. Relevant article reference lists were hand searched. Computerised database search revealed 31 citations of relevance, 9 of which with a total of 355 treated women and 345 controls fulfilled the inclusion/exclusion criteria. In women treated with misoprostol (n=150) versus placebo (n=145), the median visual analog scale (VAS) score ± standard deviation (SD) were 5.7 ± 2.1 versus 5.1 ± 2.2, respectively. In the abovementioned population, there was a non-significant change in VAS score (OR=1.44, 95%CI 0.86-2.40). In women treated with lidocaine (n=140) versus placebo (n=136), the median VAS score ± SD were 4.6 ± 2.1 versus 5.8 ± 2, respectively. In the aforementioned population, there was a significant decrease in VAS score (OR=0.12, 95%CI 0.02-0.91). In nulliparous women, lidocaine treatment seems to be a reasonable choice. However, further studies are required to examine the different routes and modes of administration as well as optimal quantities. Copyright © 2018. Published by Elsevier Inc.

Multi-dose vitamin d supplementation in stable very preterm infants: Prospective randomized trial response to three different vitamin D supplementation doses.

PubMed

Bozkurt, Ozlem; Uras, Nurdan; Sari, Fatma Nur; Atay, Funda Yavanoglu; Sahin, Suzan; Alkan, Ayse Dogan; Canpolat, Fuat Emre; Oguz, Serife Suna

2017-09-01

Preterm newborns are born with lower vitamin D stores. Although vitamin D supplementation is recommended there is no consensus regarding the adequate dose of supplementation for preterm infants. To assess the effect of three different doses of vitamin D supplementation (400, 800 and 1000IU/d) in preterm infants ≤32weeks gestation on the prevalence of vitamin D deficiency and 25(OH) D levels at 36weeks postmenstrual age (PMA). Prospective randomized trial. 121 preterm infants with gestational age of 24-32weeks were randomly allocated to receive 400, 800 or 1000IU/d vitamin D. Serum concentration of 25(OH) D and the prevalence of vitamin D deficiency at 36weeks PMA. Vitamin D deficiency was defined as serum 25(OH) D concentrations <20ng/ml. Of the 121 infants 72% had deficient vitamin D levels before supplementation. The average 25(OH) vitamin D concentrations at 36weeks PMA were significantly higher in 800IU (40±21.4ng/ml) and 1000IU group (43±18.9ng/ml) when compared to 400IU group (29.4±13ng/ml). The prevalence of vitamin D deficiency (2.5 vs 22.5; RR: 0.09; CI:0.01-0.74) and insufficiency (30 vs 57.5; RR:0.32; CI:0.13-0.80) was significantly lower in 1000IU group when compared to 400IU group at 36weeks PMA. 1000IU/d of vitamin D supplementation in preterm infants ≤32weeks gestation age effectively decreases the prevalence of vitamin D deficiency and leads to higher concentrations of 25(OH) vitamin D at 36weeks PMA TRIAL REGISTRATION: Clinical Trials.gov: NCT02941185. Copyright © 2017. Published by Elsevier B.V.

'Continuation rate', 'use-effectiveness' and their assessment for the diaphragm and jelly method.

PubMed

Chandrasekaran, C; Karkal, M

1972-11-01

Abstract The application of the life-table technique in the calculation of use-effectiveness of a contraceptive was proposed by Potter in 1963.(1) The technique was also found to be useful in assessing the duration for which the use of a contraceptive was continued. The keen interest that existed in the use of IUD in the mid-1960's was reflected in the terminology developed for assessment of the continuity of use. 'Retention rate' was a frequently used index.(2) Because of the development of the concept of segments whose end-period determined either termination of the use of a method or its continuance on a cut-off date, 'closure rate' and 'termination rate' have been used as measures of the discontinuance of the use of methods primarily of the IUD.(3) While discussing concepts relating to acceptance, use and effectiveness of family planning methods, more generally, an expert group suggested that 'continuation' should be used to denote that a client (or a couple) had begun to practise a method and that the method was still being practised.(4) Since this group defined 'an acceptor' as a person taking service and/or advice, i.e. having an IUD insertion or a sterilization operation or receiving supplies (or advice on methods such as 'rhythm' or coitus-interruptus with the intent of using the method), the base for the assessment of continuation rates, according to this group, would be only those acceptors who had begun using the method. The lifetable method has also been used for the study of the continuation rate for pill acceptors.(5) Balakrishnan, et al., made a study of continuation rates of oral contraceptives using the multiple decrement life-table technique.(6).

The Availability and Use of Postpartum LARC in Mexico and Among Hispanics in the United States.

PubMed

Potter, Joseph E; Hubert, Celia; White, Kari

2017-09-01

Objectives In the 1980s, policy makers in Mexico led a national family planning initiative focused, in part, on postpartum IUD use. The transformative impact of this initiative is not well known, and is relevant to current efforts in the United States (US) to increase women's use of long-acting reversible contraception (LARC). Methods Using six nationally representative surveys, we illustrate the dramatic expansion of postpartum LARC in Mexico and compare recent estimates of LARC use immediately following delivery through 18 months postpartum to estimates from the US. We also examine unmet demand for postpartum LARC among 321 Mexican-origin women interviewed in a prospective study on postpartum contraception in Texas in 2012, and describe differences in the Mexican and US service environments using a case study with one of these women. Results Between 1987 and 2014, postpartum LARC use in Mexico doubled, increasing from 9 to 19 % immediately postpartum and from 13 to 26 % by 18 months following delivery. In the US, <0.1 % of women used an IUD or implant immediately following delivery and only 9 % used one of these methods at 18 months. Among postpartum Mexican-origin women in Texas, 52 % of women wanted to use a LARC method at 6 months following delivery, but only 8 % used one. The case study revealed provider and financial barriers to postpartum LARC use. Conclusions Some of the strategies used by Mexico's health authorities in the 1980s, including widespread training of physicians in immediate postpartum insertion of IUDs, could facilitate women's voluntary initiation of postpartum LARC in the US.

Cross of Lorraine and Cross of Caravaca: new IUD's with low expulsion rates.

PubMed

Coutinho, E M; Mascarenhas, M J

1985-01-01

The Cross of Caravaca and Cross of Lorraine IUDs with double horizontal bar design were developed in an attempt to reduce expulsion and removal rates for pain and bleeding encountered with other IUDs. The devices were manufactured in radio-opaque plastic bearing copper wire or sleeves on the top arm. The Cross of Lorraine has the upper arm shorter than the lower arm whereas in the Cross of Caravaca the shorter is the lower arm. 748 women had insertion of the Cross of Caravaca and 412 had insertion of the Cross of Lorraine. For the Cross of Caravaca 486 women completed 1 year of use, 392 completed 2 years and 310 completed 3 years. For the Cross of Lorraine, 268 women completed the 1st year, 205 the 2nd, and 150 women completed 3 years of use. The combined number of observed months of use for the 2 devices at the end of 3 years was 24,963. Accidental pregnancy rates at the end of 3 years were 1.13% for Caravaca and 3.48% for Lorraine. Expulsion rates at the end of 3 years were nil for the Cross of Lorraine and 1.16% for the Cross of Caravaca. Pain and bleeding were the most common causes of termination for medical reasons, bleeding accounting for termination in 1.66% of Lorraine users at the end of 3 years of use and 2.75% of Caravaca users. Pain accounted for termination in 3.14% of Caravaca users and 2.02% of Lorraine users. Incidence of infection was 0.42% and nil for Caravaca and Lorraine users respectively. Total discontinuation rates at the end of 3 years were 25.39% for Caravaca and 16.67% for Lorraine.

Two Studies of Pitch in String Instrument Vibrato: Perception and Pitch Matching Responses of University and High School String Players

ERIC Educational Resources Information Center

Geringer, John M.; MacLeod, Rebecca B.; Ellis, Julia C.

2014-01-01

We investigated pitch perception of string vibrato tones among string players in two separate studies. In both studies we used tones of acoustic instruments (violin and cello) as stimuli. In the first, we asked 192 high school and university string players to listen to a series of tonal pairs: one tone of each pair was performed with vibrato and…

Geometric phase for a static two-level atom in cosmic string spacetime

NASA Astrophysics Data System (ADS)

Cai, Huabing; Ren, Zhongzhou

2018-05-01

We investigate the geometric phase of a static two-level atom immersed in a bath of fluctuating vacuum electromagnetic field in the background of a cosmic string. Our results indicate that due to the existence of the string, the geometric phase depends crucially on the position and the polarizability of the atom relative to the string. This can be ascribed to the fact that the presence of the string profoundly modify the distribution of electric field in Minkowski spacetime. So in principle, we can detect the cosmic string by experiments involving geometric phase.

Current balancing for battery strings

DOEpatents

Galloway, James H.

1985-01-01

A battery plant is described which features magnetic circuit means for balancing the electrical current flow through a pluraliircuitbattery strings which are connected electrically in parallel. The magnetic circuit means is associated with the battery strings such that the conductors carrying the electrical current flow through each of the battery strings pass through the magnetic circuit means in directions which cause the electromagnetic fields of at least one predetermined pair of the conductors to oppose each other. In an alternative embodiment, a low voltage converter is associated with each of the battery strings for balancing the electrical current flow through the battery strings.

Constraints on cosmic strings due to black holes formed from collapsed cosmic string loops

NASA Technical Reports Server (NTRS)

Caldwell, R. R.; Gates, Evalyn

1993-01-01

The cosmological features of primordial black holes formed from collapsed cosmic string loops are studied. Observational restrictions on a population of primordial black holes are used to restrict f, the fraction of cosmic string loops which collapse to form black holes, and mu, the cosmic string mass-per-unit length. Using a realistic model of cosmic strings, we find the strongest restriction on the parameters f and mu is due to the energy density in 100MeV photons radiated by the black holes. We also find that inert black hole remnants cannot serve as the dark matter. If earlier, crude estimates of f are reliable, our results severely restrict mu, and therefore limit the viability of the cosmic string large-scale structure scenario.

Symbol-string sensitivity and adult performance in lexical decision.

PubMed

Pammer, Kristen; Lavis, Ruth; Cooper, Charity; Hansen, Peter C; Cornelissen, Piers L

2005-09-01

In this study of adult readers, we used a symbol-string task to assess participants' sensitivity to the position of briefly presented, non-alphabetic but letter-like symbols. We found that sensitivity in this task explained a significant proportion of sample variance in visual lexical decision. Based on a number of controls, we show that this relationship cannot be explained by other factors including: chronological age, intelligence, speed of processing and/or concentration, short term memory consolidation, or fixation stability. This approach represents a new way to elucidate how, and to what extent, individual variation in pre-orthographic visual and cognitive processes impinge on reading skills, and the results suggest that limitations set by visuo-spatial processes constrain visual word recognition.

Stochastic gravitational wave background from light cosmic strings

DOE Office of Scientific and Technical Information (OSTI.GOV)

DePies, Matthew R.; Hogan, Craig J.

2007-06-15

Spectra of the stochastic gravitational wave backgrounds from cosmic strings are calculated and compared with present and future experimental limits. Motivated by theoretical expectations of light cosmic strings in superstring cosmology, improvements in experimental sensitivity, and recent demonstrations of large, stable loop formation from a primordial network, this study explores a new range of string parameters with masses lighter than previously investigated. A standard 'one-scale' model for string loop formation is assumed. Background spectra are calculated numerically for dimensionless string tensions G{mu}/c{sup 2} between 10{sup -7} and 10{sup -18}, and initial loop sizes as a fraction of the Hubble radiusmore » {alpha} from 0.1 to 10{sup -6}. The spectra show a low frequency power-law tail, a broad spectral peak due to loops decaying at the present epoch (including frequencies higher than their fundamental mode, and radiation associated with cusps), and a flat (constant energy density) spectrum at high frequencies due to radiation from loops that decayed during the radiation-dominated era. The string spectrum is distinctive and unlike any other known source. The peak of the spectrum for light strings appears at high frequencies, significantly affecting predicted signals. The spectra of the cosmic string backgrounds are compared with current millisecond pulsar limits and Laser Interferometer Space Antenna (LISA) sensitivity curves. For models with large stable loops ({alpha}=0.1), current pulsar-timing limits exclude G{mu}/c{sup 2}>10{sup -9}, a much tighter limit on string tension than achievable with other techniques, and within the range of current models based on brane inflation. LISA may detect a background from strings as light as G{mu}/c{sup 2}{approx_equal}10{sup -16}, corresponding to field theory strings formed at roughly 10{sup 11} GeV.« less

CMB ISW-lensing bispectrum from cosmic strings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yamauchi, Daisuke; Sendouda, Yuuiti; Takahashi, Keitaro, E-mail: yamauchi@resceu.s.u-tokyo.ac.jp, E-mail: sendouda@cc.hirosaki-u.ac.jp, E-mail: keitaro@sci.kumamoto-u.ac.jp

2014-02-01

We study the effect of weak lensing by cosmic (super-)strings on the higher-order statistics of the cosmic microwave background (CMB). A cosmic string segment is expected to cause weak lensing as well as an integrated Sachs-Wolfe (ISW) effect, the so-called Gott-Kaiser-Stebbins (GKS) effect, to the CMB temperature fluctuation, which are thus naturally cross-correlated. We point out that, in the presence of such a correlation, yet another kind of the post-recombination CMB temperature bispectra, the ISW-lensing bispectra, will arise in the form of products of the auto- and cross-power spectra. We first present an analytic method to calculate the autocorrelation ofmore » the temperature fluctuations induced by the strings, and the cross-correlation between the temperature fluctuation and the lensing potential both due to the string network. In our formulation, the evolution of the string network is assumed to be characterized by the simple analytic model, the velocity-dependent one scale model, and the intercommutation probability is properly incorporated in order to characterize the possible superstringy nature. Furthermore, the obtained power spectra are dominated by the Poisson-distributed string segments, whose correlations are assumed to satisfy the simple relations. We then estimate the signal-to-noise ratios of the string-induced ISW-lensing bispectra and discuss the detectability of such CMB signals from the cosmic string network. It is found that in the case of the smaller string tension, Gμ << 10{sup -7}, the ISW-lensing bispectrum induced by a cosmic string network can constrain the string-model parameters even more tightly than the purely GKS-induced bispectrum in the ongoing and future CMB observations on small scales.« less

CMB ISW-lensing bispectrum from cosmic strings

NASA Astrophysics Data System (ADS)

Yamauchi, Daisuke; Sendouda, Yuuiti; Takahashi, Keitaro

2014-02-01

We study the effect of weak lensing by cosmic (super-)strings on the higher-order statistics of the cosmic microwave background (CMB). A cosmic string segment is expected to cause weak lensing as well as an integrated Sachs-Wolfe (ISW) effect, the so-called Gott-Kaiser-Stebbins (GKS) effect, to the CMB temperature fluctuation, which are thus naturally cross-correlated. We point out that, in the presence of such a correlation, yet another kind of the post-recombination CMB temperature bispectra, the ISW-lensing bispectra, will arise in the form of products of the auto- and cross-power spectra. We first present an analytic method to calculate the autocorrelation of the temperature fluctuations induced by the strings, and the cross-correlation between the temperature fluctuation and the lensing potential both due to the string network. In our formulation, the evolution of the string network is assumed to be characterized by the simple analytic model, the velocity-dependent one scale model, and the intercommutation probability is properly incorporated in order to characterize the possible superstringy nature. Furthermore, the obtained power spectra are dominated by the Poisson-distributed string segments, whose correlations are assumed to satisfy the simple relations. We then estimate the signal-to-noise ratios of the string-induced ISW-lensing bispectra and discuss the detectability of such CMB signals from the cosmic string network. It is found that in the case of the smaller string tension, Gμ << 10-7, the ISW-lensing bispectrum induced by a cosmic string network can constrain the string-model parameters even more tightly than the purely GKS-induced bispectrum in the ongoing and future CMB observations on small scales.

Preparation and cupric ion release behavior of Cu/LDPE porous composites with tunable pore morphology for intrauterine devices.

PubMed

Xiao, Lian; Xia, Xianping; Xie, Changsheng; Ge, Man; Xiao, Cheng; Cai, Shuizhou

2013-07-01

Copper/low-density polyethylene (Cu/LDPE) porous composites are novel materials for copper-containing intrauterine devices (Cu-IUDs). Here we report a method, i.e., by changing the mass ratio of two kinds of porogens that have different melting points through the combined techniques of injection molding and particulate leaching, to prepare the Cu/LDPE porous composites with tunable pore morphology. After these Cu/LDPE porous composites with different pore morphologies were obtained, the influences of pore morphologies on their cupric ion release behaviors were studied. The results show that the pore morphology has great influence on the cupric ion release behavior of Cu/LDPE porous composites. This phenomenon is caused by the different influences of different pore morphologies on the effective porosity and the surface hydrophilicity. And those results can be applied to guide the fabrication of Cu/LDPE porous composite Cu-IUDs with minimal weight at an appropriate cupric ion release rate. Copyright © 2013 Elsevier B.V. All rights reserved.

Necrotising fasciitis after hysterectomy and concomitant transvaginal mesh repair in a patient with pelvic organ prolapse.

PubMed

Pushkar, Dmitry Y; Vasilchenko, Mikhail I; Kasyan, George R

2013-10-01

Necrotising fasciitis is a severe form of soft tissue infection. Herein, we present an unreported complication of the transvaginal repair of a pelvic organ prolapse (POP) with trocar-guided polypropylene mesh and a concomitant hysterectomy. A 61-year-old Caucasian female who had been using an intrauterine device (IUD) for 30 years presented with a stage 3 pelvic organ prolapse. A genital ultrasound examination confirmed the presence of an IUD, but found no endometrial abnormalities. The surgical management was limited to a transvaginal hysterectomy and simultaneous anterior vaginal wall repair augmented with trocar-guided mesh. A morphological examination of the removed uterus confirmed the presence of the intrauterine device and additionally found endometrial cancer (T1N0M0), which was not revealed during the preoperative ultrasound. Within 6 days of the surgery, she developed anaerobic bilateral necrotising fasciitis on both thighs. Non-clostridial streptococci were identified in the wound. After 18 days of intensive care, the patient died of fatal coagulopathy.

Increasing family planning in Myanmar: the role of the private sector and social franchise programs.

PubMed

Aung, Tin; Hom, Nang Mo; Sudhinaraset, May

2017-07-01

This study examines the influence of clinical social franchise program on modern contraceptive use. This was a cross-sectional survey of contraceptive use among 2390 currently married women across 25 townships in Myanmar in 2014. Social franchise program measures were from programmatic records. Multivariable models show that women who lived in communities with at least 1-5 years of a clinical social franchise intrauterine device (IUD) program had 4.770 higher odds of using a modern contraceptive method compared to women living in communities with no IUD program [CI: 3.739-6.084]. Townships where the reproductive health program had existed for at least 10 years had 1.428 higher odds of reporting modern method use compared to women living in townships where the programs had existed for less than 10 years [CI: 1.016-2.008]. This study found consistent and robust evidence for an increase in family planning methods over program duration as well as intensity of social franchise programs.

Cost Effectiveness of Contraceptives in the United States

PubMed Central

Trussell, James; Lalla, Anjana M.; Doan, Quan V.; Reyes, Eileen; Pinto, Lionel; Gricar, Joseph

2013-01-01

Background The study was conducted to estimate the relative cost effectiveness of contraceptives in the United States from a payer’s perspective. Methods A Markov model was constructed to simulate costs for 16 contraceptive methods and no method over a 5-year period. Failure rates, adverse event rates, and resource utilization were derived from the literature. Sensitivity analyses were performed on costs and failure rates. Results Any contraceptive method is superior to “no method”. The three least expensive methods were the copper-T IUD ($647), vasectomy ($713) and LNG-20 IUS ($930). Results were sensitive to the cost of contraceptive methods, the cost of an unintended pregnancy, and plan disenrollment rates. Conclusion The copper-T IUD, vasectomy, and the LNG-20 IUS are the most cost-effective contraceptive methods available in the United States. Differences in method costs, the cost of an unintended pregnancy, and time horizon are influential factors that determine the overall value of a contraceptive method. PMID:19041435

Teratogenic effects of Silastic intrauterine devices in the rat with or without added medroxyprogesterone acetate.

PubMed

Barlow, S M; Knight, A F

1983-02-01

The teratogenicity of intrauterine devices (IUDs) made of silicone rubber (Silastic, Dow Corning Corporation, Midland, MI) with or without added medroxyprogesterone acetate (MPA) has been investigated in the rat. Small rod-shaped IUDs were inserted into the uterus, one between each embryo, on day 9 of pregnancy and left in place until the rats were killed just before term for examination of the fetuses. MPA exposure caused masculinization of the external genitalia of female fetuses and feminization of the external genitalia of male fetuses. There was no increase in other, nongenital malformations in MPA-exposed fetuses, compared with fetuses exposed to Silastic alone, but both Silastic-exposed groups had significantly more malformations than untreated control rats. In a second experiment, a significant increase in malformations in fetuses exposed to Silastic alone, compared with untreated control fetuses, was confirmed. The malformation rate in control rats that underwent sham operations was not significantly increased, compared with untreated control rats.

Ghost vertices for the bosonic string using the group-theoretic approach to string theory

NASA Astrophysics Data System (ADS)

Freeman, M. D.; West, P.

1988-04-01

The N-string tree-level scattering vertices for the bosonic string are extended to include anticommuting (ghost) oscillators. These vertices behave correctly under the action of the BRST charge Q and reproduce the known results for the scattering of physical states. This work is an application of the group-theoretic approach to string theory. Permanent address: Mathematics Department, King's College, Strand, London WC2R 2LS, UK.

Cosmic strings and galaxy formation

NASA Technical Reports Server (NTRS)

Bertschinger, Edmund

1989-01-01

The cosmogonical model proposed by Zel'dovich and Vilenkin (1981), in which superconducting cosmic strings act as seeds for the origin of structure in the universe, is discussed, summarizing the results of recent theoretical investigations. Consideration is given to the formation of cosmic strings, the microscopic structure of strings, gravitational effects, cosmic string evolution, and the formation of galaxies and large-scale structure. Simulation results are presented in graphs, and several outstanding issues are listed and briefly characterized.

String Things.

ERIC Educational Resources Information Center

Mesa Public Schools, AZ.

Designed for music educators instructing grades 4 through 8 in string instruments, this Mesa (Arizona) public schools guide presents information on the string curriculum, orchestras, and practicing. The goals and objectives for string instruments delineate grade levels and how student skills will be verified. Following 17 curriculum goal tests,…

Embellished String Prints. Cover Story.

ERIC Educational Resources Information Center

Smith, Mary Ruth

1999-01-01

Focuses on a printmaking activity in which students create embellished string prints using the relief process of string glued to chip board. Explains that string prints can easily be embellished with oil pastels. Provides a description of the procedure and a list of materials and methods. (CMK)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Marolf, Donald; Palmer, Belkis Cabrera; Physics Department, Syracuse University, Syracuse, New York 13244

A thermodynamic argument is presented suggesting that near-extremal spinning D1-D5-P black strings become unstable when their angular momentum exceeds J{sub crit}=3Q{sub 1}Q{sub 5}/2{radical}(2). In contrast, the dimensionally reduced black holes are thermodynamically stable. The proposed instability involves a phase in which the spin angular momentum above J{sub crit} is transferred to gyration of the string in space, i.e., to orbital angular momentum of parts of the string about the mean location in space. Thus the string becomes a rotating helical coil. We note that an instability of this form would yield a counter-example to the Gubser-Mitra conjecture, which proposes amore » particular link between dynamic black string instabilities and the thermodynamics of black strings. There may also be other instabilities associated with radiation modes of various fields. Our arguments also apply to the D-brane bound states associated with these black strings in weakly coupled string theory.« less

Semiclassical (qft) and Quantum (string) Rotating Black Holes and Their Evaporation:. New Results

NASA Astrophysics Data System (ADS)

Bouchareb, A.; Ramón Medrano, M.; Sánchez, N. G.

Combination of both quantum field theory (QFT) and string theory in curved backgrounds in a consistent framework, the string analogue model, allows us to provide a full picture of the Kerr-Newman black hole and its evaporation going beyond the current picture. We compute the quantum emission cross-section of strings by a Kerr-Newman black hole (KNbh). It shows the black hole emission at the Hawking temperature Tsem in the early stage of evaporation and the new string emission featuring a Hagedorn transition into a string state of temperature Ts at the last stages. New bounds on J and Q emerge in the quantum string regime (besides the known ones of the classical/semiclassical QFT regime). The last state of evaporation of a semiclassical Kerr-Newman black hole with mass M > mPl, angular momentum J and charge Q is a string state of temperature Ts, string mass Ms, J = 0 and Q = 0, decaying as usual quantum strings do into all kinds of particles. (Naturally, in this framework, there is no loss of information, (there is no paradox at all).) We compute the string entropy Ss(m, j) from the microscopic string density of states of mass m and spin mode j, ρ(m, j). (Besides the Hagedorn transition at Ts) we find for high j (extremal string states j → m2α‧c), a new phase transition at a temperature Tsj = √ {j/hbar }Ts, higher than Ts. By precisely identifying the semiclassical and quantum (string) gravity regimes, we find a new formula for the Kerr black hole entropy Ssem(M, J), as a function of the usual Bekenstein-Hawking entropy S sem(0). For M ≫ mPl and J < GM2/c, S sem(0) is the leading term, but for high angular momentum, (nearly extremal case J = GM2/c), a gravitational phase transition operates and the whole entropy Ssem is drastically different from the Bekenstein-Hawking entropy S sem(0). This new extremal black hole transition occurs at a temperature Tsem J = (J/ℏ)Tsem, higher than the Hawking temperature Tsem.

Light Z' in heterotic string standardlike models

NASA Astrophysics Data System (ADS)

Athanasopoulos, P.; Faraggi, A. E.; Mehta, V. M.

2014-05-01

The discovery of the Higgs boson at the LHC supports the hypothesis that the Standard Model provides an effective parametrization of all subatomic experimental data up to the Planck scale. String theory, which provides a viable perturbative approach to quantum gravity, requires for its consistency the existence of additional gauge symmetries beyond the Standard Model. The construction of heterotic string models with a viable light Z' is, however, highly constrained. We outline the construction of standardlike heterotic string models that allow for an additional Abelian gauge symmetry that may remain unbroken down to low scales. We present a string inspired model, consistent with the string constraints.

Scaling properties of cosmic (super)string networks

NASA Astrophysics Data System (ADS)

Martins, C. J. A. P.

2014-10-01

I use a combination of state-of-the-art numerical simulations and analytic modelling to discuss the scaling properties of cosmic defect networks, including superstrings. Particular attention is given to the role of extra degrees of freedom in the evolution of these networks. Compared to the 'plain vanilla' case of Goto-Nambu strings, three such extensions play important but distinct roles in the network dynamics: the presence of charges/currents on the string worldsheet, the existence of junctions, and the possibility of a hierarchy of string tensions. I also comment on insights gained from studying simpler defect networks, including Goto-Nambu strings themselves, domain walls and semilocal strings.

Evolution of cosmic string networks

NASA Technical Reports Server (NTRS)

Albrecht, Andreas; Turok, Neil

1989-01-01

A discussion of the evolution and observable consequences of a network of cosmic strings is given. A simple model for the evolution of the string network is presented, and related to the statistical mechanics of string networks. The model predicts the long string density throughout the history of the universe from a single parameter, which researchers calculate in radiation era simulations. The statistical mechanics arguments indicate a particular thermal form for the spectrum of loops chopped off the network. Detailed numerical simulations of string networks in expanding backgrounds are performed to test the model. Consequences for large scale structure, the microwave and gravity wave backgrounds, nucleosynthesis and gravitational lensing are calculated.

Gödel universes in string theory

NASA Astrophysics Data System (ADS)

Barrow, John D.; Dabrowski, Mariusz P.

1998-11-01

We show that homogeneous Gödel spacetimes need not contain closed timelike curves in low-energy-effective string theories. We find exact solutions for the Gödel metric in string theory for the full O(α') action including both dilaton and axion fields. The results are valid for bosonic, heterotic and super-strings. To first order in the inverse string tension α', these solutions display a simple relation between the angular velocity of the Gödel universe, Ω, and the inverse string tension of the form α'=1/Ω2 in the absence of the axion field. The generalization of this relationship is also found when the axion field is present.

A note on closed-string interactions a la witten

NASA Astrophysics Data System (ADS)

Romans, L. J.

1987-08-01

We consider the problem of formulating a field theory of interacting closed strings analogous to Witten's open-string field theory. Two natural candidates have been suggested for an off-shell three-string interaction vertex: one scheme involves a cyclic geometric overlap in spacetime, while the other is obtained by ``stuttering'' the Fock-space realization of the open-string vertex. We demonstrate that these two approaches are in fact equivalent, utilizing the operator formalism as developed to describe Witten's theory. Implications of this result for the construction of closed-string theories are briefly discussed. Address after August 1, 1987: Department of Physics, University of Southern California, Los Angeles, CA 90089, USA.

Reconstruction of piano hammer force from string velocity.

PubMed

Chaigne, Antoine

2016-11-01

A method is presented for reconstructing piano hammer forces through appropriate filtering of the measured string velocity. The filter design is based on the analysis of the pulses generated by the hammer blow and propagating along the string. In the five lowest octaves, the hammer force is reconstructed by considering two waves only: the incoming wave from the hammer and its first reflection at the front end. For the higher notes, four- or eight-wave schemes must be considered. The theory is validated on simulated string velocities by comparing imposed and reconstructed forces. The simulations are based on a nonlinear damped stiff string model previously developed by Chabassier, Chaigne, and Joly [J. Acoust. Soc. Am. 134(1), 648-665 (2013)]. The influence of absorption, dispersion, and amplitude of the string waves on the quality of the reconstruction is discussed. Finally, the method is applied to real piano strings. The measured string velocity is compared to the simulated velocity excited by the reconstructed force, showing a high degree of accuracy. A number of simulations are compared to simulated strings excited by a force derived from measurements of mass and acceleration of the hammer head. One application to an historic piano is also presented.

Improving Upon String Methods for Transition State Discovery.

PubMed

Chaffey-Millar, Hugh; Nikodem, Astrid; Matveev, Alexei V; Krüger, Sven; Rösch, Notker

2012-02-14

Transition state discovery via application of string methods has been researched on two fronts. The first front involves development of a new string method, named the Searching String method, while the second one aims at estimating transition states from a discretized reaction path. The Searching String method has been benchmarked against a number of previously existing string methods and the Nudged Elastic Band method. The developed methods have led to a reduction in the number of gradient calls required to optimize a transition state, as compared to existing methods. The Searching String method reported here places new beads on a reaction pathway at the midpoint between existing beads, such that the resolution of the path discretization in the region containing the transition state grows exponentially with the number of beads. This approach leads to favorable convergence behavior and generates more accurate estimates of transition states from which convergence to the final transition states occurs more readily. Several techniques for generating improved estimates of transition states from a converged string or nudged elastic band have been developed and benchmarked on 13 chemical test cases. Optimization approaches for string methods, and pitfalls therein, are discussed.

Social Impacts Module (SIM) Transition

DTIC Science & Technology

2012-09-28

User String The authorized user’s name to access the PAVE database. Applies only to Microsoft SQL Server; leave blank, otherwise. passwd String The...otherwise. passwd String The password if an authorized user’s name is required; otherwise, leave blank driver String The class name for the driver to

Adaptation of a RAS pathway activation signature from FF to FFPE tissues in colorectal cancer.

PubMed

Omolo, Bernard; Yang, Mingli; Lo, Fang Yin; Schell, Michael J; Austin, Sharon; Howard, Kellie; Madan, Anup; Yeatman, Timothy J

2016-10-19

The KRAS gene is mutated in about 40 % of colorectal cancer (CRC) cases, which has been clinically validated as a predictive mutational marker of intrinsic resistance to anti-EGFR inhibitor (EGFRi) therapy. Since nearly 60 % of patients with a wild type KRAS fail to respond to EGFRi combination therapies, there is a need to develop more reliable molecular signatures to better predict response. Here we address the challenge of adapting a gene expression signature predictive of RAS pathway activation, created using fresh frozen (FF) tissues, for use with more widely available formalin fixed paraffin-embedded (FFPE) tissues. In this study, we evaluated the translation of an 18-gene RAS pathway signature score from FF to FFPE in 54 CRC cases, using a head-to-head comparison of five technology platforms. FFPE-based technologies included the Affymetrix GeneChip (Affy), NanoString nCounter™ (NanoS), Illumina whole genome RNASeq (RNA-Acc), Illumina targeted RNASeq (t-RNA), and Illumina stranded Total RNA-rRNA-depletion (rRNA). Using Affy_FF as the "gold" standard, initial analysis of the 18-gene RAS scores on all 54 samples shows varying pairwise Spearman correlations, with (1) Affy_FFPE (r = 0.233, p = 0.090); (2) NanoS_FFPE (r = 0.608, p < 0.0001); (3) RNA-Acc_FFPE (r = 0.175, p = 0.21); (4) t-RNA_FFPE (r = -0.237, p = 0.085); (5) and t-RNA (r = -0.012, p = 0.93). These results suggest that only NanoString has successful FF to FFPE translation. The subsequent removal of identified "problematic" samples (n = 15) and genes (n = 2) further improves the correlations of Affy_FF with three of the five technologies: Affy_FFPE (r = 0.672, p < 0.0001); NanoS_FFPE (r = 0.738, p < 0.0001); and RNA-Acc_FFPE (r = 0.483, p = 0.002). Of the five technology platforms tested, NanoString technology provides a more faithful translation of the RAS pathway gene expression signature from FF to FFPE than the Affymetrix GeneChip and multiple RNASeq technologies. Moreover, NanoString was the most forgiving technology in the analysis of samples with presumably poor RNA quality. Using this approach, the RAS signature score may now be reasonably applied to FFPE clinical samples.

Properties of Interfacial Tribo-Films

DTIC Science & Technology

1993-06-01

cf these rods is such as to have the center of gravity of or the attraction of water into the re-entrant peripheral gap the whole sample as close as...difference between the fluid dynamics, acoustic effects in stringed musical static and the kinetic friction coefficients increases with instruments...interfacial fluid molecules to static minimize oscillations, the center of gravity of the sample friction have been explored and, in this regard, adsorbed

Novel string field theory with also negative energy constituents/objects gives Veneziano amplitude

NASA Astrophysics Data System (ADS)

Nielsen, H. B.; Ninomiya, M.

2018-02-01

We have proposed a new type of string field theory. The main point of the present article is to cure some technical troubles: missing two out three terms in Veneziano amplitude. Our novel string field theory, describes a theory with many strings in terms of "objects", which are not exactly, but close to Charles Thorn's string bits. The new point is that the objects in terms of which the universe states are constructed, and which have an essentially 26-momentum variable called J μ , can have the energy J 0 be also negative as well as positive. We get a long way in deriving in this model the Veneziano model and obtain all the three terms needed for a four point amplitude. This result strongly indicates that our novel string field theory is indeed string theory.

Axion string dynamics I: 2+1D

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fleury, Leesa M.; Moore, Guy D.

2016-05-03

If the axion exists and if the initial axion field value is uncorrelated at causally disconnected points, then it should be possible to predict the efficiency of cosmological axion production, relating the axionic dark matter density to the axion mass. The main obstacle to making this prediction is correctly treating the axion string cores. We develop a new algorithm for treating the axionic string cores correctly in 2+1 dimensions. When the axionic string cores are given their full physical string tension, axion production is about twice as efficient as in previous simulations. We argue that the string network in 2+1more » dimensions should behave very differently than in 3+1 dimensions, so this result cannot be simply carried over to the physical case. We outline how to extend our method to 3+1D axion string dynamics.« less

A numerical study of the string function using a primitive equation ocean model

NASA Astrophysics Data System (ADS)

Tyler, R. H.; Käse, R.

We use results from a primitive-equation ocean numerical model (SCRUM) to test a theoretical 'string function' formulation put forward by Tyler and Käse in another article in this issue. The string function acts as a stream function for the large-scale potential energy flow under the combined beta and topographic effects. The model results verify that large-scale anomalies propagate along the string function contours with a speed correctly given by the cross-string gradient. For anomalies having a scale similar to the Rossby radius, material rates of change in the layer mass following the string velocity are balanced by material rates of change in relative vorticity following the flow velocity. It is shown that large-amplitude anomalies can be generated when wind stress is resonant with the string function configuration.

Scattering of Cosmic Strings by Black Holes:. Loop Formation

NASA Astrophysics Data System (ADS)

Dubath, Florian; Sakellariadou, Mairi; Viallet, Claude Michel

We study the deformation of a long cosmic string by a nearby rotating black hole. We examine whether the deformation of a cosmic string, induced by the gravitational field of a Kerr black hole, may lead to the formation of a string loop. The segment of the string which enters the ergo-sphere of a rotating black hole gets deformed and, if it is sufficiently twisted, it can self-intersect, chopping off a loop. We find that the formation of a loop, via such a mechanism, is a rare event. It will only arise in a small region of the collision phase space, which depends on the string velocity, the impact parameter and the black hole angular momentum. We conclude that, generically, a long cosmic string is simply scattered, or captured, by a nearby rotating black hole.

Factorization of chiral string amplitudes

DOE Office of Scientific and Technical Information (OSTI.GOV)

Huang, Yu-tin; Siegel, Warren; Yuan, Ellis Ye

We re-examine a closed-string model defined by altering the boundary conditions for one handedness of two-dimensional propagators in otherwise-standard string theory. We evaluate the amplitudes using Kawai-Lewellen-Tye factorization into open-string amplitudes. The only modification to standard string theory is effectively that the spacetime Minkowski metric changes overall sign in one open-string factor. This cancels all but a finite number of states: as found in earlier approaches, with enough supersymmetry (e.g., type II) the tree amplitudes reproduce those of the massless truncation of ordinary string theory. However, we now find for the other cases that additional fields, formerly thought to bemore » auxiliary, describe new spin-2 states at the two adjacent mass levels (tachyonic and tardyonic). The tachyon is always a ghost, but can be avoided in the heterotic case.« less

Factorization of chiral string amplitudes

DOE PAGES

Huang, Yu-tin; Siegel, Warren; Yuan, Ellis Ye

2016-09-16

We re-examine a closed-string model defined by altering the boundary conditions for one handedness of two-dimensional propagators in otherwise-standard string theory. We evaluate the amplitudes using Kawai-Lewellen-Tye factorization into open-string amplitudes. The only modification to standard string theory is effectively that the spacetime Minkowski metric changes overall sign in one open-string factor. This cancels all but a finite number of states: as found in earlier approaches, with enough supersymmetry (e.g., type II) the tree amplitudes reproduce those of the massless truncation of ordinary string theory. However, we now find for the other cases that additional fields, formerly thought to bemore » auxiliary, describe new spin-2 states at the two adjacent mass levels (tachyonic and tardyonic). The tachyon is always a ghost, but can be avoided in the heterotic case.« less

Pauses enhance chunk recognition in song element strings by zebra finches.

PubMed

Spierings, Michelle; de Weger, Anouk; Ten Cate, Carel

2015-07-01

When learning a language, it is crucial to know which syllables of a continuous sound string belong together as words. Human infants achieve this by attending to pauses between words or to the co-occurrence of syllables. It is not only humans that can segment a continuous string. Songbirds learning their song tend to copy 'chunks' from one or more tutors' songs and combine these into their own song. In the tutor songs, these chunks are often separated by pauses and a high co-occurrence of elements, suggesting that these features affect chunking and song learning. We examined experimentally whether the presence of pauses and element co-occurrence affect the ability of adult zebra finches to discriminate strings of song elements. Using a go/no-go design, two groups of birds were trained to discriminate between two strings. In one group (Pause-group), pauses were inserted between co-occurring element triplets in the strings, and in the other group (No-pause group), both strings were continuous. After making a correct discrimination, an individual proceeded to a reversal training using string segments. Segments were element triplets consistent in co-occurrence, triplets that were partly consistent in composition and triplets consisting of elements that did not co-occur in the strings. The Pause-group was faster in discriminating between the two strings. This group also responded differently to consistent triplets in the reversal training, compared to inconsistent triplets. The No-pause group did not differentiate among the triplet types. These results indicate that pauses in strings of song elements aid song discrimination and memorization of co-occurring element groups.

From the currency rate quotations onto strings and brane world scenarios

NASA Astrophysics Data System (ADS)

Horváth, D.; Pincak, R.

2012-11-01

In the paper, we study the projections of the real exchange rate dynamics onto the string-like topology. Our approach is inspired by the contemporary movements in the string theory. The string map of data is defined here by the boundary conditions, characteristic length, real valued and the method of redistribution of information. As a practical matter, this map represents the detrending and data standardization procedure. We introduced maps onto 1-end-point and 2-end-point open strings that satisfy the Dirichlet and Neumann boundary conditions. The questions of the choice of extra-dimensions, symmetries, duality and ways to the partial compactification are discussed. Subsequently, we pass to higher dimensional and more complex objects. The 2D-Brane was suggested which incorporated bid-ask spreads. Polarization by the spread was considered which admitted analyzing arbitrage opportunities on the market where transaction costs are taken into account. The model of the rotating string which naturally yields calculation of angular momentum is suitable for tracking of several currency pairs. The systematic way which allows one suggest more structured maps suitable for a simultaneous study of several currency pairs was analyzed by means of the Gâteaux generalized differential calculus. The effect of the string and brane maps on test data was studied by comparing their mean statistical characteristics. The study revealed notable differences between topologies. We review the dependence on the characteristic string length, mean fluctuations and properties of the intra-string statistics. The study explores the coupling of the string amplitude and volatility. The possible utilizations of the string theory approach in financial markets are slight.

Effects of various cooking processes on the concentrations of arsenic, cadmium, mercury, and lead in foods.

PubMed

Perelló, Gemma; Martí-Cid, Roser; Llobet, Juan M; Domingo, José L

2008-12-10

The effects of cooking processes commonly used by the population of Catalonia (Spain) on total arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) concentrations in various foodstuffs were investigated. All food samples were randomly acquired in local markets, big supermarkets, and grocery stores of Reus (Catalonia). Foods included fish (sardine, hake, and tuna), meat (veal steak, loin of pork, breast and thigh of chicken, and steak and rib of lamb), string bean, potato, rice, and olive oil. For each food item, two composite samples were prepared for metal analyses, whose levels in raw and cooked (fried, grilled, roasted, and boiled) samples were determined by inductively coupled plasma-mass spectrometry (ICP-MS). The highest concentrations of As, Hg, and Pb (raw and cooked samples) were mainly found in fish, with a clear tendency, in general, to increase metal concentrations after cooking. However, in these samples, Cd levels were very close to their detection limit. In turn, the concentrations of metals in raw and cooked meat samples were detected in all samples (As) or only in a very few samples (Cd, Hg, and Pb). A similar finding corresponded to string beans, rice, and olive oil, while in potatoes, Hg could not be detected and Pb only was detected in the raw samples. In summary, the results of the present study show that, in general terms, the cooking process is only of a very limited value as a means of reducing metal concentrations. This hypothetical reduction depends upon cooking conditions (time, temperature, and medium of cooking).

Haptic Distal Spatial Perception Mediated by Strings: Haptic "Looming"

ERIC Educational Resources Information Center

Cabe, Patrick A.

2011-01-01

Five experiments tested a haptic analog of optical looming, demonstrating string-mediated haptic distal spatial perception. Horizontally collinear hooks supported a weighted string held taut by a blindfolded participant's finger midway between the hooks. At the finger, the angle between string segments increased as the finger approached…

Fertility after contraception or abortion.

PubMed

Huggins, G R; Cullins, V E

1990-10-01

There is a very small correlation, if any, between the prior use of OCs and congenital malformations, including Down's syndrome. There are few, if any, recent reports on masculinization of a female fetus born to a mother who took an OC containing 1 mg of a progestogen during early pregnancy. However, patients suspected of being pregnant and who are desirous of continuing that pregnancy should not continue to take OCs, nor should progestogen withdrawal pregnancy tests be used. Concern still exists regarding the occurrence of congenital abnormalities in babies born to such women. The incidence of postoperative infection after first trimester therapeutic abortion in this country is low. However, increasing numbers of women are undergoing repeated pregnancy terminations, and their risk for subsequent pelvic infections may be multiplied with each succeeding abortion. The incidence of prematurity due to cervical incompetence or surgical infertility after first trimester pregnancy terminations is not increased significantly. Asherman's syndrome may occur after septic therapeutic abortion. The pregnancy rate after treatment of this syndrome is low. The return of menses and the achievement of a pregnancy may be slightly delayed after OCs are discontinued, but the fertility rate is within the normal range by 1 year. The incidence of postpill amenorrhea of greater than 6 months' duration is probably less than 1%. The occurrence of the syndrome does not seem to be related to length of use or type of pill. Patients with prior normal menses as well as those with menstrual abnormalities before use of OCs may develop this syndrome. Patients with normal estrogen and gonadotropin levels usually respond with return of menses and ovulation when treated with clomiphene. The rate for achievement of pregnancy is much lower than that for patients with spontaneous return of menses. The criteria for defining PID or for categorizing its severity are diverse. The incidence of PID is higher among IUD users than among patients taking OCs or using a barrier method. The excess risk of PID among IUD users, with the exception of the first few months after insertion, is related to sexually transmitted diseases and not the IUD. Women with no risk factors for sexually transmitted diseases have little increased risk of PID or infertility associated with IUD use. There appears to be no increased risk of congenital anomalies, altered sex ratio, or early pregnancy loss among spermicide users. All present methods of contraception entail some risk to the patient. The risk of imparied future fertility with the use of any method appears to be low.(ABSTRACT TRUNCATED AT 400 WORDS)

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa.

PubMed

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-08-11

A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d'Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative's model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d'Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South-South collaboration has been central to the initiative's accomplishments: Guinea's clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. © Pleah et al.

Increasing Use of Postpartum Family Planning and the Postpartum IUD: Early Experiences in West and Central Africa

PubMed Central

Pleah, Tsigue; Hyjazi, Yolande; Austin, Suzanne; Diallo, Abdoulaye; Dao, Blami; Waxman, Rachel; Karna, Priya

2016-01-01

ABSTRACT A global resurgence of interest in the intrauterine device (IUD) as an effective long-acting reversible contraceptive and in improving access to a wide range of contraceptive methods, as well as an emphasis on encouraging women to give birth in health care facilities, has led programs to introduce postpartum IUD (PPIUD) services into postpartum family planning (PPFP) programs. We describe strategic, organizational, and technical elements that contributed to early successes of a regional initiative in West and Central Africa to train antenatal, maternity, and postnatal care providers in PPFP counseling for the full range of available methods and in PPIUD service delivery. In November 2013, the initiative provided competency-based training in Guinea for providers from the main public teaching hospital in 5 selected countries (Benin, Chad, Côte d’Ivoire, Niger, and Senegal) with no prior PPFP counseling or PPIUD capacity. The training was followed by a transfer-of-learning visit and monitoring to support the trained providers. One additional country, Togo, replicated the initiative’s model in 2014. Although nascent, this initiative has introduced high-quality PPFP and PPIUD services to the region, where less than 1% of married women of reproductive age use the IUD. In total, 21 providers were trained in PPFP counseling, 18 of whom were also trained in PPIUD insertion. From 2014 to 2015, more than 15,000 women were counseled about PPFP, and 2,269 women chose and received the PPIUD in Benin, Côte d’Ivoire, Niger, Senegal, and Togo. (Introduction of PPIUD services in Chad has been delayed.) South–South collaboration has been central to the initiative’s accomplishments: Guinea’s clinical centers of excellence and qualified trainers provided a culturally resonant example of a PPFP/PPIUD program, and trainings are creating a network of regional trainers to facilitate expansion. Two of the selected countries (Benin and Niger) have expanded their PPFP/PPUID training programs to additional sites. Inspired after learning about the initiative at a regional meeting, Togo has outperformed the original countries involved in the initiative by training more providers than the other countries. Challenges to scale-up include a lack of formal channels for reporting PPFP and PPIUD service delivery outcomes, inconsistent coordination of services across the reproductive health continuum of care, and slow uptake in some countries. Continued success will rely on careful recordkeeping, regular monitoring and feedback, and strategic data use to advocate scale-up. PMID:27540120

Post-marketing surveillance of Norplant((R)) contraceptive implants: II. Non-reproductive health(1).

PubMed

2001-04-01

This controlled cohort study aimed to evaluate the safety and efficacy of Norplant contraceptive implants in developing countries. Women initiating Norplant implants were index subjects and women initiating intrauterine devices (IUDs) or surgical sterilization were controls. Consenting participants at 32 clinics in eight developing countries were admitted and followed-up every 6 months for 5 years. Major and less serious health events during follow-up were recorded. Incidence rate ratios of health events adjusted for clinic were estimated for initial and current method use. This paper reports non-reproductive health events. The study involved 7,977 women initiating use of Norplant, 6,625 of IUD, and 1,419 of sterilization. Five years follow-up was completed for 94.6% of the women. The study accumulated 78,323 woman-years of observation. The initial method chosen accounted for 84.4% or more of observed woman-years in users of Norplant, IUD, or sterilization. Twenty-two of the recorded 34 deaths were due to accidents, suicide or homicide. Few deaths or major health events were due to cancer or acute cardiovascular diseases and were not associated with the contraceptive method used. The incidence rates of major health events were low and with two exceptions, there was no significant excess risk of serious morbidity for Norplant users compared with controls; among Norplant initiators gallbladder disease occurred at an incidence rate of 1.5 per 1,000 woman-years and was weakly associated with use of Norplant (rate ratio 1.52 [95% C.I. 1.02, 2.27]). For current Norplant users compared to controls, the rate ratio of a combined variable of hypertension and borderline hypertension was significantly elevated (1.81, [1.12, 2.92]). The occurrence of less serious health events was also low and several of them were significantly more often reported among Norplant users. Headache-migraine, weight gain, mood disturbances, pruritus, eczema, and acne had incidence rates among Norplant users of 11.5, 4.5, 2.8, 1.5, 1.4, and 0.9 per 1,000 woman-years, respectively, and were significantly higher than in controls. Respiratory health problems, nonspecific symptoms, and several ill-defined conditions were also significantly more often reported for Norplant users, but some of the excess incidence may be attributable to reporting and detection bias. The study confirms the safety with respect to serious disease of Norplant, IUDs, and sterilization.

Tilted string cosmologies

NASA Astrophysics Data System (ADS)

Clancy, Dominic; Feinstein, Alexander; Lidsey, James E.; Tavakol, Reza

1999-04-01

Global symmetries of the string effective action are employed to generate tilted, homogeneous Bianchi type VIh string cosmologies from a previously known stiff perfect fluid solution to Einstein gravity. The dilaton field is not constant on the surfaces of homogeneity. The future asymptotic state of the models is interpreted as a plane wave and is itself an exact solution to the string equations of motion to all orders in the inverse string tension. An inhomogeneous generalization of the Bianchi type III model is also found.

Propagating stress-pulses and wiggling transition revealed in string dynamics

NASA Astrophysics Data System (ADS)

Yao, Zhenwei

2018-02-01

Understanding string dynamics yields insights into the intricate dynamic behaviors of various filamentary thin structures in nature and industry covering multiple length scales. In this work, we investigate the planar dynamics of a flexible string where one end is free and the other end is subject to transverse and longitudinal motions. Under transverse harmonic motion, we reveal the propagating pulse structure in the stress profile over the string, and analyze its role in bringing the system into a chaotic state. For a string where one end is under longitudinal uniform acceleration, we identify the wiggling transition, derive the analytical wiggling solution from the string equations, and present the phase diagram.

Noncommutative-geometry model for closed bosonic strings

NASA Technical Reports Server (NTRS)

Sen, Siddhartha; Holman, R.

1987-01-01

It is shown how Witten's (1986) noncommutative geometry may be extended to describe the closed bosonic string. For closed strings, an explicit representation is provided of the integral operator needed to construct an action and of an associative product on string fields. The proper choice of the action of the integral operator and the associative product in order to give rise to a reasonable theory is explained, and the consequences of such a choice are discussed. It is shown that the ghost numbers of the operator and associative product can be chosen arbitrarily for both open and closed strings, and that this construct can be used as an action for interacting closed bosonic strings.

Surface operators from M -strings

NASA Astrophysics Data System (ADS)

Mori, Hironori; Sugimoto, Yuji

2017-01-01

It has been found that surface operators have a significant role in Alday-Gaiotto-Tachikawa (AGT) relation. This duality is an outstanding consequence of M -theory, but it is actually encoded into the brane web for which the topological string can work. From this viewpoint, the surface defect in AGT relation is geometrically engineered as a toric brane realization. Also, there is a class of the brane configuration in M -theory called M -strings which can be translated into the language of the topological string. In this work, we propose a new M -string configuration which can realize AGT relation in the presence of the surface defect by utilizing the geometric transition in the refined topological string.

Voltage-Matched, Monolithic, Multi-Band-Gap Devices

DOEpatents

Wanlass, M. W.; Mascarenhas, A.

2006-08-22

Monolithic, tandem, photonic cells include at least a first semiconductor layer and a second semiconductor layer, wherein each semiconductor layer includes an n-type region, a p-type region, and a given band-gap energy. Formed within each semiconductor layer is a string of electrically connected photonic sub-cells. By carefully selecting the numbers of photonic sub-cells in the first and second layer photonic sub-cell string(s), and by carefully selecting the manner in which the sub-cells in a first and second layer photonic sub-cell string(s) are electrically connected, each of the first and second layer sub-cell strings may be made to achieve one or more substantially identical electrical characteristics.

Non-perturbative String Theory from Water Waves

DOE Office of Scientific and Technical Information (OSTI.GOV)

Iyer, Ramakrishnan; Johnson, Clifford V.; /Southern California U.

2012-06-14

We use a combination of a 't Hooft limit and numerical methods to find non-perturbative solutions of exactly solvable string theories, showing that perturbative solutions in different asymptotic regimes are connected by smooth interpolating functions. Our earlier perturbative work showed that a large class of minimal string theories arise as special limits of a Painleve IV hierarchy of string equations that can be derived by a similarity reduction of the dispersive water wave hierarchy of differential equations. The hierarchy of string equations contains new perturbative solutions, some of which were conjectured to be the type IIA and IIB string theoriesmore » coupled to (4, 4k ? 2) superconformal minimal models of type (A, D). Our present paper shows that these new theories have smooth non-perturbative extensions. We also find evidence for putative new string theories that were not apparent in the perturbative analysis.« less

The Neural Substrates for Letter String Readings in The Normal and Reverse Directions: An fMRI Study

NASA Astrophysics Data System (ADS)

Ge, Sheng; Saito, Takashi; Wu, Jing-Long; Ogasawara, Jun-Ichi; Yamauchi, Shuichi; Matsunaga, Naofumi; Iramina, Keiji

In order to investigate the difference in cortical activations between reading letter strings in the normal direction and the reverse direction, an fMRI study was conducted. In this study, the cortical activations elicited by Japanese letter string reading and Chinese letter string reading were investigated. The subjects performed the normal direction reading task (read letter strings from left to right), and the reverse direction reading task (read letter strings from right to left). According to the experimental results, the activated brain regions during the normal and the reverse direction reading tasks were compared. It was found that visuospatial transformation was involved in the reverse direction reading task, while this function was not significant during the normal direction reading task. Furthermore, we found that there was no significant difference in cortical activation between Japanese and Chinese letter string readings.

Constraints on Cosmic Strings from the LIGO-Virgo Gravitational-Wave Detectors

NASA Astrophysics Data System (ADS)

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D.; Giazotto, A.; Gil-Casanova, S.; Gill, C.; Gleason, J.; Goetz, E.; Goetz, R.; Gondan, L.; González, G.; Gordon, N.; Gorodetsky, M. L.; Gossan, S.; Goßler, S.; Gouaty, R.; Graef, C.; Graff, P. B.; Granata, M.; Grant, A.; Gras, S.; Gray, C.; Greenhalgh, R. J. S.; Gretarsson, A. M.; Griffo, C.; Groot, P.; Grote, H.; Grover, K.; Grunewald, S.; Guidi, G. M.; Guido, C.; Gushwa, K. E.; Gustafson, E. K.; Gustafson, R.; Hall, B.; Hall, E.; Hammer, D.; Hammond, G.; Hanke, M.; Hanks, J.; Hanna, C.; Hanson, J.; Harms, J.; Harry, G. M.; Harry, I. W.; Harstad, E. D.; Hartman, M. T.; Haughian, K.; Hayama, K.; Heefner, J.; Heidmann, A.; Heintze, M.; Heitmann, H.; Hello, P.; Hemming, G.; Hendry, M.; Heng, I. S.; Heptonstall, A. W.; Heurs, M.; Hild, S.; Hoak, D.; Hodge, K. A.; Holt, K.; Holtrop, M.; Hong, T.; Hooper, S.; Horrom, T.; Hosken, D. J.; Hough, J.; Howell, E. J.; Hu, Y.; Hua, Z.; Huang, V.; Huerta, E. A.; Hughey, B.; Husa, S.; Huttner, S. H.; Huynh, M.; Huynh-Dinh, T.; Iafrate, J.; Ingram, D. R.; Inta, R.; Isogai, T.; Ivanov, A.; Iyer, B. R.; Izumi, K.; Jacobson, M.; James, E.; Jang, H.; Jang, Y. J.; Jaranowski, P.; Jiménez-Forteza, F.; Johnson, W. W.; Jones, D.; Jones, D. I.; Jones, R.; Jonker, R. J. G.; Ju, L.; Haris, K.; Kalmus, P.; Kalogera, V.; Kandhasamy, S.; Kang, G.; Kanner, J. B.; Kasprzack, M.; Kasturi, R.; Katsavounidis, E.; Katzman, W.; Kaufer, H.; Kaufman, K.; Kawabe, K.; Kawamura, S.; Kawazoe, F.; Kéfélian, F.; Keitel, D.; Kelley, D. B.; Kells, W.; Keppel, D. G.; Khalaidovski, A.; Khalili, F. Y.; Khazanov, E. A.; Kim, B. K.; Kim, C.; Kim, K.; Kim, N.; Kim, W.; Kim, Y.-M.; King, E. J.; King, P. J.; Kinzel, D. L.; Kissel, J. S.; Klimenko, S.; Kline, J.; Koehlenbeck, S.; Kokeyama, K.; Kondrashov, V.; Koranda, S.; Korth, W. Z.; Kowalska, I.; Kozak, D.; Kremin, A.; Kringel, V.; Królak, A.; Kucharczyk, C.; Kudla, S.; Kuehn, G.; Kumar, A.; Kumar, P.; Kumar, R.; Kurdyumov, R.; Kwee, P.; Landry, M.; Lantz, B.; Larson, S.; Lasky, P. D.; Lawrie, C.; Lazzarini, A.; Le Roux, A.; Leaci, P.; Lebigot, E. O.; Lee, C.-H.; Lee, H. K.; Lee, H. M.; Lee, J.; Lee, J.; Leonardi, M.; Leong, J. R.; Leroy, N.; Letendre, N.; Levine, B.; Lewis, J. B.; Lhuillier, V.; Li, T. G. F.; Lin, A. C.; Littenberg, T. B.; Litvine, V.; Liu, F.; Liu, H.; Liu, Y.; Liu, Z.; Lloyd, D.; Lockerbie, N. A.; Lockett, V.; Lodhia, D.; Loew, K.; Logue, J.; Lombardi, A. L.; Lorenzini, M.; Loriette, V.; Lormand, M.; Losurdo, G.; Lough, J.; Luan, J.; Lubinski, M. J.; Lück, H.; Lundgren, A. P.; Macarthur, J.; Macdonald, E.; Machenschalk, B.; MacInnis, M.; Macleod, D. M.; Magana-Sandoval, F.; Mageswaran, M.; Mailand, K.; Majorana, E.; Maksimovic, I.; Malvezzi, V.; Man, N.; Manca, G. M.; Mandel, I.; Mandic, V.; Mangano, V.; Mantovani, M.; Marchesoni, F.; Marion, F.; Márka, S.; Márka, Z.; Markosyan, A.; Maros, E.; Marque, J.; Martelli, F.; Martin, I. W.; Martin, R. M.; Martinelli, L.; Martynov, D.; Marx, J. N.; Mason, K.; Masserot, A.; Massinger, T. J.; Matichard, F.; Matone, L.; Matzner, R. A.; Mavalvala, N.; May, G.; Mazumder, N.; Mazzolo, G.; McCarthy, R.; McClelland, D. E.; McGuire, S. C.; McIntyre, G.; McIver, J.; Meacher, D.; Meadors, G. D.; Mehmet, M.; Meidam, J.; Meier, T.; Melatos, A.; Mendell, G.; Mercer, R. A.; Meshkov, S.; Messenger, C.; Meyer, M. S.; Miao, H.; Michel, C.; Mikhailov, E. E.; Milano, L.; Miller, J.; Minenkov, Y.; Mingarelli, C. M. F.; Mitra, S.; Mitrofanov, V. P.; Mitselmakher, G.; Mittleman, R.; Moe, B.; Mohan, M.; Mohapatra, S. R. P.; Mokler, F.; Moraru, D.; Moreno, G.; Morgado, N.; Mori, T.; Morriss, S. R.; Mossavi, K.; Mours, B.; Mow-Lowry, C. M.; Mueller, C. L.; Mueller, G.; Mukherjee, S.; Mullavey, A.; Munch, J.; Murphy, D.; Murray, P. G.; Mytidis, A.; Nagy, M. F.; Nanda Kumar, D.; Nardecchia, I.; Nash, T.; Naticchioni, L.; Nayak, R.; Necula, V.; Nelemans, G.; Neri, I.; Neri, M.; Newton, G.; Nguyen, T.; Nishida, E.; Nishizawa, A.; Nitz, A.; Nocera, F.; Nolting, D.; Normandin, M. E.; Nuttall, L. K.; Ochsner, E.; O'Dell, J.; Oelker, E.; Ogin, G. H.; Oh, J. J.; Oh, S. H.; Ohme, F.; Oppermann, P.; O'Reilly, B.; Ortega Larcher, W.; O'Shaughnessy, R.; Osthelder, C.; Ott, C. D.; Ottaway, D. J.; Ottens, R. S.; Ou, J.; Overmier, H.; Owen, B. J.; Padilla, C.; Pai, A.; Palomba, C.; Pan, Y.; Pankow, C.; Paoletti, F.; Paoletti, R.; Papa, M. A.; Paris, H.; Pasqualetti, A.; Passaquieti, R.; Passuello, D.; Pedraza, M.; Peiris, P.; Penn, S.; Perreca, A.; Phelps, M.; Pichot, M.; Pickenpack, M.; Piergiovanni, F.; Pierro, V.; Pinard, L.; Pindor, B.; Pinto, I. M.; Pitkin, M.; Poeld, J.; Poggiani, R.; Poole, V.; Poux, C.; Predoi, V.; Prestegard, T.; Price, L. R.; Prijatelj, M.; Principe, M.; Privitera, S.; Prix, R.; Prodi, G. A.; Prokhorov, L.; Puncken, O.; Punturo, M.; Puppo, P.; Quetschke, V.; Quintero, E.; Quitzow-James, R.; Raab, F. J.; Rabeling, D. S.; Rácz, I.; Radkins, H.; Raffai, P.; Raja, S.; Rajalakshmi, G.; Rakhmanov, M.; Ramet, C.; Rapagnani, P.; Raymond, V.; Re, V.; Reed, C. M.; Reed, T.; Regimbau, T.; Reid, S.; Reitze, D. H.; Ricci, F.; Riesen, R.; Riles, K.; Robertson, N. A.; Robinet, F.; Rocchi, A.; Roddy, S.; Rodriguez, C.; Rodruck, M.; Roever, C.; Rolland, L.; Rollins, J. G.; Romano, R.; Romanov, G.; Romie, J. H.; Rosińska, D.; Rowan, S.; Rüdiger, A.; Ruggi, P.; Ryan, K.; Salemi, F.; Sammut, L.; Sandberg, V.; Sanders, J.; Sannibale, V.; Santiago-Prieto, I.; Saracco, E.; Sassolas, B.; Sathyaprakash, B. S.; Saulson, P. R.; Savage, R.; Schilling, R.; Schnabel, R.; Schofield, R. M. S.; Schreiber, E.; Schuette, D.; Schulz, B.; Schutz, B. F.; Schwinberg, P.; Scott, J.; Scott, S. M.; Seifert, F.; Sellers, D.; Sengupta, A. S.; Sentenac, D.; Sergeev, A.; Shaddock, D.; Shah, S.; Shahriar, M. S.; Shaltev, M.; Shapiro, B.; Shawhan, P.; Shoemaker, D. H.; Sidery, T. L.; Siellez, K.; Siemens, X.; Sigg, D.; Simakov, D.; Singer, A.; Singer, L.; Sintes, A. M.; Skelton, G. R.; Slagmolen, B. J. J.; Slutsky, J.; Smith, J. R.; Smith, M. R.; Smith, R. J. E.; Smith-Lefebvre, N. D.; Soden, K.; Son, E. J.; Sorazu, B.; Souradeep, T.; Sperandio, L.; Staley, A.; Steinert, E.; Steinlechner, J.; Steinlechner, S.; Steplewski, S.; Stevens, D.; Stochino, A.; Stone, R.; Strain, K. A.; Straniero, N.; Strigin, S.; Stroeer, A. S.; Sturani, R.; Stuver, A. L.; Summerscales, T. Z.; Susmithan, S.; Sutton, P. J.; Swinkels, B.; Szeifert, G.; Tacca, M.; Talukder, D.; Tang, L.; Tanner, D. B.; Tarabrin, S. P.; Taylor, R.; ter Braack, A. P. M.; Thirugnanasambandam, M. P.; Thomas, M.; Thomas, P.; Thorne, K. A.; Thorne, K. S.; Thrane, E.; Tiwari, V.; Tokmakov, K. V.; Tomlinson, C.; Toncelli, A.; Tonelli, M.; Torre, O.; Torres, C. V.; Torrie, C. I.; Travasso, F.; Traylor, G.; Tse, M.; Ugolini, D.; Unnikrishnan, C. S.; Vahlbruch, H.; Vajente, G.; Vallisneri, M.; van den Brand, J. F. J.; Van Den Broeck, C.; van der Putten, S.; van der Sluys, M. V.; van Heijningen, J.; van Veggel, A. A.; Vass, S.; Vasúth, M.; Vaulin, R.; Vecchio, A.; Vedovato, G.; Veitch, J.; Veitch, P. J.; Venkateswara, K.; Verkindt, D.; Verma, S.; Vetrano, F.; Viceré, A.; Vincent-Finley, R.; Vinet, J.-Y.; Vitale, S.; Vlcek, B.; Vo, T.; Vocca, H.; Vorvick, C.; Vousden, W. D.; Vrinceanu, D.; Vyachanin, S. P.; Wade, A.; Wade, L.; Wade, M.; Waldman, S. J.; Walker, M.; Wallace, L.; Wan, Y.; Wang, J.; Wang, M.; Wang, X.; Wanner, A.; Ward, R. L.; Was, M.; Weaver, B.; Wei, L.-W.; Weinert, M.; Weinstein, A. J.; Weiss, R.; Welborn, T.; Wen, L.; Wessels, P.; West, M.; Westphal, T.; Wette, K.; Whelan, J. T.; Whitcomb, S. E.; White, D. J.; Whiting, B. F.; Wibowo, S.; Wiesner, K.; Wilkinson, C.; Williams, L.; Williams, R.; Williams, T.; Willis, J. L.; Willke, B.; Wimmer, M.; Winkelmann, L.; Winkler, W.; Wipf, C. C.; Wittel, H.; Woan, G.; Worden, J.; Yablon, J.; Yakushin, I.; Yamamoto, H.; Yancey, C. C.; Yang, H.; Yeaton-Massey, D.; Yoshida, S.; Yum, H.; Yvert, M.; ZadroŻny, A.; Zanolin, M.; Zendri, J.-P.; Zhang, F.; Zhang, L.; Zhao, C.; Zhu, H.; Zhu, X. J.; Zotov, N.; Zucker, M. E.; Zweizig, J.; LIGO Scientific Collaboration; Virgo Collaboration

2014-04-01

Cosmic strings can give rise to a large variety of interesting astrophysical phenomena. Among them, powerful bursts of gravitational waves (GWs) produced by cusps are a promising observational signature. In this Letter we present a search for GWs from cosmic string cusps in data collected by the LIGO and Virgo gravitational wave detectors between 2005 and 2010, with over 625 days of live time. We find no evidence of GW signals from cosmic strings. From this result, we derive new constraints on cosmic string parameters, which complement and improve existing limits from previous searches for a stochastic background of GWs from cosmic microwave background measurements and pulsar timing data. In particular, if the size of loops is given by the gravitational backreaction scale, we place upper limits on the string tension Gμ below 10-8 in some regions of the cosmic string parameter space.

Constraints on Cosmic Strings from the LIGO-Virgo Gravitational-Wave Detectors

NASA Technical Reports Server (NTRS)

Aasi, J.; Abadie, J.; Abbott, B.P.; Abbott, R.; Abbott, T.; Abernathy, M.R.; Accadia, T.; Adams, C.; Adams, T.; Adhikari, R.X.;

Constraints on cosmic strings from the LIGO-Virgo gravitational-wave detectors.

PubMed

Aasi, J; Abadie, J; Abbott, B P; Abbott, R; Abbott, T; Abernathy, M R; Accadia, T; Acernese, F; Adams, C; Adams, T; Adhikari, R X; Affeldt, C; Agathos, M; Aggarwal, N; Aguiar, O D; Ajith, P; Allen, B; Allocca, A; Amador Ceron, E; Amariutei, D; Anderson, R A; Anderson, S B; Anderson, W G; Arai, K; Araya, M C; Arceneaux, C; Areeda, J; Ast, S; Aston, S M; Astone, P; Aufmuth, P; Aulbert, C; Austin, L; Aylott, B E; Babak, S; Baker, P T; Ballardin, G; Ballmer, S W; Barayoga, J C; Barker, D; Barnum, S H; Barone, F; Barr, B; Barsotti, L; Barsuglia, M; Barton, M A; Bartos, I; Bassiri, R; Basti, A; Batch, J; Bauchrowitz, J; Bauer, Th S; Bebronne, M; Behnke, B; Bejger, M; Beker, M G; Bell, A S; Bell, C; Belopolski, I; Bergmann, G; Berliner, J M; Bersanetti, D; Bertolini, A; Bessis, D; Betzwieser, J; Beyersdorf, P T; Bhadbhade, T; Bilenko, I A; Billingsley, G; Birch, J; Bitossi, M; Bizouard, M A; Black, E; Blackburn, J K; Blackburn, L; Blair, D; Blom, M; Bock, O; Bodiya, T P; Boer, M; Bogan, C; Bond, C; 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Cornish, N; Corsi, A; Costa, C A; Coughlin, M W; Coulon, J-P; Countryman, S; Couvares, P; Coward, D M; Cowart, M; Coyne, D C; Craig, K; Creighton, J D E; Creighton, T D; Crowder, S G; Cumming, A; Cunningham, L; Cuoco, E; Dahl, K; Dal Canton, T; Damjanic, M; Danilishin, S L; D'Antonio, S; Danzmann, K; Dattilo, V; Daudert, B; Daveloza, H; Davier, M; Davies, G S; Daw, E J; Day, R; Dayanga, T; De Rosa, R; Debreczeni, G; Degallaix, J; Del Pozzo, W; Deleeuw, E; Deléglise, S; Denker, T; Dent, T; Dereli, H; Dergachev, V; DeRosa, R; DeSalvo, R; Dhurandhar, S; Di Fiore, L; Di Lieto, A; Di Palma, I; Di Virgilio, A; Díaz, M; Dietz, A; Dmitry, K; Donovan, F; Dooley, K L; Doravari, S; Drago, M; Drever, R W P; Driggers, J C; Du, Z; Dumas, J-C; Dwyer, S; Eberle, T; Edwards, M; Effler, A; Ehrens, P; Eichholz, J; Eikenberry, S S; Endrőczi, G; Essick, R; Etzel, T; Evans, K; Evans, M; Evans, T; Factourovich, M; Fafone, V; Fairhurst, S; Fang, Q; Farinon, S; Farr, B; Farr, W; Favata, M; Fazi, D; Fehrmann, H; Feldbaum, D; Ferrante, I; Ferrini, F; Fidecaro, F; Finn, L S; Fiori, I; Fisher, R; Flaminio, R; Foley, E; Foley, S; Forsi, E; Fotopoulos, N; Fournier, J-D; Franco, S; Frasca, S; Frasconi, F; Frede, M; Frei, M; Frei, Z; Freise, A; Frey, R; Fricke, T T; Fritschel, P; Frolov, V V; Fujimoto, M-K; Fulda, P; Fyffe, M; Gair, J; Gammaitoni, L; Garcia, J; Garufi, F; Gehrels, N; Gemme, G; Genin, E; Gennai, A; Gergely, L; Ghosh, S; Giaime, J A; Giampanis, S; Giardina, K D; Giazotto, A; Gil-Casanova, S; Gill, C; Gleason, J; Goetz, E; Goetz, R; Gondan, L; González, G; Gordon, N; Gorodetsky, M L; Gossan, S; Goßler, S; Gouaty, R; Graef, C; Graff, P B; Granata, M; Grant, A; Gras, S; Gray, C; Greenhalgh, R J S; Gretarsson, A M; Griffo, C; Groot, P; Grote, H; Grover, K; Grunewald, S; Guidi, G M; Guido, C; Gushwa, K E; Gustafson, E K; Gustafson, R; Hall, B; Hall, E; Hammer, D; Hammond, G; Hanke, M; Hanks, J; Hanna, C; Hanson, J; Harms, J; Harry, G M; Harry, I W; Harstad, E D; Hartman, M T; Haughian, K; Hayama, K; Heefner, J; Heidmann, A; Heintze, M; Heitmann, H; Hello, P; Hemming, G; Hendry, M; Heng, I S; Heptonstall, A W; Heurs, M; Hild, S; Hoak, D; Hodge, K A; Holt, K; Holtrop, M; Hong, T; Hooper, S; Horrom, T; Hosken, D J; Hough, J; Howell, E J; Hu, Y; Hua, Z; Huang, V; Huerta, E A; Hughey, B; Husa, S; Huttner, S H; Huynh, M; Huynh-Dinh, T; Iafrate, J; Ingram, D R; Inta, R; Isogai, T; Ivanov, A; Iyer, B R; Izumi, K; Jacobson, M; James, E; Jang, H; Jang, Y J; Jaranowski, P; Jiménez-Forteza, F; Johnson, W W; Jones, D; Jones, D I; Jones, R; Jonker, R J G; Ju, L; K, Haris; Kalmus, P; Kalogera, V; Kandhasamy, S; Kang, G; Kanner, J B; Kasprzack, M; Kasturi, R; Katsavounidis, E; Katzman, W; Kaufer, H; Kaufman, K; Kawabe, K; Kawamura, S; Kawazoe, F; Kéfélian, F; Keitel, D; Kelley, D B; Kells, W; Keppel, D G; Khalaidovski, A; Khalili, F Y; Khazanov, E A; Kim, B K; Kim, C; Kim, K; Kim, N; Kim, W; Kim, Y-M; King, E J; King, P J; Kinzel, D L; Kissel, J S; Klimenko, S; Kline, J; Koehlenbeck, S; Kokeyama, K; Kondrashov, V; Koranda, S; Korth, W Z; Kowalska, I; Kozak, D; Kremin, A; Kringel, V; Królak, A; Kucharczyk, C; Kudla, S; Kuehn, G; Kumar, A; Kumar, P; Kumar, R; Kurdyumov, R; Kwee, P; Landry, M; Lantz, B; Larson, S; Lasky, P D; Lawrie, C; Lazzarini, A; Le Roux, A; Leaci, P; Lebigot, E O; Lee, C-H; Lee, H K; Lee, H M; Lee, J; Lee, J; Leonardi, M; Leong, J R; Leroy, N; Letendre, N; Levine, B; Lewis, J B; Lhuillier, V; Li, T G F; Lin, A C; Littenberg, T B; Litvine, V; Liu, F; Liu, H; Liu, Y; Liu, Z; Lloyd, D; Lockerbie, N A; Lockett, V; Lodhia, D; Loew, K; Logue, J; Lombardi, A L; Lorenzini, M; Loriette, V; Lormand, M; Losurdo, G; Lough, J; Luan, J; Lubinski, M J; Lück, H; Lundgren, A P; Macarthur, J; Macdonald, E; Machenschalk, B; MacInnis, M; Macleod, D M; Magana-Sandoval, F; Mageswaran, M; Mailand, K; Majorana, E; Maksimovic, I; Malvezzi, V; Man, N; Manca, G M; Mandel, I; Mandic, V; Mangano, V; Mantovani, M; Marchesoni, F; Marion, F; Márka, S; Márka, Z; Markosyan, A; Maros, E; Marque, J; Martelli, F; Martin, I W; Martin, R M; Martinelli, L; Martynov, D; Marx, J N; Mason, K; Masserot, A; Massinger, T J; Matichard, F; Matone, L; Matzner, R A; Mavalvala, N; May, G; Mazumder, N; Mazzolo, G; McCarthy, R; McClelland, D E; McGuire, S C; McIntyre, G; McIver, J; Meacher, D; Meadors, G D; Mehmet, M; Meidam, J; Meier, T; Melatos, A; Mendell, G; Mercer, R A; Meshkov, S; Messenger, C; Meyer, M S; Miao, H; Michel, C; Mikhailov, E E; Milano, L; Miller, J; Minenkov, Y; Mingarelli, C M F; Mitra, S; Mitrofanov, V P; Mitselmakher, G; Mittleman, R; Moe, B; Mohan, M; Mohapatra, S R P; Mokler, F; Moraru, D; Moreno, G; Morgado, N; Mori, T; Morriss, S R; Mossavi, K; Mours, B; Mow-Lowry, C M; Mueller, C L; Mueller, G; Mukherjee, S; Mullavey, A; Munch, J; Murphy, D; Murray, P G; Mytidis, A; Nagy, M F; Nanda Kumar, D; Nardecchia, I; Nash, T; Naticchioni, L; Nayak, R; Necula, V; Nelemans, G; Neri, I; Neri, M; Newton, G; Nguyen, T; Nishida, E; Nishizawa, A; Nitz, A; Nocera, F; Nolting, D; Normandin, M E; Nuttall, L K; Ochsner, E; O'Dell, J; Oelker, E; Ogin, G H; Oh, J J; Oh, S H; Ohme, F; Oppermann, P; O'Reilly, B; Ortega Larcher, W; O'Shaughnessy, R; Osthelder, C; Ott, C D; Ottaway, D J; Ottens, R S; Ou, J; Overmier, H; Owen, B J; Padilla, C; Pai, A; Palomba, C; Pan, Y; Pankow, C; Paoletti, F; Paoletti, R; Papa, M A; Paris, H; Pasqualetti, A; Passaquieti, R; Passuello, D; Pedraza, M; Peiris, P; Penn, S; Perreca, A; Phelps, M; Pichot, M; Pickenpack, M; Piergiovanni, F; Pierro, V; Pinard, L; Pindor, B; Pinto, I M; Pitkin, M; Poeld, J; Poggiani, R; Poole, V; Poux, C; Predoi, V; Prestegard, T; Price, L R; Prijatelj, M; Principe, M; Privitera, S; Prix, R; Prodi, G A; Prokhorov, L; Puncken, O; Punturo, M; Puppo, P; Quetschke, V; Quintero, E; Quitzow-James, R; Raab, F J; Rabeling, D S; Rácz, I; Radkins, H; Raffai, P; Raja, S; Rajalakshmi, G; Rakhmanov, M; Ramet, C; Rapagnani, P; Raymond, V; Re, V; Reed, C M; Reed, T; Regimbau, T; Reid, S; Reitze, D H; Ricci, F; Riesen, R; Riles, K; Robertson, N A; Robinet, F; Rocchi, A; Roddy, S; Rodriguez, C; Rodruck, M; Roever, C; Rolland, L; Rollins, J G; Romano, R; Romanov, G; Romie, J H; Rosińska, D; Rowan, S; Rüdiger, A; Ruggi, P; Ryan, K; Salemi, F; Sammut, L; Sandberg, V; Sanders, J; Sannibale, V; Santiago-Prieto, I; Saracco, E; Sassolas, B; Sathyaprakash, B S; Saulson, P R; Savage, R; Schilling, R; Schnabel, R; Schofield, R M S; Schreiber, E; Schuette, D; Schulz, B; Schutz, B F; Schwinberg, P; Scott, J; Scott, S M; Seifert, F; Sellers, D; Sengupta, A S; Sentenac, D; Sergeev, A; Shaddock, D; Shah, S; Shahriar, M S; Shaltev, M; Shapiro, B; Shawhan, P; Shoemaker, D H; Sidery, T L; Siellez, K; Siemens, X; Sigg, D; Simakov, D; Singer, A; Singer, L; Sintes, A M; Skelton, G R; Slagmolen, B J J; Slutsky, J; Smith, J R; Smith, M R; Smith, R J E; Smith-Lefebvre, N D; Soden, K; Son, E J; Sorazu, B; Souradeep, T; Sperandio, L; Staley, A; Steinert, E; Steinlechner, J; Steinlechner, S; Steplewski, S; Stevens, D; Stochino, A; Stone, R; Strain, K A; Straniero, N; Strigin, S; Stroeer, A S; Sturani, R; Stuver, A L; Summerscales, T Z; Susmithan, S; Sutton, P J; Swinkels, B; Szeifert, G; Tacca, M; Talukder, D; Tang, L; Tanner, D B; Tarabrin, S P; Taylor, R; ter Braack, A P M; Thirugnanasambandam, M P; Thomas, M; Thomas, P; Thorne, K A; Thorne, K S; Thrane, E; Tiwari, V; Tokmakov, K V; Tomlinson, C; Toncelli, A; Tonelli, M; Torre, O; Torres, C V; Torrie, C I; Travasso, F; Traylor, G; Tse, M; Ugolini, D; Unnikrishnan, C S; Vahlbruch, H; Vajente, G; Vallisneri, M; van den Brand, J F J; Van Den Broeck, C; van der Putten, S; van der Sluys, M V; van Heijningen, J; van Veggel, A A; Vass, S; Vasúth, M; Vaulin, R; Vecchio, A; Vedovato, G; Veitch, J; Veitch, P J; Venkateswara, K; Verkindt, D; Verma, S; Vetrano, F; Viceré, A; Vincent-Finley, R; Vinet, J-Y; Vitale, S; Vlcek, B; Vo, T; Vocca, H; Vorvick, C; Vousden, W D; Vrinceanu, D; Vyachanin, S P; Wade, A; Wade, L; Wade, M; Waldman, S J; Walker, M; Wallace, L; Wan, Y; Wang, J; Wang, M; Wang, X; Wanner, A; Ward, R L; Was, M; Weaver, B; Wei, L-W; Weinert, M; Weinstein, A J; Weiss, R; Welborn, T; Wen, L; Wessels, P; West, M; Westphal, T; Wette, K; Whelan, J T; Whitcomb, S E; White, D J; Whiting, B F; Wibowo, S; Wiesner, K; Wilkinson, C; Williams, L; Williams, R; Williams, T; Willis, J L; Willke, B; Wimmer, M; Winkelmann, L; Winkler, W; Wipf, C C; Wittel, H; Woan, G; Worden, J; Yablon, J; Yakushin, I; Yamamoto, H; Yancey, C C; Yang, H; Yeaton-Massey, D; Yoshida, S; Yum, H; Yvert, M; Zadrożny, A; Zanolin, M; Zendri, J-P; Zhang, F; Zhang, L; Zhao, C; Zhu, H; Zhu, X J; Zotov, N; Zucker, M E; Zweizig, J

2014-04-04

Cosmic strings can give rise to a large variety of interesting astrophysical phenomena. Among them, powerful bursts of gravitational waves (GWs) produced by cusps are a promising observational signature. In this Letter we present a search for GWs from cosmic string cusps in data collected by the LIGO and Virgo gravitational wave detectors between 2005 and 2010, with over 625 days of live time. We find no evidence of GW signals from cosmic strings. From this result, we derive new constraints on cosmic string parameters, which complement and improve existing limits from previous searches for a stochastic background of GWs from cosmic microwave background measurements and pulsar timing data. In particular, if the size of loops is given by the gravitational backreaction scale, we place upper limits on the string tension Gμ below 10(-8) in some regions of the cosmic string parameter space.

Using Survey IDs to Enhance Survey Research and Administration

ERIC Educational Resources Information Center

Edgeley, Catrin M.

2017-01-01

Survey IDs are short strings of unique characters assigned to each recipient in a sample population. Extension research can benefit from the improved organization of survey implementation and data collection, better researcher-respondent communication, and reduced survey material costs supported through the use of survey IDs. This article outlines…

Cerium Oxide Nanoparticle Nose-Only Inhalation Exposures Using a Low-Sample-Consumption String Generator

EPA Science Inventory

There is a critical need to assess the health effects associated with exposure of commercially produced NPs across the size ranges reflective of that detected in the industrial sectors that are generating, as well as incorporating, NPs into products. Generation of stable and low ...

CRTP-13: ABC-GCB Expression Signatures in Human B-cell Lymphoma on the NanoString Platform | Frederick National Laboratory for Cancer Research

Cancer.gov

The CLIA Molecular Diagnostics Laboratory within the Cancer Research Technology Program will perform messenger RNA isolation and expression analysis specific to a 20-gene panel on formalin-fixed paraffin-embedded (FFPE) patient samples using the Nano

Dualities in String Cosmology

NASA Astrophysics Data System (ADS)

Meissner, K. A.

We describe in this chapter a set of duality symmetries present in the string-inspired theory of gravity coupled to the dilaton. These dualities are the cornerstones of String Cosmology, which provides alternatives to the usual inflation scenario. The crucial role of Prof. Gabriele Veneziano in the discovery and the development of string dualities is described and emphasized.

Effects of overlapping strings in pp collisions

DOE PAGES

Bierlich, Christian; Gustafson, Gösta; Lönnblad, Leif; ...

2015-03-26

In models for hadron collisions based on string hadronization, the strings are usually treated as independent, allowing no interaction between the confined colour fields. In studies of nucleus collisions it has been suggested that strings close in space can fuse to form "colour ropes." Such ropes are expected to give more strange particles and baryons, which also has been suggested as a signal for plasma formation. Overlapping strings can also be expected in pp collisions, where usually no phase transition is expected. In particular at the high LHC energies the expected density of strings is quite high. To investigate possiblemore » effects of rope formation, we present a model in which strings are allowed to combine into higher multiplets, giving rise to increased production of baryons and strangeness, or recombine into singlet structures and vanish. Also a crude model for strings recombining into junction structures is considered, again giving rise to increased baryon production. The models are implemented in the DIPSY MC event generator, using PYTHIA8 for hadronization, and comparison to pp minimum bias data, reveals improvement in the description of identified particle spectra.« less

Hydraulic drill string breakdown and bleed off unit

DOE Office of Scientific and Technical Information (OSTI.GOV)

Zeringue, F.J. Jr.

1987-02-17

An apparatus is described for use within an oil well rig for decoupling a tubing string into pipe segments comprising, in combination: rotary tong means for applying an unthreading torque to a first, upper pipe segment within the tubing string; torque resisting means for securing a second, lower pipe segment within the tubing string against the unthreading torque; containing means, intermediate the rotary tong means and the torque resisting means, enclosing a threaded joint of the tubing string, adapted for containing pressurized gases, liquids, and particulates, released from the threaded joint upon the decoupling; fluid communicating means for allowing fluidmore » communication between the containing means and a receiving point adapted for receiving the pressurized gases, liquids, and particulates; means for moving the rotary tong means, the torque resisting means and the containing means between a closed, engaging position with the tubing string and an open position; and means for horizontally moving the rotary tong means, the torque resisting means and the containing means between a position adjacent the tubing string and a position away from the tubing string.« less

Perceiving the affordance of string tension for power strokes in badminton: expertise allows effective use of all string tensions.

PubMed

Zhu, Qin

2013-01-01

Affordances mean opportunities for action. These affordances are important for sports performance and relevant to the abilities developed by skilled athletes. In racquet sports such as badminton, different players prefer widely different string tension because it is believed to provide opportunities for effective strokes. The current study examined whether badminton players can perceive the affordance of string tension for power strokes and whether the perception of affordance itself changed as a function of skill level. The results showed that string tension constrained the striking performance of both novice and recreational players, but not of expert players. When perceptual capability was assessed, perceptual mode did not affect perception of the optimal string tension. Skilled players successfully perceived the affordance of string tension, but only experts were concerned about saving energy. Our findings demonstrated that perception of the affordance of string tension in badminton was determined by action abilities. Furthermore, experts could adjust the action to maintain a superior level of performance based on the perception of affordance.

The three-dimensional simulation analysis of dynamic response on perforated strings

NASA Astrophysics Data System (ADS)

Li, M. F.; Liu, H. F.; Dou, Y. H.; Cao, L. H.; Liu, Y. X.

2018-06-01

It analyzes the dynamic response and stresses of perforating tubular string to detonating impact load in oil-gas well in ANSYS, obtains the response of vibration displacement, velocity and acceleration of perforating tubularstring caused by detonating impact load, finds the influence of the length and wall thickness of perforating tubular string to working stresses. The result shows that:when the detonating impact load exerts the perforating tubular string with compressive and tensile axial force alternatively;the vibration displacement, velocity and acceleration of perfora-ting tubular string change periodically at same cycle;the closer to the perforating gun, the larger the amplitude of vi-bration velocity and acceleration;the closer to the packer the smaller the vibration displacement, the larger the work-ing equivalent stress of perforating tubular string;the longer or the thicker the perforating tubular string, the smaller the working equivalent stress and the higher the strength safety. Therefore, it uses the damping tube between packer and perforating gun as well as thick walled tubing to increase the strength safety of perforating tubular string.

Worldsheet factorization for twistor-strings

NASA Astrophysics Data System (ADS)

Adamo, Tim

2014-04-01

We study the multiparticle factorization properties of two worldsheet theories which — at tree-level — describe the scattering of massless particles in four dimensions: the Berkovits-Witten twistor-string for = 4 super-Yang-Mills coupled to = 4 conformal supergravity, and the Skinner twistor-string for = 8 supergravity. By considering these string-like theories, we can study factorization at the level of the worldsheet before any Wick contractions or integrals have been performed; this is much simpler than considering the factorization properties of the amplitudes themselves. In Skinner's twistor-string this entails the addition of worldsheet gravity as well as a formalism that represents all external states in a manifestly symmetric way, which we develop explicitly at genus zero. We confirm that the scattering amplitudes of Skinner's theory, as well as the gauge theory amplitudes for the planar sector of the Berkovits-Witten theory, factorize appropriately at genus zero. In the non-planar sector, we find behavior indicative of conformal gravity in the Berkovits-Witten twistor-string. We contrast factorization in twistor-strings with the story in ordinary string theory, and also make some remarks on higher genus factorization and disconnected prescriptions.

The role of visual spatial attention in adult developmental dyslexia.

PubMed

Collis, Nathan L; Kohnen, Saskia; Kinoshita, Sachiko

2013-01-01

The present study investigated the nature of visual spatial attention deficits in adults with developmental dyslexia, using a partial report task with five-letter, digit, and symbol strings. Participants responded by a manual key press to one of nine alternatives, which included other characters in the string, allowing an assessment of position errors as well as intrusion errors. The results showed that the dyslexic adults performed significantly worse than age-matched controls with letter and digit strings but not with symbol strings. Both groups produced W-shaped serial position functions with letter and digit strings. The dyslexics' deficits with letter string stimuli were limited to position errors, specifically at the string-interior positions 2 and 4. These errors correlated with letter transposition reading errors (e.g., reading slat as "salt"), but not with the Rapid Automatized Naming (RAN) task. Overall, these results suggest that the dyslexic adults have a visual spatial attention deficit; however, the deficit does not reflect a reduced span in visual-spatial attention, but a deficit in processing a string of letters in parallel, probably due to difficulty in the coding of letter position.

Self-similar motion of a Nambu-Goto string

NASA Astrophysics Data System (ADS)

Igata, Takahisa; Houri, Tsuyoshi; Harada, Tomohiro

2016-09-01

We study the self-similar motion of a string in a self-similar spacetime by introducing the concept of a self-similar string, which is defined as the world sheet to which a homothetic vector field is tangent. It is shown that in Nambu-Goto theory, the equations of motion for a self-similar string reduce to those for a particle. Moreover, under certain conditions such as the hypersurface orthogonality of the homothetic vector field, the equations of motion for a self-similar string simplify to the geodesic equations on a (pseudo)Riemannian space. As a concrete example, we investigate a self-similar Nambu-Goto string in a spatially flat Friedmann-Lemaître-Robertson-Walker expanding universe with self-similarity and obtain solutions of open and closed strings, which have various nontrivial configurations depending on the rate of the cosmic expansion. For instance, we obtain a circular solution that evolves linearly in the cosmic time while keeping its configuration by the balance between the effects of the cosmic expansion and string tension. We also show the instability for linear radial perturbation of the circular solutions.

Wavelet-Bayesian inference of cosmic strings embedded in the cosmic microwave background

NASA Astrophysics Data System (ADS)

McEwen, J. D.; Feeney, S. M.; Peiris, H. V.; Wiaux, Y.; Ringeval, C.; Bouchet, F. R.

2017-12-01

Cosmic strings are a well-motivated extension to the standard cosmological model and could induce a subdominant component in the anisotropies of the cosmic microwave background (CMB), in addition to the standard inflationary component. The detection of strings, while observationally challenging, would provide a direct probe of physics at very high-energy scales. We develop a framework for cosmic string inference from observations of the CMB made over the celestial sphere, performing a Bayesian analysis in wavelet space where the string-induced CMB component has distinct statistical properties to the standard inflationary component. Our wavelet-Bayesian framework provides a principled approach to compute the posterior distribution of the string tension Gμ and the Bayesian evidence ratio comparing the string model to the standard inflationary model. Furthermore, we present a technique to recover an estimate of any string-induced CMB map embedded in observational data. Using Planck-like simulations, we demonstrate the application of our framework and evaluate its performance. The method is sensitive to Gμ ∼ 5 × 10-7 for Nambu-Goto string simulations that include an integrated Sachs-Wolfe contribution only and do not include any recombination effects, before any parameters of the analysis are optimized. The sensitivity of the method compares favourably with other techniques applied to the same simulations.

A string theory which isn't about strings

NASA Astrophysics Data System (ADS)

Lee, Kanghoon; Rey, Soo-Jong; Rosabal, J. A.

2017-11-01

Quantization of closed string proceeds with a suitable choice of worldsheet vacuum. A priori, the vacuum may be chosen independently for left-moving and right-moving sectors. We construct ab initio quantized bosonic string theory with left-right asymmetric worldsheet vacuum and explore its consequences and implications. We critically examine the validity of new vacuum and carry out first-quantization using standard operator formalism. Remarkably, the string spectrum consists only of a finite number of degrees of freedom: string gravity (massless spin-two, Kalb-Ramond and dilaton fields) and two massive spin-two Fierz-Pauli fields. The massive spin-two fields have negative norm, opposite mass-squared, and provides a Lee-Wick type extension of string gravity. We compute two physical observables: tree-level scattering amplitudes and one-loop cosmological constant. Scattering amplitude of four dilatons is shown to be a rational function of kinematic invariants, and in D = 26 factorizes into contributions of massless spin-two and a pair of massive spin-two fields. The string one loop partition function is shown to perfectly agree with one loop Feynman diagram of string gravity and two massive spin-two fields. In particular, it does not exhibit modular invariance. We critically compare our construction with recent studies and contrast differences.

Critical non-Abelian vortex in four dimensions and little string theory

NASA Astrophysics Data System (ADS)

Shifman, M.; Yung, A.

2017-08-01

As was shown recently, non-Abelian vortex strings supported in four-dimensional N =2 supersymmetric QCD with the U(2) gauge group and Nf=4 quark multiplets (flavors) become critical superstrings. In addition to the translational moduli, non-Abelian strings under consideration carry six orientational and size moduli. Together, they form a ten-dimensional target space required for a superstring to be critical. The target space of the string sigma model is a product of the flat four-dimensional space and a Calabi-Yau noncompact threefold, namely, the conifold. We study closed string states which emerge in four dimensions and identify them with hadrons of four-dimensional N =2 QCD. One massless state was found previously; it emerges as a massless hypermultiplet associated with the deformation of the complex structure of the conifold. In this paper, we find a number of massive states. To this end, we exploit the approach used in LST little string theory, namely, the equivalence between the critical string on the conifold and noncritical c =1 string with the Liouville field and a compact scalar at the self-dual radius. The states we find carry "baryonic" charge (its definition differs from standard). We interpret them as "monopole necklaces" formed (at strong coupling) by the closed string with confined monopoles attached.

Patterned-string tasks: relation between fine motor skills and visual-spatial abilities in parrots.

PubMed

Krasheninnikova, Anastasia

2013-01-01

String-pulling and patterned-string tasks are often used to analyse perceptual and cognitive abilities in animals. In addition, the paradigm can be used to test the interrelation between visual-spatial and motor performance. Two Australian parrot species, the galah (Eolophus roseicapilla) and the cockatiel (Nymphicus hollandicus), forage on the ground, but only the galah uses its feet to manipulate food. I used a set of string pulling and patterned-string tasks to test whether usage of the feet during foraging is a prerequisite for solving the vertical string pulling problem. Indeed, the two species used techniques that clearly differed in the extent of beak-foot coordination but did not differ in terms of their success in solving the string pulling task. However, when the visual-spatial skills of the subjects were tested, the galahs outperformed the cockatiels. This supports the hypothesis that the fine motor skills needed for advanced beak-foot coordination may be interrelated with certain visual-spatial abilities needed for solving patterned-string tasks. This pattern was also found within each of the two species on the individual level: higher motor abilities positively correlated with performance in patterned-string tasks. This is the first evidence of an interrelation between visual-spatial and motor abilities in non-mammalian animals.

Spontaneous knotting of an agitated string.

PubMed

Raymer, Dorian M; Smith, Douglas E

2007-10-16

It is well known that a jostled string tends to become knotted; yet the factors governing the "spontaneous" formation of various knots are unclear. We performed experiments in which a string was tumbled inside a box and found that complex knots often form within seconds. We used mathematical knot theory to analyze the knots. Above a critical string length, the probability P of knotting at first increased sharply with length but then saturated below 100%. This behavior differs from that of mathematical self-avoiding random walks, where P has been proven to approach 100%. Finite agitation time and jamming of the string due to its stiffness result in lower probability, but P approaches 100% with long, flexible strings. We analyzed the knots by calculating their Jones polynomials via computer analysis of digital photos of the string. Remarkably, almost all were identified as prime knots: 120 different types, having minimum crossing numbers up to 11, were observed in 3,415 trials. All prime knots with up to seven crossings were observed. The relative probability of forming a knot decreased exponentially with minimum crossing number and Möbius energy, mathematical measures of knot complexity. Based on the observation that long, stiff strings tend to form a coiled structure when confined, we propose a simple model to describe the knot formation based on random "braid moves" of the string end. Our model can qualitatively account for the observed distribution of knots and dependence on agitation time and string length.

A method for the automated processing and analysis of images of ULVWF-platelet strings.

PubMed

Reeve, Scott R; Abbitt, Katherine B; Cruise, Thomas D; Hose, D Rodney; Lawford, Patricia V

2013-01-01

We present a method for identifying and analysing unusually large von Willebrand factor (ULVWF)-platelet strings in noisy low-quality images. The method requires relatively inexpensive, non-specialist equipment and allows multiple users to be employed in the capture of images. Images are subsequently enhanced and analysed, using custom-written software to perform the processing tasks. The formation and properties of ULVWF-platelet strings released in in vitro flow-based assays have recently become a popular research area. Endothelial cells are incorporated into a flow chamber, chemically stimulated to induce ULVWF release and perfused with isolated platelets which are able to bind to the ULVWF to form strings. The numbers and lengths of the strings released are related to characteristics of the flow. ULVWF-platelet strings are routinely identified by eye from video recordings captured during experiments and analysed manually using basic NIH image software to determine the number of strings and their lengths. This is a laborious, time-consuming task and a single experiment, often consisting of data from four to six dishes of endothelial cells, can take 2 or more days to analyse. The method described here allows analysis of the strings to provide data such as the number and length of strings, number of platelets per string and the distance between each platelet to be found. The software reduces analysis time, and more importantly removes user subjectivity, producing highly reproducible results with an error of less than 2% when compared with detailed manual analysis.

Characterization of binary string statistics for syntactic landmine detection

NASA Astrophysics Data System (ADS)

Nasif, Ahmed O.; Mark, Brian L.; Hintz, Kenneth J.

2011-06-01

Syntactic landmine detection has been proposed to detect and classify non-metallic landmines using ground penetrating radar (GPR). In this approach, the GPR return is processed to extract characteristic binary strings for landmine and clutter discrimination. In our previous work, we discussed the preprocessing methodology by which the amplitude information of the GPR A-scan signal can be effectively converted into binary strings, which identify the impedance discontinuities in the signal. In this work, we study the statistical properties of the binary string space. In particular, we develop a Markov chain model to characterize the observed bit sequence of the binary strings. The state is defined as the number of consecutive zeros between two ones in the binarized A-scans. Since the strings are highly sparse (the number of zeros is much greater than the number of ones), defining the state this way leads to fewer number of states compared to the case where each bit is defined as a state. The number of total states is further reduced by quantizing the number of consecutive zeros. In order to identify the correct order of the Markov model, the mean square difference (MSD) between the transition matrices of mine strings and non-mine strings is calculated up to order four using training data. The results show that order one or two maximizes this MSD. The specification of the transition probabilities of the chain can be used to compute the likelihood of any given string. Such a model can be used to identify characteristic landmine strings during the training phase. These developments on modeling and characterizing the string statistics can potentially be part of a real-time landmine detection algorithm that identifies landmine and clutter in an adaptive fashion.

Nonequilibrium umbrella sampling in spaces of many order parameters

NASA Astrophysics Data System (ADS)

Dickson, Alex; Warmflash, Aryeh; Dinner, Aaron R.

2009-02-01

We recently introduced an umbrella sampling method for obtaining nonequilibrium steady-state probability distributions projected onto an arbitrary number of coordinates that characterize a system (order parameters) [A. Warmflash, P. Bhimalapuram, and A. R. Dinner, J. Chem. Phys. 127, 154112 (2007)]. Here, we show how our algorithm can be combined with the image update procedure from the finite-temperature string method for reversible processes [E. Vanden-Eijnden and M. Venturoli, "Revisiting the finite temperature string method for calculation of reaction tubes and free energies," J. Chem. Phys. (in press)] to enable restricted sampling of a nonequilibrium steady state in the vicinity of a path in a many-dimensional space of order parameters. For the study of transitions between stable states, the adapted algorithm results in improved scaling with the number of order parameters and the ability to progressively refine the regions of enforced sampling. We demonstrate the algorithm by applying it to a two-dimensional model of driven Brownian motion and a coarse-grained (Ising) model for nucleation under shear. It is found that the choice of order parameters can significantly affect the convergence of the simulation; local magnetization variables other than those used previously for sampling transition paths in Ising systems are needed to ensure that the reactive flux is primarily contained within a tube in the space of order parameters. The relation of this method to other algorithms that sample the statistics of path ensembles is discussed.

Drill string enclosure

DOEpatents

Jorgensen, D.K.; Kuhns, D.J.; Wiersholm, O.; Miller, T.A.

1993-03-02

The drill string enclosure consists of six component parts, including; a top bracket, an upper acrylic cylinder, an acrylic drill casing guide, a lower acrylic cylinder, a bottom bracket, and three flexible ducts. The upper acrylic cylinder is optional based upon the drill string length. The drill string enclosure allows for an efficient drill and sight operation at a hazardous waste site.

Drill string enclosure

DOEpatents

Jorgensen, Douglas K.; Kuhns, Douglass J.; Wiersholm, Otto; Miller, Timothy A.

1993-01-01

The drill string enclosure consists of six component parts, including; a top bracket, an upper acrylic cylinder, an acrylic drill casing guide, a lower acrylic cylinder, a bottom bracket, and three flexible ducts. The upper acrylic cylinder is optional based upon the drill string length. The drill string enclosure allows for an efficient drill and sight operation at a hazardous waste site.

The Illusive Sound of a Bundengan String

ERIC Educational Resources Information Center

Parikesit, Gea O. F.; Kusumaningtyas, Indraswari

2017-01-01

The acoustics of a vibrating string is frequently used as a simple example of how physics can be applied in the field of art. In this paper we describe a simple experiment and analysis using a clipped string. This experiment can generate scientific curiosity among students because the sound generated by the string seem surprising to our senses.…

Hammered Strings

NASA Astrophysics Data System (ADS)

Rossing, Thomas D.

In the next three chapters we consider the science of hammered string instruments. In this chapter, we present a brief discussion of vibrating strings excited by a hard or soft hammer. Chapter 20 discusses the most important hammered string instrument, the piano - probably the most versatile and popular of all musical instruments. Chapter 21 discusses hammered dulcimers, especially the American folk dulcimer.

Reflecting on the Rationales for String Study in Schools

ERIC Educational Resources Information Center

Brenner, Brenda

2010-01-01

This essay will address the question of the value of string education by first examining arguments offered on behalf of string education in schools, and noting their somewhat mixed value. Then a set of arguments will be presented that may have greater promise. The focal point will be the establishment of excellence in string teaching and playing.…

Got 'Em on a String: The Skills, Knowledge and Attributes of Group String Teachers in Queensland

ERIC Educational Resources Information Center

Ashton, Graham R.; Klopper, Christopher J.

2018-01-01

There appear to be considerable differences in the outcomes of group string teaching programs in Queensland. Some teachers appear to be able to generate, manage, and administrate highly efficacious programs; others seem to experience difficulty transferring the knowledge and skills required for students to become successful string players. As a…

Upgrades to the Closed Bomb Facility and Measurement of Propellant Burning Rate

DTIC Science & Technology

2010-01-01

attenuation ratio myScope.WriteString (":CHAN1:RANGe " + CStr (Me.tbVRange.value)) ‘Sets the vertical voltage range myScope.WriteString (":CHAN1...OFFSet " + CStr (Me.tboffset.value)) ‘Sets the voltage offset myScope.WriteString ":CHAN1:PROB:STYP SING" ‘Sets the signal type...myScope.WriteString (":TRIG:EDGE:SOURce CHAN" + CStr (Int(val(GetRegistry(CollType, cCHANNEL))))) ‘Sets the source channel myScope.WriteString

Bell's Inequalities, Superquantum Correlations, and String Theory

DOE PAGES

Chang, Lay Nam; Lewis, Zachary; Minic, Djordje; ...

2011-01-01

We offermore » an interpretation of superquantum correlations in terms of a “doubly” quantum theory. We argue that string theory, viewed as a quantum theory with two deformation parameters, the string tension α ' , and the string coupling constant g s , is such a superquantum theory that transgresses the usual quantum violations of Bell's inequalities. We also discuss the ℏ → ∞ limit of quantum mechanics in this context. As a superquantum theory, string theory should display distinct experimentally observable supercorrelations of entangled stringy states.« less

The Hubble Web: The Dark Matter Problem and Cosmic Strings

NASA Astrophysics Data System (ADS)

Alexander, Stephon

2009-07-01

I propose a reinterpretation of cosmic dark matter in which a rigid network of cosmic strings formed at the end of inflation. The cosmic strings fulfill three functions: At recombination they provide an accretion mechanism for virializing baryonic and warm dark matter into disks. These cosmic strings survive as configurations which thread spiral and elliptical galaxies leading to the observed flatness of rotation curves and the Tully-Fisher relation. We find a relationship between the rotational velocity of the galaxy and the string tension and discuss the testability of this model.

Surface controlled blade stabilizer

DOEpatents

Russell, Larry R.

1983-01-01

Drill string stabilizer apparatus, controllable to expand and retract entirely from the surface by control of drill string pressure, wherein increase of drill string pressure from the surface closes a valve to create a piston means which is moved down by drill string pressure to expand the stabilizer blades, said valve being opened and the piston moving upward upon reduction of drill string pressure to retract the stabilizer blades. Upward and downward movements of the piston and an actuator sleeve therebelow are controlled by a barrel cam acting between the housing and the actuator sleeve.

Null cosmological singularities and free strings

DOE Office of Scientific and Technical Information (OSTI.GOV)

Narayan, K.

2010-03-15

We continue exploring free strings in the background of null Kasner-like cosmological singularities, following K. Narayan, arXiv:0904.4532. We study the free string Schrodinger wave functional along the lines of K. Narayan, arXiv:0807.1517. We find the wave functional to be nonsingular in the vicinity of singularities whose Kasner exponents satisfy certain relations. We compare this with the description in other variables. We then study certain regulated versions of these singularities where the singular region is replaced by a substringy but nonsingular region and study the string spectra in these backgrounds. The string modes can again be solved for exactly, giving somemore » insight into how string oscillator states get excited near the singularity.« less

CMB temperature trispectrum of cosmic strings

NASA Astrophysics Data System (ADS)

Hindmarsh, Mark; Ringeval, Christophe; Suyama, Teruaki

2010-03-01

We provide an analytical expression for the trispectrum of the cosmic microwave background (CMB) temperature anisotropies induced by cosmic strings. Our result is derived for the small angular scales under the assumption that the temperature anisotropy is induced by the Gott-Kaiser-Stebbins effect. The trispectrum is predicted to decay with a noninteger power-law exponent ℓ-ρ with 6<ρ<7, depending on the string microstructure, and thus on the string model. For Nambu-Goto strings, this exponent is related to the string mean square velocity and the loop distribution function. We then explore two classes of wave number configuration in Fourier space, the kite and trapezium quadrilaterals. The trispectrum can be of any sign and appears to be strongly enhanced for all squeezed quadrilaterals.

Galileon string measure and other modified measure extended objects

NASA Astrophysics Data System (ADS)

Vulfs, T. O.; Guendelman, E. I.

2017-12-01

We show that it is possible to formulate string theory as a “Galileon string theory”. The Galileon field χ enters in the definition of the integration measure in the action. Following the methods of the modified measure string theory, we find that the final equations are again those of the sigma-model. Moreover, the string tension appears again as an additional dynamical degree of freedom. At the same time, the theory satisfies all requirements of the Galileon higher derivative theory at the action level while the equations of motion are still of the second-order. A Galileon symmetry is displayed explicitly in the conformal string worldsheet frame. Also, we define the Galileon gauge transformations. Generalizations to branes with other modified measures are discussed.

Large-D gravity and low-D strings.

PubMed

Emparan, Roberto; Grumiller, Daniel; Tanabe, Kentaro

2013-06-21

We show that in the limit of a large number of dimensions a wide class of nonextremal neutral black holes has a universal near-horizon limit. The limiting geometry is the two-dimensional black hole of string theory with a two-dimensional target space. Its conformal symmetry explains the properties of massless scalars found recently in the large-D limit. For black branes with string charges, the near-horizon geometry is that of the three-dimensional black strings of Horne and Horowitz. The analogies between the α' expansion in string theory and the large-D expansion in gravity suggest a possible effective string description of the large-D limit of black holes. We comment on applications to several subjects, in particular to the problem of critical collapse.