Science.gov

Sample records for ius

  1. Ius Chasma Mega Gullies

    NASA Image and Video Library

    2011-03-30

    This image captured by NASA Mars Odyssey shows parts of two giant gully that are located on the southern side of Ius Chasma. Ius Chasma has the largest number of mega gullies of any of the chasmata that make up Valles Marineris.

  2. IUS prerelease alignment

    NASA Technical Reports Server (NTRS)

    Evans, F. A.

    1978-01-01

    Space shuttle orbiter/IUS alignment transfer was evaluated. Although the orbiter alignment accuracy was originally believed to be the major contributor to the overall alignment transfer error, it was shown that orbiter alignment accuracy is not a factor affecting IUS alignment accuracy, if certain procedures are followed. Results are reported of alignment transfer accuracy analysis.

  3. Inertial Upper Stage (IUS) software analysis

    NASA Technical Reports Server (NTRS)

    Grayson, W. L.; Nickel, C. E.; Rose, P. L.; Singh, R. P.

    1979-01-01

    The Inertial Upper Stage (IUS) System, an extension of the Space Transportation System (STS) operating regime to include higher orbits, orbital plane changes, geosynchronous orbits, and interplanetary trajectories is presented. The IUS software design, the IUS software interfaces with other systems, and the cost effectiveness in software verification are described. Tasks of the IUS discussed include: (1) design analysis; (2) validation requirements analysis; (3) interface analysis; and (4) requirements analysis.

  4. Sedimentary Deposits within Ius Chasma

    NASA Image and Video Library

    2015-07-15

    Sedimentary deposits are common within Valles Marineris. Most larger chasmata contain kilometer-thick light-toned layered deposits composed of sulfates. However, some of the chasmata, like Ius Chasma shown in this image from NASA Mars Reconnaissance Orbiter, lack these deposits or have much thinner deposits. The light-toned deposits in Ius Chasma are observed both along the floor and inner wallrock materials. Some of the light-toned deposits appear to post-date formation of the chasma floor, whereas other deposits appear to lie beneath wallrock materials, indicating they are older. By examining the stratigraphy using digital terrain models and 3D images, it should be possible to decipher the relative ages of the different geologic units. CRISM data may also provide insight into the mineralogy, which will tell scientists about the aqueous conditions that emplaced the light-toned deposits. http://photojournal.jpl.nasa.gov/catalog/PIA19855

  5. Orbiter CIU/IUS communications hardware evaluation

    NASA Technical Reports Server (NTRS)

    Huth, G. K.

    1979-01-01

    The DOD and NASA inertial upper stage communication system design, hardware specifications and interfaces were analyzed to determine their compatibility with the Orbiter payload communications equipment (Payload Interrogator, Payload Signal Processors, Communications Interface Unit, and the Orbiter operational communications equipment (the S-Band and Ku-band systems). Topics covered include (1) IUS/shuttle Orbiter communications interface definition; (2) Orbiter avionics equipment serving the IUS; (3) IUS communication equipment; (4) IUS/shuttle Orbiter RF links; (5) STDN/TDRS S-band related activities; and (6) communication interface unit/Orbiter interface issues. A test requirement plan overview is included.

  6. Astronomy education awards in the IUSE:EHR portfolio

    NASA Astrophysics Data System (ADS)

    Lee, Kevin M.

    2017-01-01

    Improving Undergraduate STEM Education (IUSE) is a National Science Foundation (NSF) program that addresses immediate challenges and opportunities facing undergraduate STEM education. IUSE endeavors to support faculty as they incorporate educational research results into the classroom and advance our understanding of effective teaching and learning. Note that IUSE is an NSF-wide framework. This paper will focus upon IUSE:EHR - the IUSE program administered from NSF's Education and Human Resources Directorate (EHR) through the Division of Undergraduate Education (DUE). Other branches of IUSE operating within this framework include IUSE:RED in the Engineering Directorate and IUSE:GEOPATHS in the Geosciences Directorate.

  7. Orbiter CIU/IUS communications hardware evaluation

    NASA Technical Reports Server (NTRS)

    Huth, G. K.

    1979-01-01

    Inertial Upper Stage (IUS) and DoD Communication Interface Unit (CIU) communication system design, hardware specifications, and interfaces were evaluated to determine their compatibility with the Orbiter payload communication and data handling equipment and the Orbiter network communication equipment.

  8. Tithonium and Ius Chasmata False Color

    NASA Image and Video Library

    2014-11-28

    This image from NASA 2001 Mars Odyssey spacecraft shows a false color image of the region including both Tithonium and Ius Chasmata, which includes a bluish region in both canyons. This may indicate an atmospheric haze.

  9. Shuttle/IUS performance for planetary missions. [Interim Upper Stage

    NASA Technical Reports Server (NTRS)

    Cork, M. J.; Driver, J. M.; Wright, J. L.

    1975-01-01

    Potential requirements for planetary missions in the 1980s, capabilities of the Interim Upper Stage (IUS) candidates to perform those missions, and Shuttle/IUS mission profile options for performance enhancement are examined. The most demanding planetary missions are the Pioneer Saturn/Uranus/Titan Probe and the Mariner-class orbiters of Mercury, Jupiter, and Saturn. Options available to designers of these missions will depend on the specific IUS selected for development and the programmatic phasing of the IUS and the NASA Tug. Use of Shuttle elliptic orbits as initial conditions for IUS ignition offers significant performance improvements; specific values are mission dependent.

  10. Northwest Ius Chasma Landslide and Dune Field

    NASA Image and Video Library

    2013-07-10

    Landslides in Valles Marineris are truly enormous, sometimes stretching from one wall to the base of another. This landslide, known as Ius Labes, would occupy the surface area of the state of Delaware, U.S., seen by NASA Mars Reconnaissance Orbiter.

  11. Therapeutic use of the LNG IUS, and counseling.

    PubMed

    Pakarinen, P; Toivonen, J; Luukkainen, T

    2001-12-01

    The intrauterine release of levonorgestrel (LNG) alters the function of the endometrium. This phenomenon offers special health benefits for users and a manner of local intrauterine therapy. In this review we discuss use of LNG-releasing intrauterine system (LNG IUS) in treatment and prevention of anemia and in the therapy of menorrhagia and dysmenorrhea. The antiproliferative effect of the LNG IUS on the endometrium offers targeted therapy against the proliferative action of estrogen on the endometrium during hormone replacement therapy. The LNG IUS as an alternative to sterilization is also discussed. There are also promising therapeutic fields such as use of the LNG IUS in the treatment of endometriosis and in the protection of endometrium exposed to tamoxifen during breast cancer treatment. Special attention is paid to counseling because successful use of the LNG IUS requires good training of the providers and extensive counseling of users.

  12. A Real-Time Telemetry Simulator of the IUS Spacecraft

    NASA Technical Reports Server (NTRS)

    Drews, Michael E.; Forman, Douglas A.; Baker, Damon M.; Khazoyan, Louis B.; Viazzo, Danilo

    1998-01-01

    A real-time telemetry simulator of the IUS spacecraft has recently entered operation to train Flight Control Teams for the launch of the AXAF telescope from the Shuttle. The simulator has proven to be a successful higher fidelity implementation of its predecessor, while affirming the rapid development methodology used in its design. Although composed of COTS hardware and software, the system simulates the full breadth of the mission: Launch, Pre-Deployment-Checkout, Burn Sequence, and AXAF/IUS separation. Realism is increased through patching the system into the operations facility to simulate IUS telemetry, Shuttle telemetry, and the Tracking Station link (commands and status message).

  13. STS-44 Defense Support Program (DSP) / IUS during preflight operations

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-44 Defense Support Program (DSP) satellite atop the inertial upper stage (IUS) is prepared for transfer in a processing facility at Cape Canaveral Air Force Station. Clean-suited technicians overseeing the operation are dwarfed by the size of the 5,200-pound DSP satellite and the IUS. The underside of the IUS (bottom) mounted in the airborne support equipment (ASE) aft frame tilt actuator (AFTA) table and ASE forward frame is visible at the base. The umbilical boom between the two ASE frames and the forward frame keel trunnion are visible. DSP, a surveillance satellite that can detect missle and space launches as well as nuclear detonations will be boosted into geosynchronous Earth orbit by the IUS. View provided by KSC with alternate number KSC-91PC-1749.

  14. Navigation for IUS deployment. TDRSS navigation accuracy in support of IUS deployment, phase 1

    NASA Technical Reports Server (NTRS)

    Wylie, A. D.

    1977-01-01

    The navigation accuracy for tracking the orbiter prior to interim upper stage (IUS) deployment using the tracking data relay satellite system (TDRSS) was studied. The orbiter navigation accuracy for both one and two TDRSS satellites, for short and long data arcs, and for Doppler-only and Doppler-plus range solutions was examined. All test cases were run with the orbiter in a 150-n. mi. circular orbit, 28.5 degree inclination, at the time interval from the completion of the orbital maneuvering system (OMS)-2 maneuver to OMS-2 plus 2 hours (approximate time for IUS deployment). The data used were simulated by the simulation navigation (SIMNAV) program. The software tool used to process the TDRS data was the Shuttle Navigation Analysis Program (SNAP), a Kalman filter tool used to solve for the orbiter position and velocity. Results summarize the expected navigation accuracy using the TDRS system. It was concluded that: (1) data from both TDRS satellites were essential for accurate navigation results: (2) range data were essential for the short arc test case but were not needed for the long arc test case; and (3) with Doppler and range data from both TDRS satellites, the results converged to a reasonable solution after 5 to 10 minutes of data.

  15. IUS/TUG orbital operations and mission support study. Volume 2: Interim upper stage operations

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Background data and study results are presented for the interim upper stage (IUS) operations phase of the IUS/tug orbital operations study. The study was conducted to develop IUS operational concepts and an IUS baseline operations plan, and to provide cost estimates for IUS operations. The approach used was to compile and evaluate baseline concepts, definitions, and system, and to use that data as a basis for the IUS operations phase definition, analysis, and costing analysis. Both expendable and reusable IUS configurations were analyzed and two autonomy levels were specified for each configuration. Topics discussed include on-orbit operations and interfaces with the orbiter, the tracking and data relay satellites and ground station support capability analysis, and flight control center sizing to support the IUS operations.

  16. Does an intraabdominally placed LNG-IUS have an adverse effect on fertility? A case report.

    PubMed

    Doris, Nadine; Shabib, Gihad; Corbett, Shannon; Leader, Arthur; Black, Amanda

    2014-01-01

    This case of secondary infertility with an associated intraabdominal levonorgestrel intrauterine system (LNG-IUS) demonstrates the importance of adequate imaging in women with a missing intrauterine contraceptive device and the possible fertility implications of an extrauterine LNG-IUS.

  17. Inertial Upper Stage (IUS) Solid Rocket Motor (SRM) Core Flow Sampling at High Altitudes

    DTIC Science & Technology

    1983-11-01

    16 I L L U S T R A T I O N S Figure I. Photograph of IUS Solid Rocket Motor and J-5 Diffuser ...Installation in Diffuser o f J-5 Test Cell for Core Flow Sampling of IUS Plume before Firing...24 12. Photograph and Histogram of IUS- DSSC Centerline Probe m Bottle 3, 21.5 sec, (A1203

  18. Ius Chasma by Day and Night

    NASA Technical Reports Server (NTRS)

    2004-01-01

    [figure removed for brevity, see original site]

    Released 18 June 2004 This pair of images shows part of Ius Chasma.

    Day/Night Infrared Pairs

    The image pairs presented focus on a single surface feature as seen in both the daytime and nighttime by the infrared THEMIS camera. The nighttime image (right) has been rotated 180 degrees to place north at the top.

    Infrared image interpretation

    Daytime: Infrared images taken during the daytime exhibit both the morphological and thermophysical properties of the surface of Mars. Morphologic details are visible due to the effect of sun-facing slopes receiving more energy than antisun-facing slopes. This creates a warm (bright) slope and cool (dark) slope appearance that mimics the light and shadows of a visible wavelength image. Thermophysical properties are seen in that dust heats up more quickly than rocks. Thus dusty areas are bright and rocky areas are dark.

    Nighttime: Infrared images taken during the nighttime exhibit only the thermophysical properties of the surface of Mars. The effect of sun-facing versus non-sun-facing energy dissipates quickly at night. Thermophysical effects dominate as different surfaces cool at different rates through the nighttime hours. Rocks cool slowly, and are therefore relatively bright at night (remember that rocks are dark during the day). Dust and other fine grained materials cool very quickly and are dark in nighttime infrared images.

    Image information: IR instrument. Latitude -1, Longitude 276 East (84 West). 100 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the

  19. IUS/TUG orbital operations and mission support study. Volume 4: Project planning data

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Planning data are presented for the development phases of interim upper stage (IUS) and tug systems. Major project planning requirements, major event schedules, milestones, system development and operations process networks, and relevant support research and technology requirements are included. Topics discussed include: IUS flight software; tug flight software; IUS/tug ground control center facilities, personnel, data systems, software, and equipment; IUS mission events; tug mission events; tug/spacecraft rendezvous and docking; tug/orbiter operations interface, and IUS/orbiter operations interface.

  20. STS-44 DSP / IUS spacecraft tilted to deployment position in OV-104's PLB

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-44 Defense Support Program (DSP) / Inertial Upper Stage (IUS) spacecraft, with forward airborne support equipment (ASE) payload retention latch actuator and umbilical boom released (foreground), is raised to a 58 degree deployment position by the ASE aft frame tilt actuator (AFTA) table in the payload bay (PLB) of Atlantis, Orbiter Vehicle (OV) 104. The IUS is supported in the ASE AFTA table and is inscribed with USAF. Above the IUS is the DSP satellite with stowed solar paddles (box-like structure) visible just above the DSP/IUS interface. Lights illuminate the PLB and highlight the IUS and some DSP components against the blackness of space.

  1. Contamination measurements during IUS thermal vacuum tests in a large space chamber. [IUS equipment support system

    NASA Technical Reports Server (NTRS)

    Mullen, C. R.; Shaw, C. G.

    1984-01-01

    The levels of contamination that originate from inside the IUS equipment support section (ESS) due to outgassing from electronics components and wiring operating at elevated temperatures (80-160 F) were investigated. Pressure was measured inside and outside the ESS. Mass deposition measurements were made with quartz crystal microbalances (QCM) facing into and away from ESS vents. The OCM's were operated at -50 C and -180 C using thermoelectrically and cryogenically cooled QCM's. Gaseous nitrogen flow inside the ESS was used to obtain the effective molecular flow vent area of the ESS, which was evaluated to be 359 sq cm (56 sq in) compared to the 978 sq cm (150 sq in) estimated by an earlier atmosphere pressure billowing test. The total outgassing rate of the ESS materials at a temperature of 60 C (140 F) decays with a time constant of 11.5 hours based on pressure measurements during the hot cycle. A time constant of 22 hours was estimated for the fraction of the outgassing which will condense on a -50 C surface. In contrast, the time constant is only 10.1 hours for the outgassing material which condenses on a surface at -180 C. A surface at -180 C collects approximately one half of the material vented from the ESS which impinges on it. Pressure measurements show very good correlation with the mass deposition measurements.

  2. Solid rocket technology advancements for space tug and IUS applications

    NASA Technical Reports Server (NTRS)

    Ascher, W.; Bailey, R. L.; Behm, J. W.; Gin, W.

    1975-01-01

    In order for the shuttle tug or interim upper stage (IUS) to capture all the missions in the current mission model for the tug and the IUS, an auxiliary or kick stage, using a solid propellant rocket motor, is required. Two solid propellant rocket motor technology concepts are described. One concept, called the 'advanced propulsion module' motor, is an 1800-kg, high-mass-fraction motor, which is single-burn and contains Class 2 propellent. The other concept, called the high energy upper stage restartable solid, is a two-burn (stop-restartable on command) motor which at present contains 1400 kg of Class 7 propellant. The details and status of the motor design and component and motor test results to date are presented, along with the schedule for future work.

  3. STS-34 Galileo spacecraft / inertial upper stage (IUS) deployment

    NASA Image and Video Library

    1989-10-18

    STS034-72-070 (18 Oct 1989) --- Backdropped against the blackness of space, the Galileo spacecraft and its inertial upper stage (IUS) begin relative separation from the Earth-orbiting Space Shuttle Atlantis. The five-member STS-34 crew deployed the Jupiter-bound satellite within six hours of achieving Earth orbit on Oct. 18, 1989. The scene was exposed with a 70mm handheld Hasselblad camera.

  4. Engineering evaluations and studies. Report for IUS studies

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The reviews, investigations, and analyses of the Inertial Upper Stage (IUS) Spacecraft Tracking and Data Network (STDN) transponder are reviewed. Carrier lock detector performance for Tracking and Data Relay Satellite System (TDRSS) dual-mode operation is discussed, as is the problem of predicting instantaneous frequency error in the carrier loop. Coastal loop performance analysis is critiqued and the static tracking phase error induced by thermal noise biases is discussed.

  5. Stratigraphic mapping of hydrated phases in Western Ius Chasma, Mars

    NASA Astrophysics Data System (ADS)

    Cull, S.; McGuire, P. C.; Gross, C.; Dumke, A.

    2013-12-01

    Recent mapping with the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) and Observatoire pour la Minéralogie, l'Eau, les Glaces et l'Activité (OMEGA) has revealed a wide range of hydrated minerals throughout Valles Marineris. Noctis Labyrinthus has interbedded polyhydrated and monohydrated sulfates, with occasional beds of nontronite (Weitz et al. 2010, Thollot et al. 2012). Tithonium Chasma has interbedded poly- and monohydrated sulfates (Murchie et al. 2012); Juventae has poly- and monohydrated sulfates and an anhydrous ferric hydroxysulfate-bearing material (Bishop et al. 2009); and Melas and Eastern Candor contain layers of poly- and monohydrated sulfates (e.g., Roach et al. 2009). Though each chasm displays its own mineralogy, in general, the eastern valles tend to be dominated by layered sequences with sulfates; whereas, the far western valles (Noctis Labyrinthus) has far more mineral phases, possibly due to a wider variety of past environments or processes affecting the area. Ius Chasma, which is situated between Noctis Labyrinthus and the eastern valles and chasmata, also displays a complex mineralogy, with polyhydrated sulfates, Fe/Mg smectites, hydrated silica, and kieserite (e.g. Roach et al. 2010). Here, we present mapping of recently acquired CRISM observations over Ius Chasma, combining the recent CRISM cubes with topographic terrains produced using High Resolution Stereo Camera (HRSC) data from the Mars Express spacecraft. Stratigraphic columns are produced along the length of Ius Chasma, and compared to stratigraphic columns produced throughout the Valles Marineris

  6. Hydrated mineral stratigraphy of Ius Chasma, Valles Marineris

    USGS Publications Warehouse

    Roach, L.H.; Mustard, J.F.; Swayze, G.; Milliken, R.E.; Bishop, J.L.; Murchie, S.L.; Lichtenberg, K.

    2010-01-01

    New high-resolution spectral and morphologic imaging of deposits on walls and floor of Ius Chasma extend previous geomorphic mapping, and permit a new interpretation of aqueous processes that occurred during the development of Valles Marineris. We identify hydrated mineralogy based on visible-near infrared (VNIR) absorptions. We map the extents of these units with CRISM spectral data as well as morphologies in CTX and HiRISE imagery. Three cross-sections across Ius Chasma illustrate the interpreted mineral stratigraphy. Multiple episodes formed and transported hydrated minerals within Ius Chasma. Polyhydrated sulfate and kieserite are found within a closed basin at the lowest elevations in the chasma. They may have been precipitates in a closed basin or diagenetically altered after deposition. Fluvial or aeolian processes then deposited layered Fe/Mg smectite and hydrated silicate on the chasma floor, postdating the sulfates. The smectite apparently was weathered out of Noachian-age wallrock and transported to the depositional sites. The overlying hydrated silicate is interpreted to be an acid-leached phyllosilicate transformed from the underlying smectite unit, or a smectite/jarosite mixture. The finely layered smectite and massive hydrated silicate units have an erosional unconformity between them, that marks a change in surface water chemistry. Landslides transported large blocks of wallrock, some altered to contain Fe/Mg smectite, to the chasma floor. After the last episode of normal faulting and subsequent landslides, opal was transported short distances into the chasma from a few m-thick light-toned layer near the top of the wallrock, by sapping channels in Louros Valles. Alternatively, the material was transported into the chasma and then altered to opal. The superposition of different types of hydrated minerals and the different fluvial morphologies of the units containing them indicate sequential, distinct aqueous environments, characterized by alkaline

  7. Shuttle orbiter - IUS/DSP satellite interface contamination study

    NASA Technical Reports Server (NTRS)

    Rantanen, R. O.; Strange, D. A.

    1978-01-01

    The results of a contamination analysis on the Defense Support Program (DSP) satellite during launch and deployment by the Space Transportation System (STS) are presented. Predicted contaminant deposition was also included on critical DSP surfaces during the period soon after launch when the DSP is in the shuttle orbiter bay with the doors closed, the bay doors open, and during initial deployment. Additionally, a six sided box was placed at the spacecraft position to obtain directional contaminant flux information for a general payload while in the bay and during deployment. The analysis included contamination sources from the shuttle orbiter, IUS and cradle, the DSP sensor and the DSP support package.

  8. Materials testing of the IUS techroll seal material

    NASA Technical Reports Server (NTRS)

    Nichols, R. L.; Hall, W. B.

    1984-01-01

    As a part of the investigation of the control system failure Inertial Upper Stage on IUS-1 flight to position a Tracking and Data Relay Satellite (TDRS) in geosynchronous orbit, the materials utilized in the techroll seal are evaluated for possible failure models. Studies undertaken included effect of temperature on the strength of the system, effect of fatigue on the strength of the system, thermogravimetric analysis, thermomechanical analysis, differential scanning calorimeter analysis, dynamic mechanical analysis, and peel test. The most likely failure mode is excessive temperature in the seal. In addition, the seal material is susceptible to fatigue damage which could be a contributing factor.

  9. IUS/TUG orbital operations and mission support study. Volume 5: Cost estimates

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The costing approach, methodology, and rationale utilized for generating cost data for composite IUS and space tug orbital operations are discussed. Summary cost estimates are given along with cost data initially derived for the IUS program and space tug program individually, and cost estimates for each work breakdown structure element.

  10. STS-44 DSP / IUS spacecraft tilted to deployment position in OV-104's PLB

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-44 Defense Support Program (DSP) / Inertial Upper Stage (IUS) spacecraft, with forward airborne support equipment (ASE) payload retention latch actuator and umbilical boom released, is raised to a 58 degree deployment position by the ASE aft frame tilt actuator (AFTA) table in the payload bay (PLB) of Atlantis, Orbiter Vehicle (OV) 104. The IUS is supported in the ASE AFTA table and is inscribed with USAF. Above the IUS is the DSP satellite with stowed solar paddles (box-like structure) visible just above the DSP/IUS interface. The cylinder at the very top of the DSP satellite is the Infrared (IR) Sensor. Lights illuminate the PLB and highlight the IUS and some DSP components against the blackness of space.

  11. Feasibility of LNG-IUS in a baboon model

    PubMed Central

    Bell Jason, Jason D.; Bergin, Ingrid L.; Natavio, Melissa F.; Jibrel, Fatima; Zochowski, Melissa K.; Weadock, William J.; Swanson, Scott D.; Aronoff, David M.; Patton, Dorothy L.

    2012-01-01

    Background The baboon (Papio hamadryas anubis) is an attractive model for intrauterine contraception research due to anatomic similarity to the human. Although non-human primates have previously been used for intrauterine contraception research, it was unknown whether modern intrauterine devices (IUDs) can be placed in an anatomically similar position in the baboon. This study sought to determine whether human-use IUDs could be seated correctly in the uterus of the baboon. Study Design The levonorgestrel-releasing intrauterine system (LNG-IUS) was placed ex vivo into two baboon uteri collected at necropsy and in 3 living, reproductively proven baboons. Results Correct placement of human-use IUDs in the baboon was confirmed by both MRI and ultrasound. This study establishes that a LNG-IUS can be inserted into the baboon uterus and maintained without clinically adverse effects for at least 6 months. The positioning of the device is similar to positioning found in women. Conclusion These findings provide important support for studying IUD safety and efficacy in the baboon. PMID:23114737

  12. Emerging indications for the levonorgestrel-releasing intrauterine system (LNG-IUS).

    PubMed

    Heikinheimo, Oskari; Gemzell-Danielsson, Kristina

    2012-01-01

    The levonorgestrel intrauterine system (LNG-IUS), originally designed for long-term contraceptive use, has been on the Scandinavian market for approximately 20 years. Novel clinical indications for the LNG-IUS, derived mainly from investigator-initiated studies, are emerging. These include heavy menstrual bleeding associated with uterine fibroids, endometriosis, adenomyosis, as well as endometrial hyperplasia. In both cohort and randomized studies, the LNG-IUS is effective in decreasing heavy menstrual bleeding, also in women diagnosed with uterine fibroids. In randomized studies the LNG-IUS has shown comparable clinical efficacy to GnRH analogues or progestins for the symptomatic treatment of endometriosis. Experience with LNG-IUS in adenomyosis is based on prospective cohort studies. Dysmenorrhea has been reported to decrease in all women, and uterine volume was seen to diminish in some of these studies. In the treatment of endometrial hyperplasias, including atypical hyperplasia, the LNG-IUS is equal or superior to treatment with systemic progestins. Further studies are needed to examine the full potential of the LNG-IUS in such common clinical situations.

  13. STS-44 DSP / IUS spacecraft tilted to predeployment position in OV-104's PLB

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-44 Defense Support Program (DSP) / Inertial Upper Stage (IUS) spacecraft, with forward airborne support equipment (ASE) payload retention latch actuator released (foreground), is raised to a 29 degree predeployment position by the ASE aft frame tilt actuator (AFTA) table in the payload bay (PLB) of Atlantis, Orbiter Vehicle (OV) 104. Underneath the DSP / IUS combination, the umbilical boom is connected to the IUS. DSP components include Infrared (IR) sensor (top), AR I, SHF Antenna, EHF Antenna, Link 2 High-Gain Antenna, star sensor, and stowed solar paddles (box-like structure around the base). The Earth's limb and the blackness of space create the backdrop for this deployment scene.

  14. Technicians listen to instructions during STS-44 DSP / IUS transfer operation

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Clean-suited technicians, wearing headsets, listen to instructions during Defense Support Program (DSP) satellite / inertial upper stage (IUS) transfer operations in a processing facility at Cape Canaveral Air Force Station. In the background, the DSP satellite atop an inertial upper stage (IUS) is readied for transfer to a payload canister transporter. DSP, a surveillance satellite that can detect missle and space launches as well as nuclear detonations will be boosted into geosynchronous Earth orbit by the IUS during STS-44 mission. View provided by the Kennedy Space Center (KSC) with alternate number KSC-91PC-1748.

  15. Analysis of the NSF IUSE Physics & Astronomy Education Portfolio

    NASA Astrophysics Data System (ADS)

    Lee, Kevin M.

    2017-01-01

    The National Science Foundation’s IUSE:EHR (Improving Undergraduate STEM Education) Program is now over 3 years old. This presentation will describe the characteristics of the awards presently in the physics & astronomy portfolio. Awards will be described based upon a) general characteristics (duration, total funding, PI rank, type of institution, etc.), b) applicability (intended audience, level, and arena of implementation), c) nature of project (educational research, practical implementation, or both), and d) pedagogical focus (curriculum, STEM recruitment, STEM retention, information collection, and tools and/or skills development). General trends and exemplars will be identified as well as voids in the portfolio. Understanding what has been funded will help attendees design future proposals that will make innovative contributions to the portfolio.

  16. Glacial landforms in Ius Chasma, Mars — Indicators of Two Glaciation Episodes

    NASA Astrophysics Data System (ADS)

    Dębniak, K. T.; Kromuszczyńska, O.

    2016-06-01

    Results of geomorphological mapping of glacial landforms in Ius Chasma, Valles Marineris, Mars are presented. The results indicate at least two episodes of glaciations which occurred in the trough system.

  17. Preliminary design of an Orbiter/IUS separation sequence. [requirements for Space Shuttle Orbital Flight 8

    NASA Technical Reports Server (NTRS)

    Wilson, S. W.

    1978-01-01

    An orbiter/IUS separation sequence to satisfy the assumed requirements of Shuttle Flight 8 was defined for the purpose of gaining an insight into the flight design software requirements. The key to economical and effective flight design for orbiter/IUS proximity operations is considered to be the capability for rapid and accurate generation of graphical displays that will facilitate not only decision making on the part of the designer, but also lucid documentation of rationale and the resulting design features. The data indicate that (1) an OMS burn is required to attain the necessary velocity without subjecting the IUS and its payload to undue plume impingement, and (2) a departure trajectory that places the orbiter above and behind the IUS at SRM ignition time is preferred over the alternative which would place it below and ahead.

  18. STS-26 Discovery, Orbiter Vehicle (OV) 103, IUS / TDRS-C deployment

    NASA Image and Video Library

    1988-09-29

    STS026-31-071 (3 Oct 1988) --- After deployment from Discovery, Orbiter Vehicle (OV) 103, the inertial upper stage (IUS) with the tracking and data relay satellite C (TDRS-C) drifts above the cloud-covered Earth surface. TDRS-C, in stowed configuration (solar array panels visible), is mounted atop the IUS with the interstage and solid rocket motor and nozzle seen in the foreground.

  19. Effects of LNG-IUS on nerve growth factor and its receptors expression in patients with adenomyosis.

    PubMed

    Choi, Young Sik; Cho, Sihyun; Lim, Kyung Jin; Jeon, Young Eun; Yang, Hyo In; Lee, Kyung Eun; Heena, Kamdar; Seo, Seok Kyo; Kim, Hye Yeon; Lee, Byung Seok

    2010-12-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is effective in the treatment of dysmenorrhea associated with adenomyosis. However, the mechanism of pain relief of LNG-IUS in patients with adenomyosis is unclear. We aimed to investigate the effects of LNG-IUS on the expression of nerve growth factor (NGF) and its receptors, NGFR p75 and TrkA in patients with adenomyosis. Endometrial and myometrial tissues were prepared from 17 LNG-IUS-treated patients and 15 hormonally untreated patients who had undergone hysterectomies for adenomyosis. Immunohistochemistry with antibodies against NGF, NGFR p75, and TrkA, was performed. The expression of NGF, NGFR p75, and TrkA in endometrium and myometrium of LNG-IUS-treated patients was significantly decreased compared to those of hormonally untreated patients. Our findings may indicate that the suppression of NGF and its receptors by LNG-IUS is another possible mechanism of relieving pain in patients with adenomyosis.

  20. IUS materials outgassing condensation effects on sensitive spacecraft surfaces

    NASA Technical Reports Server (NTRS)

    Mullen, C. R.; Shaw, C. G.; Crutcher, E. R.

    1982-01-01

    Four materials used on the inertial upper state (IUS) were subjected to vacuum conditions and heated to near-operational temperatures (93 to 316 C), releasing volatile materials. A fraction of the volatile materials were collected on 25 C solar cells, optical solar reflectors (OSR's) or aluminized Mylar. The contaminated surfaces were exposed to 26 equivalent sun hours of simulated solar ultraviolet (UV) radiation. Measurements of contamination deposit mass, structure, reflectance and effects on solar cell power output were made before and after UV irradiation. Standard total mass loss - volatile condensible materials (TML - VCM) tests were also performed. A 2500 A thick contaminant layer produced by EPDM rubber motor-case insulation outgassing increased the solar absorptance of the OSR's from 0.07 to 0.14, and to 0.18 after UV exposure. An 83,000 A layer caused an increase from 0.07 to 0.21, and then the 0.46 after UV exposure. The Kevlar-epoxy motor-case material outgassing condensation raised the absorptance from 0.07 to 0.13, but UV had no effect. Outgassing from multilayer insulation and carbon-carbon nozzle materials did not affect the solar absorptance of the OSR's.

  1. IUS/SPINSIM - INERTIAL UPPER STAGE SPIN STAGE SIX DEGREE OF FREEDOM SIMULATION

    NASA Technical Reports Server (NTRS)

    Dauro, V. A.

    1994-01-01

    IUS/SPINSIM was written to evaluate a proposed spinning third stage for the Inertial Upper Stage (IUS) Jupiter Mission. The third stage of the IUS was not to have altitude control during the solid motor burn for this mission. IUS was to be spun up about its principle thrust axis in the desired attitude prior to ignition of its solid motor. IUS/SPINSIM can also be used to evaluate the performance of other spinning stages that utilize a fixed burn motor. IUS/SPINSIM is a Six-Degree-of-Freedom simulation for exo-atmospheric flight of an IUS. It assumes the stage is released in orbit at or near its desired inertial attitude, and is spinning slowly. The code models three phases: a coast phase in which further spin-up may occur, a burn stage during which a solid rocket motor (SRM) burn injects the space craft into a transfer trajectory, and a final coast phase. IUS/SPINSIM takes into account the effects of the following: a reaction control system (RCS) spinning the vehicle; SRM thrust buildup, decay, and misalignment; changing mass, center of gravity, principle moments of inertia, cross products of inertia, time derivatives of inertia; jet damping moments; and an oblate gravity model. Numerical integration of the equations of motion using a Runge-Kutta fourth order integrator and small step sizes is used to track the vehicle's position, velocity, attitude and spin rates. Instead of using Euler angles or the Direction Cosine Matrix, Quarternions are used to model the attitude and spinning of the vehicle. This eliminates the renormalization difficulties associated with either of the other methods. Program input is taken from a file, and output is to a print file and a data file suitable for use in plotting. The IUS/SPINSIM is written in FORTRAN 77 for DEC VAX series computers running VMS. The standard distribution medium for this program is a 9track 1600 BPI magnetic tape in DEC VAX BACKUP format. It is also available on a TK50 tape cartridge in DEC VAX BACKUP format. This

  2. IUS capability for earth orbital spacecraft. [Interim Upper Stage program for shuttle transportation

    NASA Technical Reports Server (NTRS)

    Huber, W. G.; Huffaker, C. F.

    1976-01-01

    A basic element of the Space Transportation System (STS) is the Interim Upper Stage (IUS) currently being planned by the USAF. The prime use of the basic two-stage IUS vehicle by both NASA and DoD will be to place satellites in geosynchronous orbit. High energy missions such as planetary will be accomplished by three- and four-stage vehicles. Various other configurations such as tandem vehicles in a single Shuttle and multiple spacecraft are being planned. Also under study is a smaller stage that can be flown with other payloads on a space available basis. The various concepts being studied offer economical transportation alternatives to potential users. This paper describes details of the IUS program status, design requirements, concepts and applications to Earth orbital spacecraft.

  3. STS-44 DSP satellite and IUS during preflight processing at Cape Canaveral

    NASA Technical Reports Server (NTRS)

    1991-01-01

    In a processing facility at Cape Canaveral Air Force Station, clean-suited technicians oversee the transfer of the Defense Support Program (DSP) satellite atop an inertial upper stage (IUS) into a payload canister transporter for shipment to Kennedy Space Center (KSC) Launch Complex (LC) Pad 39A. During the transfer, the underside of the IUS mounted in the airborne support equipment (ASE) aft frame tilt actuactor (AFTA) table (bottom) and ASE forward frame (middle) is visible. The umbilical boom between the two frames and forward frame keel trunnion are visible. DSP, a surveillance satellite that can detect missle and space launches as well as nuclear detonations will be boosted into its proper orbital position by the IUS during STS-44. View provided by KSC with alternate number KSC-91PC-1751.

  4. STS-29 IUS with TDRS-D after deployment from Discovery, OV-103

    NASA Technical Reports Server (NTRS)

    1989-01-01

    During STS-29, the inertial upper stage (IUS) with tracking and data relay satellite D (TDRS-D) undergoes thermal rolls and orientation after reaction control subsystem activation following deployment from Discovery, Orbiter Vehicle (OV) 103. As the STS-29 payload drifts against the blackness of space, the IUS (white) and the TDRS-D with solar cell panels still closed around the stowed single access #1 and #2 and S-Band omni antenna are visible. When at its final destination high above the Earth, TDRS-D will become TDRS-4 and no longer maintain this cylindrical form, having transferred into an operational satellite with antenna spanned out in various directions and its IUS discarded. Nadir latitude 15 North and Nadir longitude 115.1 West.

  5. Non-contraceptive uses of levonorgestrel-releasing hormone system (LNG-IUS)--a systematic enquiry and overview.

    PubMed

    Varma, Rajesh; Sinha, Deepali; Gupta, Janesh K

    2006-03-01

    Levonorgestrel releasing-intrauterine systems (LNG-IUS) were originally developed as a method of contraception in the mid 1970s. The only LNG-IUS approved for general public use is the Mirena LNG-IUS, which releases 20 mcg of levonorgestrel per day directly in to the uterine cavity. However, new lower dose (10 and 14 mcg per day) and smaller sized LNG-IUS (MLS, FibroPlant-LNG) are currently under clinical development and investigation. Research into the non-contraceptive uses of LNG-IUS is rapidly expanding. In the UK, LNG-IUS is licensed for use in menorrhagia and to provide endometrial protection to perimenopausal and postmenopausal women on estrogen replacement therapy. There is limited evidence to suggest that LNG-IUS may also be beneficial in women with endometriosis, adenomyosis, fibroids, endometrial hyperplasia and early stage endometrial cancer (where the patient is deemed unfit for primary surgical therapy). This systematic enquiry and overview evaluates the quality of evidence relating to the non-contraceptive therapeutic uses of LNG-IUS in gynaecology.

  6. The new LNG-releasing IUS: a new opportunity to reduce the burden of unintended pregnancy.

    PubMed

    Cristobal, Ignacio; Neyro, José-Luis; Lete, Iñaki

    2015-07-01

    Unintended pregnancies still remain a worldwide public health problem. They have received much attention in adolescents given the strong impact they have on their present and future lives. Young women wishing to delay maternity are also especially vulnerable to unintended pregnancies. Studies have revealed a pattern of use of contraceptive methods that is likely to increase this risk. Methods of long-acting reversible contraception (LARC), among which copper and levonorgestrel-releasing intrauterine devices (IUD and IUS) are the most common, have been widely recommended to avoid unintended pregnancy at any age. Despite this, the use of these devices is very limited. Several barriers to their wide spread use have been identified, which specially affect a higher use by nulliparous women. A new levonorgestrel-releasing IUS containing only 13.5mg of levonorgestrel (IUS12) recently marketed as Jaydess® in Europe, has a smaller size, provides a shorter duration of action, and a lower hormonal content compared to Mirena®, along with a similar efficacy and safety profile, may offer a long-term option that better addresses the needs of nulliparous women. Evidence on the risk of unintended pregnancies in young women--with a special emphasis in Europe, barriers associated with a lower-than-desirable use of LARC methods--especially intrauterine devices (IUD and IUS), and the potential benefits of the new IUS12 including changes in bleeding pattern, safety and user satisfaction--especially with respect to nulliparous and adolescents--are reviewed here. Evidence supports that IUS12 may offer a LARC option that better addresses the needs of these women.

  7. Levonorgestrel-releasing intrauterine system (LNG-IUS 12) for prevention of pregnancy for up to five years.

    PubMed

    Nelson, Anita L

    2017-08-01

    A new five-year low dose, smaller-framed, levonorgestrel-releasing intrauterine contraceptive system (LNG-IUS 12) has been introduced to complement the currently available systems. Areas Covered: This article will provide an overview of this new intrauterine system - its composition and its mechanisms of action as well as the results of the Phase II and III clinical trials of its efficacy, safety and tolerability. Expert Commentary: This new LNG-IUS 12 provides five-year contraceptive protection a pregnancy rate (less than 1%) in first year of use, which puts it into the top tier with the existing LNG-IUS 20 products; however, the LNG-IUS 12 does not have the high rates of amenorrhea often seen with the higher dose devices. On the other hand, this new IUD shares the smaller frame and narrower insertion tube with the lower dose LNG-IUS 8, but offers longer effective life.

  8. Mechanisms to deploy the two-stage IUS from the shuttle cargo bay

    NASA Technical Reports Server (NTRS)

    Haynie, H. T.

    1980-01-01

    The Inertial Upper Stage (IUS) is a two-stage or three-stage booster used to transport spacecraft from the space shuttle orbit to synchronous orbit or on an interplanetary trajectory. The mechanisms which were designed specifically to perform the two-stage IUS required functions while contained within the cargo bay of the space shuttle during the boost phase and while in a low Earth orbit are discussed. The requirements, configuration, and operation of the mechanisms are described, with particular emphasis on the tilt actuator and the mechanism for decoupling the actuators during boost to eliminate redundant load paths.

  9. STS-29 crewmembers inspect TDRS-D inertial upper stage (IUS) at KSC VPF

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Astronaut Mae C. Jemison and STS-29 Mission Specialist (MS) James P. Bagian and MS Robert C. Springer inspect the interface between the tracking and data relay satellite D (TDRS-D) and inertial upper stage (IUS-9) in a test cell located in the Kennedy Space Center (KSC) Vertical Processing Facility (VPF). The clean-suited astronauts, engineers, and technicians discuss the payload. Springer and Bagian are responsible for deployment of IUS / TDRS-D from Discovery's, Orbiter Vehicle (OV) 103's, payload bay (PLB) on STS-29. View provided by KSC with alternate number KSC-89PC-16.

  10. Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5mg in contraception

    PubMed Central

    Trussell, James; Hassan, Fareen; Henry, Nathaniel; Pocoski, Jennifer; Law, Amy; Filonenko, Anna

    2014-01-01

    Background LNG-IUS 13.5mg (total content) is a low-dose levonorgestrel intrauterine system for up to three years of use. This analysis evaluated the cost-effectiveness of LNG-IUS 13.5mg in comparison with short-acting reversible contraceptive (SARC) methods in a cohort of young women in the US from a third-party payer’s perspective. Study Design A state-transition model consisting of three mutually exclusive health states – initial method, unintended pregnancy (UP) and subsequent method – was developed. Cost-effectiveness of LNG-IUS 13.5mg was assessed versus SARC methods in a cohort of 1,000 women aged 20–29 years. SARC methods comprise oral contraceptives (OC), ring, patch and injections which are the methods commonly used by this cohort. Failure and discontinuation probabilities were based on published literature, contraceptive uptake was determined by the most recent data from the National Survey of Family Growth and costs were taken from standard US databases. One-way sensitivity analysis was conducted around key inputs while scenario analysis assessed a comparison between LNG-IUS 13.5mg and the existing IUS, LNG-IUS 20mcg/24 hours. The key model output was cost per UP avoided. Results Compared to SARC methods, initiating contraception with LNG-IUS 13.5mg resulted in fewer UP (64 UP vs. 276 UP) and lower total costs ($1,283,479 USD vs. $1,862,633 USD, a 31% saving) over the three-year time horizon. Results were most sensitive to the probability of failure on OC, the probability of LNG-IUS 13.5mg discontinuation and the cost of live births. Scenario analysis suggests that further cost savings may be generated with the initiation of LNG-IUS 20mcg/24 hours in place of SARC methods. Conclusions From a third-party payer perspective, LNG-IUS 13.5mg is a more cost-effective contraceptive option than SARC. Therefore, women switching from current SARC use to LNG-IUS 13.5mg are likely to generate cost savings to third-party healthcare payers, driven principally

  11. Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5 mg in contraception.

    PubMed

    Trussell, James; Hassan, Fareen; Henry, Nathaniel; Pocoski, Jennifer; Law, Amy; Filonenko, Anna

    2014-05-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) 13.5 mg (total content) is a low-dose levonorgestrel intrauterine system for up to 3 years of use. This analysis evaluated the cost-effectiveness of LNG-IUS 13.5 mg in comparison with short-acting reversible contraceptive (SARC) methods in a cohort of young women in the United States from a third-party payer's perspective. A state transition model consisting of three mutually exclusive health states -- initial method, unintended pregnancy (UP) and subsequent method -- was developed. Cost-effectiveness of LNG-IUS 13.5 mg was assessed vs. SARC methods in a cohort of 1000 women aged 20-29 years. SARC methods comprise oral contraceptives (OC), ring, patch and injections, which are the methods commonly used by this cohort. Failure and discontinuation probabilities were based on published literature, contraceptive uptake was determined by the most recent data from the National Survey of Family Growth, and costs were taken from standard US databases. One-way sensitivity analysis was conducted around key inputs, while scenario analysis assessed a comparison between LNG-IUS 13.5 mg and the existing IUS, LNG-IUS 20 mcg/24 h. The key model output was cost per UP avoided. Compared to SARC methods, initiating contraception with LNG-IUS 13.5 mg resulted in fewer UP (64 UP vs. 276 UP) and lower total costs ($1,283,479 USD vs. $1,862,633 USD, a 31% saving) over the 3-year time horizon. Results were most sensitive to the probability of failure on OC, the probability of LNG-IUS 13.5 mg discontinuation and the cost of live births. Scenario analysis suggests that further cost savings may be generated with the initiation of LNG-IUS 20 mcg/24 h in place of SARC methods. From a third-party payer perspective, LNG-IUS 13.5 mg is a more cost-effective contraceptive option than SARC. Therefore, women switching from current SARC use to LNG-IUS 13.5 mg are likely to generate cost savings to third-party health care payers, driven

  12. STS-44 DSP satellite and IUS during preflight processing at Cape Canaveral

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Overall view shows the Defense Support Program (DSP) satellite atop an inertial upper stage (IUS) during transfer operations in a processing facility at Cape Canaveral Air Force Station. Clean-suited technicians monitor the operations to prepare the 5,200-pound DSP satellite for transfer to Kennedy Space Center (KSC) Launch Complex (LC) Pad 39A. DSP solar paddles are in stowed position around the base of the satellite with the Infrared (IR) sensor hidden by a protective cover at the top of the satellite. DSP, a surveillance satellite that can detect missle and space launches as well as nuclear detonations will be boosted into geosynchronous orbit by the IUS during the STS-44 mission. View provided by the Kennedy Space Center (KSC) with alternate number KSC-91PC-1747.

  13. Artist concept of Galileo with inertial upper stage (IUS) in low Earth orbit

    NASA Image and Video Library

    1989-08-25

    S89-42940 (April 1989) --- In this artist's rendition, the Galileo spacecraft is being boosted into its inter-planetary trajectory by the Inertial Upper Stage (IUS) rocket. The Space Shuttle Atlantis, which is scheduled to take Galileo and the IUS from Earth's surface into space, is depicted against the curve of Earth. Galileo will be placed on a trajectory to Venus, from which it will return to Earth at higher velocity and then gain still more energy in two gravity-assist passes, until it has enough velocity to reach Jupiter. Passing Venus, it will take scientific data using instruments designed for observing Jupiter; later, it will make measurements at Earth and the moon, crossing above the moon's north pole in the second pass. Between the two Earth passes, it will edge into the asteroid belt, beyond Mars' orbit; there, the first close-up observation of an asteroid is planned. Crossing the belt later, another asteroid flyby is possible.

  14. Hydraulic mechanism to limit torsional loads between the IUS and space transportation system orbiter

    NASA Technical Reports Server (NTRS)

    Farmer, James R.

    1986-01-01

    The Inertial Upper Stage (IUS) is a two-stage booster used by NASA and the Defense Department to insert payloads into geosynchronous orbit from low-Earth orbit. The hydraulic mechanism discussed here was designed to perform a specific dynamic and static interface function within the Space Transportation System's Orbiter. Requirements, configuration, and application of the hydraulic mechanism with emphasis on performance and methods of achieving zero external hydraulic leakage are discussed. The hydraulic load-leveler mechanism meets the established design requirements for operation in a low-Earth orbit. Considerable testing was conducted to demonstrate system performance and verification that external leakage had been reduced to zero. Following each flight use of an ASE, all hydraulic mechanism components are carefully inspected for leakage. The ASE, including the hydraulic mechanism, has performed without any anomalies during all IUS flights.

  15. Origin of collapsed pits and branched valleys surrounding the Ius chasma on Mars

    NASA Astrophysics Data System (ADS)

    Vamshi, G. T.; Martha, T. R.; Vinod Kumar, K.

    2014-11-01

    Chasma is a deep, elongated and steep sided depression on planetary surfaces. Several hypothesis have been proposed regarding the origin of chasma. In this study, we analysed morphological features in north and south of Ius chasma. Collapsed pits and branched valleys alongwith craters are prominent morphological features surrounding Ius Chasma, which forms the western part of the well known Valles Marineris chasma system on Martian surface. Analysis of images from the High Resolution Stereo Camera (HRSC) in ESA's Mars Express (MEX) with a spatial resolution of 10 m shows linear arrangement of pits north of the Ius chasma. These pits were initially developed along existing narrow linear valleys parallel to Valles Merineris and are conical in shape unlike flat floored impact craters found adjacent to them. The width of conical pits ranges 1-10 km and depth ranges 1-2 km. With more subsidence, size of individual pits increased gradually and finally coalesced together to create a large depression forming a prominent linear valley. Arrangement of pits in this particular fashion can be attributed to collapse of the surface due to l arge hollows created in the subsurface because of the withdrawal of either magma or dry ice. Branched valleys which are prominent morphologic features south of the Ius chasma could have been formed due to groundwater sapping mechanism as proposed by previous researchers. Episodic release of groundwater in large quantity to the surface could have resulted in surface runoff creating V-shaped valleys, which were later modified into U-shaped valleys due to mass wasting and lack of continued surface runoff.

  16. STS-29 crewmembers inspect TDRS-D inertial upper stage (IUS) at KSC VPF

    NASA Image and Video Library

    1989-01-05

    S89-28108 --- Astronaut Mae C. Jemison and STS-29 Mission Specialist James P. Bagian and Robert C. Springer inspect the interface between the tracking and data relay satellite D (TDRS-D) and inertial upper stage (IUS-9) in a test cell located in the Kennedy Space Center (KSC) Vertical Processing Facility (VPF). The clean-suited astronauts, engineers, and technicians discuss the payload. Photo credit: NASA

  17. STS-29 crewmembers inspect TDRS-D inertial upper stage (IUS) at KSC VPF

    NASA Image and Video Library

    1989-02-14

    S89-27384 (5 Jan 1989) --- Astronauts James P. Bagian, left, and Robert C. Springer inspect a portion of the first stage of the Inertial Upper Stage (IUS-9) in a test cell of the KSC vertical processing facility. The two, along with three other NASA astronauts, will fly aboard Discovery and are responsible for the deployment of the tracking and data relay satellite (TDRS).

  18. Improving Undergraduate STEM Education: Pathways into Geoscience (IUSE: GEOPATHS) - A National Science Foundation Initiative

    NASA Astrophysics Data System (ADS)

    Jones, B.; Patino, L. C.

    2016-12-01

    Preparation of the future professional geoscience workforce includes increasing numbers as well as providing adequate education, exposure and training for undergraduates once they enter geoscience pathways. It is important to consider potential career trajectories for geoscience students, as these inform the types of education and skill-learning required. Recent reports have highlighted that critical thinking and problem-solving skills, spatial and temporal abilities, strong quantitative skills, and the ability to work in teams are among the priorities for many geoscience work environments. The increasing focus of geoscience work on societal issues (e.g., climate change impacts) opens the door to engaging a diverse population of students. In light of this, one challenge is to find effective strategies for "opening the world of possibilities" in the geosciences for these students and supporting them at the critical junctures where they might choose an alternative pathway to geosciences or otherwise leave altogether. To address these and related matters, The National Science Foundation's (NSF) Directorate for Geosciences (GEO) has supported two rounds of the IUSE: GEOPATHS Program, to create and support innovative and inclusive projects to build the future geoscience workforce. This program is one component in NSF's Improving Undergraduate STEM Education (IUSE) initiative, which is a comprehensive, Foundation-wide effort to accelerate the quality and effectiveness of the education of undergraduates in all of the STEM fields. The two tracks of IUSE: GEOPATHS (EXTRA and IMPACT) seek to broaden and strengthen connections and activities that will engage and retain undergraduate students in geoscience education and career pathways, and help prepare them for a variety of careers. The long-term goal of this program is to dramatically increase the number and diversity of students earning undergraduate degrees or enrolling in graduate programs in geoscience fields, as well as

  19. Shuttle program. STS-7 conceptual flight profile. IUS/TDRS-A

    NASA Technical Reports Server (NTRS)

    1979-01-01

    The Space Transportation System (STS) Flight Assignment Manifest has has scheduled a Tracking and Data Relay Satellite System (TDRSS) spacecraft for a February 1981 launch on STS Flight 7. The preliminary flight profile that conceptually implements the flight requirements and constraints levied by the STS, inertial upper stage (IUS), and the TDRS spacecraft is presented. The integrated major flight design guidelines and requirements used in the development of the flight profile are included together with a flight sequence of events and time line that describe the profile and reflect implementation of the integrated set of requirements.

  20. Potential problems relative to TDRS/IUS tilt table elevation with failed VRCS

    NASA Technical Reports Server (NTRS)

    Bell, J.

    1980-01-01

    Operational concerns and preliminary solution alternatives related to elevating the inertial upper stage/tracking and data relay satellite (IUS/TDRS) with a failed orbiter vernier reaction control system (VRCS) are presented. Problems arise from the combination of TDRS thermal constraints and tilt table constraints (the primary reaction control system (PRCS) cannot be used to hold attitude while the tilt table is being elevated), and the problems are compounded by the minimum PRCS attitude deadband. The potential solution options are affected by the launch window, flight profile, crew procedures, vehicle capability and constraints, and flight rules.

  1. STS-29 IUS with TDRS-D after deployment from Discovery, OV-103

    NASA Image and Video Library

    1989-03-13

    STS029-78-019 (13 March 1989) --- Headed on its way to a much higher orbit is another Tracking and Data Relay Satellite (TDRS-D), as photographed with a 70mm camera from inside Discovery's cabin. Moments earlier, the STS-29 crewmembers released the cylindrical form into space from Discovery's cargo bay. When at its final destination high above Earth, TDRS-D will no longer maintain its cylindrical form, having transformed into an operational satellite with antenna spanned out in various directions and its Interim Upper Stage (IUS), covered with gold foil and forward-most in this frame, discarded.

  2. During STS-54 IUS/TDRS is released from cradle/tilt table above OV-105's PLB

    NASA Technical Reports Server (NTRS)

    1993-01-01

    During STS-54, with Endeavour's, Orbiter Vehicle (OV) 105's, reaction control system (RCS) thrusters inhibited, the pyrotechnic separation device physically separates the inertial upper stage (IUS) / Tracking and Data Relay Satellite F (TDRS-F) spacecraft from the payload bay (PLB) at approximately 0.4 foot per second. The airborne support equipment (ASE) aft frame tilt actuator (AFTA) table at 58-degree deployment position, the forward frame cradle, and the released umbilical boom appear below the IUS/TDRS spacecraft combination. Stowed on top of the IUS are TDRS-F's solar array panels, its single access antennas, and the SGL antenna. In the foreground is Diffuse X-ray Spectrometer (DXS) payload. On the left is the DXS starboard and the Hitchhiker avionics. On the right is the port DXS. The entire scene is backdropped against the Earth's limb and its blue and white surface.

  3. Usage of the levonorgestrel-releasing intrauterine system (LNG-IUS) in adolescence: what is the evidence so far?

    PubMed

    Patseadou, Magdalini; Michala, Lina

    2017-03-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is an effective method of contraception, while also providing various non-contraceptive benefits. Although targeted primarily to adults, there is increasing experience in its use in adolescence. The aim of this review is to assess the available information on LNG-IUS usage in adolescence. We conducted an online search on MEDLINE and SCOPUS from inception to May 24, 2015. All studies that examined LNG-IUS use in teen populations were eligible for inclusion. Primary outcome measures included description of indications for LNG-IUS usage and relevant efficacy. Secondary outcomes included complications, such as device-related problems (perforation and expulsion) and other adverse events (pelvic inflammatory disease, PID). Acceptability of the LNG-IUS was also estimated through evaluation of continuation rate and reasons for removal were assessed. Twenty-one studies met our inclusion criteria. We identified only one randomized controlled trial (RCT). All other twenty studies were observational. Pregnancy rates ranged from 0 to 2.7%. Management of heavy or/and painful periods was successful in 92-100%. Menstrual manipulation in patients with developmental delay was achieved in over 93% of cases. Expulsion rates ranged from 0 to 13% and pelvic infection/cervicitis between 0 and 2.7%. There were no reported uterine perforations. Usage of the LNG-IUS in teen populations appears to be safe and efficacious both in terms of contraception and menstrual management. However, more robust evidence is needed so as to provide firm confirmation on benefits and potential side effects.

  4. A case of endometrial carcinoma in a long-term Levonorgestrel Intrauterine System (LNG 52 mg-IUS) user.

    PubMed

    Thomas, Melisa; Briggs, Paula

    2017-03-01

    This report describes a 50-year-old woman who presented to a community gynaecology clinic complaining of persistent heavy vaginal bleeding with an LNG 52 mg-IUS in situ. She was subsequently found to have stage 1 grade 1a endometrioid carcinoma. From the literature, we have identified five similar cases. This case highlights the possibility of endometrial carcinoma despite treatment with an LNG 52 mg-IUS and reinforces the importance of investigating women who present with unusual persistent or heavy vaginal bleeding.

  5. [Changes of menstruation patterns and adverse effects during the treatment of LNG-IUS for symptomatic adenomyosis].

    PubMed

    Li, L; Leng, J H; Zhang, J J; Jia, S Z; Li, X Y; Shi, J H; Dai, Y; Zhang, J R; Li, T; Xu, X X; Liu, Z Z; You, S S; Chang, X Y; Lang, J H

    2016-09-25

    Objective: To investigate the changes of mestruation patterns and adverse effects during the treatment of levonorgestrel-releasing intrauterine system(LNG-IUS)for symptomatic adenomyosis in a prospective cohort study. Methods: From December, 2006 to December, 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in Peking Union Medical College Hospital were given LNG-IUS. Before and after placement of IUS, all patients' parameters were recorded, including carrying status of IUS, symptoms and scores of dysmenorrhea, menstruation scores, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Risk factors for changes of menstruation patterns and adverse effects, and their impact on treatment effects were analyzed. Results: Totally 1 100 cases met inclusion criteria, with median age 36 years(range 20-44 years), median follow-up 35 months(range 1 -108 months). During follow-up changes of menstruation patterns increased significantly with amenorrhea and shortened-menstruation being the most common manifestations. On 3, 6, 12, 24, 36, 48 and 60 months after the placement of LNG-IUS, 0, 5.8%(43/744), 6.9%(47/682), 10.1%(60/595), 17.3%(87/502), 27.2%(104/383)and 29.6%(82/277)patients achieved amenorrhea respectively(P<0.01). Total and subclassification of adverse effects decreased significantly(P<0.01). Within 12 months and >12 months after placement, abdominal pain and body weight increasing ≥5 kg/year were the most common adverse effects. Changes of menstruation patterns, total and subclassifications of adverse effects were neither dependent on patient parameters, treatment modes and treatment effects, nor could predict future LNG-IUS carrying status(all P> 0.05). After taking out of LNG-IUS, most changes of menstruation and adverse effects disappeared. Conclusions: During the treatment of LNG-IUS for symptomatic adenomyosis, changes of menstruation patterns increase gradually with amenorrhea and shortened

  6. Sulfates and Other Hydrated Minerals in Ius Chasma, Valles Marineris and Implications for Water Geochemistry

    NASA Astrophysics Data System (ADS)

    Roach, L. H.; Mustard, J. F.; Murchie, S. L.; Milliken, R. E.; Crowley, J. K.; Bishop, J. L.; Arvidson, R. E.

    2008-12-01

    Ius Chasma is a linear trough in western Valles Marineris containing horst and graben structures, multiple landslides, and light-toned floor deposits. Elsewhere is Valles Marineris, sulfate deposits identified by OMEGA and CRISM are restricted to Interior Layered Deposits or nearby autochthonous loose material (Gendrin et al., 2005; Murchie et al., 2007; Murchie et al., in revision). In Ius Chasma, however, sulfates are found in thin floor units in enclosed depressions at the lowest elevations. Kieserite is at the lowest elevation, with polyhydrated sulfate and an unidentified hydrated phase, at higher elevations. Some poorly defined layering is visible on the HiRISE scale, but is not diagnostic. The total exposed thickness of kieserite is 300 m, with a total range in elevation of -4175 to -4475 m. The kieserite deposit is covered in places by pyroxene-bearing dunes. The polyhydrated sulfate outcrops range from -3515 to -4000 m. The unidentified hydrated phase outcrops between -3770 to -4100 m. The polyhydrated sulfate and unidentified hydrated material occur at the same elevations and do not have a clear stratigraphic relationship. Elsewhere in Ius Chasma, the unidentified hydrated material clearly drapes chasma floor units. The unidentified hydrated material is characterized by absorptions near 1.4 and 1.9 μm, and a narrow doublet at 2.21 and 2.27 μm. The deep ~1.9 μm is due to the combination tone of the OH stretch and H2O bend and the ~1.4 μm absorption is due to the 1st overtone of the OH stretch. Sulfates or other minerals with 2 or more water molecules per unit cell in their structure are necessary to account for deep water and hydroxyl absorptions in many spectra we observe. The doublet doesn't match any known sulfate, phyllosilicate, chloride, hydrated silica library spectra. Possibly a mixture of hydrated phases could explain this phase. The 2.21-2.26 μm region is generally convex in sulfates, but gypsum (CaSO4 2H2O ) and jarosite group members (MFe3

  7. Results of a 5-year contraceptive trial in parous and nulliparous women with a new LNG-IUS.

    PubMed

    Wildemeersch, Dirk; Goldstuck, Norman D; Jackers, Geert

    2017-03-01

    To report on the contraceptive performance and continuation of a new T-shaped LNG-IUS, releasing 20 μg of levonorgestrel/day, in both parous and nulliparous nulliparous women after 5 years of use. An observational prospective contraceptive study conducted in parous and nulliparous women up to 48 years of age. The study was conducted in a sample size of 356 women of whom 67.1% were parous and 32.9% were nulliparous with mean age of 35.1 (range 15-48). The total cumulative observation period was 27 269 woman-months. Only one accidental pregnancy was observed and two expulsions were reported with no partial expulsions. There were 12.7% medical removals for abnormal bleeding, pain and other medical reasons, mostly not related to the use of the LNG-IUS, and 13.3% removals in women wishing to become pregnant. The discontinuation rate at 5 years amounts to 25.7% including women with pregnancy wish, who used the LNG-IUS for an average of 44 months. There were no serious adverse events (e.g. perforation, pelvic inflammatory disease). The LNG-IUS used in this study is highly effective and well tolerated resulting in a high continuation of use. The only two expulsions that occurred during the study is remarkable. The ease and safety of insertion together with optimal retention is considered an advance in intrauterine contraceptive device technology.

  8. LNG-IUS 12: a 19.5 levonorgestrel-releasing intrauterine system for prevention of pregnancy for up to five years.

    PubMed

    Nelson, Anita L

    2017-09-01

    Globally, intrauterine devices (IUDs) are the second most commonly used form of reversible contraception because of their high efficacy, safety, convenience and cost effectiveness. The levonorgestrel releasing intrauterine system with daily average release of 20 mcg (LNG-IUS 20) is the popular choice because of its favorable bleeding patterns and many noncontraceptive benefits. A three year (LNG-IUS 8) became available three years ago. More recently, the LNG-IUS 12 was added. This new IUD shares a smaller frame, narrow inserter and lower rate of amenorrhea with the LNG-IUS 8, but it offers the five years of contraceptive protection of the LNG-IUS 20. Areas covered: This article provides information on the contraceptive efficacy, safety and tolerability of this new IUS based on approximately 60,000 cycles of use. Where available, the impacts of subject age, parity and body mass index (BMI) on study outcomes are reported. Expert opinion: This new LNG-IUS 12 with mid-dose hormone levels, smaller frame and longer effective life fills a niche that may better meet the needs of women who might appreciate the narrow insertion tube and/or the lower rates of amenorrhea. Cost will ultimately help determine success.

  9. Resources and procedures in the treatment of heavy menstrual bleeding with the levonorgestrel-releasing intrauterine system (LNG-IUS) or hysterectomy in Brazil.

    PubMed

    Bahamondes, M Valeria; de Lima, Yuri; Teich, Vanessa; Bahamondes, Luis; Monteiro, Ilza

    2012-09-01

    Heavy menstrual bleeding (HMB) is the most common complaint of women seeking gynecological care. Treatments included surgical or medical options including hysterectomy and the levonorgestrel-releasing intrauterine system (LNG-IUS) due to the profound suppression of endometrial growth that intrauterine LNG exerts which results in amenorrhea or in a reduction of blood loss. The study was conducted to evaluate the resources and procedures involved in inserting an LNG-IUS compared to performing hysterectomy in women with HMB in a public sector hospital in Brazil. Two cohorts of women were studied: women who accepted an LNG-IUS (n=124) and matched women who underwent hysterectomy on the same day (n=122). We evaluate the number of procedures carried out in each group of women, including those performed before the decision was made to insert an LNG-IUS or to perform hysterectomy, the insertion of the device itself and the surgical procedure, in addition to the procedures and complications registered up to 1 year after LNG-IUS insertion or hysterectomy. Age and the duration of HMB were significantly lower in the LNG-IUS acceptors than women at the hysterectomy group. The numbers of gynecological consultations and Pap smears were similar in both groups; however, women in the hysterectomy group also underwent laboratory tests, ultrasonography, chest X-ray and electrocardiogram. In the hysterectomy group, the main complications were hemorrhage (six), bladder/bowel perforation (four), complications with anesthesia (one), ureteral reimplantation required (one) and abdominal pain (two). At 1 year, HMB was controlled in 83.1% of women in the LNG-IUS group, and 106 women continued with the device. Both treatments were effective in HMB control. Fewer resources and complications were observed in LNG-IUS acceptors when compared to hysterectomy. The LNG-IUS represents a good strategy for reducing the number of hysterectomies and the resources required for women with HMB. Copyright

  10. Submucosal uterine fibroid prolapsed into vagina in a symptomatic patient with IUS

    PubMed Central

    Matytsina-Quinlan, Lyubov; Matytsina, Laura

    2014-01-01

    A female patient in her mid 40s presents with heavy menstrual bleeding (HMB) and a history of spotting/irregular light per vagina (PV) bleeding since intrauterine system (IUS) insertion 1 year ago. She is known to have submucosal uterine fibroid (SMUF). The patient reported abdominal pain and sudden onset of ‘miscarriage-like’ HMB with clots 2 days ago. On speculum examination there was a smooth round-shaped mass lying over the external cervical os. On bimanual examination PV, a round-shaped smooth mass of a walnut's size was palpable in the upper third of the vagina. Subsequent ultrasound imaging revealed an SMUF prolapsed into the vagina. Further surgical treatment was undertaken. Histology showed a fibroid (leiomyoma) with no evidence of malignancy. PMID:24739657

  11. One year quality of life measured with SEC-QoL in levonorgestrel 52 mg IUS users.

    PubMed

    Cristobal, Ignacio; Lete, Luis Ignacio; Viuda, Esther de la; Perulero, Nuria; Arbat, Agnes; Canals, Ignasi

    2016-04-01

    The present study aims to prospectively evaluate quality of life (QoL) of women using 52-mg levonorgestrel intrauterine system (LNG-IUS) for contraception determined through the Sociedad Española de Contracepción (Spanish contraception Society) (SEC)-QoL, a questionnaire specifically designed to assess the impact of contraceptive methods on QoL of fertile women. We conducted a prospective observational multicenter study of 201 reproductive age women who initiated the LNG-IUS for contraception. Sociodemographic and clinical data were collected at baseline and 12 months afterwards. Participants filled in the SEC-QoL questionnaire at both visits. SEQ-QoL scores range from 0 (worst QoL) to 100 (best QoL). Participants claimed an increased QoL 12 months after insertion in all five dimensions of SEC-QoL due to its high contraceptive efficacy and its capability to reduce other menstrual symptoms (e.g., heavy menstrual bleeding or dysmenorrhoea), overall exerting a positive impact on user's satisfaction. SEC-QoL general overall score went from a mean (S.D.) score of 46.3 (17.3) at baseline to 72.2 (14.8) 12 months afterwards (p<.001). Overall, 94.6% of women claimed having found additional benefits other than contraception. No pregnancies were reported during the 12 months of study duration, and only 14 women discontinued use of LNG-IUS (only two of them due to an adverse event), representing a continuation rate of 93%. Women using LNG-IUS for contraception have an increased QoL after 12 months of use, demonstrated by the increased score in all dimensions of the SEC-QoL questionnaire. The present study prospectively evaluated QoL of women using LNG-IUS for contraception through the SEC-QoL questionnaire. Participants claimed increased QoL 12 months afterwards, implying that women using LNG-IUS for contraception in usual clinical practise also benefit from the reduction of period-related symptoms, overall leading to very low discontinuation rates. Copyright © 2016

  12. Investigation of storage system designs and techniques for optimizing energy conservation in integrated utility systems. Volume 2: (Application of energy storage to IUS)

    NASA Technical Reports Server (NTRS)

    1976-01-01

    The applicability of energy storage devices to any energy system depends on the performance and cost characteristics of the larger basic system. A comparative assessment of energy storage alternatives for application to IUS which addresses the systems aspects of the overall installation is described. Factors considered include: (1) descriptions of the two no-storage IUS baselines utilized as yardsticks for comparison throughout the study; (2) discussions of the assessment criteria and the selection framework employed; (3) a summary of the rationale utilized in selecting water storage as the primary energy storage candidate for near term application to IUS; (4) discussion of the integration aspects of water storage systems; and (5) an assessment of IUS with water storage in alternative climates.

  13. Preliminary analysis of selected gas dynamic problems. [space shuttle main engine main combustion transients and IUS nozzle flow

    NASA Technical Reports Server (NTRS)

    Prozan, R. J.; Farmer, R. C.

    1985-01-01

    The VAST computer code was used to analyze SSME main combustion chamber start-up transients and the IUS flow field for a damaged nozzle was investigated to better understand the gas dynamic considerations involved in vehicle problems, the effect of start transients on the nozzle flow field for the SSME, and the possibility that a damaged nozzle could account for the acceleration anomaly noted on IUS burn. The results obtained were compared with a method of characteristics prediction. Pressure solutions from both codes were in very good agreement and the Mach number solution on the nozzle centerline deviates substantially for the high expansions for the SSME. Since this deviation was unexpected, the phenomenon is being further examined.

  14. Prognostic significance of estrogen and progesterone receptor expression in LNG-IUS (Mirena) treatment of endometrial hyperplasia: an immunohistochemical study.

    PubMed

    Akesson, Emelie; Gallos, Ioannis D; Ganesan, Raji; Varma, Rajesh; Gupta, Janesh K

    2010-03-01

    We performed immunohistochemical analysis of estrogen (ERalpha) and progesterone receptors (PRA and PRB), phosphatase and tensin homolog (PTEN) and aromatase in endometrial hyperplasia treated with Mirena (levonorgestrel-releasing intrauterine system; LNG-IUS) and explored their prognostic significance. The baseline pre-treatment endometrial hyperplasia of a selected prospective cohort was analyzed [complex (n = 29) and atypical (n = 5)]. Study participants were categorized into those that showed endometrial regression (responders, n = 28) and those that showed non-regression or histological progression to atypia or malignancy (non-responders, n = 6). Immunohistochemical expression was expressed as a histological score (HS). Responders compared to non-responders showed significantly higher HSs for estrogen and progesterone receptors. Absence of estrogen and progesterone receptors predicted non-responder status with likelihood ratios of 9.33 (95% CI 2.19-39.81) and 2.92 (95% CI 1.47-5.79), respectively. Neither PTEN nor aromatase expression were associated with LNG-IUS therapy responsiveness. Responsiveness of endometrial hyperplasia to LNG-IUS therapy may be determined through analysis of baseline estrogen and progesterone receptors, but these exploratory findings require confirmation in a larger dataset.

  15. Migration of levonorgestrel IUS in a patient with complex medical problems: what should be done?

    PubMed

    Soleymani Majd, Hooman; El Hamamy, Essam; Chandrasekar, Ramya; Ismail, Lamiese

    2009-03-01

    Patients with complex medical problems should be counselled about the need for highly effective contraception. As failure resulting in pregnancy, could cause significant morbidity and mortality. The LNG-IUS has gained great popularity and generally has a low side effect profile; however, perforation of the uterus and migration of the device is a potentially serious complication known to be associated with its use. The current accepted management is removal of the device from the abdominal cavity in order to prevent further morbidity. However this is not always a simple matter in patients who have complex medical problems and who are deemed unfit for surgery. Each time the patient comes for renewal of the contraceptive method, clinicians need to reassess the risks and benefits. This is particularly relevant in patients who have complex medical problems where special attention needs to be given, not only to immediate risks but also to long-term ones. Careful individualised counselling and consideration are paramount and perhaps it would have been prudent to discuss vasectomy with this patient and her husband (as the first line of contraception), as this may have avoided the ensuing complications arising from the chosen method.

  16. XPS analysis of Al/EPDM bondlines from IUS SRM-1 polar bosses

    NASA Astrophysics Data System (ADS)

    Hemminger, Carol S.; Marquez, Nicholas

    1993-03-01

    A temperature-stress rupture method using partial immersion in liquid nitrogen was developed for the aluminum/EPDM rubber insulation bondline of the IUS SRM-1 polar bosses in order to investigate a corrosion problem. Subsequent XPS analysis of the ruptured bondline followed changes in the locus of failure as corrosion progressed. Samples from the forward polar bosses had a predominantly noncorroded appearance on the ruptured surfaces. The locus of failure was predominantly through the primer layer, which is distinguished by a high concentration of chlorinated hydrocarbon. The aft polar boss segments analyzed were characterized by the presence of corrosion over the entire mid-section of the ruptured aluminum to insulation bondline. The predominant corrosion product detected was aluminum oxide/hydroxide. The corroded bondline sections had significantly higher concentrations of aluminum oxide/hydroxide than the noncorroded areas, and lower concentrations of primer material. The temperature-stress rupture appeared to progress most readily through areas of thickened aluminum oxide/hydroxide infiltrated into the primer layer. In general there was a very good correlation between the calculated Cl:Al atomic % ratio, and the visual characterization of the extent of corrosion. The Cl:Al ratio, which represents the primer to corrosion product ratio at the locus of failure, varied from 0.4 to 47. With only a few exceptions, surfaces with a predominantly noncorroded appearance had Cl:Al ratios greater than 2, and surfaces with a heavily corroded appearance had Cl:Al ratios less than 1.

  17. The NSF IUSE-EHR Program: What's New (and Old) About It, and Resources for Geoscience Proposers

    NASA Astrophysics Data System (ADS)

    Singer, J.; Ryan, J. G.

    2015-12-01

    The NSF Division of Undergraduate Education recently released a new solicitation for the IUSE program -- the latest iteration in a succession of funding programs dating back over 30 years (including the Instrumentation and Laboratory Improvement Program (ILI), the Course and Curriculum Development Program (CCD), the Course Curriculum and Laboratory Improvement Program (CCLI), and the Transforming Undergraduate STEM Education Program (TUES). All of these programs sought/seek to support high quality STEM education for majors and non-majors in lower- and upper-division undergraduate courses. The current IUSE-EHR program is described in a 2-year solicitation that includes two tracks: Engaged Student Learning, and Institutional & Community Transformation. Each track has several options for funding level and project duration. A wide range of activities can be proposed for funding, and the program recognizes the varying needs across STEM disciplines. Geoscientists and other potential IUSE proposers are strongly encouraged to form collaborations with colleagues that conduct educational research and to propose projects that build upon the educational knowledge base in the discipline as well as contribute to it. Achieving this may not be immediately obvious to many geoscientists who have interests in improving student learning in their courses, but are not fluent in the scholarship of education in their field. To lower the barriers that have historically prevented larger numbers of geoscientists from developing their ideas into competitive education-related proposals, we have explored strategies for building and leveraging partnerships, sought to identify available resources for proposers, and explored a range of strategies for engaging and supporting larger numbers of potential geoscience proposers.

  18. Shuttle program standard maneuver sequences for orbiter/upper-stage separation SSUS-A, SSUS-D, and IUS

    NASA Technical Reports Server (NTRS)

    Wilson, S. W.

    1980-01-01

    Descriptions of standard post-ejection maneuver sequences for the deployment of IUS, SSUS-A, and SSUS-D upper stages from the space shuttle orbiter are presented. The sequences were designed to satisfy requirements for limiting the damage inflicted on the orbiter by upper-stage exhaust particles, subject to a further requirement for minimizing the impingement of orbiter thruster plumes on the deployed payload. In all cases it was assumed that the orbital maneuvering system engines would be used to apply the orbiter's major separation velocity increment.

  19. Efficacy of the levonorgestrel intrauterine system (LNG-IUS) in the prevention of the atypical endometrial hyperplasia and endometrial cancer: retrospective data from selected obese menopausal symptomatic women.

    PubMed

    Morelli, Michele; Di Cello, Annalisa; Venturella, Roberta; Mocciaro, Rita; D'Alessandro, Pietro; Zullo, Fulvio

    2013-02-01

    The aim of this retrospective study was to evaluate the efficacy of levonorgestrel intrauterine system-releasing (LNG-IUS) insertion in preventing atypical endometrial hyperplasia (AH) and endometrial cancer (EC) in symptomatic postmenopausal overweight/obese women. A total of 34 overweight/obese postmenopausal women, presenting abnormal uterine bleeding (AUB) and endometrial hyperplasia (EH), and who were submitted to LNG-IUS insertion, were identified from registry data. Endometrial histology at LNG-IUS insertion showed simple EH in 20 cases (58.8%), complex EH in 14 cases (41.2%). At 36 months, 91% of patients showed no recurrence of AUB and a significant reduction in the mean endometrial thickness (from 8.2 ± 2.2 to 3.2 ± 1.5 mm, p < 0.05) was observed. Histologic regression of EH was observed in 27 (79.4%) and 33 (97.5%) cases at 12 and 36 months, respectively. None of the women in which EH persisted, reported cellular atypia or cancer progression at 12 and 36 months of follow-up. LNG-IUS represents an effective treatment option to manage postmenopausal obese women affected by AUB and EH. The device seems to be able to prevent the onset of AH and EC in women at high risk. Further prospective controlled studies in a well selected group of women are needed.

  20. STS-43 TDRS-E / IUS in OV-104's PLB ASE aft frame tilt actuator (AFTA) table

    NASA Technical Reports Server (NTRS)

    1991-01-01

    During STS-43 the Tracking and Data Relay Satellite E (TDRS-E) atop the inertial upper stage (IUS) and positioned in the airborne support equipment (ASE) aft frame tilt actuator (AFTA) table with the forward frame ASE latch actuator released and umbilical cables separated is raised by the aft frame ASE electromechanical tilt actuator to a 58-degree deployment position. The scene is highlighted against the Earth's limb. In the foreground on the port side and mounted on a getaway special (GAS) adapter beam are (forward to aft) the two Shuttle Solar Backscatter Ultraviolet (SSBUV) GAS canisters (one with motorized door assembly (MDA)) and the Tank Pressure Control Experiment (TPCE) GAS canister. Along the starboard sill longeron is the Space Station Heat Pipe Advanced Radiator Element II (SHARE-II).

  1. Use of a frameless LNG-IUS as conservative treatment for a pre-malignant uterine polyp in a premenopausal woman - a case report.

    PubMed

    Janssens, D; Verbeeck, G; Wildemeersch, D

    2015-12-28

    Prevention of progression to invasive carcinoma in patients with a premalignant endometrial lesion using longterm treatment with levonorgestrel (LNG) releasing intrauterine systems (IUS) remains controversial, especially when manifest cellular atypia has been found in the endometrial biopsy specimen. We present a case of a 44-year old premenopausal woman with a premalignant uterine polyp who declined hysterectomy and was followed-up for more than 12 years after the first LNG-IUS was inserted. Endometrial atrophy installed, no pathology was detected and hysterectomy was thereby successfully avoided. The positive experience in this case should encourage further studies as literature data indicate that conservative treatment of premalignant endometrial pathology is a real option with a high success rate for women who have a contra-indication for surgery, refuse the classical approach for personal reasons or want to preserve their fertility.

  2. Workers in the VPF observe the lower end of the IUS to be mated to the Chandra X-ray Observatory

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Workers in the Vertical Processing Facility observe the lower end of the Inertial Upper Stage (IUS) that will be mated with the Chandra X-ray Observatory (out of sight above it). After the two components are mated, they will undergo testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93.

  3. Workers in the VPF observe the lower end of the IUS to be mated to the Chandra X-ray Observatory

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Workers in the Vertical Processing Facility observe the lower end of the Inertial Upper Stage (IUS) that will be mated with the Chandra X-ray Observatory (out of sight above it). After the two components are mated, they will undergo testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93.

  4. Risk of bacterial vaginosis, Trichomonas vaginalis and Candida albicans infection among new users of combined hormonal contraception vs LNG-IUS.

    PubMed

    Rezk, Mohamed; Sayyed, Tarek; Masood, Alaa; Dawood, Ragab

    2017-08-29

    The study assessed the risk of bacterial vaginosis, Trichomonas vaginalis and Candida albicans infection among new users of either a combined oral contraceptive pill (COC) or the levonorgestrel-releasing intrauterine system (LNG-IUS). This prospective observational study included 430 women, without active vaginitis at inclusion, who were divided into two groups according to their chosen method of contraception: COC group (n = 236) and LNG-IUS group (n = 194). Participants were examined for bacterial vaginosis, T. vaginalis and C. albicans infection initially and then at 6 weeks, 6 months and 12 months after the start of contraceptive use. Data were collected and statistically analysed. The rates of acquisition of bacterial vaginosis, T. vaginalis and C. albicans infection during follow-up were significantly increased and comparable between the groups (p < .001) and decreased in frequency over time (p < .05). The rates of acquisition of bacterial vaginosis among COC users (Nugent score) were 24.6, 18.6 and 15.2% and among LNG-IUS users 20.6, 13.5 and 9.3% at 6 weeks, 6 months and 12 months, respectively (p < .001). Body mass index >25 kg/m(2), history of bacterial vaginosis, history of sexually transmitted infection, vaginal douching more than five times per week and coital frequency more than five times per week were strong risk factors for acquisition of bacterial vaginosis during the follow-up period (p < .001). The use of COCs and LNG-IUS is associated with an increased, comparable risk of acquisition of bacterial vaginosis, T. vaginalis and C. albicans infections, which is greatest during initial use of the method but which improves over time.

  5. Recent volcanism in Ius and Tithonium Chasmata, Valles Marineris, Mars? First views from the High Resolution Stereo Camera (HRSC)

    NASA Astrophysics Data System (ADS)

    Hauber, E.; Masson, P.; Kronberg, P.; Gwinner, K.; Jaumann, R.; Neukum, G.; HRSC Co-Investigator Team

    The Valles Marineris in the western equatorial region of Mars are a system of ~4000 km long, up to several hundred km wide and up to 10,000 m deep linear E-W trending troughs. Two main processes have been proposed to explain their origin: Tectonism/rifting and erosion/collapse. Firm evidence of volcanic structures within the troughs would support a rifting contribution to their formation, since volcanism occurs frequently along terrestrial continental rifts. While several studies reported possible volcanic structures in the Valles Marineris (e.g., Lucchitta, 1987, 1990), no unambiguous identification has been possible yet. The first image of Valles Marineris taken through the HRSC camera on mars Express crosses Ius and Tithonium Chasmata at a longitude of about 280°E (resolution about 12 m/pixel). On the floor of Ius Chasma, several dark and circular structures with positive topographic relief can be distinguished. Some of them overlap each other. There are circular depressions on the summits of some of these cones. We tentatively interpret these features, which have not been reported before, as cinder cones. Such edifices are made up by more or less unconsolidated volcanic ash and glass particles. They can be eroded very easily, so their presence suggests a relatively recent origin. The cones are associated with a very bright material. This material is often aligned along possible faults which are strike parallel to the trend of the canyons. At least in one place it seems to be erosion-resistant. This material might be the product of (silicic) volcanism. Alternatives include, e.g., evaporitic products, since several sapping valleys debouch into the main trough very nearby. We also investigate a large mound in Tithonium Chasma. It is very bright and has a surface which is affected by eolian erosion. This mound has been suggested to be of volcanic origin before (Lucchitta, 1990). We could determine its area (270 km2), volume (200 km3), and slope angles in HRSC

  6. Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS

    PubMed Central

    Bednarek, Paula H; Jensen, Jeffrey T

    2010-01-01

    Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 μg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% – similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device’s strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia. PMID:21072274

  7. Safety, efficacy and patient acceptability of the contraceptive and non-contraceptive uses of the LNG-IUS.

    PubMed

    Bednarek, Paula H; Jensen, Jeffrey T

    2010-08-09

    Intrauterine devices (IUDs) provide highly effective, long-term, safe, reversible contraception, and are the most widely used reversible contraceptive method worldwide. The levonorgestrel-releasing intrauterine system (LNG-IUS) is a T-shaped IUD with a steroid reservoir containing 52 mg of levonorgestrel that is released at an initial rate of 20 μg daily. It is highly effective, with a typical-use first year pregnancy rate of 0.1% - similar to surgical tubal occlusion. It is approved for 5 years of contraceptive use, and there is evidence that it can be effective for up to 7 years of continuous use. After removal, there is rapid return to fertility, with 1-year life-table pregnancy rates of 89 per 100 for women less than 30 years of age. Most users experience a dramatic reduction in menstrual bleeding, and about 15% to 20% of women become amenorrheic 1 year after insertion. The device's strong local effects on the endometrium benefit women with various benign gynecological conditions such as menorrhagia, dysmenorrhea, leiomyomata, adenomyosis, and endometriosis. There is also evidence to support its role in endometrial protection during postmenopausal estrogen replacement therapy, and in the treatment of endometrial hyperplasia.

  8. A multicentre, open-label, randomised phase III study comparing a new levonorgestrel intrauterine contraceptive system (LNG-IUS 8) with combined oral contraception in young women of reproductive age.

    PubMed

    Borgatta, Lynn; Buhling, Kai J; Rybowski, Sarah; Roth, Katrin; Rosen, Kimberly

    2016-10-01

    To compare user satisfaction and adverse events (AEs) with a levonorgestrel intrauterine system (LNG-IUS 8; average levonorgestrel release rate approximately 8 μg/24 h over the first year [total content 13.5 mg]) and a 30 μg ethinyl estradiol/3 mg drospirenone (EE/DRSP) combined oral contraceptive (COC) in a population of young women. Nulliparous and parous women (aged 18-29 years) with regular menstrual cycles (21-35 days) were randomised to LNG-IUS 8 or EE/DRSP for 18 months. The primary endpoint was the overall user satisfaction rate at month 18/end of study visit. Overall, 279 women were randomised to LNG-IUS 8 with attempted placement and 281 women were randomised to EE/DRSP and took ≥1 pill; the mean age was 23.7 and 23.9 years, and 77.4% and 73.3% were nulliparous, respectively. At month 18/end of study, 82.1% and 81.9% of women, respectively, reported being 'very satisfied' or 'satisfied' with their treatment; however, significantly more LNG-IUS 8 users reported a preference to continue their treatment post-study (66.2% vs 48.8%; p = 0.0001). There were two pregnancies (one ectopic pregnancy, one spontaneous abortion) reported in the LNG-IUS 8 group and six (three live births, two spontaneous abortions, one induced abortion) in the EE/DRSP group. LNG-IUS 8 and EE/DRSP were associated with similarly high user satisfaction rates. However, LNG-IUS 8 users were significantly more likely to prefer to continue their contraceptive method post-study, indicating that a levonorgestrel intrauterine system is an appealing contraceptive option for young women.

  9. Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care

    PubMed Central

    Kai, Joe; Middleton, Lee; Daniels, Jane; Pattison, Helen; Tryposkiadis, Konstantinos; Gupta, Janesh

    2016-01-01

    Background Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. Aim To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. Design and setting A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands. Method In total, 571 women aged 25–50 years, with HMB were randomised to LNG-IUS or usual medical treatment (tranexamic/mefenamic acid, combined oestrogen–progestogen, or progesterone alone). The primary outcome was the patient reported Menorrhagia Multi-Attribute Scale (MMAS, measuring effect of HMB on practical difficulties, social life, psychological and physical health, and work and family life; scores from 0 to 100). Secondary outcomes included surgical intervention (endometrial ablation/hysterectomy), general quality of life, sexual activity, and safety. Results At 5 years post-randomisation, 424 (74%) women provided data. While the difference between LNG-IUS and usual treatment groups was not significant (3.9 points; 95% confidence interval = −0.6 to 8.3; P = 0.09), MMAS scores improved significantly in both groups from baseline (mean increase, 44.9 and 43.4 points, respectively; P<0.001 for both comparisons). Rates of surgical intervention were low in both groups (surgery-free survival was 80% and 77%; hazard ratio 0.90; 95% CI = 0.62 to 1.31; P = 0.6). There was no difference in generic quality of life, sexual activity scores, or serious adverse events. Conclusion Large improvements in symptom relief across both groups show treatment for HMB can be successfully initiated with long-term benefit and with only modest need for surgery. PMID:27884916

  10. Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care.

    PubMed

    Kai, Joe; Middleton, Lee; Daniels, Jane; Pattison, Helen; Tryposkiadis, Konstantinos; Gupta, Janesh

    2016-12-01

    Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands. In total, 571 women aged 25-50 years, with HMB were randomised to LNG-IUS or usual medical treatment (tranexamic/mefenamic acid, combined oestrogen-progestogen, or progesterone alone). The primary outcome was the patient reported Menorrhagia Multi-Attribute Scale (MMAS, measuring effect of HMB on practical difficulties, social life, psychological and physical health, and work and family life; scores from 0 to 100). Secondary outcomes included surgical intervention (endometrial ablation/hysterectomy), general quality of life, sexual activity, and safety. At 5 years post-randomisation, 424 (74%) women provided data. While the difference between LNG-IUS and usual treatment groups was not significant (3.9 points; 95% confidence interval = -0.6 to 8.3; P = 0.09), MMAS scores improved significantly in both groups from baseline (mean increase, 44.9 and 43.4 points, respectively; P<0.001 for both comparisons). Rates of surgical intervention were low in both groups (surgery-free survival was 80% and 77%; hazard ratio 0.90; 95% CI = 0.62 to 1.31; P = 0.6). There was no difference in generic quality of life, sexual activity scores, or serious adverse events. Large improvements in symptom relief across both groups show treatment for HMB can be successfully initiated with long-term benefit and with only modest need for surgery. © British Journal of General Practice 2016.

  11. Ius Chasma - False Color

    NASA Image and Video Library

    2016-07-28

    The THEMIS camera contains 5 filters. The data from different filters can be combined in multiple ways to create a false color image. These false color images may reveal subtle variations of the surface not easily identified in a single band image. Today's false color image shows the northern tip of Baetis Mensa. In false color images dark blue is often basaltic sands. In this image it is possible to trace the sands from the erosion of Beatis Mensa moving down the canyon gullies to the floor of Ophir Chasma. Orbit Number: 42247 Latitude: -4.17728 Longitude: 287.975 Instrument: VIS Captured: 2011-06-23 21:11 http://photojournal.jpl.nasa.gov/catalog/PIA20792

  12. Investigation of storage system designs and techniques for optimizing energy conservation in integrated utility systems. Volume 3: (Assessment of technical and cost characteristics of candidate IUS energy storage devices)

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Six energy storage technologies (inertial, superconducting magnetic, electrochemical, chemical, compressed air, and thermal) were assessed and evaluated for specific applicability to the IUS. To provide a perspective for the individual storage technologies, a brief outline of the general nature of energy storage and its significance to the user is presented.

  13. [Clinical study of high intensity focused ultrasound ablation combined with GnRH-a and LNG-IUS for the treatment of adenomyosis].

    PubMed

    Ye, M Z; Deng, X L; Zhu, X G; Xue, M

    2016-09-25

    Objective: To investigate the clinical effect of dysmenorrhea in patients with adenomyosis treated by high intensity focused ultrasound(HIFU)ablation combined with gonadotropin-releasing hormone agonist(GnRH-a)and levonorgestrel-releasing intrauterine system(LNG-IUS). Methods: From April 2012 to December 2015, 477 cases of adenomyosis patients with dysmenorrhea were treated by HIFU in the Third Xiangya Hospital. Among them, some patients were treated with HIFU alone, some of them were treated with HIFU combined with GnRH-a and(or)LNG-IUS, thus were classified as H group, H+G group, H+M group and H+G+M group. The improvements of clinical results were compared among the four groups and the influencing factors of HIFU treatment for adenomyosis were also analyzed. Results: During the follow-up period, the overall effective rates of the treatment decreased with time, 3 months 89.4%(345/386), 12 months 84.0%(221/263), 24 months 74.2%(98/132), and the overall recurrence rate was 12.9%(39/303). The significant difference in the curative at 3 months[H group 83.7%(170/203), H+M group 95.0%(95/100), H+G group 100.0%(43/43), H+G+M group 96.8%(30/31)], 12 months[H group 79.4%(123/155), H+M group 93.2%(69/74), H+G group 11/12, H+G+M group 15/17], and 24 months[H group 68.0%(51/75), H+M group 96.4%(27/28), H+G group 6/12, H+G+M group 15/15]after HIFU treatment and recurrence rate[H group 19.0%(29/153), H+M group 3.3%(3/90), H+G group 19.4%(6/31), H+G+M group 4.5%(1/22)]were observed among the four groups(P<0.05). Pairwise comparison further showed that, in 3 months after the treatment, the effect of H group was significantly lower than those of H+M group and H+G group(P= 0.003, P=0.005); in 12 months after the treatment, the effect of H group was significantly lower than that of H+M group(P=0.006); while in 24 months after treatment, the effect of H group was significantly lower than that of H+G+M group(P=0.005), and the effect of H+G group was lower than that of H+G+M group(P= 0

  14. A single-arm phase III study exploring the efficacy and safety of LNG-IUS 8, a low-dose levonorgestrel intrauterine contraceptive system (total content 13.5 mg), in an Asia-Pacific population.

    PubMed

    Fan, Guangsheng; Kang, Sukho; Ren, Mulan; Weisberg, Edith; Lukkari-Lax, Eeva; Roth, Katrin; Shin, SoYoung

    2017-04-01

    The objective was to evaluate the efficacy and safety of a low-dose levonorgestrel intrauterine system with total content 13.5 mg (average approximately 8 μg/24 h over the first year; LNG-IUS 8; Jaydess®) in an Asia-Pacific population. An open-label, single-arm phase III study conducted at 25 centers in China, Australia and Korea assessed LNG-IUS 8 use over 3 years in nulliparous and parous women (N=1114) aged 18-40 years with regular menstrual cycles (21-35 days). Primary outcome was pregnancy rate, expressed as the Pearl Index. Secondary outcomes included 3-year cumulative failure rate, treatment-emergent adverse events (TEAEs), discontinuation rate, bleeding profile and placement pain. The full analysis set comprised 925 women (mean age 31.6 years, 6.4% nulliparous). Overall unadjusted Pearl Index was 0.35 (95% confidence interval 0.15-0.70); the 3-year cumulative failure rate was 0.9% (95% confidence interval 0.4-1.9). TEAEs and study drug-related TEAEs were reported in 70.1% and 31.2% of women, respectively. Overall, 27.9% of women discontinued the study, 16.9% due to adverse events. Frequent or prolonged bleeding (World Health Organization criteria) decreased from the first to the twelfth 90-day reference intervals (from 5.0% to 0.7% and from 44.1% to 3.0%, respectively), and the percentage of women with amenorrhea increased over time (from 0.4% to 10.8%). Pain on placement was reported as "none" or "mild" in 91.9% of women. LNG-IUS 8 was an effective and well-tolerated contraceptive method, providing another option for women in the Asia-Pacific region. In this phase III study, LNG-IUS 8 was shown to be highly effective and well tolerated in an Asia-Pacific population and was not associated with any new or unexpected safety events. LNG-IUS 8 provides another contraceptive option for women in the Asia-Pacific region. Copyright © 2016. Published by Elsevier Inc.

  15. Overcoming barriers to levonorgestrel-releasing intrauterine system placement: an evaluation of placement of LNG-IUS 8 using the modified EvoInserter® in a majority nulliparous population.

    PubMed

    Gemzell-Danielsson, Kristina; Apter, Dan; Lukkari-Lax, Eeva; Roth, Katrin; Serrani, Marco

    2017-08-24

    To report placement success rate, and ease and pain associated with placement, of the levonorgestrel-releasing intrauterine system (LNG-IUS) 8 using the modified EvoInserter® placement device. This was a pooled analysis using data from three previously reported Phase III studies in nulliparous (83.3%) or parous (16.7%) women aged 12-35 years (N=965). LNG-IUS 8 was placed using the modified Evolnserter®. The main outcomes assessed were placement success, ease of placement as reported by healthcare professionals (HCPs), pain at placement as reported by participants, and assessment of the EvoInserter® placement device by HCPs. LNG-IUS 8 placement using the modified EvoInserter® with an insertion tube diameter of 3.8 mm was successful in 99.5% of subjects. HCPs rated the placement procedure as "easy" in 91.6% of cases. Placement pain was reported as absent by 19.1% of participants, as mild by 39.3%, as moderate by 31.6%, and as severe by 10.0%. Overall 89.2% of HCPs completely agreed that the device was easy to prepare and 85.7% completely agreed that placement of an LNG-IUS was easy/simple with the EvoInserter®. Post hoc exploratory analyses indicated a significant association between ease/pain of placement and patient age and between pain of placement and parity. The modified Evolnserter® was associated with a high placement success rate, ease of placement, and manageable pain, and was assessed to have a user-friendly design. These findings suggest that the EvoInserter® may remove some concerns among HCPs about difficult placement of LNG-IUSs, thereby encouraging increased uptake of an effective contraceptive. Results reported in this study further strengthen evidence of the high placement success rate, ease of deployment, and manageable pain associated with the modified EvoInserter® placement device. These findings might reduce concerns among HCPs about placement of LNG-IUSs, meaning uptake of such contraceptives is increased. Copyright © 2017 The Authors

  16. IUS guidance algorithm gamma guide assessment

    NASA Technical Reports Server (NTRS)

    Bray, R. E.; Dauro, V. A.

    1980-01-01

    The Gamma Guidance Algorithm which controls the inertial upper stage is described. The results of an independent assessment of the algorithm's performance in satisfying the NASA missions' targeting objectives are presented. The results of a launch window analysis for a Galileo mission, and suggested improvements are included.

  17. Shuttle program. STS-7 feasibility assessment: IUS/TDRS-A

    NASA Technical Reports Server (NTRS)

    1979-01-01

    This Space Transportation System 7 (STS-7) Flight Feasibility Assessment (FFA) provides a base from which the various design, operation, and integration elements associated with Tracking and Data Relay Satellite-A can perform mission planning and analysis. The STS-7 FFA identifies conflicts, issues, and concerns associated with the integrated flight design requirements and constraints.

  18. Copper IUD and LNG IUS compared with tubal occlusion.

    PubMed

    Mansour, Diana

    2007-06-01

    This article will cover current contraceptive use around the world, then examine the advantages and disadvantages of female sterilization, the hormonal intrauterine system and the copper intrauterine device. Finally, the need for contraceptive choice will be discussed along with a discussion on the cost-effectiveness of these methods.

  19. STS-43 TDRS-E / IUS is deployed from OV-104's payload bay (PLB)

    NASA Image and Video Library

    1991-08-02

    STS043-72-020 (2 Aug 1991) --- The Tracking and Data Relay Satellite (TDRS-E), is loosened from its restraint device and begins to leave the payload bay of the earth-orbiting Atlantis. The deployment came a mere six hours after the Space Shuttle was launched from Pad 39A at Kennedy Space Center, Florida. TDRS, built by TRW, will be placed in a geosynchronous orbit and after on-orbit testing, which requires several weeks, will be designated TDRS-5. The communications satellite will replace TDRS-3 at 174 degrees West longitude. The backbone of NASA's space-to-ground communications, the Tracking and Data Relay satellites have increased NASA's ability to send and receive data to spacecraft in low-earth orbit to more than 85 percent of the time. The five astronauts of the STS 43 mission are John E. Blaha, mission commander, Michael A. Baker, pilot, and Shannon W. Lucid, G. David Low, and James C. Adamson, all mission specialists.

  20. IUS/TUG Orbital Operations and Mission Support Study. Volume 1; Executive Summary

    NASA Technical Reports Server (NTRS)

    1975-01-01

    The space transportation system (STS) is discussed which will include a propulsive stage that is carried into low earth orbit by the space shuttle. Data were accumulated from the analyses of various stage concepts, operating modes, and projected missions (space tug systems studies, growth stage studies, engine studies, and critical area studies). The foundation formulated by these studies aided in establishing a tentative two-phase approach for the extension of the STS operating regime beyond the space shuttle including plane changes, higher orbits, geosynchronous orbits and beyond. The orbital operations study, was conducted to provide the generation and analysis of operational plans, requirement, and concepts for the utilization of these vehicles. Primary emphasis was placed on methods and techniques to provide a sound technical approach to operations at reduced cost for the STS mission period.

  1. IUS/TUG orbital operations and mission support study. Volume 3: Space tug operations

    NASA Technical Reports Server (NTRS)

    1975-01-01

    A study was conducted to develop space tug operational concepts and baseline operations plan, and to provide cost estimates for space tug operations. Background data and study results are presented along with a transition phase analysis (the transition from interim upper state to tug operations). A summary is given of the tug operational and interface requirements with emphasis on the on-orbit checkout requirements, external interface operational requirements, safety requirements, and system operational interface requirements. Other topics discussed include reference missions baselined for the tug and details for the mission functional flows and timelines derived for the tug mission, tug subsystems, tug on-orbit operations prior to the tug first burn, spacecraft deployment and retrieval by the tug, operations centers, mission planning, potential problem areas, and cost data.

  2. IUS/payload communication system simulator configuration definition study. [payload simulator for pcm telemetry

    NASA Technical Reports Server (NTRS)

    Udalov, S.; Springett, J. C.

    1978-01-01

    The requirements and specifications for a general purpose payload communications system simulator to be used to emulate those communications system portions of NASA and DOD payloads/spacecraft that will in the future be carried into earth orbit by the shuttle are discussed. For the purpose of on-orbit checkout, the shuttle is required to communicate with the payloads while they are physically located within the shuttle bay (attached) and within a range of 20 miles from the shuttle after they have been deployed (detached). Many of the payloads are also under development (and many have yet to be defined), actual payload communication hardware will not be available within the time frame during which the avionic hardware tests will be conducted. Thus, a flexible payload communication system simulator is required.

  3. Ultrasound Location of Misplaced Levonorgestrel Releasing Intrauterine System (LNG-IUS) – is it easy?

    PubMed Central

    Gowri, Vaidyanathan; Mathew, Mariam

    2009-01-01

    The Levonorgestrel intrauterine device (LNG-IUD) is a hormone-containing device licensed for treatment of menorrhagia and contraception. Though complications such as perforation have been reported similar to other non-hormonal intrauterine devices, the diagnosis of such complications is difficult with this device because the LNG-IUD has a different ultrasound appearance compared to copper devices and these case reports are intended to emphasize this point. PMID:22303513

  4. Ultrasound Location of Misplaced Levonorgestrel Releasing Intrauterine System (LNG-IUS) - is it easy?

    PubMed

    Gowri, Vaidyanathan; Mathew, Mariam

    2009-01-01

    The Levonorgestrel intrauterine device (LNG-IUD) is a hormone-containing device licensed for treatment of menorrhagia and contraception. Though complications such as perforation have been reported similar to other non-hormonal intrauterine devices, the diagnosis of such complications is difficult with this device because the LNG-IUD has a different ultrasound appearance compared to copper devices and these case reports are intended to emphasize this point.

  5. Equations for calculating orbiter surface erosion and breakage rates in IUS and SSUS SRM exhaust plumes

    NASA Technical Reports Server (NTRS)

    Wilson, S. W.

    1978-01-01

    Equations and coefficients for calculating the flux of solid particles in the exhaust plumes of the interim upper stage and SSUS solid rocket motors (SRM) are considered. Modifications required to account for the independent motions of the orbiter and the SRM, such as will result during an on-orbit SRM firing are described.

  6. Art concept of Magellan spacecraft and inertial upper stage (IUS) deployment

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Magellan spacecraft mounted on inertial upper stage drifts above Atlantis, Orbiter Vehicle (OV) 104, after its deployment during mission STS-30 in this artist concept. Solar panels are deployed and in OV-104's open payload bay (PLB) the airborne support equipment (ASE) is visible. Both spacecraft are orbiting the Earth. Magellan, named after the 16th century Portuguese explorer, will orbit Venus about once every three hours, acquiring radar data for 37 minutes of each orbit when it is closest to the surface. Using an advanced instrument called a synthetic aperture radar (SAR), it will map more than 90 per cent of the surface with resolution ten times better than the best from prior spacecraft. Magellan is managed by the Jet Propulsion Laboratory (JPL); Martin Marietta Aerospace is developing the spacecraft and Hughes Aircraft Company, the advanced imaging radar.

  7. STS-44 DSP satellite and IUS during preflight processing at Cape Canaveral

    NASA Image and Video Library

    1991-10-19

    S91-50773 (19 Oct 1991) --- At a processing facility on Cape Canaveral Air Force Station, the Defense Support Program (DSP) satellite is being transferred into the payload canister transporter for shipment to Launch Pad 39A at KSC. The DSP will be deployed during Space Shuttle Mission STS-44 later this year. It is a surveillance satellite, developed for the Department of Defense, which can detect missile and space launches, as well as nuclear detonations. The Inertial Upper Stage which will boost the DSP satellite to its proper orbital position is the lower portion of the payload. DSP satellites have comprised the spaceborne segment of NORAD's (North American Air Defense Command) Tactical Warning and Attack Assessment System since 1970. STS- 44, carrying a crew of six, will be a ten-day flight.

  8. Insights into Fourier Synthesis and Analysis: Part I--Using Simple Programs and Equipment.

    ERIC Educational Resources Information Center

    Moore, Guy S. M.

    1988-01-01

    Introduced is a unique generation method of Fourier series requiring simple mathematical skills and using computer programs. Discusses Fourier synthesis by microcomputer, and Fourier analysis with simple equipment. Shown are a circuit diagram, computer programs, monitor displays and tables of data. (YP)

  9. Performance evaluation of fault-tolerant systems with application to the IUS

    NASA Technical Reports Server (NTRS)

    Missana, J.-O.; Walker, Bruce K.

    1988-01-01

    A new method for quantitatively evaluating the performance of fault-tolerant systems is developed and applied to an example. The method assumes that the random failure and diagnostic decision behavior of the system can be modeled by a finite state Markov process. A performance value must be assigned to each of the states of the model. The method then generates the moments of the probability mass function of the cumulative performance and uses these to generate a maximum entropy approximation to the performance PMF. Some computational considerations are discussed. The method is applied to a typical mission for the Inertial Upper Stage to examine the attitude accuracy performance of the inertial system.

  10. STS-34 Galileo spacecraft / IUS deployment taken by the IMAX camera

    NASA Image and Video Library

    1989-10-18

    S89-48714 (18 Oct 1989) --- This photograph was taken by the STS-34 crew aboard the Space Shuttle Atlantis and shows the Galileo spacecraft being deployed on Oct. 18, 1989 from the payload bay. Galileo is a scientific craft that will go into orbit around the planet Jupiter and drop a probe into its atmosphere in search of primordial solar system material believed to be present there. The 70mm motion picture film will be used in the forthcoming "Blue Planet," which will address Earth's environmental problems from the perspective of space-based observation and solar system exploration. The film is being produced by IMAX Space Technology Inc. for the sponsor, the Smithsonian Institution, with funding provided by the Lockheed Corporation. PHOTO CREDIT: NASA/Smithsonian Institution

  11. MObIUS (Massive Object Integrated Universal Store): A Survey Toward a More General Framework

    SciTech Connect

    Sirp, J K; Brugger, S T

    2004-06-07

    General frameworks for distributed computing are slowly evolving out of Grid, Peer Architecture, and Web Services. The following results from a summer long survey into distributing computing practices have revealed three things. One, that Legion and Cactus-G have achieved the most in terms of providing an all-purpose application environment. Two, that extending a local programming environment to operate in a highly distributed fashion can be facilitated with toolkits like Globus. Three, that building a new system from the ground up could be realized, in part, by using some of the following components; an Object Oriented Database, Tapestry, JXTA, BOINC, Globus, component architecture technology, XML and related libraries, Condor-G, Proteus, and ParMETIS.

  12. STS-43 TDRS-E / IUS is deployed from OV-104's payload bay (PLB)

    NASA Image and Video Library

    1991-08-02

    STS043-72-059 (2 Aug 1991) --- The Tracking and Data Relay Satellite (TDRS-E), leaves the payload bay of the earth-orbiting Atlantis a mere six hours after the Space Shuttle was launched from Pad 39A at Kennedy Space Center, Florida. TDRS, built by TRW, will be placed in a geosynchronous orbit and after on-orbit testing, which requires several weeks, will be designated TDRS-5. The communications satellite will replace TDRS-3 at 174 degrees West longitude. The backbone of NASA's space-to-ground communications, the Tracking and Data Relay satellites have increased NASA's ability to send and receive data to spacecraft in low-earth orbit to more than 85 percent of the time. The five astronauts of the STS 43 mission are John E. Blaha, mission commander, Michael A. Baker, pilot, and Shannon W. Lucid, G. David Low, and James C. Adamson, all mission specialists.

  13. STS-43 TDRS-E & IUS over the Pacific Ocean after deployment from OV-104's PLB

    NASA Image and Video Library

    1991-08-02

    STS043-601-042 (2 Aug 1991) --- The Tracking and Data Relay Satellite (TDRS-E), is backdropped against an interesting cloud pattern over blue water soon after leaving the payload bay of the Earth-orbiting Space Shuttle Atlantis. The deployment came a mere six hours after the Space Shuttle was launched from Pad 39A at Kennedy Space Center (KSC), Florida. TDRS, built by TRW, will be placed in a geosynchronous-orbit and after on orbit testing, which requires several weeks, will be designated TDRS-5. The communications satellite will replace TDRS-3 at 174 degrees west longitude. The backbone of NASA's space-to-ground communications, the Tracking and Data Relay satellites have increased NASA's ability to send and receive data to spacecraft in low-Earth orbit to more than 85 percent of the time. The five astronauts of the STS-43 mission are John E. Blaha, mission commander, Michael A. Baker, pilot, and Shannon W. Lucid, G. David Low, and James C. Adamson, all mission specialists.

  14. STS-43 TDRS-E & IUS over the Pacific Ocean after deployment from OV-104's PLB

    NASA Image and Video Library

    1991-08-02

    STS043-601-033 (2 Aug 1991) --- The Tracking and Data Relay Satellite (TDRS-E), is seen almost as a silhouette in this 70mm image. The TDRS spacecraft was captured on film as it moved away from the earth-orbiting Atlantis a mere six hours after the shuttle was launched from Pad 39A at Kennedy Space Center, Florida. TDRS, built by TRW, will be placed in a geosynchronous orbit and after on-orbit testing, which requires several weeks, will be designated TDRS-5. The communications satellite will replace TDRS-3 at 174 degrees west longitude. The backbone of NASA's space-to-ground communications, the Tracking and Data Relay Satellites have increased NASA's ability to send and receive data to spacecraft in low-earth orbit to more than 85 percent of the time. Before TDRS, NASA relied solely on a system of ground stations that permitted communications only 15 percent of the time. Increased coverage has allowed on-orbit repairs, live television broadcast from space and continuous dialogues between astronaut crews and ground control during critical periods such as space shuttle landings. The five astronauts of the STS-43 are John E. Blaha, mission commander, Michael a. Baker, pilot, and mission specialists Shannon W. Lucid, G. David Low and James C. Adamson.

  15. STS-43 TDRS-E / IUS in OV-104's PLB ASE aft frame tilt actuator (AFTA) table

    NASA Image and Video Library

    1991-08-02

    STS043-72-002 (2 Aug 1991) --- The Tracking and Data Relay Satellite (TDRS-E), leaves the payload bay of the earth-orbiting Atlantis a mere six hours after the Space Shuttle was launched from Pad 39A at Kennedy Space Center, Florida. TDRS, built by TRW, will be placed in a geosynchronous orbit and after on-orbit testing, which requires several weeks, will be designated TDRS-5. The communications satellite will replace TDRS-3 at 174 degrees West longitude. The backbone of NASA's space-to-ground communications, the Tracking and Data Relay satellites have increased NASA's ability to send and receive data to spacecraft in low-earth orbit to more than 85 percent of the time. The five astronauts of the STS 43 mission are John E. Blaha, mission commander, Michael A. Baker, pilot, and Shannon W. Lucid, G. David Low, and James C. Adamson, all mission specialists.

  16. AUTOMOTIVE DIESEL MAINTENANCE 1, UNIT XVI, I--USE AND CARE OF SMALL HAND TOOLS, II--PRINCIPLES OF THE POWER DIVIDER.

    ERIC Educational Resources Information Center

    Minnesota State Dept. of Education, St. Paul. Div. of Vocational and Technical Education.

    THIS MODULE OF A 30-MODULE COURSE IS DESIGNED TO DEVELOP AN UNDERSTANDING OF SMALL HAND TOOLS USED IN DIESEL ENGINE MAINTENANCE AND THE OPERATING PRINCIPLES AND MAINTENANCE OF POWER DIVIDERS (GEAR BOXES) USED IN DIESEL ENGINE POWER DISTRIBUTION. TOPICS ARE (1) UNDERSTANDING TORQUE AND HOW IT IS MEASURED, (2) REPAIRING AND REPLACING THREADED…

  17. An evaluation of the simultaneous use of the levonorgestrel-releasing intrauterine device (LNG-IUS, Mirena®) combined with endometrial ablation in the management of menorrhagia.

    PubMed

    Vaughan, D; Byrne, P

    2012-05-01

    The objective of our study was to document the efficacy and possible complications in women who were treated for menorrhagia with the simultaneous use of endometrial ablation and the levonorgestrel-releasing intrauterine device. Women were offered this combined treatment if they complained of menorrhagia and needed contraception. A structured questionnaire was mailed to 150 women who had undergone this combined treatment; 105 (70%) returned a completed questionnaire. The mean duration of follow-up was 25 months (range 6-54 months). Following treatment, 53 women (50.5%) described their periods as being lighter than normal and 49 (46%) had become amenorrhoeic. Overall, 101 (96%) stated that they were satisfied with the treatment. Of the women, 95 (90.5%) said that the treatment had been a 'complete success'; eight (7.6%) 'partly successful' and two women (1.9%) said the treatment had been a 'failure'. One woman subsequently required a hysterectomy. This observational study supports the hypothesis that combined endometrial ablation and insertion of a levonorgestrel-releasing intrauterine device is an effective treatment for menorrhagia and has some advantages when compared with the individual use of these treatments.

  18. Split-time artificial insemination in beef cattle: I-Using estrous response to determine the optimal time(s) at which to administer GnRH in beef heifers and postpartum cows.

    PubMed

    Bishop, B E; Thomas, J M; Abel, J M; Poock, S E; Ellersieck, M R; Smith, M F; Patterson, D J

    2016-09-01

    Two experiments evaluated timing of GnRH administration in beef heifers and cows on the basis of estrous status during split-time artificial insemination (AI) after controlled internal drug release (CIDR) based protocols. In experiment 1, estrus was synchronized for 816 pubertal and prepubertal or peripubertal heifers using the 14-day CIDR-PGF2α (PG) protocol, and in experiment 2, estrus was synchronized for 622 lactating cows using the 7-day CO-Synch + CIDR protocol. For both experiments, estrus detection aids (Estrotect) were applied at PG, with estrus recorded at 66 and 90 hours after PG. Treatments were balanced across locations for heifers using reproductive tract score and weight; whereas for cows, treatments were assigned and balanced to treatment according to age, body condition score, and days postpartum. Timing of AI for heifers and cows was on the basis of estrus expression 66 hours after PG. Females in each treatment that exhibited estrus before 66 hours were inseminated at 66 hours, whereas AI was delayed 24 hours until 90 hours after PG for females failing to exhibit estrus before 66 hours. Females in treatment one received GnRH 66 hours after PG irrespective of estrus expression; however, in treatment 2, GnRH was administered coincident with delayed AI only to females not detected in estrus at 66 hours after PG. Among heifers, there was no effect of treatment on overall estrous response (P = 0.49) or AI pregnancy rate (P = 0.54). Pregnancy rate for heifers inseminated at 66 hours was not influenced by GnRH (P = 0.65), and there were no differences between treatments in estrous response during the 24 hours delay period (P = 0.22). Cows in treatment 2 had a greater (P = 0.04) estrous response during the 24-hour delay period resulting in a greater overall estrous response (P = 0.04), but this did not affect AI pregnancy rate at 90 hours (P = 0.51) or total AI pregnancy rate (P = 0.89). Pregnancy rate resulting from AI for cows inseminated at 66 hours was not influenced by GnRH (P = 0.50). In summary, when split-time AI was used with the 14-day CIDR-PG protocol in heifers or the 7-day CO-Synch + CIDR protocol in cows, administration of GnRH at AI to females that exhibited estrus before 66 hours after PG was not necessary. Furthermore, among heifers for which AI was delayed on the basis of failure to exhibit estrus before 66 hours after PG, timing of GnRH (66 vs. 90 hours after PG) was more flexible. Delayed administration of GnRH to 90 hours after PG coincident with AI for cows that failed to exhibit estrus before 66 hours improved overall estrous response; however, in this study, a corresponding increase in pregnancy rate resulting from AI was not observed. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Pharmacokinetics of two low-dose levonorgestrel-releasing intrauterine systems and effects on ovulation rate and cervical function: pooled analyses of phase II and III studies.

    PubMed

    Apter, Dan; Gemzell-Danielsson, Kristina; Hauck, Brian; Rosen, Kimberly; Zurth, Christian

    2014-06-01

    To assess the pharmacokinetics and pharmacodynamics of levonorgestrel intrauterine system (LNG-IUS) 13.5 mg and LNG-IUS 19.5 mg (total content). Pooled pharmacokinetic and pharmacodynamic analyses of phase II and III studies. Randomized, open-label, multicenter studies. Nulliparous and parous women. Levonorgestrel intrauterine system 13.5 mg, LNG-IUS 19.5 mg, or LNG-IUS 20 μg/24 h (total content 52 mg). Pharmacokinetics of LNG, ovulation rate, cervical function, and endometrium effects. The in vivo LNG release rate of LNG-IUS 13.5 mg was approximately 14 μg/24 h after 24 days, declining progressively to 5 μg/24 h after 3 years. The average LNG serum concentration over 3 years of use was 74.3 ng/L, 114 ng/L, and 218 ng/L for LNG-IUS 13.5 mg, LNG-IUS 19.5 mg, and LNG-IUS 20 μg/24 h, respectively. All treatments showed very similar progestogenic effects on cervical mucus, with low and similar cervical scores throughout treatment. Ovulation was observed in the majority of women in all groups where assessment was possible, although there was a lower incidence of anovulation with LNG-IUS 13.5 mg and LNG-IUS 19.5 mg compared with LNG-IUS 20 μg/24 h. The progestogenic effect on the endometrium was marked in all three LNG-IUS groups. Levonorgestrel intrauterine system 13.5 mg and LNG-IUS 19.5 mg result in alower systemic exposure to LNG, lower incidence of anovulation, and similar progestin impact on the endometrium and cervical function compared with LNG-IUS 20 μg/24 h. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  20. RUNX transcription factors: association with pediatric asthma and modulated by maternal smoking

    PubMed Central

    Lasky-Su, Jessica; Manoli, Sara E.; Smith, Lacey A.; Shahsafaei, Aliakbar; Weiss, Scott T.; Tantisira, Kelan

    2011-01-01

    Intrauterine smoke exposure (IUS) is a strong risk factor for development of airways responsiveness and asthma in childhood. Runt-related transcription factors (RUNX1–3) have critical roles in immune system development and function. We hypothesized that genetic variations in RUNX1 would be associated with airway responsiveness in asthmatic children and that this association would be modified by IUS. Family-based association testing analysis in the Childhood Asthma Management Program genome-wide genotype data showed that 17 of 100 RUNX1 single-nucleotide polymorphisms (SNPs) were significantly (P < 0.03–0.04) associated with methacholine responsiveness. The association between methacholine responsiveness and one of the SNPs was significantly modified by a history of IUS exposure. Quantitative PCR analysis of immature human lung tissue with and without IUS suggested that IUS increased RUNX1 expression at the pseudoglandular stage of lung development. We examined these associations by subjecting murine neonatal lung tissue with and without IUS to quantitative PCR (N = 4–14 per group). Our murine model showed that IUS decreased RUNX expression at postnatal days (P)3 and P5 (P < 0.05). We conclude that 1) SNPs in RUNX1 are associated with airway responsiveness in asthmatic children and these associations are modified by IUS exposure, 2) IUS tended to increase the expression of RUNX1 in early human development, and 3) a murine IUS model showed that the effects of developmental cigarette smoke exposure persisted for at least 2 wk after birth. We speculate that IUS exposure-altered expression of RUNX transcription factors increases the risk of asthma in children with IUS exposure. PMID:21803869

  1. The Effectiveness of Levonorgestrel-Releasing Intrauterine System in the Treatment of Heavy Menstrual Bleeding.

    PubMed

    Eralil, Georgy Joy

    2016-10-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) has been shown to be an effective treatment for patients with abnormal uterine bleeding (AUB) in many Western studies. The purpose of study was to examine the effectiveness of LNG-IUS in the treatment of Indian women with AUB. We conducted a retrospective observational study of 70 women diagnosed with AUB and treated with LNG-IUS insertion between February 2010 and 2014 at the Department of Gynecology of Sree Narayana Institute of Medical Sciences. Baseline endometrial biopsies were done before insertion of LNG-IUS, and outpatient follow-up with symptom diary was undertaken at 3-month intervals after insertion of LNG-IUS. Primary outcome in the two treatment groups was significantly greater among women assigned to levonorgestrel-IUS than among those assigned to usual treatment (mean difference in scores over the course of 1 year 13.4 points; 95 % confidence interval [CI] 9.9-16.9; P < 0.001). All six domains of the MMAS favored the levonorgestrel-IUS at every time point (P < 0.001) with the use of a test for trend. In conclusion, our study showed that both the levonorgestrel-IUS and usual medical treatments reduced the adverse effect of menorrhagia on women's lives over the course of 2 years, but the levonorgestrel-IUS was the more effective first choice, as assessed by the impact of bleeding on the women's quality of life.

  2. The levonorgestrel-releasing intrauterine system is associated with delayed endocervical clearance of Chlamydia trachomatis without alterations in vaginal microbiota

    PubMed Central

    Liechty, Emma R.; Bergin, Ingrid L.; Bassis, Christine M.; Chai, Daniel; LeBar, William; Young, Vincent B.; Bell, Jason D.

    2015-01-01

    Progestin-based contraception may impact women's susceptibility to sexually transmitted infection. We evaluated the effect of the levonorgestrel intrauterine system (LNG-IUS) on cervical persistence of Chlamydia trachomatis (CT) in a baboon model. Female olive baboons (Papio anubis) with or without an LNG-IUS received CT or sham inoculations. CT was detected in cervical epithelium with weekly nucleic acid amplification testing (NAAT) and culture. Presence of the LNG-IUS was associated with prolonged persistence of CT. Median time to post-inoculation clearance of CT as detected by NAAT was 10 weeks (range 7–12) for animals with an LNG-IUS and 3 weeks (range 0–12) for non-LNG-IUS animals (P = 0.06). Similarly, median time to post-inoculation clearance of CT by culture was 9 weeks (range 3–12) for LNG-IUS animals and 1.5 weeks (range 0–10) for non-LNG-IUS animals (P = 0.04). We characterized the community structure of the vaginal microbiota with the presence of the LNG-IUS to determine if alterations in CT colonization dynamics were associated with changes in vaginal commensal bacteria. Vaginal swabs were collected weekly for microbiome analysis. Endocervical CT infection was not correlated with alterations in the vaginal microbiota. Together, these results suggest that LNG-IUS may facilitate CT endocervical persistence through a mechanism distinct from vaginal microbial alterations. PMID:26371177

  3. Beyond Acculturation: Political "Change", Indigenous Knowledges, and Intercultural Higher Education in Mexico

    ERIC Educational Resources Information Center

    Perez-Aguilera, Dulce Abigail; Figueroa-Helland, Leonardo E.

    2011-01-01

    This article critiques the evolution of higher education in Mexico in light of the political "change" that led to the establishment of Intercultural Universities (IUs) for Indigenous communities. We argue that the "change" touted by the post-2000 regime isn't as profound or beneficial as claimed. Although IUs embody valuable…

  4. Solar Equipment

    NASA Astrophysics Data System (ADS)

    1983-01-01

    A medical refrigeration and a water pump both powered by solar cells that convert sunlight directly into electricity are among the line of solar powered equipment manufactured by IUS (Independent Utility Systems) for use in areas where conventional power is not available. IUS benefited from NASA technology incorporated in the solar panel design and from assistance provided by Kerr Industrial Applications Center.

  5. Quality of life and costs of levonorgestrel-releasing intrauterine system or hysterectomy in the treatment of menorrhagia: a 10-year randomized controlled trial.

    PubMed

    Heliövaara-Peippo, Satu; Hurskainen, Ritva; Teperi, Juha; Aalto, Anna-Mari; Grénman, Seija; Halmesmäki, Karoliina; Jokela, Markus; Kivelä, Aarre; Tomás, Eija; Tuppurainen, Marjo; Paavonen, Jorma

    2013-12-01

    Menorrhagia is a common problem impairing the quality of life (QOL) of many women. Both levonorgestrel-releasing intrauterine system (LNG-IUS) and hysterectomy are effective treatment modalities but no long-term comparative studies of QOL and costs exist. The objective of this study was to compare QOL and costs of LNG-IUS or hysterectomy in the treatment of menorrhagia during 10-year follow-up. A total of 236 women, aged 35-49 years, referred for menorrhagia to 5 university hospitals in Finland were randomly assigned to treatment with LNG-IUS (n = 119) or hysterectomy (n = 117) and were monitored for 10 years. The main outcome measures were health-related QOL (HRQOL), psychosocial well-being, and cost-effectiveness. A total of 221 (94%) women were followed for 10 years. Although 55 (46%) women assigned to the LNG-IUS subsequently underwent hysterectomy, the overall costs in the LNG-IUS group ($3423) were substantially lower than in the hysterectomy group ($4937). Overall, levels of HRQOL and psychosocial well-being improved during first 5 years but diminished between 5 years and 10 years and the improved HRQOL returned close to the baseline level. There were no significant differences between LNG-IUS and hysterectomy groups. Both LNG-IUS and hysterectomy improved HRQOL. The improvement was most striking during the first 5 years. Although many women eventually had hysterectomy, LNG-IUS remained cost-effective. Copyright © 2013 Mosby, Inc. All rights reserved.

  6. Temporal changes in cervical mucus after insertion of the levonorgestrel-releasing intrauterine system.

    PubMed

    Natavio, Melissa F; Taylor, Deshawn; Lewis, Radha A; Blumenthal, Paul; Felix, Juan C; Melamed, Alexander; Gentzschein, Elisabet; Stanczyk, Frank Z; Mishell, Daniel R

    2013-04-01

    The major contraceptive action of the levonorgestrel-releasing intrauterine system (LNG-IUS) is cervical mucus (CM) thickening, which prevents sperm penetration. No study to date has examined the temporal relationship between the insertion of the LNG-IUS and changes in CM quality and sperm penetration. Participants were enrolled in a clinically descriptive study to compare the quality of CM and three parameters of sperm penetration prior to insertion of the LNG-IUS and on Days 1, 3 and 5 after insertion. Measurements of estradiol, progesterone and levonorgestrel (LNG) in serum and LNG in CM were also carried out at these times. CM was analyzed using the World Health Organization CM grading criteria. Sperm penetration was determined using an in vitro sperm-CM penetration test. All 10 participants underwent LNG-IUS insertion during midcycle when CM quality was good and sperm penetration was excellent. On Day 1 after LNG-IUS insertion, the majority of participants demonstrated poor CM quality and poor sperm penetration. On Day 3, all participants had poor CM quality, and all but one subject had poor sperm penetration. By Day 5, all participants had poor CM quality and poor sperm penetration. LNG levels in CM peaked on the day after LNG-IUS insertion. Significant changes in quality of CM and sperm penetration were observed shortly after LNG-IUS insertion; however, CM can remain penetrable for up to 5 days when the LNG-IUS is inserted midcycle. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. The Marketability of Integrated Energy/Utility Systems: A Guide to the Dollar Savings Potential in Integrated Energy/Utility Systems; for Campuses, Medical Complexes, and Communities; Architect/Engineers, Industrial and Power Plant Owners; Suppliers; and Constructors.

    ERIC Educational Resources Information Center

    Coxe, Edwin F.; Hill, David E.

    This publication acquaints the prospective marketplace with the potential and underlying logic of the Integrated Utility System (IUS) concept. This system holds promise for educational and medical institutions seeking to reduce their energy costs. The generic IUS concept is described and how it can be incorporated into existing heating and…

  8. A Factor Analytic Study of the Internet Usage Scale

    ERIC Educational Resources Information Center

    Monetti, David M.; Whatley, Mark A.; Hinkle, Kerry T.; Cunningham, Kerry T.; Breneiser, Jennifer E.; Kisling, Rhea

    2011-01-01

    This study developed an Internet Usage Scale (IUS) for use with adolescent populations. The IUS is a 26-item scale that measures participants' beliefs about how their Internet usage impacts their behavior. The sample for this study consisted of 947 middle school students. An exploratory factor analysis with varimax rotation was conducted on the…

  9. A Comparison of the 27-Item and 12-Item Intolerance of Uncertainty Scales

    ERIC Educational Resources Information Center

    Khawaja, Nigar G.; Yu, Lai Ngo Heidi

    2010-01-01

    The 27-item Intolerance of Uncertainty Scale (IUS) has become one of the most frequently used measures of Intolerance of Uncertainty. More recently, an abridged, 12-item version of the IUS has been developed. The current research used clinical (n = 50) and non-clinical (n = 56) samples to examine and compare the psychometric properties of both…

  10. Beyond Acculturation: Political "Change", Indigenous Knowledges, and Intercultural Higher Education in Mexico

    ERIC Educational Resources Information Center

    Perez-Aguilera, Dulce Abigail; Figueroa-Helland, Leonardo E.

    2011-01-01

    This article critiques the evolution of higher education in Mexico in light of the political "change" that led to the establishment of Intercultural Universities (IUs) for Indigenous communities. We argue that the "change" touted by the post-2000 regime isn't as profound or beneficial as claimed. Although IUs embody valuable…

  11. Intraoperative ultrasound in neurosurgery - a practical guide.

    PubMed

    Ivanov, Marcel; Wilkins, Simone; Poeata, Ion; Brodbelt, Andrew

    2010-10-01

    Intraoperative ultrasound (iUS) provides low-cost real-time imaging that is simple and rapid to use. Recent advances in probe technology, image fusion, 3D techniques and contrast have led to significant improvements in image quality. This article provides an overview of the current uses of iUS, including technical advice for practical use, and future directions.

  12. A Comparison of the 27-Item and 12-Item Intolerance of Uncertainty Scales

    ERIC Educational Resources Information Center

    Khawaja, Nigar G.; Yu, Lai Ngo Heidi

    2010-01-01

    The 27-item Intolerance of Uncertainty Scale (IUS) has become one of the most frequently used measures of Intolerance of Uncertainty. More recently, an abridged, 12-item version of the IUS has been developed. The current research used clinical (n = 50) and non-clinical (n = 56) samples to examine and compare the psychometric properties of both…

  13. Solar Equipment

    NASA Technical Reports Server (NTRS)

    1983-01-01

    A medical refrigeration and a water pump both powered by solar cells that convert sunlight directly into electricity are among the line of solar powered equipment manufactured by IUS (Independent Utility Systems) for use in areas where conventional power is not available. IUS benefited from NASA technology incorporated in the solar panel design and from assistance provided by Kerr Industrial Applications Center.

  14. User benefits and funding strategies

    NASA Technical Reports Server (NTRS)

    Beauchamp, N. A.

    1975-01-01

    A three-step, systematic method is described for selecting relevant and highly beneficial payloads for the Interim Upper Stage (IUS) that will be used with the space shuttle until the space tug becomes available. Viable cost-sharing strategies which would maximize the number of IUS payloads and the benefits obtainable under a limited NASA budget were also determined.

  15. In Utero Smoke Exposure and Impaired Response to Inhaled Corticosteroids in Children with Asthma

    PubMed Central

    Cohen, Robyn T.; Raby, Benjamin A.; Van Steen, Kristel; Fuhlbrigge, Anne L.; Celedón, Juan C.; Rosner, Bernard A.; Strunk, Robert C.; Zeiger, Robert S.; Weiss, Scott T.

    2010-01-01

    Background Few studies have examined the effects of in utero smoke exposure (IUS) on lung function in children with asthma, and there are no published data on the impact of IUS on treatment outcomes in asthmatic children. Objectives To explore whether IUS exposure is associated with increased airway responsiveness among children with asthma, and whether IUS modifies the response to treatment with inhaled corticosteroids (ICS). Methods To assess the impact of parent-reported IUS exposure on airway responsiveness in childhood asthma we performed a repeated-measures analysis of methacholine PC20 data from the Childhood Asthma Management Program (CAMP), a four-year, multicenter, randomized double masked placebo controlled trial of 1041 children ages 5–12 comparing the long term efficacy of ICS with mast cell stabilizing agents or placebo. Results Although improvement was seen in both groups, asthmatic children with IUS exposure had on average 26% less of an improvement in airway responsiveness over time compared to unexposed children (p=.01). Moreover, while children who were not exposed to IUS who received budesonide experienced substantial improvement in PC20 compared to untreated children (1.25 fold-increase, 95% CI 1.03, 1.50, p=.02) the beneficial effects of budesonide were attenuated among children with a history of IUS exposure (1.04 fold-increase, 95% CI 0.65, 1.68, p=.88). Conclusions IUS reduces age-related improvements in airway responsiveness among asthmatic children. Moreover, IUS appears to blunt the beneficial effects of ICS use on airways responsiveness. These results emphasize the importance of preventing this exposure through smoking cessation counseling efforts with pregnant women. PMID:20673983

  16. The Effect of Age, Parity and Body Mass Index on the Efficacy, Safety, Placement and User Satisfaction Associated With Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems: Subgroup Analyses of Data From a Phase III Trial.

    PubMed

    Gemzell-Danielsson, Kristina; Apter, Dan; Hauck, Brian; Schmelter, Thomas; Rybowski, Sarah; Rosen, Kimberly; Nelson, Anita

    2015-01-01

    Two low-dose levonorgestrel intrauterine contraceptive systems (LNG-IUSs; total content 13.5 mg [average approx. 8 μg/24 hours over the first year; LNG-IUS 8] and total content 19.5 mg [average approx. 13 μg/24 hours over the first year; LNG-IUS 13]) have previously been shown to be highly effective (3-year Pearl Indices: 0.33 and 0.31, respectively), safe and well tolerated. The present subgroup analyses evaluated whether or not outcomes were affected by parity, age (18-25 vs 26-35 years), or body mass index (BMI, <30 vs ≥30 kg/m2). Nulliparous and parous women aged 18‒35 years with regular menstrual cycles (21‒35 days) requesting contraception were randomized to 3 years of LNG-IUS 8 or LNG-IUS 13 use. In the LNG-IUS 8 and LNG-IUS 13 groups, 1432 and 1452 women, respectively, had a placement attempted and were included in the full analysis set; 39.2%, 39.2% and 17.1% were 18-25 years old, nulliparous and had a BMI ≥30 kg/m2, respectively. Both systems were similarly effective regardless of age, parity or BMI; the subgroup Pearl Indices had widely overlapping 95% confidence intervals. Placement of LNG-IUS 8 and LNG-IUS 13 was easier (p < 0.0001) and less painful (p < 0.0001) in women who had delivered vaginally than in women who had not. The complete/partial expulsion rate was 2.2-4.2% across all age and parity subgroups and higher in parous than in nulliparous women (p = 0.004). The incidence of pelvic inflammatory disease was 0.1-0.6% across all age and parity subgroups: nulliparous and younger women were not at higher risk than parous and older women, respectively. The ectopic pregnancy rate was 0.3-0.4% across all age and parity subgroups. Across all age and parity subgroups, the 3-year completion rate was 50.9-61.3% for LNG-IUS 8 and 57.9-61.1% for LNG-IUS 13, and was higher (p = 0.0001) among older than younger women in the LNG-IUS 8 group only. LNG-IUS 8 and LNG-IUS 13 were highly effective, safe and well tolerated regardless of age or parity

  17. The Effect of Age, Parity and Body Mass Index on the Efficacy, Safety, Placement and User Satisfaction Associated With Two Low-Dose Levonorgestrel Intrauterine Contraceptive Systems: Subgroup Analyses of Data From a Phase III Trial

    PubMed Central

    Gemzell-Danielsson, Kristina; Apter, Dan; Hauck, Brian; Schmelter, Thomas; Rybowski, Sarah; Rosen, Kimberly; Nelson, Anita

    2015-01-01

    Objective Two low-dose levonorgestrel intrauterine contraceptive systems (LNG-IUSs; total content 13.5 mg [average approx. 8 μg/24 hours over the first year; LNG-IUS 8] and total content 19.5 mg [average approx. 13 μg/24 hours over the first year; LNG-IUS 13]) have previously been shown to be highly effective (3-year Pearl Indices: 0.33 and 0.31, respectively), safe and well tolerated. The present subgroup analyses evaluated whether or not outcomes were affected by parity, age (18–25 vs 26–35 years), or body mass index (BMI, <30 vs ≥30 kg/m2). Methods Nulliparous and parous women aged 18‒35 years with regular menstrual cycles (21‒35 days) requesting contraception were randomized to 3 years of LNG-IUS 8 or LNG-IUS 13 use. Results In the LNG-IUS 8 and LNG-IUS 13 groups, 1432 and 1452 women, respectively, had a placement attempted and were included in the full analysis set; 39.2%, 39.2% and 17.1% were 18–25 years old, nulliparous and had a BMI ≥30 kg/m2, respectively. Both systems were similarly effective regardless of age, parity or BMI; the subgroup Pearl Indices had widely overlapping 95% confidence intervals. Placement of LNG-IUS 8 and LNG-IUS 13 was easier (p < 0.0001) and less painful (p < 0.0001) in women who had delivered vaginally than in women who had not. The complete/partial expulsion rate was 2.2–4.2% across all age and parity subgroups and higher in parous than in nulliparous women (p = 0.004). The incidence of pelvic inflammatory disease was 0.1–0.6% across all age and parity subgroups: nulliparous and younger women were not at higher risk than parous and older women, respectively. The ectopic pregnancy rate was 0.3–0.4% across all age and parity subgroups. Across all age and parity subgroups, the 3-year completion rate was 50.9–61.3% for LNG-IUS 8 and 57.9–61.1% for LNG-IUS 13, and was higher (p = 0.0001) among older than younger women in the LNG-IUS 8 group only. Conclusions LNG-IUS 8 and LNG-IUS 13 were highly effective

  18. Bleeding pattern and user satisfaction in second consecutive levonorgestrel-releasing intrauterine system users: results of a prospective 5-year study

    PubMed Central

    Heikinheimo, O.; Inki, P.; Schmelter, T.; Gemzell-Danielsson, K.

    2014-01-01

    STUDY QUESTION What is the bleeding pattern during second consecutive levonorgestrel-releasing intrauterine system (LNG-IUS) use? SUMMARY ANSWER Consecutive use of LNG-IUS is associated with a predictable bleeding pattern, characterized by the absence of the initial period of irregular bleeding seen after interval insertion of an LNG-IUS and a non-bleeding pattern in the vast majority of women. WHAT IS KNOWN ALREADY With increased popularity of the LNG-IUS for long-term birth control and treatment of heavy menstrual bleeding (HMB), consecutive use of the system is becoming more frequent. One previous study showed 60% amenorrhea rate in consecutive IUS users; however, the sample size was small. STUDY DESIGN, SIZE, DURATION A prospective multicenter study in four European countries recruited women who wished to continue with LNG-IUS use immediately after the first 5-year period. A total of 204 women were followed up until the end of the first year of the second IUS. Thereafter 170 women continued into the extension phase of the study up to the full 5 years of use of the second IUS and 144 women continued to the end of the study. PARTICIPANTS, SETTING, METHODS A total of 170 women (mean age 39 years) who had been using their first LNG-IUS for between 4 years 3 months and 4 years 9 months, either for contraception or for treatment of HMB, and who planned to replace the device with a new LNG-IUS, were recruited and followed up to 5 years of the second IUS use. A total of 17 centers in four European countries were involved in the study. Bleeding patterns were analyzed using daily bleeding diaries using 90-day reference periods (RP) for the first year of the second IUS use and for the last RP of each year during Years 2–5 of use. MAIN RESULTS AND THE ROLE OF CHANCE Approximately 70% of women were free of bleeding during Years 2–5 and up to 49% were amenorrheic. There was a slight increase in the number of bleeding/spotting days of ∼3 days during the first RP

  19. Low-lying or malpositioned intrauterine devices and systems.

    PubMed

    Golightly, Ellen; Gebbie, Ailsa E

    2014-04-01

    The intrauterine device (IUD) and intrauterine system (IUS) are widely used forms of long-acting reversible contraception. Occasionally, IUD/IUS users have an ultrasound scan that shows a low-lying IUD/IUS or an IUD/IUS is found incidentally on scan to be low-lying within the uterus. No formal guidelines exist on the clinical implications of this scenario or the most appropriate management. We report here on a systematic review of the literature. A search of the online database PubMed was performed to identify articles relating to low-lying or malpositioned IUD/IUS. A total of 1101 articles was identified, and 15 were determined to be relevant to the research question. There is little published evidence to determine the nature and extent of the clinical relevance of a low-lying IUD. We recommend individualised management of these women, with particular caution in younger women and those with a history of previous IUD/IUS expulsion. Consideration may be given to attempting to readjust the IUD/IUS position, but if removal is performed, immediate replacement is essential if provision of alternative effective contraception has not been established.

  20. Flight Results of the Chandra X-ray Observatory Inertial Upper Stage Space Mission

    NASA Technical Reports Server (NTRS)

    Tillotson, R.; Walter, R.

    2000-01-01

    Under contract to NASA, a specially configured version of the Boeing developed Inertial Upper Stage (IUS) booster was provided by Boeing to deliver NASA's 1.5 billion dollar Chandra X-Ray Observatory satellite into a highly elliptical transfer orbit from a Shuttle provided circular park orbit. Subsequently, the final orbit of the Chandra satellite was to be achieved using the Chandra Integral Propulsion System (IPS) through a series of IPS burns. On 23 July 1999 the Shuttle Columbia (STS-93) was launched with the IUS/Chandra stack in the Shuttle payload bay. Unfortunately, the Shuttle Orbiter was unexpectantly inserted into an off-nominal park orbit due to a Shuttle propulsion anomaly occurring during ascent. Following the IUS/Chandra on-orbit deployment from the Shuttle, at seven hours from liftoff, the flight proven IUS GN&C system successfully injected Chandra into the targeted transfer orbit, in spite of the off-nominal park orbit. This paper describes the IUS GN&C system, discusses the specific IUS GN&C mission data load development, analyses and testing for the Chandra mission, and concludes with a summary of flight results for the IUS part of the Chandra mission.

  1. Effects of levonorgestrel-releasing intrauterine system on lymphangiogenesis of adenomyosis.

    PubMed

    Cho, SiHyun; Choi, Young Sik; Yun, Bo Hyon; Chon, Seung Joo; Jung, Yeon Soo; Kim, HyeYeon; Park, Joo Hyun; Seo, Seok Kyo; Kim, Se Hoon; Lee, Byung Seok

    2015-03-01

    Lymphangiogenesis may be involved in the pathogenesis of adenomyosis. We investigated the lymphatic vessels of patients with adenomyosis, including those treated with levonorgestrel-releasing intrauterine system (LNG-IUS). Full-thickness uterine samples were obtained from patients who received hysterectomies. Twenty-one patients with adenomyosis and 17 patients with adenomyosis who were treated with LNG-IUS were included. Eighteen patients with cervical intraepithelial neoplasia served as controls. Immunohistochemical staining was performed with antibodies against podoplanin and lymphatic vessel endothelial hyaluronan receptor 1. The lymphovascular density (LVD) was analyzed in each sample by the "hot spot" method. The LVDs were significantly higher in the endometrial and myometrial tissues of patients with adenomyosis compared with those of patients treated with the LNG-IUS or controls. No significant differences were noted between the LNG-IUS-treated group and controls. Evaluation of the LVDs according to the menstrual cycle showed that the differences in the endometrial tissues of the adenomyosis group and those of the LNG-IUS-treated group or the controls were more prominent during the secretory phase. Treatment with the LNG-IUS resulted in reduced lymphangiogenesis and LVD in the endometrial and myometrial tissues of patients with adenomyosis. Reduced lymphangiogenesis may be one mechanism by which the LNG-IUS reduces adenomyosis-related symptoms. Copyright© by the American Society for Clinical Pathology.

  2. In utero smoke exposure and impaired response to inhaled corticosteroids in children with asthma.

    PubMed

    Cohen, Robyn T; Raby, Benjamin A; Van Steen, Kristel; Fuhlbrigge, Anne L; Celedón, Juan C; Rosner, Bernard A; Strunk, Robert C; Zeiger, Robert S; Weiss, Scott T

    2010-09-01

    Few studies have examined the effects of in utero smoke exposure (IUS) on lung function in children with asthma, and there are no published data on the impact of IUS on treatment outcomes in children with asthma. To explore whether IUS exposure is associated with increased airway responsiveness among children with asthma and whether IUS modifies the response to treatment with inhaled corticosteroids (ICSs). To assess the impact of parent-reported IUS exposure on airway responsiveness in childhood asthma, we performed a repeated-measures analysis of methacholine PC(20) data from the Childhood Asthma Management Program, a 4-year, multicenter, randomized, double-masked, placebo-controlled trial of 1041 children age 5 to 12 years comparing the long-term efficacy of ICS with mast cell stabilizing agents or placebo. Although improvement was seen in both groups, children with asthma and IUS exposure had on average 26% less of an improvement in airway responsiveness over time compared with unexposed children (P = .01). Moreover, while children who were not exposed to IUS who received budesonide experienced substantial improvement in PC(20) compared with untreated children (1.25-fold increase; 95% CI, 1.03-1.50; P = .02), the beneficial effects of budesonide were attenuated among children with a history of IUS exposure (1.04-fold increase, 95% CI, 0.65-1.68; P = .88). In utero smoke exposure reduces age-related improvements in airway responsiveness among children with asthma. Moreover, IUS appears to blunt the beneficial effects of ICS use on airways responsiveness. These results emphasize the importance of preventing this exposure through smoking cessation counseling efforts with pregnant women. Copyright (c) 2010 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.

  3. Characteristics of Idiopathic Urethral Strictures: A Link to Remote Perineal Trauma?

    PubMed

    Viers, Boyd R; Pagliara, Travis J; Rew, Charles A; Folgosa Cooley, Lauren; Shiang, Christine Y; Scott, Jeremy M; Morey, Allen F

    2017-07-26

    To characterize the physical features and reconstructive outcomes of a series of idiopathic urethral strictures (IUS) in an effort to elucidate the nature of this common yet poorly understood entity. We retrospectively reviewed our urethroplasty database to identify men undergoing initial urethral reconstruction from 2007 to 2014 at 1 of 3 hospitals (N = 514). Patients were stratified by stricture etiology, including IUS, acute trauma, iatrogenic, hypospadias, balanitis xerotica obliterans, and radiation. IUS that had a known history of subacute or repetitive blunt force to the perineum (horseback riding, avid cycling, motocross, etc.) were subclassified as subacute or repetitive perineal trauma (SRPT). Among 466 men undergoing initial reconstruction with available data, 215 (46%) were IUS cases. The median delay between IUS diagnosis and urethroplasty was 5.2 years, during which time men underwent a median of 2 endoscopic treatments. A total of 51 (24%) IUS cases recalled a distinct history of SRPT. Men with SRPT were slightly younger (median 43 vs 48 years, P = .01) but were remarkably similar in terms of urethral stricture length (2 vs 2 cm, P = .15), location (bulbar 96% vs 89%, P = .41), and treatment success (92% vs 88%; P = .61). Bulbar (-)SRPT and (+)SRPT IUS had similar clinical and morphometric features as those with known acute bulbar trauma with excellent 24-month stricture recurrence-free survival rates (93% vs 92% vs 97%, P = .19). IUS have clinical features suggesting that many may be related to unrecognized or repetitive perineal trauma. Although treatment tends to be delayed, IUS have excellent urethroplasty success because most are short bulbar strictures amenable to anastomotic urethroplasty. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. Immediate versus delayed initiation of the levonorgestrel-releasing intrauterine system following medical termination of pregnancy - 1 year continuation rates: a randomised controlled trial.

    PubMed

    Korjamo, R; Mentula, M; Heikinheimo, O

    2017-06-26

    To assess the 1-year continuation rates and new pregnancies following immediate versus delayed insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) after medical termination of pregnancy (MTOP) up to 20 weeks of gestation. A randomised controlled trial. Helsinki University Hospital, Finland, January 2013 to December 2014. A total of 267 women requesting MTOP and planning LNG-IUS for post-MTOP contraception. Insertion of LNG-IUS occurred immediately (0-3 days) or after a delay (2-4 weeks) following MTOP. Follow-up visits were at 3 months and 1 year after MTOP. LNG-IUS use at 1 year after MTOP. Women were randomised to immediate (n = 134) or delayed (n = 133) insertion of the LNG-IUS, and 133 and 131 were analysed; 127 (95.5%) women received immediate insertion and 111 (84.7%) women had delayed insertion of the LNG-IUS (risk ratio [RR] 1.13, 95% CI 1.04-1.22). The verified numbers of women continuing the LNG-IUS use at 1 year were 83 (62.4%) and 52 (39.7%) (RR 1.57, 95% CI 1.23-2.02). The numbers of new pregnancies were 6 (4.5%) and 16 (12.2%) (RR 0.37, 95% CI 0.15-0.91), and numbers of subsequent TOPs were 4 (3.0%) and 5 (3.8%) (RR 0.79, 95% CI 0.22-2.87). Immediate insertion of the LNG-IUS following MTOP resulted in higher 1-year continuation rates compared with delayed insertion. In addition, those receiving immediate insertion demonstrated a decreased new pregnancy rate, but no difference in the numbers of another TOP. Immediate LNG-IUS insertion after MTOP results in a higher 1-year continuation compared with delayed insertion. © 2017 Royal College of Obstetricians and Gynaecologists.

  5. Levonorgestrel-releasing intrauterine system versus medical therapy for menorrhagia: a systematic review and meta-analysis.

    PubMed

    Qiu, Jin; Cheng, Jiajing; Wang, Qingying; Hua, Jie

    2014-09-23

    The aim of this study was to compare the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) with conventional medical treatment in reducing heavy menstrual bleeding. Relevant studies were identified by a search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and clinical trials registries (from inception to April 2014). Randomized controlled trials comparing the LNG-IUS with conventional medical treatment (mefenamic acid, tranexamic acid, norethindrone, medroxyprogesterone acetate injection, or combined oral contraceptive pills) in patients with menorrhagia were included. Eight randomized controlled trials that included 1170 women (LNG-IUS, n=562; conventional medical treatment, n=608) met inclusion criteria. The LNG-IUS was superior to conventional medical treatment in reducing menstrual blood loss (as measured by the alkaline hematin method or estimated by pictorial bleeding assessment chart scores). More women were satisfied with the LNG-IUS than with the use of conventional medical treatment (odds ratio [OR] 5.19, 95% confidence interval [CI] 2.73-9.86). Compared with conventional medical treatment, the LNG-IUS was associated with a lower rate of discontinuation (14.6% vs. 28.9%, OR 0.39, 95% CI 0.20-0.74) and fewer treatment failures (9.2% vs. 31.0%, OR 0.18, 95% CI 0.10-0.34). Furthermore, quality of life assessment favored LNG-IUS over conventional medical treatment, although use of various measurements limited our ability to pool the data for more powerful evidence. Serious adverse events were statistically comparable between treatments. The LNG-IUS was the more effective first choice for management of menorrhagia compared with conventional medical treatment. Long-term, randomized trials are required to further investigate patient-based outcomes and evaluate the cost-effectiveness of the LNG-IUS and other medical treatments.

  6. The levonorgestrel-releasing intrauterine system is associated with delayed endocervical clearance of Chlamydia trachomatis without alterations in vaginal microbiota.

    PubMed

    Liechty, Emma R; Bergin, Ingrid L; Bassis, Christine M; Chai, Daniel; LeBar, William; Young, Vincent B; Bell, Jason D

    2015-11-01

    Progestin-based contraception may impact women's susceptibility to sexually transmitted infection. We evaluated the effect of the levonorgestrel intrauterine system (LNG-IUS) on cervical persistence of Chlamydia trachomatis (CT) in a baboon model. Female olive baboons (Papio anubis) with or without an LNG-IUS received CT or sham inoculations. CT was detected in cervical epithelium with weekly nucleic acid amplification testing (NAAT) and culture. Presence of the LNG-IUS was associated with prolonged persistence of CT. Median time to post-inoculation clearance of CT as detected by NAAT was 10 weeks (range 7-12) for animals with an LNG-IUS and 3 weeks (range 0-12) for non-LNG-IUS animals (P = 0.06). Similarly, median time to post-inoculation clearance of CT by culture was 9 weeks (range 3-12) for LNG-IUS animals and 1.5 weeks (range 0-10) for non-LNG-IUS animals (P = 0.04). We characterized the community structure of the vaginal microbiota with the presence of the LNG-IUS to determine if alterations in CT colonization dynamics were associated with changes in vaginal commensal bacteria. Vaginal swabs were collected weekly for microbiome analysis. Endocervical CT infection was not correlated with alterations in the vaginal microbiota. Together, these results suggest that LNG-IUS may facilitate CT endocervical persistence through a mechanism distinct from vaginal microbial alterations. © FEMS 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Introduction of the levonorgestrel intrauterine system in Kenya through mobile outreach: review of service statistics and provider perspectives

    PubMed Central

    Hubacher, David; Akora, Vitalis; Masaba, Rose; Chen, Mario; Veena, Valentine

    2014-01-01

    Background: The levonorgestrel intrauterine system (LNG IUS) was developed over 30 years ago, but the product is currently too expensive for widespread use in many developing countries. In Kenya, one organization has received donated commodities for 5 years, providing an opportunity to assess impact and potential future role of the product. Methods: We reviewed service statistics on insertions of the LNG IUS, copper intrauterine device (IUD), and subdermal implant from 15 mobile outreach teams during the 2011 calendar year. To determine the impact of the LNG IUS introduction, we analyzed changes in uptake and distribution of the copper IUD and subdermal implant by comparing periods of time when the LNG IUS was available with periods when it was not available. In addition, we interviewed 27 clinicians to assess their views of the product and of its future role. Results: When the LNG IUS was not available, intrauterine contraception accounted for 39% of long-acting method provision. The addition of the LNG IUS created a slight rise in intrauterine contraception uptake (to 44%) at the expense of the subdermal implant, but the change was only marginally significant (P = .08) and was largely attributable to the copper IUD. All interviewed providers felt that the LNG IUS would increase uptake of long-acting methods, and 70% felt that the noncontraceptive benefits of the product are important to clients. Conclusions: The LNG IUS was well-received among providers and family planning clients in this population in Kenya. Although important changes in service statistics were not apparent from this analysis (perhaps due to the small quantity of LNG IUS that was available), provider enthusiasm for the product was high. This finding, above all, suggests that a larger-scale introduction effort would have strong support from providers and thus increase the chances of success. Adding another proven and highly acceptable long-acting contraceptive technology to the method mix

  8. Combined Endometrial Ablation and Levonorgestrel Intrauterine System Use in Women With Dysmenorrhea and Heavy Menstrual Bleeding: Novel Approach for Challenging Cases.

    PubMed

    Papadakis, Efstathios P; El-Nashar, Sherif A; Laughlin-Tommaso, Shannon K; Shazly, Sherif A M; Hopkins, Matthew R; Breitkopf, Daniel M; Famuyide, Abimbola O

    2015-01-01

    To evaluate the feasibility and impact of levonorgestrel intrauterine system (LNG-IUS) on treatment failure after endometrial ablation (EA) in women with heavy menstrual bleeding (HMB) and dysmenorrhea at 4 years. Cohort study (Canadian Task Force II-2). An academic institution in the upper Midwest. All women with HMB and dysmenorrhea who underwent EA with combined placement of LNG-IUS (EA/LNG-IUS cohort, 23 women) after 2005 and an historic reference group from women who had EA alone (EA cohort, 65 women) from 1998 through the end of 2005. Radiofrequency EA, thermal balloon ablation, and LNG-IUS. The primary outcome was treatment failure defined as persistent pain, bleeding, and hysterectomy after EA at 4 years. The combined treatment failure outcome was documented in 2 patients (8.7%) in the EA/LNG-IUS group and 19 patients (29.2%) in the EA group with an unadjusted OR of .23 (95% CI, .05-1.08). After adjusting for known risk factors of failure, the adjusted OR was .19 (95% CI, .26-.88). None of the women who underwent EA/LNG-IUS had hysterectomy for treatment failure compared with 16 (24%) in the EA group (p = .009); postablation pelvic pain was documented in 1 woman (4.3%) in the EA/LNG-IUS group compared with 8 women (12.3%) in the EA group (p = .24). One woman in the EA/LNG-IUS group (4.3%) presented with persistent bleeding compared with 15 (23.1%) in the EA group (p = .059). Office removal of the intrauterine device was performed in 4 women with no complications. LNG-IUS insertion at the time of EA is feasible and can provide added benefit after EA in women with dysmenorrhea and HMB. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

  9. Levonorgestrel-Releasing Intrauterine System versus Medical Therapy for Menorrhagia: A Systematic Review and Meta-Analysis

    PubMed Central

    Qiu, Jin; Cheng, Jiajing; Wang, Qingying; Hua, Jie

    2014-01-01

    Background The aim of this study was to compare the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) with conventional medical treatment in reducing heavy menstrual bleeding. Material/Methods Relevant studies were identified by a search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and clinical trials registries (from inception to April 2014). Randomized controlled trials comparing the LNG-IUS with conventional medical treatment (mefenamic acid, tranexamic acid, norethindrone, medroxyprogesterone acetate injection, or combined oral contraceptive pills) in patients with menorrhagia were included. Results Eight randomized controlled trials that included 1170 women (LNG-IUS, n=562; conventional medical treatment, n=608) met inclusion criteria. The LNG-IUS was superior to conventional medical treatment in reducing menstrual blood loss (as measured by the alkaline hematin method or estimated by pictorial bleeding assessment chart scores). More women were satisfied with the LNG-IUS than with the use of conventional medical treatment (odds ratio [OR] 5.19, 95% confidence interval [CI] 2.73–9.86). Compared with conventional medical treatment, the LNG-IUS was associated with a lower rate of discontinuation (14.6% vs. 28.9%, OR 0.39, 95% CI 0.20–0.74) and fewer treatment failures (9.2% vs. 31.0%, OR 0.18, 95% CI 0.10–0.34). Furthermore, quality of life assessment favored LNG-IUS over conventional medical treatment, although use of various measurements limited our ability to pool the data for more powerful evidence. Serious adverse events were statistically comparable between treatments. Conclusions The LNG-IUS was the more effective first choice for management of menorrhagia compared with conventional medical treatment. Long-term, randomized trials are required to further investigate patient-based outcomes and evaluate the cost-effectiveness of the LNG-IUS and other medical treatments. PMID:25245843

  10. Impact of levonorgestrel-releasing intrauterine system use on the cancer risk of the ovary and fallopian tube.

    PubMed

    Soini, Tuuli; Hurskainen, Ritva; Grénman, Seija; Mäenpää, Johanna; Paavonen, Jorma; Pukkala, Eero

    2016-11-01

    Levonorgestrel-releasing intrauterine system (LNG-IUS) is used for contraception and heavy menstrual bleeding. A long-term hormone therapy can modify the risk of gynecologic cancers. Little is known about the impact of LNG-IUS use on the risk for invasive and borderline ovarian tumor subtypes or for primary fallopian tube carcinoma. We examined the associations of LNG-IUS use with these tumors. We identified from the national Medical Reimbursement Registry of Finland the women aged 30-49 years who had used LNG-IUS for menorrhagia in 1994-2007, and from the Finnish Cancer Registry ovarian cancers and primary fallopian tube carcinomas diagnosed before the age of 55 and by the end of 2013. A total of 77 invasive ovarian cancers and seven primary fallopian tube carcinoma cases were diagnosed in a cohort of 93 843 LNG-IUS users during the follow-up of 1 083 126 women-years. The LNG-IUS users had decreased risk for both invasive ovarian cancer [standardized incidence ratio (SIR) 0.59, 95% confidence interval (CI) 0.47-0.73] and for borderline ovarian tumors (SIR 0.76, 95% CI 0.57-0.99) as compared to the background population. The risk of primary fallopian tube carcinoma was not increased (SIR 1.22, 95% CI 0.49-2.50). Decreased risks for mucinous (SIR 0.49, 95% CI 0.24-0.87), endometrioid (SIR 0.55, 95% CI 0.28-0.98), and serous ovarian carcinomas (SIR 0.75, 95% CI 0.55-0.99) were seen in LNG-IUS users. LNG-IUS use associated with decreased risk for both invasive and borderline ovarian tumors. The incidence of primary fallopian tube carcinoma did not significantly differ between LNG-IUS users and the background population.

  11. Investigation of storage system designs and techniques for optimizing energy conservation in integrated utility systems. Volume 1: (Executive summary)

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Integrated Utility Systems (IUS) have been suggested as a means of reducing the cost and conserving the nonrenewable energy resources required to supply utility services (energy, water, and waste disposal) to developments of limited size. The potential for further improving the performance and reducing the cost of IUS installations through the use of energy storage devices is examined and the results are summarized. Candidate energy storage concepts in the general areas of thermal, inertial, superconducting magnetic, electrochemical, chemical, and compressed air energy storage are assessed and the storage of thermal energy as the sensible heat of water is selected as the primary candidate for near term application to IUS.

  12. Chronic vulvovaginal candidiasis in patients using a levonorgestrel-containing intrauterine device.

    PubMed

    Nguyen, Yvonne; Fischer, Gayle

    2016-12-13

    Chronic vulvovaginal candidiasis is usually responsive to therapy with oral antifungals. We present a case series of 13 patients with this condition who were also using a levonorgestrel intrauterine system (LNG-IUS). All cases responded to ongoing oral fluconazole therapy while the LNG-IUS was in situ. The LNG-IUS was removed in six patients and of these, two experienced clinical improvement with lower fluconazole dosage requirements and three experienced complete resolution of symptoms. One remains on fluconazole 100 mg daily. © 2016 The Australasian College of Dermatologists.

  13. Space Transportation System Cargo projects: inertial stage/spacecraft integration plan. Volume 1: Management plan

    NASA Technical Reports Server (NTRS)

    1981-01-01

    The Kennedy Space Center (KSC) Management System for the Inertial Upper Stage (IUS) - spacecraft processing from KSC arrival through launch is described. The roles and responsibilities of the agencies and test team organizations involved in IUS-S/C processing at KSC for non-Department of Defense missions are described. Working relationships are defined with respect to documentation preparation, coordination and approval, schedule development and maintenance, test conduct and control, configuration management, quality control and safety. The policy regarding the use of spacecraft contractor test procedures, IUS contractor detailed operating procedures and KSC operations and maintenance instructions is defined. Review and approval requirements for each documentation system are described.

  14. Comparative effectiveness and impact on health-related quality of life of hysterectomy vs. levonorgestrel intra-uterine system for abnormal uterine bleeding.

    PubMed

    Cozza, G; Pinto, A; Giovanale, V; Bianchi, P; Guarino, A; Marziani, R; Frega, A; Caserta, D

    2017-05-01

    To compare hysterectomy and levonorgestrel intra-uterine system (LNG-IUS) for the treatment of abnormal uterine bleeding (AUB) and iron deficiency anemia. Retrospective study evaluating quality of life, sexual function, satisfaction and blood hemoglobin concentration improvement in 60 pre-menopausal women treated with hysterectomy or LNG-IUS. All analysis was performed with statistical software SPSS 21.0 (SPSS Inc., Chicago, IL, USA). Despite superior control of bleeding and dysmenorrhea observed after hysterectomy, LNG-IUS showed similar impact on blood hemoglobin levels, quality of life, satisfaction and sexual function resulting more cost-effective. In the absence of contraindications, LNG-IUS should always be the first therapeutic choice for chronic AUB. Surgical treatment must be considered as an "extrema ratio".

  15. The Industrial User Permitting Guidance Manual

    EPA Pesticide Factsheets

    Provides guidance for control authorities to effectively develop and issue control mechanisms to IUs discharging to the POTW and covers developing and implementing control mechanisms for both SIUs and non-SIUs.

  16. Postpartum glucose tolerance in women with gestational diabetes using levonorgestrel intrauterine contraception.

    PubMed

    Kiley, Jessica W; Hammond, Cassing; Niznik, Charlotte; Rademaker, Alfred; Liu, Dachao; Shulman, Lee P

    2015-01-01

    Postpartum contraception is critical in women with gestational diabetes mellitus (GDM). We evaluated the effect of the levonorgestrel intrauterine system (LNG-IUS) on glucose tolerance in postpartum women with GDM. The study is a descriptive analysis of 12-month glucose tolerance in women with recent GDM who used the LNG-IUS, the copper IUD or postpartum sterilization. Twelve months postpartum, 3 of 13 LNG-IUS users (23.1%) and 1 of 6 nonhormonal contraceptive users (16.6%) had prediabetes. No woman developed overt diabetes. This study is the first and only to measure the metabolic effects of the LNG-IUS women with GDM. Larger trials are necessary. Use of levonorgestrel intrauterine contraception does not appear to negatively affect glucose tolerance in postpartum women with a history of gestational diabetes. Additional appropriately powered clinical studies are needed to confirm these results. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Pyrolysis system evaluation study

    NASA Technical Reports Server (NTRS)

    1974-01-01

    An evaluation of two different pyrolysis concepts which recover energy from solid waste was conducted in order to determine the merits of each concept for integration into a Integrated Utility System (IUS). The two concepts evaluated were a Lead Bath Furnace Pyrolysis System and a Slagging Vertical Shaft, Partial Air Oxidation Pyrolysis System. Both concepts will produce a fuel gas from the IUS waste and sewage sludge which can be used to offset primary fuel consumption in addition to the sanitary disposal of the waste. The study evaluated the thermal integration of each concept as well as the economic impact on the IUS resulting from integrating each pyrolysis concepts. For reference, the pyrolysis concepts were also compared to incineration which was considered the baseline IUS solid waste disposal system.

  18. Return to Space Mission: The STS-26 Crew Report

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This videotape features footage from NASA's return to space flight after the 51-L accident. The videotape is narrated by the crew, and it includes the following: launch, landing, and the TDRS/IUS deployment.

  19. Levonorgestrel intrauterine system: Current role in management of heavy menstrual bleeding

    PubMed Central

    Magon, Navneet; Chauhan, Monica; Goel, Poonam; Malik, Sonia; Kapur, Krishan; Kriplani, Alka; Dhaliwal, Lakhbir; Pandit, Suchitra N.

    2013-01-01

    A review of literature was conducted to report on the effectiveness of levonorgestrel intrauterine system (LNG-IUS) in women with heavy menstrual bleeding (HMB). The relevant data were obtained by computerized searches of PubMed up to December 2012 and other references available with the authors. Information was obtained from references listed. Studies and case reports were excluded if they did not specifically provide information about LNG-IUS usage in women with HMB. After perusal, each relevant publication was summarized and appraised in terms of whether it contained information relevant to the stated objective. Available data shows that LNG-IUS therapy is effective and safe, providing significant reduction of menstrual bleeding in patients with HMB. LNG-IUS is a good strategy to reduce the number of hysterectomies in women with HMB. PMID:23833527

  20. STS-29 tracking and data relay satellite D (TDRS-D) mating at KSC VPF

    NASA Image and Video Library

    1988-12-29

    S89-28093 (29 Dec 1988) --- In the clean room of the vertical processing facility, the TDRS-D satellite is hoisted, thus beginning the mating process with the inertial upper stage (IUS), located in an adjacent test cell.

  1. Speeding the Recovery from Ultraslow Inactivation of Voltage-Gated Na+ Channels by Metal Ion Binding to the Selectivity Filter: A Foot-on-the-Door?

    PubMed Central

    Szendroedi, Julia; Sandtner, Walter; Zarrabi, Touran; Zebedin, Eva; Hilber, Karlheinz; Dudley, Samuel C.; Fozzard, Harry A.; Todt, Hannes

    2007-01-01

    Slow inactivated states in voltage-gated ion channels can be modulated by binding molecules both to the outside and to the inside of the pore. Thus, external K+ inhibits C-type inactivation in Shaker K+ channels by a “foot-in-the-door” mechanism. Here, we explore the modulation of a very long-lived inactivated state, ultraslow inactivation (IUS), by ligand binding to the outer vestibule in voltage-gated Na+ channels. Blocking the outer vestibule by a mutant μ-conotoxin GIIIA substantially accelerated recovery from IUS. A similar effect was observed if Cd2+ was bound to a cysteine engineered to the selectivity filter (K1237C). In K1237C channels, exposed to 30 μM Cd2+, the time constant of recovery from IUS was decreased from 145.0 ± 10.2 s to 32.5 ± 3.3 s (P < 0.001). Recovery from IUS was only accelerated if Cd2+ was added to the bath solution during recovery (V = −120 mV) from IUS, but not when the channels were selectively exposed to Cd2+ during the development of IUS (−20 mV). These data could be explained by a kinetic model in which Cd2+ binds with high affinity to a slow inactivated state (IS), which is transiently occupied during recovery from IUS. A total of 50 μM Cd2+ produced an ∼8 mV hyperpolarizing shift of the steady-state inactivation curve of IS, supporting this kinetic model. Binding of lidocaine to the internal vestibule significantly reduced the number of channels entering IUS, suggesting that IUS is associated with a conformational change of the internal vestibule of the channel. We propose a molecular model in which slow inactivation (IS) occurs by a closure of the outer vestibule, whereas IUS arises from a constriction of the internal vestibule produced by a widening of the selectivity filter region. Binding of Cd2+ to C1237 promotes the closure of the selectivity filter region, thereby hastening recovery from IUS. Thus, Cd2+ ions may act like a foot-on-the-door, kicking the IS gate to close. PMID:17720727

  2. Environmental Impact Analysis Process. Environmental Impact Statement Space Shuttle Program Vandenberg AFB, California

    DTIC Science & Technology

    1978-01-01

    NASA. Finally, anticipated effects associated with the development and C operation of an Interim Upper Stage (IUS)--a vehicle which can be integrated...for developing the Interim Upper Stage (IUS), which will be carried in the payload bay and used to boost spacecraft from the low earth orbit of the... stage (which may be the Interim Upper Stage ) and a satellite in low earth orbit, (3) the use of Orbiter itself as an orbiting satellite, hosting

  3. Expulsions and adverse events following immediate and later insertion of a levonorgestrel-releasing intrauterine system after medical termination of late first- and second-trimester pregnancy: a randomised controlled trial.

    PubMed

    Korjamo, R; Mentula, M; Heikinheimo, O

    2017-07-10

    To compare expulsions and adverse events (AEs) between immediate and delayed insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) following medical termination of pregnancy (MTOP). Randomised controlled trial. Helsinki University Hospital, Finland, January 2013-December 2014. Cohorts of 102 (gestational age 64-84 days, late first trimester) and 57 (gestational age 85-140 days, second trimester) women requesting MTOP and LNG-IUS contraception. LNG-IUS insertion occurred immediately (same day) or 2-4 weeks following MTOP. Follow-up visits were at 2-4 weeks, 3 months, and 1 year. LNG-IUS expulsion by 3 months and 1 year. AEs and bleeding profiles within 3 months. Following late first-trimester MTOP the LNG-IUS expulsion rates by 3 months were 14 (27.5%) in the immediate-insertion group and two (4.0%) in the delayed-insertion group (risk ratio, RR 6.86; 95% confidence interval, 95% CI 1.64-28.66). By 1 year the expulsion rates were 17 (33.3%) and six (12.0%) (RR 2.78, 95% CI 1.19-6.47). Following second-trimester MTOP LNG-IUS expulsion rates by 3 months and 1 year were five (18.5%) in the immediate-insertion group and one (3.6%) in the delayed-insertion group (RR 5.19, 95% CI 0.65-41.54). No differences in AEs and bleeding profiles emerged between the groups. Immediate LNG-IUS insertion after late first- or second-trimester MTOP is feasible, does not increase the complication rate, or alter the uterine bleeding patterns; however, immediate insertion increased the expulsion rate, which may limit the cost-effectiveness. Immediate insertion of LNG-IUS following MTOP at 9-20 weeks of gestation is feasible and safe. © 2017 Royal College of Obstetricians and Gynaecologists.

  4. Malposition and expulsion of the levonorgestrel intrauterine system among women with inherited bleeding disorders.

    PubMed

    Rimmer, E; Jamieson, M A; James, P

    2013-11-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is indicated for the management of menorrhagia and for contraception. The LNG-IUS is effective at reducing menstrual bleeding and improving haemoglobin among women with bleeding disorders. Expulsion rates for the LNG-IUS among normal women are reported to be approximately 5-10%. The aim of this study was to examine the malposition and expulsion rates of the LNG-IUS among women with inherited bleeding disorders. We conducted a retrospective study of women with an inherited bleeding disorder in Kingston, Canada treated with an LNG-IUS between May 2005 and June 2012. The primary outcome was a combined endpoint of expulsion and/or malposition. Predetermined secondary outcomes were patient satisfaction and changes in haemoglobin and ferritin levels. The median age of the women at the time of LNG-IUS insertion was 31 years (range 18-43, mean 32.1 years). The most common diagnosis was type 1 VWD (12/20, 60%). There were three LNG-IUS expulsions and two episodes of device malposition resulting in removal [5/20 (25.0%), 95% CI 11.2-46.9%]. An additional five women had their device removed prematurely. The overall proportion of devices resulting in discontinuation in this population was 10/20 (50.0%, 95% CI 29.9-70.1%). In this retrospective study, a significant proportion of women with an inherited bleeding disorder had an LGN-IUS removed due to poor patient satisfaction, malposition, or expulsion. Further studies into the causes of higher complication rates and interventions such as premedication or prolonged treatment with antifibrinolytic agents targeted at improving outcomes in this population are required. © 2013 John Wiley & Sons Ltd.

  5. Overall view of PLB and OMS / RCS engine thrusting

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Overall payload bay (PLB) view shows Inertial Upper Stage (IUS) Airborne Support Equipment (ASE) forward frame and aft frame tilt actuator (AFTA) table after IUS Tracking and Data Relay Satellite (TDRS) deploy. Vertical tail and Orbital Maneuvering System (OMS) pods with rear reaction control system (RCS) thruster firing (sidefiring) appears in background against blackness of space. Right right jet firing was photographed from more than 18 meters (60 feet) away in the cabin of the Earth-orbiting Challenger, Orbiter Vehicle (OV) 099.

  6. Overall view of PLB and OMS / RCS engine thrusting

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Overall payload bay (PLB) view shows Inertial Upper Stage (IUS) Airborne Support Equipment (ASE) forward frame and aft frame tilt actuator (AFTA) table after IUS Tracking and Data Relay Satellite (TDRS) deploy. Vertical tail and Orbital Maneuvering System (OMS) pods with rear reaction control system (RCS) thruster firing (upfiring) appears in background against blackness of space. Right up jet firing was photographed from more than 18 meters (60 feet) away by crewmembers on flight deck.

  7. Joint DOD/NASA study: Consolidation of expendable launch vehicles during transition to the space transportation system

    NASA Technical Reports Server (NTRS)

    1977-01-01

    A considerable amount of data is presented which was needed to compare consolidation options. The study shows that there is no clean-cut DOD/NASA advantage for consolidation. However, for DOD uses, the technical advantage of using the Titan III/IUS for the Titan IIIC in the transition era, coupled with a possible cost-push in converting to the Titan III/IUS, warrants serious DOD consideration.

  8. Oral Progestogens Versus Levonorgestrel-Releasing Intrauterine System for Treatment of Endometrial Intraepithelial Neoplasia().

    PubMed

    Marnach, Mary L; Butler, Kristina A; Henry, Michael R; Hutz, Catherine E; Langstraat, Carrie L; Lohse, Christine M; Casey, Petra M

    2017-04-01

    Limited therapeutic guidelines exist regarding medical therapy, ideal dosing, duration of therapy, or recommendations for timing of endometrial reassessment for women with endometrial intraepithelial neoplasia (EIN) who desire fertility preservation or who are not optimal surgical candidates. We aimed to determine the effectiveness of oral progestogens (OP) versus the levonorgestrel-releasing intrauterine system (LNG IUS) in the medical treatment of EIN. We retrospectively identified women with EIN at our institution from 2007 through 2014 and compared the outcomes of those treated with OP versus LNG IUS. Among 390 women, 296 were initially treated with OP and 94 with LNG IUS. Baseline characteristics of the patient groups were comparable, except for higher median body mass index in the LNG IUS group versus the OP group (37 kg/m(2) vs. 31 kg/m(2); p < 0.001). Among 332 women with follow-up endometrial biopsies (263 OP and 69 LNG IUS), EIN subcategory 1 (benign endometrial hyperplasia) resolved in 83% and 87% of patients, respectively (p = 0.31). Rates of resolution of EIN subcategory 2 (endometrial intraepithelial neoplasia) were also similar between groups (68% vs. 62%; p = 0.82). In women with EIN subcategory 3 (endometrial adenocarcinoma), 22% of those using LNG IUS and one of two women treated with OP had resolution of disease as of last follow-up. OP and LNG IUS offer similar endometrial protection for women with EIN. LNG IUS offers convenience, minimal adverse effects, reversibility, and long-term endometrial protection.

  9. History of Chandra X-Ray Observatory

    NASA Image and Video Library

    1999-07-01

    A crew member of the STS-93 mission took this photograph of the Chandra X-Ray Observatory, still attached to the Inertial Upper Stage (IUS), backdropped against the darkness of space not long after its release from Orbiter Columbia. Two firings of an attached IUS rocket placed the Observatory into its working orbit. The primary duty of the crew of this mission was to deploy the 50,162-pound Observatory, the world's most powerful x-ray telescope.

  10. Evaluation of quality of life and cost-effectiveness of definitive surgery and the levonorgestrel intrauterine system as treatment options for heavy menstrual bleeding.

    PubMed

    Adigüzel, Cevdet; Seyfettinoğlu, Sevtap; Aka Satar, Deniz; Arlier, Sefa; Eskimez, Eda; Kaya, Fatma; Nazik, Hakan

    2017-06-12

    This study aimed to compare the levonorgestrel intrauterine system (LNG-IUS) with abdominal hysterectomy (TAH) and total laparoscopic hysterectomy (TLH) as first-line treatments for heavy menstrual bleeding (HMB). Ninety-eight patients aged 20-55 years who complained of regular heavy menstrual bleeding were enrolled in the study. The TAH group included 29 patients, the LNG-IUS group included 34, and the TLH group included 35. These groups were compared in terms of quality of life and the cost-effectiveness of the selected methods. Quality of life was assessed using the 36-Item Short Form (SF-36), and cost-effectiveness was assessed according to the current cost of each approach. The quality of life parameters, with the exception of mental health, improved significantly in the LNG-IUS, TAH, and TLH groups. The mean costs of the LNG-IUS, TAH, and TLH procedures were $99.15 ± 4.90, $538.82 ± 193.00 and $1617.05 ± 258.44, respectively (P < 0.05). Overall, LNG-IUS was the most cost-effective treatment option. The outcome measures of the SF-36 revealed that after 6 months, these treatments were equal in terms of quality of life, except for mental health. LNG-IUS was the most cost-effective approach.

  11. 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.

  12. Acceptability of long-acting, progestin-only contraception in Europe: a two-year prospective, non-interventional study.

    PubMed

    Short, Mary; Dallay, Dominique; Omokanye, Salmon; Stauch, Kathrin; Inki, Pirjo

    2014-02-01

    OBJECTIVES To compare two-year continuation rates and user satisfaction with the levonorgestrel releasing-intrauterine system (LNG-IUS) and the etonogestrel releasing-subdermal implant (ENG implant) in women in Europe. METHODS This prospective, non-interventional study was undertaken at 72 sites in France (n = 61), Great Britain (n = 2), Ireland (n = 3) and Slovakia (n = 6). Women opting to switch their method of contraception to the LNG-IUS or the ENG implant were followed-up over 24 months to document continuation and satisfaction with their chosen contraceptive method. Reasons for discontinuation were documented. RESULTS The data analysed were based on 363 women (LNG-IUS [n = 247] and ENG implant [n = 116]), aged 20 to 45 years, with at least one follow-up visit after contraceptive placement. The documented cumulative continuation rate was 82% in the LNG-IUS group and 67% in the ENG implant group at 24 months. The documented discontinuation rates were 13% and 17%, respectively. Bleeding problems were cited as reason for discontinuation in 4% and 11% of women in the LNG-IUS and ENG implant groups, respectively. CONCLUSIONS The LNG-IUS is associated with higher continuation rates and user satisfaction than the ENG implant in this study of women in Europe, though the groups were not similar in all respects. Bleeding problems with the ENG implant account for most of the reasons for discontinuing its use.

  13. Efficacy of the Levonorgestrel-Releasing Intrauterine System on IVF-ET Outcomes in PCOS With Simple Endometrial Hyperplasia.

    PubMed

    Bian, Jiang; Shao, Hongfang; Liu, Hua; Li, Hui; Fang, Lu; Xing, Changying; Wang, Lihong; Tao, Minfang

    2015-06-01

    This study investigated the in vitro fertilization (IVF) outcome of levonorgestrel-releasing intrauterine system (LNG-IUS) pretreatment for simple endometrial hyperplasia (EH) in patients with polycystic ovary syndrome (PCOS) undergoing IVF embryo transfer (IVF-ET). One hundred ninety patients with PCOS and simple EH without cytologic atypia were allocated randomly to 2 independent arms, that is, the LNG-IUS group (90 patients) and the non-LNG-IUS group (100 patients). Four hundred fourteen patients with PCOS without endometrial disease comprised the control group. Each patient was reevaluated by transvaginal ultrasonography (TVS) and endometrial biopsy after 6 months. For each patient, IVF outcome measures, such as number of recombinant follicle-stimulating hormone, endometrial thickness on human chorionic gonadotropin (HCG) day, hormone levels (progesterone, luetinizing hormone, and serum estradiol) on HCG day, number of oocytes, fertilization rate, clinical pregnancy rate, and miscarriage rate were compared among the 3 groups. In general, the 3 groups did not differ with respect to the main clinical and biochemical data. After 6 months, patients in LNG-IUS group had an EH resolution rate of 87.77%. In the non-LNG-IUS group, the resolution rate was 15.00%, and 3% of these patients showed progression of EH. The clinical pregnancy rates in the non-LNG-IUS group were significantly lower (28.04%) than that in the LNG-IUS group (46.06%) and the control group (44.65%). The miscarriage rate was highest in the non-LNG-IUS group, but no significant difference in miscarriage rate existed among the 3 groups. The study illustrates that the LNG-IUS can be safely used for 6 months as a treatment for patients with PCOS and simple EH. Additionally, use of the LNG-IUS can increase the clinical pregnancy rates and implantation rates of patients with PCOS and simple EH who undergo gonadotropin-releasing hormone agonist IVF-ET protocols. © The Author(s) 2014.

  14. Intolerance of Uncertainty Scale: Measurement invariance among adolescent boys and girls and relationships with anxiety and risk taking.

    PubMed

    Dekkers, Laura M S; Jansen, Brenda R J; Salemink, Elske; Huizenga, Hilde M

    2017-06-01

    Adolescence-related increases in both anxiety and risk taking may originate in variability in Intolerance of Uncertainty (IU), rendering the study of IU of importance. We therefore studied the psychometric properties of the Intolerance of Uncertainty Scale-Short version (IUS-12), including its associations with trait anxiety and risk taking, among adolescents. A sample of 879 Dutch adolescents, from diverse educational levels, and with an equal distribution of boys and girls, was classically tested. To obtain indices of IU, and self-reported trait anxiety and need for risk taking, questionnaires were administrated; to obtain an index of risk taking behavior, adolescents performed a risk taking task. Multi-group Confirmatory Factor Analyses revealed that the IUS-12 consists of a Prospective and an Inhibitory IU subscale, which are partially measurement invariant across sex. Cronbach's alphas and item-total correlations revealed that the IUS-12 and its subscales have reasonable-to-good internal consistency. Correlational analyses support convergent validity, as higher IUS-12 scores were related to, respectively, higher and lower levels of self-reported trait anxiety and need for risk taking. However, we found no relationship between IUS-12 scores and risk taking behavior, operationalized by performance on the risk taking task. A community, instead of clinical, sample was included. Also, IU was measured by a paper-and-pencil version of the IUS-12, instead of a computerized version. The IUS-12 has good psychometric properties and may be a central measure to assess IU, which enables to explain the adolescence-related increase in both anxiety and risk taking. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Vaginal microbiome changes with levonorgestrel intrauterine system placement.

    PubMed

    Jacobson, Janet C; Turok, David K; Dermish, Amna I; Nygaard, Ingrid E; Settles, Matthew L

    2014-08-01

    To investigate changes in female genital tract bacterial ecology associated with levonorgestrel intrauterine system (LNG IUS) use. Study participants were regularly cycling Caucasian women without recent history of pregnancy or exogenous hormone use. Vaginal, cervical and uterine samples were obtained at nine time intervals, from 1 week before to 12 weeks after LNG IUS placement. Replicate paired vaginal and cervical specimens were collected to determine the consistency of specimen collection and processing. A total of 406 samples from 11 women were available for analysis after DNA extraction, amplification and species identification. Of the 355 bacterial species or genera detected, Lactobacillus crispatus was most prevalent representing 48.9% of over 6 million total reads. L. crispatus reads of replicate vaginal samples were not significantly different [odds ratio (OR) 0.79, 0.36-1.73]. In addition, L. crispatus reads of vaginal and cervical samples from the same visit were not significantly different (OR 0.69, 0.31-1.51). Compared to sampling visits prior to LNG IUS placement, sampling visits after LNG IUS insertion were more likely to have L. crispatus reads greater than 50% of total reads (OR 2.13, 1.01-4.48). Of the 63 uterine samples demonstrating bacteria, Burkholderia genus proteobacteria, a common environmental contaminant, were most prevalent both before and after LNG IUS insertion accounting for 48.0% of all uterine sample reads. The vaginal microbiome changes very little in response to LNG IUS placement. Further study is needed to place this finding in context with clinical outcomes. There do not appear to be any clinically important differences in the vaginal microbiome in response to insertion of the LNG IUS. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. A randomised clinical trial to assess satisfaction with the levonorgestrel- releasing intrauterine system inserted at caesarean section compared to postpartum placement.

    PubMed

    Braniff, Kathleen; Gomez, Edmund; Muller, Reinhold

    2015-06-01

    Insertion of levonorgestrel-releasing intrauterine system (LNG-IUS) at caesarean section (CS) provides contraception prior to resumption of ovulation or sexual activity. Patient satisfaction with insertion at CS has not previously been studied. The aim of this study was to compare patient satisfaction with LNG-IUS inserted at the time of lower uterine segment CS to six weeks postpartum. Open-label randomised controlled trial. Women booked for elective CS were randomised to LNG-IUS insertion either at the time of CS (study group) or at six weeks postpartum (control group). The primary outcome measure was patient satisfaction. Outcomes were measured at six weeks, three months and six months postpartum. Forty-eight women were randomised into two treatment groups. Twenty-five women were randomised to have LNG-IUS inserted at the time of CS, 23 of whom had the planned intervention and two had the LNG-IUS inserted postpartum. Twenty-three women were randomised to the control group, four of whom withdrew prior to treatment. The 44 remaining women contributed to data analysis. Patient satisfaction was high and similar in both groups. At six months postpartum, 90.5% of the study group were very satisfied or somewhat satisfied compared with 88.2% of the control group. Patient satisfaction is high with LNG-IUS insertion at CS and not different to that with delayed insertion. LNG-IUS insertion may be an option for women who find postpartum contraception difficult to access. © 2015 The Authors. Australian and New Zealand Journal of Obstetrics and Gynaecology published by Wiley Publishing Asia Pty Ltd on behalf of Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. Weight variation in users of depot-medroxyprogesterone acetate, the levonorgestrel-releasing intrauterine system and a copper intrauterine device for up to ten years of use.

    PubMed

    Modesto, Waleska; de Nazaré Silva dos Santos, Priscila; Correia, Vinicius Machado; Borges, Luiza; Bahamondes, Luis

    2015-02-01

    Data on record regarding weight variation in depot-medroxyprogesterone acetate (DMPA) and levonorgestrel-releasing intrauterine system (LNG-IUS) users are controversial. To date, no studies have yet evaluated weight variation in DMPA and LNG-IUS users in up to ten years of use compared to non-hormonal contraceptive users. A retrospective study analysed weight variations in 2138 women using uninterruptedly DMPA (150 mg intramuscularly, three-monthly; n = 714), the LNG-IUS (n = 701) or a copper-intrauterine device (Cu-IUD; n = 723). At the end of the first year of use, there was a mean weight increase of 1.3 kg, 0.7 kg and 0.2 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively, compared to weight at baseline (p < 0.0001). After ten years of use, the mean weight had risen by 6.6 kg, 4.0 and 4.9 kg among the DMPA-, LNG-IUS- and Cu-IUD users, respectively. DMPA-users had gained more weight than LNG-IUS- (p = 0.0197) and than Cu-IUD users (p = 0.0294), with the latter two groups not differing significantly from each other in this respect (p = 0.5532). Users of hormonal and non-hormonal contraceptive methods gained a significant amount of weight over the years. DMPA users gained more weight over the treatment period of up to ten years than women fitted with either a LNG-IUS or a Cu-IUD.

  18. Treatment of menorrhagia associated with oral anticoagulation: efficacy and safety of the levonorgestrel releasing intrauterine device (Mirena coil).

    PubMed

    Pisoni, C N; Cuadrado, M J; Khamashta, M A; Hunt, B J

    2006-01-01

    Menorrhagia is common in women receiving oral anticoagulation. In healthy women, reductions of up to 90% of menstrual loss have been described with the levonorgestrel releasing intrauterine device (LNG-IUS). However there is no data about the use of LNG-IUS in women receiving oral anticoagulation and so we assessed the efficacy and safety of LNG-IUS in this setting. Patients with menorrhagia who used LNG-IUS and warfarin were contacted by post and asked to complete a questionnaire assessing the extent and duration of menstrual bleeding, quality of life and treatment satisfaction. The questionnaire was sent to 23 patients and returned by 17. The amount of bleeding was reduced with the LNG-IUS in 10 (58.8%) women; amenorrhea occurred in four (23.5%), no change in blood loss in one (5.9%) and greater blood loss in two (11.8%) patients. The number of sanitary pads used was less in 12 (70.6%) patients; same in one (5.9%) patient, more in two (11.8%) patients and two (11.8%) did not remember. Five patients (29.4%) had shorter duration of bleeding, four (23.5%) had amenorrhoea, four (23.5%) had longer periods and four (23.5%) had same duration by subjective assessment. Eight (47.1%) patients felt very satisfied, four (23.5%) felt satisfied, two (11.8%) felt dissatisfied with the treatment, one felt very dissatisfied (5.9%) and two (11.8%) did not respond to the question. This small study suggests LNG-IUS is effective in reducing the duration and amount of menstrual bleeding in women with menorrhagia associated with oral anticoagulation. We feel the use of LNG-IUS is a major advance in reducing menorrhagia in women on oral anticoagulation as the previous alternative--hysterectomy--is associated with an increased risk of thrombosis and bleeding.

  19. Changes in body composition in women using long-acting reversible contraception.

    PubMed

    Silva Dos Santos, Priscilla de Nazaré; Madden, Tessa; Omvig, Karen; Peipert, Jeffrey F

    2017-04-01

    Users of hormonal long-acting reversible contraception (LARC) report weight gain as a side effect, but few studies have assessed body composition change among LARC users. We evaluated weight and body composition of healthy women using the levonorgestrel intrauterine system (LNG-IUS), copper intrauterine device (copper IUD) or etonogestrel implant (ENG implant). We hypothesized that weight gain and body composition over 12 months would not differ between copper IUD, LNG-IUS and ENG implant users. We performed a prospective cohort study of a subgroup of women enrolled in the Contraceptive CHOICE Project who initiated the LNG-IUS, copper IUD or ENG implant. Inclusion criteria included lack of metabolic and eating disorders or change in body weight of more than 5% in the 6 months before enrollment. We measured changes in weight and body composition (body fat percentage, total body fat mass, total lean mass and total body mass) in women who continued their method for 12 months. We analyzed data from 149 participants: 85 LNG-IUS users, 31 copper IUD users and 33 ENG implant users. The mean age was 25.9 years, 56.4% were White, 82.5% had some college education and 67.6% were nulliparous. Although lean body mass increased over 12 months in LNG-IUS and copper IUD users but not in ENG implant users, changes in body weight and body composition did not differ between the groups. In the adjusted model, Black race was associated with change in total body mass (p<.05). Among those who continued the method for 12 months, changes in body weight and composition did not differ between copper IUD, LNG-IUS and ENG implant users. Changes in body weight and composition over 12 months did not differ between copper IUD users and LNG-IUS and ENG implant users among those with 12 months of continuous use. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. 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.

  1. Tobacco smoke in infants with bronchopulmonary dysplasia.

    PubMed

    Martinez, Stéphanie; Garcia-Meric, Patricia; Millet, Véronique; Aymeric-Ponsonnet, Mellie; Alagha, Khuder; Dubus, Jean-Christophe

    2015-07-01

    Exposure to tobacco smoke has been not evaluated in children with bronchopulmonary dysplasia (BPD). We evaluate the association of in utero smoking (IUS) and environmental tobacco smoke (ETS) with the respiratory events of BPD and non-BPD children. Two hundred sixty-two children born before 35 weeks of gestational age (GA) and regularly followed up in our regional network for preterms were enrolled. They were paired according to their BPD status, their gestational age and birth weight (131 children with BPD and 131 without BPD, 28 mean weeks GA; mean weight 1000 g). Respiratory data were obtained prospectively during their first 2 years of life. A complementary questionnaire was completed by the parents about their child's respiratory health at the age of 2, their home environment, and tobacco status. IUS concerned 12.6 %; ETS, 48.8 % (67 % in BPD children treated with oxygen at home). No further influence on respiratory outcome could be found by exposure to intrauterine smoke or extrauterine tobacco smoke in this patient sample. IUS and ETS exposures are as high in preterm children as in a general pediatric population. The highest exposure occurs among BPD infants treated with oxygen at home. • Environmental tobacco smoke (ETS) and in utero smoking (IUS) are responsible for many morphological, functional, and clinical changes in children. • Children with bronchopulmonary dysplasia (BPD) have more respiratory events in their first years of life than preterm children without BPB, maybe triggered by ETS and IUS. What is New: • The exposition to ETS and IUS is high in preterm children with and without BDP, as high as in a general. • Pedaitric population, particularly in children with BPD and treated with oxygen at home. • No further influence on respiratory outcome could be found by exposure to ETS or IUS in our studied population.

  2. A 12-month multicenter, randomized study comparing the levonorgestrel intrauterine system with the etonogestrel subdermal implant.

    PubMed

    Apter, Dan; Briggs, Paula; Tuppurainen, Marjo; Grunert, Julia; Lukkari-Lax, Eeva; Rybowski, Sarah; Gemzell-Danielsson, Kristina

    2016-07-01

    To compare the levonorgestrel intrauterine system (LNG-IUS 8), which has an average levonorgestrel release rate of ∼8 μg/24 hours during the first year (total levonorgestrel content 13.5 mg; Jaydess/Skyla), with the etonogestrel (ENG) subdermal implant (total content, 68 mg) with regard to the 12-month discontinuation rate (primary outcome). Randomized, open-label, phase III study. Thirty-eight centers in six European countries. Study population of 766 healthy nulliparous and parous women aged 18-35 years. The LNG-IUS 8 or the ENG implant. Discontinuation rate, by treatment group, at Month 12. The 12-month discontinuation rates were 19.6% and 26.8% in the LNG-IUS 8 and ENG implant groups, respectively. The -7.2% difference was statistically significant (95% confidence interval -13.2%, -1.2%). Fewer women in the LNG-IUS 8 group than in the ENG implant group discontinued because of increased bleeding (3.2% vs. 11.3%) or adverse events (14.3% vs. 21.8%). At 12 months, more women in the LNG-IUS 8 group than in the ENG implant group were "very/somewhat satisfied" with their bleeding pattern (60.9% vs. 33.6%) and reported a preference to use their study treatment after study completion (70.1% vs. 58.5%). The LNG-IUS 8 was associated with a significantly lower 12-month discontinuation rate compared with the ENG implant; mainly because ENG implant users frequently discontinued due to increased bleeding. More LNG-IUS 8 users than ENG implant users reported being "very/somewhat satisfied" with their bleeding pattern, and reported a preference to continue using their study treatment after the study. NCT01397097. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. Assessment of the quality of cervical mucus among users of the levonorgestrel-releasing intrauterine system at different times of use.

    PubMed

    Moraes, Leticia G; Marchi, Nadia M; Pitoli, Ana C; Hidalgo, Maria M; Silveira, Carolina; Modesto, Waleska; Bahamondes, Luis

    2016-08-01

    The quality of cervical mucus (CM) among the levonorgestrel-releasing intrauterine system (LNG-IUS) users is controversial. The objectives were to assess CM compared to the levels of oestradiol (E2) and the frequency of cycles with luteal activity among users of the LNG-IUS. In total, 224 LNG-IUS users for between two months and five years were recruited at a Brazilian family planning clinic. For the cross-sectional part of the study, we enrolled 175 LNG-IUS users at 2, 6 12, 24, 36, 48, and 60 months after insertion (25 women in each group), and we performed one evaluation. For the prospective part of the study, we enrolled 49 LNG-IUS users at the same lengths of use after insertion (7 women in each group), and we evaluated these women once a week for five consecutive weeks. . Mean (± SEM) CM scores of all evaluations among women with single and weekly evaluations were between 3.3 ± 0.9 and 8.5 ± 0.3, respectively independently of the length of use of the LNG-IUS. Mean E2 values ranged from 45.5 ± 6.8 to 472.5 ± 34.7 pg/ml and the maximum ovarian follicle diameter on the days of evaluation varied from 14.0 ± 1.3 to 31.2 ± 0.4 mm. The mean CM score of all evaluations, independent of the length of use of the LNG-IUS and normal levels of serum E2, was below 10 was according to the WHO is inadequate for sperm penetration.

  4. [A prospective study on the effects of levonorgestrel-releasing intrauterine system for adenomyosis with menorrhagia].

    PubMed

    Li, L; Leng, J H; Shi, J H; Zhang, J J; Jia, S Z; Li, X Y; Dai, Y; Zhang, J R; Li, T; Xu, X X; Liu, Z Z; You, S S; Chang, X Y; Lang, J H

    2016-06-25

    To investigate treatment effects of levonorgestrel-releasing intrauterine system (LNG-IUS) for adenomyosis with menorrhea in a prospective study. From December 2006 to December 2014, patients of symptomatic adenomyosis diagnosed by transvaginal ultrasound in outpatient or inpatient clinics of Peking Union Medical College Hospital were given the treatment of LNG-IUS. Before and after placement of LNG-IUS, all the patients' parameters were recorded prospectively, including scores of menstruation blood loss, carrying status of IUS, symptoms and scores of dysmenorrhea, biochemical indicators, physical parameters, menstruation patterns and adverse effects. Changes of pictorial chart scores of menstruation and distribution of anemia during follow-up were analyzed. Totally 1 100 women meets inclusion criteria, among which 618 cases (56.18%, 618/1 100) had severe menorrhea, with median follow-up period of 28 months (range 1- 60 months), and accumulative carrying rate of 66% at 60 months follow-up. After placement of LNG-IUS, compared with baselines, pictorial chart scores and ratio of menorrhea had decreased significantly (all P<0.01), the scroes of menstruation were 157±34, 94±35, 70±33, 67±18, 67±20, 65±19, 66±19, 65±21 at 0, 3, 6, 12, 24, 36, 48 and 60 months respectively. During 24 months after placement of LNG-IUS, pictorial chart scores and distribution of anemia had improved significantly compared with preceding period (all P<0.01). We found no dependent factors predicting improvement of pictorial chart scores of menorrhea, which was neither relevant with simultaneous changes of menstruation patterns nor adverse effects (all P>0.05). LNG-IUS is effective for adenomyosis of menorrhea. Improvement of menstruation blood loss is independent on patients characters, menstruation patterns or adverse effects.

  5. Evaluation of a new, low-dose levonorgestrel intrauterine contraceptive system over 5 years of use.

    PubMed

    Gemzell-Danielsson, Kristina; Apter, Dan; Dermout, Sylvia; Faustmann, Thomas; Rosen, Kimberly; Schmelter, Thomas; Merz, Martin; Nelson, Anita

    2017-03-01

    To evaluate the efficacy and safety of a new, low-dose levonorgestrel intrauterine contraceptive system (LNG-IUS 12) for up to 5 years of use. In this Phase III study, 2885 nulliparous and parous women aged 18-35 years were randomized to LNG-IUS 8 or LNG-IUS 12 for 3 years. After 3 years, women using LNG-IUS 12 could continue for up to 2 additional years (5 years total). The primary outcome was occurrence of pregnancy (Pearl Index). Secondary outcomes included safety, bleeding, dysmenorrhea, discontinuations, and user satisfaction. From August 2007 through May 2008, out of 2885 women who were enrolled, 1453 were randomized to LNG-IUS 12. Placement was attempted in 1452/1453 (full analysis set). Mean age at baseline was 27.1 years; 39.5% were nulliparous. The cumulative 5-year Pearl Index (PI) was 0.29; the 5-year cumulative failure rate was 1.4%. The 5-year PI for ectopic pregnancy was 0.18. Over 5 years, 55.3% of women reported study drug-related treatment-emergent adverse events (TEAEs). Crude incidences of pelvic inflammatory disease, uterine perforation, and complete/partial LNG-IUS 12 expulsion were 0.6%, 0.2%, and 3.7%, respectively. Women using LNG-IUS 12 generally experienced less frequent bleeding over time. The incidence of amenorrhea during the last 90-day reference interval (end of Year 5) was 22.6%. Overall, 870 (59.9%) and 550 (37.9%) women completed 3 and 5 years of treatment, respectively; 77.8% of women who entered the extension phase completed 5 years of use. Over 5 years, 22.6% discontinued due to TEAEs, including 13 women who discontinued due to pregnancy; 76 discontinued due to bleeding problems including amenorrhea; and 163 discontinued due to desire for pregnancy, 71.2% of whom conceived within 12 months. In this study including parous and nulliparous women, LNG-IUS 12 was highly effective over 5 years of use and associated with a favorable safety profile. LNG-IUS 12 offers women a low-dose contraceptive option for up to 5 years. Copyright

  6. Benefit-risk assessment of the levonorgestrel intrauterine system in contraception.

    PubMed

    Backman, Tiina

    2004-01-01

    The levonorgestrel-releasing intrauterine system (IUS) is a long-acting, fully reversible method of contraception. It is one of the most effective forms of contraception available, and combines the advantages of both hormonal and intrauterine contraception. The levonorgestrel-releasing IUS also gives the users many non-contraceptive benefits: the amount of menstrual bleeding and the number of days of menstrual bleeding are reduced, which makes it suitable for the treatment of menorrhagia (heavy menstrual blood loss). Dysmenorrhoea (painful menstruation) and premenstrual symptoms are also relieved. In addition, the levonorgestrel-releasing IUS provides protection for the endometrium during hormone replacement therapy. The local release of levonorgestrel into the uterine cavity results in a strong uniform suppression of the endometrial epithelium as the epithelium becomes insensitive to estradiol released from the ovaries. This accounts for the reduction in menstrual blood loss. All possible patterns of bleeding are seen among users of the levonorgestrel-releasing IUS; however, most of the women who experience total amenorrhoea continue to ovulate. The first months of use are often characterised by irregular, scanty bleeding, which in most cases resolves spontaneously. The menstrual pattern and fertility return to normal soon after the levonorgestrel-releasing IUS is removed. The contraceptive efficacy is high with 5-year failure rates of 0.5-1.1 per 100 users. The absolute number of ectopic pregnancies is low, as is the rate per 1000 users. The levonorgestrel-releasing IUS is equally effective in all age groups and the bodyweight of the user is not associated with failure of the method. In Western cultures continuance rates among users of the levonorgestrel-releasing IUS are comparable with those of other long-term methods of contraception. Premature removal of the device is most often associated with heavy menstrual bleeding and pain, as with other long

  7. Impact of a Hormone-Releasing Intrauterine System on the Vaginal Microbiome: A Prospective Baboon Model

    PubMed Central

    Hashway, Sara A.; Bergin, Ingrid L.; Bassis, Christine M.; Uchihashi, Mayu; Schmidt, Kelsey C.; Young, Vincent B.; Aronoff, David M.; Patton, Dorothy L.; Bell, Jason D.

    2014-01-01

    Background Use of a levonorgestrel-releasing intrauterine system (LNG-IUS) in humans may alter vaginal microbial populations and susceptibility to pathogens. This study evaluated the time-dependent effects of an LNG-IUS on the vaginal microbiome of the baboon, a useful animal model for reproductive studies. Methods LNG-IUS were inserted into three reproductively mature, female baboons. The animals were evaluated for six months by physical examination and Gram-stained cytology. The vaginal microbiota was characterized at each timepoint by culture-independent analysis of the16S rRNA-encoding gene. Results Each baboon harbored a diverse vaginal microbiome. Inter-individual variation exceeded intra-individual variation. Diversity declined over time in one baboon and showed mild fluctuations in the other two. There were no significant community differences from early to late post LNG-IUS placement. Conclusions The baboon vaginal microbiome is unique to each individual and is polymicrobial. In this pilot study, the vaginal microbiome remained stable from early to late post LNG-IUS placement. PMID:24266633

  8. Evaluating the Efficacy of Levonorgestrel Intrauterine System and Danazol for Relief of Postoperative Pain in Endometriosis.

    PubMed

    Taneja, Ashima; Kaur, Satinder; Soni, R K; Bhanupriya; Kaur, Jaspreet; Singla, Laveen

    2017-07-01

    Endometriosis is an oestrogen-dependent disorder, manifests during reproductive years and is associated with pain and infertility. There is considerable debate about the effectiveness of various interventions for pain relief. To evaluate the efficacy of Levonorgestrel Intrauterine System (LNG-IUS) and Danazol in postoperative pain relief for patients with endometriosis. Hundred patients with diagnosis of endometriosis, who were treated laparoscopically, entered the study to receive either danazol (600 mg once daily) or LNG-IUS (inserted during immediate post operative period) postsurgery, for pain relief. Patients were analysed for pain relief according to VAS score and recurrence of disease using ultrasonography at third and sixth months of follow up. There were 50% patients in stage IV of endometriosis. Majority of them presented with complaint of infertility (49%) and pelvic pain (43%). It was observed that LNG-IUS was significantly more effective in relieving pain compared to danazol (65.2% vs 38.0%, p<0.05). Recurrence rate was significantly lower in LNG-IUS users compared to other group. LNG-IUS was found to be more effective in relieving pain compared to danazol.

  9. Estimated economic impact of the levonorgestrel intrauterine system on unintended pregnancy in active duty women.

    PubMed

    Heitmann, Ryan J; Mumford, Sunni L; Hill, Micah J; Armstrong, Alicia Y

    2014-10-01

    Unintended pregnancy is reportedly higher in active duty women; therefore, we sought to estimate the potential impact of the levonorgestrel-containing intrauterine system (LNG-IUS) could have on unintended pregnancy in active duty women. A decision tree model with sensitivity analysis was used to estimate the number of unintentional pregnancies in active duty women which could be prevented. A secondary cost analysis was performed to analyze the direct cost savings to the U.S. Government. The total number of Armed Services members is estimated to be over 1.3 million, with an estimated 208,146 being women. Assuming an age-standardized unintended pregnancy rate of 78 per 1,000 women, 16,235 unintended pregnancies occur each year. Using a combined LNG-IUS failure and expulsion rate of 2.2%, a decrease of 794, 1588, and 3970 unintended pregnancies was estimated to occur with 5%, 10% and 25% usage, respectively. Annual cost savings from LNG-IUS use range from $3,387,107 to $47,352,295 with 5% to 25% intrauterine device usage. One-way sensitivity analysis demonstrated LNG-IUS to be cost-effective when the cost associated with pregnancy and delivery exceeded $11,000. Use of LNG-IUS could result in significant reductions in unintended pregnancy among active duty women, resulting in substantial cost savings to the government health care system. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  10. The role of levonorgestrel-releasing intrauterine system for endometrial protection in women with breast cancer taking tamoxifen.

    PubMed

    Shi, Qingquan; Li, Jinhong; Li, Ming; Wu, Jing; Yao, Qiang; Xing, Aiyun

    2014-01-01

    To review the evidence concerning the efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) in preventing endometrial pathology in women treated with tamoxifen. Randomized controlled trials (RCTs) of women with breast cancer on tamoxifen that compared endometrial surveillance or placebo alone vs. the LNG-IUS were reviewed. The eligible trials were identified from the following electronic databases: Cochrane CENTRAL, Medline, and EMBASE. The authors extracted data on all reported outcomes and conducted meta-analyses on the endometrial polyps, endometrial hyperplasia, proliferative endometrium, and endometrium thickness. According to the subgroup analysis, a significant reduction of endometrial polyps was obtained (OR = 0.22, 95% CI 0.13-0.37, p < 0.00001). The use of LNG-IUS reduced the incidence of endometrial hyperplasia (OR = 0.13, 95% CI 0.03-0.58, p = 0.007). Increased abnormal vaginal bleeding for LNG-IUS users may be an adverse aspect of LNG-IUS. This meta-analysis confirms that endometrial hyperplasia is also reduced as well as endometrial polyp formation reduced after long-term follow-up.

  11. Mechanism of action of the levonorgestrel-releasing intrauterine system in the treatment of heavy menstrual bleeding.

    PubMed

    Cihangir, Uzunçakmak; Ebru, Akbay; Murat, Ekin; Levent, Yaşar

    2013-11-01

    To assess the efficacy and adverse effects, and reveal the effective pathway of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of heavy menstrual bleeding. In a prospective single-center study in Istanbul, Turkey, the LNG-IUS was inserted in 60 patients diagnosed with heavy menstrual bleeding between January 2008 and June 2010. Menstrual bleeding pattern, coagulation parameters, uterine arterial blood flow, endometrial thickness, and uterine and ovarian volumes were assessed pre-insertion, and at 6 and 12months. Forty-nine women completed the study. When compared with pre-insertion values, the LNG-IUS led to improvements in hemoglobin and marked decreases in visual bleeding scores, endometrial thickness, and fibrinogen levels (P<0.001); platelet count, international normalized ratio, prothrombin time, activated partial thromboplastin time, and uterine volume also decreased (P<0.05). No significant change in ovarian volumes, or uterine artery resistive and pulsatility indices was observed at 6 or 12months compared with pre-insertion values. The decline in menstrual blood loss among LNG-IUS users was associated with local progestogenic effects and aggravation of intrinsic and extrinsic coagulation pathways. Although the LNG-IUS is a highly effective method for treating heavy menstrual bleeding, care must be taken when a patient has thromboembolic risk factors. © 2013.

  12. Tug fleet and ground operations schedules and controls. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1975-01-01

    This study presents Tug Fleet and Ground Operations Schedules and Controls plan. This plan was developed and optimized out of a combination of individual Tug program phased subplans, special emphasis studies, contingency analyses and sensitivity analyses. The subplans cover the Tug program phases: (1) Tug operational, (2) Interim Upper Stage (IUS)/Tug fleet utilization, (3) and IUS/Tug payload integration, (4) Tug site activation, (5) IUS/Tug transition, (6) Tug acquisition. Resource requirements (facility, GSE, TSE, software, manpower, logistics) are provided in each subplan, as are appropriate Tug processing flows, active and total IUS and Tug fleet requirements, fleet management and Tug payload integration concepts, facility selection recommendations, site activation and IUS to Tug transition requirements. The impact of operational concepts on Tug acquisition is assessed and the impact of operating Tugs out of KSC and WTR is analyzed and presented showing WTR as a delta. Finally, cost estimates for fleet management and ground operations of the DDT&E and operational phases of the Tug program are given.

  13. Hormonal and intrauterine methods for contraception for women aged 25 years and younger.

    PubMed

    Krashin, Jamie; Tang, Jennifer H; Mody, Sheila; Lopez, Laureen M

    2015-08-17

    Mantel-Haenszel odds ratio (OR) with 95% confidence interval (CI). Because of disparate interventions and outcome measures, we did not conduct meta-analysis. Five trials met the inclusion criteria. The studies included a total of 1503 women, with a mean of 301 participants. The trials compared the following contraceptives: combined oral contraceptive (COC) versus transdermal contraceptive patch, vaginal contraceptive ring, or levonorgestrel intrauterine system 20 µg/day (LNG-IUS 20); LNG-IUS 12 µg/day (LNG-IUS 12) versus LNG-IUS 16 µg/day (LNG-IUS 16); and LNG-IUS 20 versus the copper T380A intrauterine device (IUD). In the trials comparing two different types of methods, the study arms did not differ significantly for contraceptive efficacy or continuation. The sample sizes were small for two of those studies. The only significant outcome was that a COC group had a higher proportion of women who discontinued for 'other personal reasons' compared with the group assigned to the LNG-IUS 20 (OR 0.27, 95% CI 0.09 to 0.85), which may have little clinic relevance. The trial comparing LNG-IUS 12 versus LNG-IUS 16 showed similar efficacy over one and three years. In three trials that examined different LNG-IUS, continuation was at least 75% at 6 to 36 months. We considered the overall quality of evidence to be moderate to low. Limitations were due to trial design or limited reporting. Different doses in the LNG-IUS did not appear to influence efficacy over three years. In another study, continuation of the LNG-IUS appeared at least as high as that for the COC. The current evidence was insufficient to compare efficacy and continuation rates for hormonal and intrauterine contraceptive methods in women aged 25 years and younger.

  14. KSC-99pp0617

    NASA Image and Video Library

    1999-06-01

    The Inertial Upper Stage (IUS) booster (right) is lifted out of its container after arriving at Kennedy Space Center's Vertical Processing Facility. The IUS will be mated with the Chandra X-ray Observatory (at left) and then undergo testing to validate the IUS/Chandra connections and check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  15. KSC-99pp0622

    NASA Image and Video Library

    1999-06-01

    In the Vertical Processing Facility, the Chandra X-ray Observatory is lowered toward the Inertial Upper Stage (IUS) in a workstand beneath it. There it will be mated with the IUS and then undergo testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  16. KSC-99pp0619

    NASA Image and Video Library

    1999-06-01

    The Inertial Upper Stage (IUS) booster is lowered toward a workstand in Kennedy Space Center's Vertical Processing Facility. The IUS will be mated with the Chandra X-ray Observatory and then undergo testing to validate the IUS/Chandra connections and check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  17. KSC-99pp0621

    NASA Image and Video Library

    1999-06-01

    In the Vertical Processing Facility, the Chandra X-ray Observatory is moved toward the Inertial Upper Stage (IUS) in a workstand at right. There it will be mated with the IUS and then undergo testing to validate the IUS/Chandra connections and check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  18. KSC-99pp0618

    NASA Image and Video Library

    1999-06-01

    The Inertial Upper Stage (IUS) booster is moved toward a workstand in Kennedy Space Center's Vertical Processing Facility. The IUS will be mated with the Chandra X-ray Observatory and then undergo testing to validate the IUS/Chandra connections and check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  19. Novel Ultrasound Joint Selection Methods Using a Reduced Joint Number Demonstrate Inflammatory Improvement when Compared to Existing Methods and Disease Activity Score at 28 Joints.

    PubMed

    Tan, York Kiat; Allen, John C; Lye, Weng Kit; Conaghan, Philip G; D'Agostino, Maria Antonietta; Chew, Li-Ching; Thumboo, Julian

    2016-01-01

    A pilot study testing novel ultrasound (US) joint-selection methods in rheumatoid arthritis. Responsiveness of novel [individualized US (IUS) and individualized composite US (ICUS)] methods were compared with existing US methods and the Disease Activity Score at 28 joints (DAS28) for 12 patients followed for 3 months. IUS selected up to 7 and 12 most ultrasonographically inflamed joints, while ICUS additionally incorporated clinically symptomatic joints. The existing, IUS, and ICUS methods' standardized response means were -0.39, -1.08, and -1.11, respectively, for 7 joints; -0.49, -1.00, and -1.16, respectively, for 12 joints; and -0.94 for DAS28. Novel methods effectively demonstrate inflammatory improvement when compared with existing methods and DAS28.

  20. A numerical algorithm to propagate navigation error covariance matrices associated with generalized strapdown inertial measurement units

    NASA Technical Reports Server (NTRS)

    Weir, Kent A.; Wells, Eugene M.

    1990-01-01

    The design and operation of a Strapdown Navigation Analysis Program (SNAP) developed to perform covariance analysis on spacecraft inertial-measurement-unit (IMU) navigation errors are described and demonstrated. Consideration is given to the IMU modeling subroutine (with user-specified sensor characteristics), the data input procedures, state updates and the simulation of instrument failures, the determination of the nominal trajectory, the mapping-matrix and Monte Carlo covariance-matrix propagation methods, and aided-navigation simulation. Numerical results are presented in tables for sample applications involving (1) the Galileo/IUS spacecraft from its deployment from the Space Shuttle to a point 10 to the 8th ft from the center of the earth and (2) the TDRS-C/IUS spacecraft from Space Shuttle liftoff to a point about 2 h before IUS deployment. SNAP is shown to give reliable results for both cases, with good general agreement between the mapping-matrix and Monte Carlo predictions.

  1. A comparative study of the levonorgestrel-releasing intrauterine system Mirena versus the Copper T380A intrauterine device during lactation: breast-feeding performance, infant growth and infant development.

    PubMed

    Shaamash, Ayman H; Sayed, Gamal H; Hussien, Mostafa M; Shaaban, Mamdouh M

    2005-11-01

    Mirena is a levonorgestrel-releasing intrauterine system (LNG-IUS) that provides highly effective and long-acting progestogen-only contraception. The objective of this study was to analyze the possible effects of using LNG-20 microg IUS on breast-feeding performance, infant growth and infant development during the first postpartum year as compared with the Copper T380A intrauterine device (Cu T380A IUD). This study is a prospective, controlled and randomized trial. The study was conducted at the Department of Obstetrics and Gynecology, Assiut University Hospital, Egypt. Three hundred twenty lactating women asking for initiation of contraception during the early postpartum stage were assigned randomly into two groups, the LNG-20 microg IUS group (n=163) and the Cu T380A group (n=157). The insertions were done 6-8 weeks postpartum. Each participant was followed up at three monthly intervals after insertion and until the first birthday of her baby. During these visits, the breast-feeding pattern was assessed, certain infant physical growth parameters were measured and a set of infant development tests was performed. No pregnancy occurred in both groups. There were no significant differences in the net continuation rates between the two groups (89.3 for LNG-IUS vs. 90.9 for Cu T380A). The LNG-20 microg IUS group had comparable rates of breast-feeding continuation, complete weaning, full breast-feeding and partial breast-feeding, with the Cu-IUD group. No statistically significant differences were found between groups with regard to all infant physical growth parameters and various infant development tests. The findings of the current study confirm that the use of LNG-20 microg IUS during the first postpartum year in lactating women provides highly effective and acceptable contraception and does not negatively influence breast-feeding or the growth and development of breast-fed infants.

  2. Association of baseline bleeding pattern on amenorrhea with levonorgestrel intrauterine system use.

    PubMed

    Mejia, Manuela; McNicholas, Colleen; Madden, Tessa; Peipert, Jeffrey F

    2016-11-01

    This study aims to evaluate the effect of baseline bleeding patterns on rates of amenorrhea reported at 12 months in levonorgestrel (LNG) 52 mg intrauterine system (IUS) users. We also assessed the effect of baseline bleeding patterns at 3 and 6 months postinsertion. In this secondary analysis of the Contraceptive CHOICE Project, we included participants who had an LNG-IUS inserted within 1 month of enrollment and continued use for 12 months. Using 12-month telephone survey data, we defined amenorrhea at 12 months of use as no bleeding or spotting during the previous 6 months. We used chi-square and multivariable logistic regression to assess the association of baseline bleeding pattern with amenorrhea while controlling for confounding variables. Of 1802 continuous 12-month LNG-IUS users, amenorrhea was reported by 4.9%, 14.8% and 15.4% of participants at 3, 6 and 12 months, receptively. Participants with light baseline bleeding or short duration of flow reported higher rates of amenorrhea at 3 and 6 months postinsertion (p<.03), while LNG-IUS users with heavy or prolonged flow were less likely to report amenorrhea at 3 and 6 months (p<.03). In a multivariable analysis, participants with self-reported heavy bleeding at baseline were less likely to report amenorrhea at 12 months than those who reported moderate bleeding (ORadj, 0.36; 95% CI, 0.16-0.69). Women with heavier menstrual bleeding are less likely than women with moderate flow to report amenorrhea following 12 months of LNG-IUS use. Baseline heavy menstrual flow reduces the likelihood of amenorrhea with LNG-IUS use, information that could impact contraceptive counseling. Anticipatory counseling can improve method satisfaction and continuation, an important strategy to continue to reduce unintended pregnancy and abortion rates. Copyright © 2016 Elsevier Inc. All rights reserved.

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

    PubMed

    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

  4. Relationship between user satisfaction with the levonorgestrel-releasing intrauterine system and bleeding patterns.

    PubMed

    Carvalho, Nelsilene M; Chou, Victoria; Modesto, Waleska; Margatho, Deborah; Garcia, Elaine A L; Bahamondes, Luis

    2017-08-17

    Satisfaction with a contraceptive method constitutes an important factor in its acceptance and long-term use. The objective of this study was to assess the relationship between user satisfaction with the 20-μg/day levonorgestrel-releasing intrauterine system (LNG-IUS) and the bleeding patterns reported at two different time-points during follow-up. A total of 251 LNG-IUS users aged 18-45 years were invited to answer a questionnaire on their return to the clinic for a routine follow-up visit and again 1 year later. Data were collected face-to-face. Twenty women discontinued prematurely; therefore, the analysis was performed on 231 women. Most users were either highly satisfied (66.6% and 66.2% at the first and second interviews, respectively) or satisfied (26.4% and 26.4% at the first and second interviews, respectively) with the LNG-IUS. Satisfaction was related to amenorrhea (P < 0.001) and duration of use (P < 0.001). Prolonged bleeding and spotting were the main causes of dissatisfaction with the device. Most LNG-IUS users in this sample were satisfied with the device. The only two factors associated with satisfaction were amenorrhea and duration of use, while prolonged bleeding and spotting were the main causes of dissatisfaction. These findings could be useful for health-care professionals and policy-makers when developing information material for women. The study provides insight into the profile of satisfied LNG-IUS users; however, this information is not suitable for counseling women who are considering using an LNG-IUS. © 2017 Japan Society of Obstetrics and Gynecology.

  5. The cost-effectiveness of the levonorgestrel-releasing intrauterine system for the treatment of idiopathic heavy menstrual bleeding in the United States.

    PubMed

    Ganz, Michael L; Shah, Dhvani; Gidwani, Risha; Filonenko, Anna; Su, Wenqing; Pocoski, Jennifer; Law, Amy

    2013-01-01

    Heavy menstrual bleeding negatively impacts the health and quality of life of about 18 million women in the United States. Although some studies have established the clinical effectiveness of heavy menstrual bleeding treatments, few have evaluated their cost-effectiveness. Our objective was to evaluate the cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) compared with other therapies for idiopathic heavy menstrual bleeding. We developed a model comparing the clinical and economic outcomes (from a US payer perspective) of three broad initial treatment strategies over 5 years: LNG-IUS, oral agents, or surgery. Up to three nonsurgical treatment lines, followed by up to two surgical lines, were allowed; unintended pregnancy was possible, and women could discontinue any time during nonsurgical treatments. Menstrual blood loss of 80 ml or more per cycle determined treatment failure. Initiating treatment with LNG-IUS resulted in the fewest hysterectomies (6 per 1000 women), the most quality-adjusted life-years (3.78), and the lowest costs ($1137) among all the nonsurgical strategies. Initiating treatment with LNG-IUS was also less costly than surgery, resulted in fewer hysterectomies (vs. 9 per 1000 for ablation) but was associated with fewer quality-adjusted life-years gained per patient (vs. 3.80 and 3.88 for ablation and hysterectomy, respectively). Sensitivity analyses confirmed these results. LNG-IUS resulted in the lowest treatment costs and the fewest number of hysterectomies performed over 5 years compared with all other initial strategies and resulted in the most quality-adjusted life-years gained among nonsurgical options. Initial treatment with LNG-IUS is the least costly and most effective option for women desiring to preserve their fertility. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  6. Effects of the levonorgestrel-releasing intrauterine system plus estrogen therapy in perimenopausal and postmenopausal women: systematic review and meta-analysis.

    PubMed

    Somboonporn, Woraluk; Panna, Sunida; Temtanakitpaisan, Teerayut; Kaewrudee, Srinaree; Soontrapa, Sukree

    2011-10-01

    The objective of this study was to compare the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) with those of systemic progestogen in perimenopausal and postmenopausal women taking systemic estrogen therapy (ET). We searched Medline (August 8, 2009), Embase (August 8, 2009), the Cochrane Central Register of Controlled Trials on the Cochrane Library Issue 3 (2009), the MetaRegister of Controlled Trials, and the reference lists of articles for relevant trials. Randomized controlled studies of LNG-IUS versus systemic progestogen in perimenopausal and postmenopausal women taking ET were included in the review. Two reviewers abstracted the trials independently. Any disagreement was resolved through discussion with the third reviewer. For dichotomous outcomes, a Peto odds ratio was calculated. For continuous outcomes, nonskewed data from valid scales were synthesized using a weighted mean difference or a standardized mean difference. Six trials with a total of 518 participants were included. The methodological limitation was an attrition bias. In perimenopausal and postmenopausal women taking ET, the incidence of a proliferative endometrium was comparable between the use of systemic progestogen and LNG-IUS, except for sequential medroxyprogesterone acetate, which had a higher incidence of proliferative endometrium. Descriptive data synthesis showed that ET combined with either LNG-IUS or systemic progestogen effectively relieved climacteric symptoms. Vaginal bleeding and spotting were common in the LNG-IUS group for the first 3 to 6 months of use. The discontinuation rate was not different. There was insufficient evidence to draw any conclusions about the other outcomes. The LNG-IUS was more effective than sequential medroxyprogesterone acetate but was comparable with other systemic progestogen regimens for endometrial protection in perimenopausal and postmenopausal women taking ET.

  7. History of Chandra X-Ray Observatory

    NASA Image and Video Library

    1999-01-01

    In this photograph, the Chandra X-Ray Observatory (CXO) was installed and mated to the Inertial Upper Stage (IUS) inside the Shuttle Columbia's cargo bay at the Kennedy Space Center. The CXO will help astronomers world-wide better understand the structure and evolution of the universe by studying powerful sources of x-rays such as exploding stars, matter falling into black holes, and other exotic celestial objects. X-ray astronomy can only be done from space because Earth's atmosphere blocks x-rays from reaching the surface. The Observatory provides images that are 50 times more detailed than previous x-ray missions. At more than 45 feet in length and weighing more than 5 tons, the CXO was carried into low-Earth orbit by the Space Shuttle Columbia (STS-93 mission) on July 22, 1999. The Observatory was deployed from the Shuttle's cargo bay at 155 miles above the Earth. Two firings of an attached IUS rocket, and several firings of its own onboard rocket motors, after separating from the IUS, placed the Observatory into its working orbit. The IUS is a solid rocket used to place spacecraft into orbit or boost them away from the Earth on interplanetary missions. Since its first use by NASA in 1983, the IUS has supported a variety of important missions, such as the Tracking and Data Relay Satellite, Galileo spacecraft, Magellan spacecraft, and Ulysses spacecraft. The IUS was built by the Boeing Aerospace Co., at Seattle, Washington and managed by the Marshall Space Flight Center.

  8. 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

  9. Using Intraoperative Ultrasonography for Spinal Cord Tumor Surgery.

    PubMed

    Ivanov, Marcel; Budu, Alexandru; Sims-Williams, Hugh; Poeata, Ion

    2017-01-01

    Our aim was to evaluate the usefulness of modern intraoperative ultrasonography (iUS) in the resection of a wide variety of spinal intradural pathologic entities. We evaluated patients with spinal cord disease treated between January 2006 and September 2015. Intraoperative standard B-mode images were acquired using a 3.5-MHz to 12-MHz ultrasonographic probes (linear and curvilinear) on various ultrasound machines. The benefits and disadvantages of iUS were assessed for each case. A total number of 158 intradural spinal lesions were operated on using iUS. Of these, 107 lesions (68%) were intradural extramedullary and 51 (32%) were intramedullary. All lesions were clearly visible using the ultrasound probe. The high-frequency linear probes (10-12 MHz) provided a better image quality compared with lower-frequency probes. Color and power-angiography modes were helpful in assessing the vascularization of the tumors and location of the major vessels in the vascular lesions. We document how iUS was used to facilitate safe and efficient spinal tumor resection at each stage of the operation. iUS was beneficial in confirmation of tumor location and extension, planning myelotomy, and estimation of degree of resection of the intramedullary tumors. It was particularly helpful in guiding the approach in redo surgeries for recurrent spinal cord tumors. iUS has a fast learning curve and offers additional intraoperative information that can help improve surgical accuracy and therefore may reduce procedure-related morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Geoscience Education Programs in the NSF Division of Undergraduate Education: Different Acronyms with Similar Intent

    NASA Astrophysics Data System (ADS)

    Singer, J.; Ryan, J. G.

    2014-12-01

    For the past three decades, the National Science Foundation's (NSF) Division of Undergraduate Education (DUE) has administered a succession of programs intended to improve undergraduate STEM education for all students. The IUSE (Improving Undergraduate STEM Education) program is the latest program in this succession, and reflects an expanded, NSF-wide effort to make sustainable improvements in STEM education on a national scale. The origins and thinking behind IUSE can be in part traced back to precursor programs including: ILI (Instrumentation and Laboratory Improvement), CCD (Course and Curriculum Development), UFE (Undergraduate Faculty Enhancement), CCLI (Course, Curriculum and Laboratory Improvement), and TUES (Transforming Undergraduate Education in STEM), all of which sought to support faculty efforts to investigate and improve curriculum and instructional practice in undergraduate STEM education, and to disseminate effective STEM educational practices for broad adoption. IUSE, like its predecessor programs, is open to all STEM fields, and as such is intended to support improvements in geoscience education, spanning the atmospheric, ocean, and Earth sciences, as well as in environmental science, GIS science, climate change and sustainability/resilience. An emphasis on discipline-based research on learning that had origins in the CCLI and TUES programs is a new priority area in IUSE, with the ambition that projects will take advantage of the integrated expertise of domain scientists, educational practioners, and experts in learning science. We trace and describe the history of undergraduate education efforts with an emphasis placed on the recently introduced IUSE program. Understanding the origin of DUE's IUSE program can provide insights for faculty interested in developing proposals for submission and gain a greater appreciation of trends and priorities within the division.

  11. Levonorgestrel-releasing intrauterine system and the risk of breast cancer: A nationwide cohort study.

    PubMed

    Soini, Tuuli; Hurskainen, Ritva; Grénman, Seija; Mäenpää, Johanna; Paavonen, Jorma; Joensuu, Heikki; Pukkala, Eero

    2016-01-01

    Prolonged steroid hormone therapy increases the risk of breast cancer, especially the risk of lobular cancer, but the effect of the levonorgestrel-releasing intrauterine system (LNG-IUS) use is controversial. In this study we aimed to test the hypothesis that risk for lobular breast cancer is elevated among LNG-IUS users. We identified from the national Medical Reimbursement Registry of Finland the women aged 30-49 who had used LNG-IUS for the treatment or prevention of menorrhagia in 1994-2007, and from the Finnish Cancer Registry breast cancers diagnosed before the age of 55 and by the end of 2012. A total of 2015 women had breast cancer diagnosed in a cohort of 93 843 LNG-IUS users during follow-up consisting of 1 032 767 women-years. The LNG-IUS users had an increased risk for both ductal breast cancer [standardized incidence ratio (SIR) 1.20, 95% confidence interval (CI) 1.14-1.25] and for lobular breast cancer (SIR 1.33, 95% CI 1.20-1.46), as compared with the general female population. The highest risk was found in LNG-IUS users who purchased the device at least twice, whose SIR for lobular cancer was 1.73 (95% CI 1.37-2.15). The results imply that intrauterine administration of levonorgestrel is not only related to an excess risk of lobular breast cancer but also, in contrary to previous assumptions, to an excess risk of ductal breast cancer.

  12. Medical treatment of a grossly enlarged adenomyotic uterus with the levonorgestrel-releasing intrauterine system.

    PubMed

    Fong, Y F; Singh, K

    1999-09-01

    Adenomyosis is an important cause of menorrhagia. Besides hysterectomy, the treatment options for adenomyosis have been limited. Presented here is the successful treatment of adenomyosis in a woman presenting with menorrhagia, dysmenorrhea, and an enlarging uterus, for whom conservative therapy initiated with mefenamic acid was unsatisfactory. The patient had insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS). A marked decrease in uterine size occurred within 12 months of insertion accompanied by resolution of the menorrhagia and dysmenorrhea. Thus, the LNG-IUS is a viable option and represents a real advance in the treatment of adenomyosis.

  13. Long-term effects of levonorgestrel-releasing intrauterine system on tamoxifen-treated breast cancer patients: a meta-analysis.

    PubMed

    Fu, Yun; Zhuang, Zhigang

    2014-01-01

    The aim of the study is to assess the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) on the tamoxifen-induced endometrial lesions in breast cancer patients. PubMed and EMBASE databases were searched for eligible studies. Odds ratios were obtained to estimate the association between the LNG-IUS and tamoxifen-induced endometrial lesions. The fixed effects or random-effects model was used to combine data depending on heterogeneity. With three eligible randomized clinical trials involving 359 patients, this analysis demonstrated tamoxifen-treated breast cancer patients using the LNG-IUS derived benefit from de novo polyps prevention (P < 0.0001, OR 0.18, 95% CI: 0.08-0.42). However, the LNG-IUS only showed a trend of maintaining endometrial proliferation or secretory status (P = 0.05, OR 0.36, 95% CI 0.13-1.02) and no statistical difference in atrophic or inactive changes (P = 0.13, OR 0.24, 95% CI 0.04-1.53) or endometrial hyperplasia without atypia (P = 0.08, OR 0.20, 95% CI 0.04-1.18). The LNG-IUS didn't have an increased incidence in breast cancer recurrence (P = 0.28, OR 1.75, 95% CI: 0.64-4.80) and cancer-induced death (P = 0.71, OR 1.22, 95% CI: 0.42-3.52). Bleeding in the treatment group was statistically more frequent than that in the control group (OR 6.20, 95% CI: 2.99-12.85, P < 0.00001). This analysis verifies the efficacy of the LNG-IUS in preventing tamoxifen-induced polyps. The LNG-IUS didn't have an increased incidence in breast cancer recurrence and cancer-induced death. Long-term, large randomized studies of the LNG-IUS will be necessary to determine the benefit and risk in tamoxifen-treated breast cancer patients.

  14. Analytical investigation of solid rocket nozzle failure

    NASA Technical Reports Server (NTRS)

    Mccoy, K. E.; Hester, J.

    1985-01-01

    On April 5, 1983, an Inertial Upper Stage (IUS) spacecraft experienced loss of control during the burn of the second of two solid rocket motors. The anomaly investigation showed the cause to be a malfunction of the solid rocket motor. This paper presents a description of the IUS system, a failure analysis summary, an account of the thermal testing and computer modeling done at Marshall Space Flight Center, a comparison of analysis results with thermal data obtained from motor static tests, and describes some of the design enhancement incorporated to prevent recurrence of the anomaly.

  15. ISTAR: Intelligent System for Telemetry Analysis in Real-time

    NASA Technical Reports Server (NTRS)

    Simmons, Charles

    1994-01-01

    The intelligent system for telemetry analysis in real-time (ISTAR) is an advanced vehicle monitoring environment incorporating expert systems, analysis tools, and on-line hypermedia documentation. The system was developed for the Air Force Space and Missile Systems Center (SMC) in Los Angeles, California, in support of the inertial upper stage (IUS) booster vehicle. Over a five year period the system progressed from rapid prototype to operational system. ISTAR has been used to support five IUS missions and countless mission simulations. There were a significant number of lessons learned with respect to integrating an expert system capability into an existing ground system.

  16. Quantitative levonorgestrel plasma level measurements in patients with regular and prolonged use of the levonorgestrel-releasing intrauterine system.

    PubMed

    Seeber, Beata; Ziehr, Stephanie C; Gschlieβer, Andreas; Gschliesser, Aandrea; Moser, Christina; Mattle, Verena; Seger, Christoph; Griesmacher, Andrea; Concin, Nicole; Concin, Hans; Wildt, Ludwig

    2012-10-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) is well accepted as an easy-to-use contraceptive with an excellent side-effect profile. It contains a reservoir of 52 mg of levonorgestrel (LNG) with continuous release of the steroid. Its contraceptive use is approved for 5 years. The aim of this study was to determine the plasma concentration of LNG and its variation with time in patients with in-dwelling LNG-IUS Mirena®. In this study, we determined LNG plasma concentrations in 110 women with LNG-IUS at different time points of use. Time from insertion of the system in the study population ranged from 20 days to 11.1 years. Quantitative LNG levels were determined using a validated liquid chromatography-tandem mass spectrometry assay. The mean±SD LNG plasma level in all women was 147±59 pg/mL. A highly significant negative correlation between LNG plasma level and LNG-IUS time of use could be demonstrated. In the first year of use, LNG plasma level was as high as 191±71 pg/mL, decreasing to 157±68 pg/mL in the second year and 134±41 pg/mL in the third year. Even after exceeding the recommended period of LNG-IUS use, systemic LNG concentrations were detectable: 133±38 pg/mL in the sixth year, 133±48 pg/mL in the seventh year and 117±45 pg/mL in the eighth year. Furthermore, a significant negative correlation between LNG plasma level and body mass index could be shown. Systemic LNG concentrations can be found in all patients with LNG-IUS IUS. However, concentrations are much lower than in other forms of LNG application. Moreover, this study demonstrates that a systemic effect of LNG-IUS can also be found after the recommended contraceptive lifespan of 5 years. Copyright © 2012 Elsevier Inc. All rights reserved.

  17. Levonorgestrel-Releasing Intrauterine System (52 mg) for Idiopathic Heavy Menstrual Bleeding: A Health Technology Assessment.

    PubMed

    2016-01-01

    Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding. We conducted a systematic review of the clinical and economic evidence comparing LNG-IUS with usual medical therapy, endometrial ablation, or hysterectomy. Medline, EMBASE, Cochrane, and the Centres for Reviews and Dissemination were searched from inception to August 2015. The quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also completed an economic evaluation to determine the cost-effectiveness and budget impact of the LNG-IUS compared with endometrial ablation and with hysterectomy. The economic evaluation was conducted from the perspective the Ontario Ministry of Health and Long-Term Care. Relevant systematic reviews (n = 18) returned from the literature search were used to identify eligible randomized controlled trials, and 16 trials were included. The LNG-IUS improved quality of life and reduced menstrual blood loss better than usual medical therapy. There was no evidence of a significant difference in these outcomes compared with the improvements offered by endometrial ablation or hysterectomy. Mild hormonal side effects were the most commonly reported. The quality of the evidence varied from very low to moderate across outcomes. Results from the economic evaluation showed the LNG-IUS was less costly (incremental saving of $372 per person) and more effective providing higher quality-adjusted life years (incremental

  18. Long-term effects of levonorgestrel-releasing intrauterine system on tamoxifen-treated breast cancer patients: a meta-analysis

    PubMed Central

    Fu, Yun; Zhuang, Zhigang

    2014-01-01

    Objective: The aim of the study is to assess the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) on the tamoxifen-induced endometrial lesions in breast cancer patients. Methods: PubMed and EMBASE databases were searched for eligible studies. Odds ratios were obtained to estimate the association between the LNG-IUS and tamoxifen-induced endometrial lesions. The fixed effects or random-effects model was used to combine data depending on heterogeneity. Results: With three eligible randomized clinical trials involving 359 patients, this analysis demonstrated tamoxifen-treated breast cancer patients using the LNG-IUS derived benefit from de novo polyps prevention (P < 0.0001, OR 0.18, 95% CI: 0.08-0.42). However, the LNG-IUS only showed a trend of maintaining endometrial proliferation or secretory status (P = 0.05, OR 0.36, 95% CI 0.13-1.02) and no statistical difference in atrophic or inactive changes (P = 0.13, OR 0.24, 95% CI 0.04-1.53) or endometrial hyperplasia without atypia (P = 0.08, OR 0.20, 95% CI 0.04-1.18). The LNG-IUS didn’t have an increased incidence in breast cancer recurrence (P = 0.28, OR 1.75, 95% CI: 0.64-4.80) and cancer-induced death (P = 0.71, OR 1.22, 95% CI: 0.42-3.52). Bleeding in the treatment group was statistically more frequent than that in the control group (OR 6.20, 95% CI: 2.99-12.85, P < 0.00001). Conclusions: This analysis verifies the efficacy of the LNG-IUS in preventing tamoxifen-induced polyps. The LNG-IUS didn’t have an increased incidence in breast cancer recurrence and cancer-induced death. Long-term, large randomized studies of the LNG-IUS will be necessary to determine the benefit and risk in tamoxifen-treated breast cancer patients. PMID:25400720

  19. Levonorgestrel-Releasing Intrauterine System (52 mg) for Idiopathic Heavy Menstrual Bleeding: A Health Technology Assessment

    PubMed Central

    Schaink, Alexis; Chan, Brian; Higgins, Caroline

    2016-01-01

    Background Heavy menstrual bleeding affects as many as one in three women and has negative physical, economic, and psychosocial impacts including activity limitations and reduced quality of life. The goal of treatment is to make menstruation manageable, and options include medical therapy or surgery such as endometrial ablation or hysterectomy. This review examined the evidence of effectiveness and cost-effectiveness of the 52-mg levonorgestrel-releasing intrauterine system (LNG-IUS) as a treatment alternative for idiopathic heavy menstrual bleeding. Methods We conducted a systematic review of the clinical and economic evidence comparing LNG-IUS with usual medical therapy, endometrial ablation, or hysterectomy. Medline, EMBASE, Cochrane, and the Centres for Reviews and Dissemination were searched from inception to August 2015. The quality of the evidence was assessed according to the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. We also completed an economic evaluation to determine the cost-effectiveness and budget impact of the LNG-IUS compared with endometrial ablation and with hysterectomy. The economic evaluation was conducted from the perspective the Ontario Ministry of Health and Long-Term Care. Results Relevant systematic reviews (n = 18) returned from the literature search were used to identify eligible randomized controlled trials, and 16 trials were included. The LNG-IUS improved quality of life and reduced menstrual blood loss better than usual medical therapy. There was no evidence of a significant difference in these outcomes compared with the improvements offered by endometrial ablation or hysterectomy. Mild hormonal side effects were the most commonly reported. The quality of the evidence varied from very low to moderate across outcomes. Results from the economic evaluation showed the LNG-IUS was less costly (incremental saving of $372 per person) and more effective providing higher quality

  20. Effect of the levonorgestrel-releasing intrauterine system on uterine myomas in a renal transplant patient.

    PubMed

    Fong, Y F; Singh, K

    1999-07-01

    The levonorgestrel-releasing intrauterine system (LNG-IUS) has been used in the treatment of both idiopathic menorrhagia and adenomyosis. An electronic search of the on-line medical literature revealed no reports of its use for menorrhagia secondary to uterine myomas. Presented here is the successful treatment of uterine myomas with menorrhagia in a woman with a renal transplant. There was a significant reduction in menorrhagia, dysmenorrhea, and uterine and myoma size with the use of the LNG-IUS. We believe that this system provides an alternative to conventional hysterectomy and gonadotrophin-releasing hormonal analog medical treatment for uterine myomas, with a possibly inhibitory effect on myoma growth.

  1. Use of frameless intrauterine devices and systems in young nulliparous and adolescent women: results of a multicenter study

    PubMed Central

    Wildemeersch, Dirk; Jandi, Sohela; Pett, Ansgar; Nolte, Kilian; Hasskamp, Thomas; Vrijens, Marc

    2014-01-01

    Background The purpose of this study was to provide additional data on the experience with frameless copper and levonorgestrel (LNG) intrauterine devices (IUDs) in nulliparous and adolescent women. Methods Nulliparous and adolescent women, 25 years of age or younger, using the frameless copper IUD or the frameless LNG-releasing intrauterine system (IUS), were selected from previous studies and a current multicenter post-marketing study with the frameless copper IUD. The small copper-releasing GyneFix® 200 IUD consists of four copper cylinders, each 5 mm long and only 2.2 mm wide. The frameless FibroPlant® LNG-IUS consists of a fibrous delivery system releasing the hormone levonorgestrel (LNG-IUS). The main features of these intrauterine contraceptives are that they are frameless, flexible, and anchored to the fundus of the uterus. Results One hundred and fifty-four nulliparous and adolescent women participated in the combined study. One pregnancy occurred with the GyneFix 200 IUD after unnoticed early expulsion of the device (cumulative pregnancy rate 1.1 at one year). Two further expulsions were reported, one with the GyneFix 200 IUD and the other with the FibroPlant LNG-IUS. The cumulative expulsion rate at one year was 1.1 with the copper IUD and 2.2 with the LNG-IUS. The total discontinuation rate at one year was low (3.3 and 4.3 with the copper IUD and LNG-IUS, respectively) and resulted in a high rate of continuation of use at one year (96.7 with the copper IUD and 95.7 with the LNG-IUS, respectively). Continuation rates for both frameless copper IUD and frameless LNG-IUS remained high at 3 years (>90%). There were no cases of perforations or pelvic inflammatory disease reported during or following insertion. Conclusion This report confirms earlier studies with frameless devices and suggests that the high user continuation rate is attributable to the optimal relationship between the IUD and the uterine cavity. IUD studies have shown that an IUD that does

  2. Femilis(®) 60 Levonorgestrel-Releasing Intrauterine System-A Review of 10 Years of Clinical Experience.

    PubMed

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman

    2016-01-01

    The aim of this study was to update the clinical experience with the Femilis® 60 levonorgestrel-releasing intrauterine system (LNG-IUS), now up to 10 years in parous and nulliparous women, particularly with regard to ease and safety of insertion, contraceptive performance, retention, acceptability, continuation of use, impact on menstrual blood loss (MBL), and duration of action. Using the Femilis® 60 LNG-IUS releasing 20 µg of levonorgestrel/day, the following studies were conducted: an open, prospective noncomparative contraceptive study, an MBL study, a perimenopausal study, a study for the treatment of endometrial hyperplasia, and early cancer of the uterus, a residue study. A total of 599 Femilis LNG-IUS were inserted in various clinical trials, the majority for contraceptive purposes. The total exposure in the first and second contraceptive studies, covering 558 parous and nulliparous women, was 32,717 woman-months. Femilis has high contraceptive effectiveness as only one pregnancy occurred. Expulsion of the LNG-IUS was rare with only two total and no partial expulsions (stem protruding through the cervical canal) occurred. Femilis was well tolerated, with continuation rates remaining high. Several MBL studies were conducted, totaling 80 heavy and normal menstrual bleeders, using the pictorial bleeding assessment chart method or the quantitative alkaline hematin technique. Virtually all women responded well with strongly reduced menstrual bleeding. Amenorrhea rates were high, up to 80% after three months, and ferritin levels simultaneously increased significantly. The Femilis LNG-IUS was tested in 104 symptomatic perimenopausal women for seamless transition to and through menopause, adding estrogen therapy when required. Patient tolerability appeared high as >80% requested a second and a third LNG-IUS. Twenty women presenting with nonatypical and atypical hyperplasia and one woman presenting with early endometrial carcinoma were treated with Femilis LNG-IUS

  3. Femilis® 60 Levonorgestrel-Releasing Intrauterine System—A Review of 10 Years of Clinical Experience

    PubMed Central

    Wildemeersch, Dirk; Andrade, Amaury; Goldstuck, Norman

    2016-01-01

    OBJECTIVE The aim of this study was to update the clinical experience with the Femilis® 60 levonorgestrel-releasing intrauterine system (LNG-IUS), now up to 10 years in parous and nulliparous women, particularly with regard to ease and safety of insertion, contraceptive performance, retention, acceptability, continuation of use, impact on menstrual blood loss (MBL), and duration of action. STUDY DESIGN Using the Femilis® 60 LNG-IUS releasing 20 µg of levonorgestrel/day, the following studies were conducted: an open, prospective noncomparative contraceptive study, an MBL study, a perimenopausal study, a study for the treatment of endometrial hyperplasia, and early cancer of the uterus, a residue study. RESULTS A total of 599 Femilis LNG-IUS were inserted in various clinical trials, the majority for contraceptive purposes. The total exposure in the first and second contraceptive studies, covering 558 parous and nulliparous women, was 32,717 woman-months. Femilis has high contraceptive effectiveness as only one pregnancy occurred. Expulsion of the LNG-IUS was rare with only two total and no partial expulsions (stem protruding through the cervical canal) occurred. Femilis was well tolerated, with continuation rates remaining high. Several MBL studies were conducted, totaling 80 heavy and normal menstrual bleeders, using the pictorial bleeding assessment chart method or the quantitative alkaline hematin technique. Virtually all women responded well with strongly reduced menstrual bleeding. Amenorrhea rates were high, up to 80% after three months, and ferritin levels simultaneously increased significantly. The Femilis LNG-IUS was tested in 104 symptomatic perimenopausal women for seamless transition to and through menopause, adding estrogen therapy when required. Patient tolerability appeared high as >80% requested a second and a third LNG-IUS. Twenty women presenting with nonatypical and atypical hyperplasia and one woman presenting with early endometrial carcinoma

  4. Progesterone or progestogen-releasing intrauterine systems for heavy menstrual bleeding.

    PubMed

    Lethaby, Anne; Hussain, Munawar; Rishworth, Josephine R; Rees, Margaret C

    2015-04-30

    -releasing intrauterine devices versus no treatment, placebo, or other medical or surgical therapy for heavy menstrual bleeding within primary care, family planning or specialist clinic settings were eligible for inclusion. Women with postmenopausal bleeding, intermenstrual or irregular bleeding, or pathological causes of heavy menstrual bleeding were excluded. Potential trials were independently assessed by at least two review authors. The review authors extracted the data independently and data were pooled where appropriate. Risk ratios (RRs) were estimated from the data for dichotomous outcomes and mean differences (MD) for continuous outcomes. The primary outcomes were reduction in menstrual blood loss and satisfaction; in addition, rate of adverse effects, changes in quality of life, failure of treatment and withdrawal from treatment were also assessed. We included 21 RCTs (2082 women). The included trials mostly assessed the levonorgestrel-releasing intrauterine device (LNG IUS) (no conclusions could be reached from one small study assessing Progestasert which was discontinued in 2001) and so conclusions are based only on LNG IUS. Comparisons were made with placebo, oral medical treatment, endometrial destruction techniques and hysterectomy. Ratings for the overall quality of the evidence for each comparison ranged from very low to high. Limitations in the evidence included inadequate reporting of study methods and inconsistency.Seven studies compared the LNG IUS with oral medical therapy: either norethisterone acetate (NET) administered over most of the menstrual cycle, medroxyprogesterone acetate (MPA) (administered for 10 days), the oral contraceptive pill, mefenamic acid or usual medical treatment where participants could choose the oral treatment that was most suitable. The LNG IUS was more effective at reducing HMB as measured by the alkaline haematin method (MD 66.91 mL, 95% CI 42.61 to 91.20; two studies, 170 women; I(2) = 81%, low quality evidence) or by Pictorial Bleeding

  5. Levonorgestrel intrauterine system for endometrial protection in women with breast cancer on adjuvant tamoxifen.

    PubMed

    Dominick, Sally; Hickey, Martha; Chin, Jason; Su, H Irene

    2015-12-09

    Adjuvant tamoxifen reduces the risk of breast cancer recurrence in women with oestrogen receptor-positive breast cancer. Tamoxifen also increases the risk of postmenopausal bleeding, endometrial polyps, hyperplasia, and endometrial cancer. The levonorgestrel-releasing intrauterine system (LNG-IUS) causes profound endometrial suppression. This systematic review considered the evidence that the LNG-IUS prevents the development of endometrial pathology in women taking tamoxifen as adjuvant endocrine therapy for breast cancer. To determine the effectiveness and safety of levonorgestrel intrauterine system (LNG-IUS) in pre- and postmenopausal women taking adjuvant tamoxifen following breast cancer for the outcomes of endometrial and uterine pathology including abnormal vaginal bleeding or spotting, and secondary breast cancer events. We searched the following databases: Cochrane Menstrual Disorders and Subfertility Group Specialised Register (MDSG), Cochrane Breast Cancer Group Specialised Register (CBCG), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Abstracts of Reviews of Effects (DARE), The Cochrane Library, clinicaltrials.gov, The World Health Organisation International Trials Registry, ProQuest Dissertations & Theses, MEDLINE, EMBASE, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PsycINFO, Web of Science, OpenGrey, LILACS, PubMed, and Google. The final search was performed in October 2015. Randomised controlled trials of women with breast cancer on adjuvant tamoxifen that compared endometrial surveillance alone (control condition) versus the LNG-IUS with endometrial surveillance (experimental condition) on the incidence of endometrial pathology. Study selection, risk of bias assessment and data extraction were performed independently by two review authors. The primary outcome measure was endometrial pathology (including polyps, endometrial hyperplasia, or endometrial cancer) diagnosed at hysteroscopy or

  6. Bacterial Growth in Amniotic Fluid Is Dependent on the Iron-Availability and the Activity of Bacterial Iron-Uptake System

    PubMed Central

    Ahn, Young-Joon; Park, Sang-Kee; Oh, Jae-Wook; Sun, Hui-Yu

    2004-01-01

    In the present study, the relationship among iron-availability, antibacterial activity, role of meconium as an iron source and the activity of bacterial iron-uptake system (IUS) for bacterial growth in amniotic fluid (AF) were investigated. Staphylococcus aureus ATCC 6538 and its streptonigrin-resistant (SR) mutant with defective IUS were used as the test strains. The growth of S. aureus in AF was stimulated dosedependently by addition of meconium. Bacterial growth stimulated by meconium was re-inhibited dose-dependently by addition of iron-chelator, dipyridyl and apotransferrin. Iron concentration was correlated with the meconium content in AF (r2=0.989, p=0.001). High-affinity IUS of S. aureus was expressed only in AF but not in AF with meconium. The growth of SR strain was more retarded than that of the parental strain in the iron-deficient brain heart infusion (ID-BHI), clear AF and AF containing apotransferrin. The retarded growth of both strains in the ID-BHI and AF was recovered by addition of holotransferrin, hemoglobin and FeCl3. Taken together, the antibacterial activity of AF is closely related with low iron-availability. Bacterial growth in AF considerably depends on the activity of bacterial IUS. Meconium acts as one of the exogenous iron-sources and thus can stimulate bacterial growth in AF. PMID:15201496

  7. Evaluation of model-based deformation correction in image-guided liver surgery via tracked intraoperative ultrasound

    PubMed Central

    Clements, Logan W.; Collins, Jarrod A.; Weis, Jared A.; Simpson, Amber L.; Adams, Lauryn B.; Jarnagin, William R.; Miga, Michael I.

    2016-01-01

    Abstract. Soft-tissue deformation represents a significant error source in current surgical navigation systems used for open hepatic procedures. While numerous algorithms have been proposed to rectify the tissue deformation that is encountered during open liver surgery, clinical validation of the proposed methods has been limited to surface-based metrics, and subsurface validation has largely been performed via phantom experiments. The proposed method involves the analysis of two deformation-correction algorithms for open hepatic image-guided surgery systems via subsurface targets digitized with tracked intraoperative ultrasound (iUS). Intraoperative surface digitizations were acquired via a laser range scanner and an optically tracked stylus for the purposes of computing the physical-to-image space registration and for use in retrospective deformation-correction algorithms. Upon completion of surface digitization, the organ was interrogated with a tracked iUS transducer where the iUS images and corresponding tracked locations were recorded. Mean closest-point distances between the feature contours delineated in the iUS images and corresponding three-dimensional anatomical model generated from preoperative tomograms were computed to quantify the extent to which the deformation-correction algorithms improved registration accuracy. The results for six patients, including eight anatomical targets, indicate that deformation correction can facilitate reduction in target error of ∼52%. PMID:27081664

  8. Integrated Utility Systems Feasibility Study and Conceptual Design at the University of Florida. Executive Summary.

    ERIC Educational Resources Information Center

    Kirmse, Dale W.; Manyimo, Steve B.

    This executive summary presents a brief analysis of findings and recommendations. The concept of the Integrated Utility System (IUS) is to consider the interaction and mutual support of five utility subsystems needed by a campus complex of buildings. The subsystems are: (1) Electric power service; (2) Heating - ventilating - air conditioning and…

  9. Catalog of Reports, Decisions and Opinions, Testimonies and Speeches, GAO Documents 113171-113401. Volume 5. Number 10.

    DTIC Science & Technology

    1980-10-01

    Annuits tDect- Army Anament Reeeerh and Develop GAO Views on H.R. 7893 ( Tesi - Sion) 113286 en1 Cotwand. Dover. NJ Protest of Procedures IUsed in Arms% mon...Fcderal Insecti- cide , Fungicide, and Rodenticide Act. Abstract-Abeluet: Federal efforts to protect consumers from illegal and potentially harmful

  10. Postoperative Levonorgestrel-Releasing Intrauterine System Insertion After Gonadotropin-Releasing Hormone Agonist Treatment for Preventing Endometriotic Cyst Recurrence: A Prospective Observational Study.

    PubMed

    Kim, Min Kyoung; Chon, Seung Joo; Lee, Jae Hoon; Yun, Bo Hyon; Cho, SiHyun; Choi, Young Sik; Lee, Byung Seok; Seo, Seok Kyo

    2017-01-01

    The aim of this study was to evaluate the effectiveness of postoperative levonorgestrel-releasing intrauterine system (LNG-IUS) insertion after gonadotropin-releasing hormone agonist (GnRH-a) treatment for preventing endometriotic cyst recurrence. The LNG-IUS was applied to 28 women who had undergone surgery for endometriosis followed by 6 cycles of GnRH-a treatment. Clinical characteristics, endometriosis recurrence, and adverse effects were analyzed. Student t test was performed for analysis. Before surgery, 20 (71.4%) patients had dysmenorrhea, and the mean pain score (visual analog scale [VAS]) was 4.26. The numbers of women diagnosed with stage III endometriosis and stage IV endometriosis were 15 (53.6%) and 13 (46.4%), respectively, according to the revised American Fertility Society scoring system. The mean cancer antigen 125 levels and VAS scores were significantly lower after treatment than before treatment (11.61 vs 75.66 U/mL, P < .0001 and 0.50 vs 4.26 U/mL, P < .0001, respectively). Of the 28 patients, 13 (46.4%) simultaneously had adenomyosis, and 2 (7.1%) underwent LNG-IUS removal because of unresolved vaginal bleeding and dysmenorrhea. Recurrence was noted in 2 (7.1%) women. Postoperative LNG-IUS insertion after GnRH-a treatment is an effective approach for preventing endometriotic cyst recurrence, especially in women who do not desire to conceive.

  11. Reflected view of the TDRS in the STS-6 Challengers payload bay

    NASA Technical Reports Server (NTRS)

    1983-01-01

    The stowed tracking and data relay satellite (TDRS) and its inertial upper stage (IUS) are seen in duplicate in the frame taken by the STS-6 crew. A reflection in the aft window of the flight deck resulted in the mirage effect of the 'second' TDRS. The three canisters in the aft foreground contain experiments of participants in the STS getaway special (GAS) program.

  12. Levonorgestrel-releasing intrauterine device use as an alternative to surgical therapy for uterine leiomyoma.

    PubMed

    Senol, T; Kahramanoglu, I; Dogan, Y; Baktiroglu, M; Karateke, A; Suer, N

    2015-01-01

    To evaluate the efficacy of the levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of leiomyoma related menorrhagia and to assess the effect of LNG-IUS on uterine, leiomyoma, and ovarian volume. In this prospective before and after study, LNG-IUS was inserted in 38 women with myoma-related menorrhagia. The patients were evaluated for serum levels of hemoglobin, hematocrit and uterine, leiomyoma, and ovarian volume at the time of insertion and at six months. Significant reduction in the Pictorial Blood Loss Assessment Chart (PBAC) score and increases in serum hemoglobin levels and in amenorrhea was observed within three months. However, there was no statistically significant reduction in the myoma and uterine volume. Ovarian volume, also, did not changed significantly. The use of LNG-IUS is effective in reducing menorrhagia associated with leiomyomas with improvement in hemoglobin levels and may be a simple and effective alternative to surgical treatment of leiomyoma-related abnormal uterine bleeding (AUB-L) without significant influence on the volume of leiomyoma and ovarian and uterine volume.

  13. Hemoglobin and serum ferritin levels in women using copper-releasing or levonorgestrel-releasing intrauterine devices: a systematic review.

    PubMed

    Lowe, Richard F; Prata, Ndola

    2013-04-01

    The use of intrauterine devices as a contraceptive method has been steadily growing in developing countries. Anemia in reproductive-age women is a growing concern in those settings. A systematic review of studies with measured hemoglobin and serum ferritin at baseline and after 1 year of use of copper intrauterine devices (IUDs) or a levonorgestrel-releasing intrauterine system (LNG IUS) was performed. Fourteen studies involving copper IUDs in nonanemic women and 4 studies in anemic women and 6 involving the LNG IUS met the criteria for the systematic review. Meta-analyses for hemoglobin changes showed significant decreases for users of copper IUDs and an increase for the LNG IUS, but with limited data. In general, ferritin levels followed the same pattern. Decreases in hemoglobin mean values in copper IUD users were not sufficient to induce anemia in previously nonanemic women. Women who are borderline anemic would likely benefit from using the LNG IUS. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Bleeding patterns with the levonorgestrel-releasing intrauterine system when used for heavy menstrual bleeding in women without structural pelvic pathology: a pooled analysis of randomized controlled studies.

    PubMed

    Jensen, Jeffrey; Mansour, Diana; Lukkari-Lax, Eeva; Inki, Pirjo; Burock, Karin; Fraser, Ian S

    2013-01-01

    The study was conducted to characterize the changes in bleeding pattern over time in women receiving the levonorgestrel-releasing intrauterine system (LNG-IUS) for heavy menstrual bleeding (HMB). The reduction in menstrual blood loss volume has been well documented elsewhere. Post hoc pooled analysis of the impact of the LNG-IUS on bleeding patterns in four comparator studies of medical and surgical treatment options for HMB. We enrolled women aged ≥18 years with HMB without organic pathology. The change in the number of bleeding and spotting (B/S) days and bleeding patterns was assessed over the duration of the studies pooled. One hundred and sixty-three women received the LNG-IUS in randomized trials. Relative to pretreatment baseline, there was a transient increase in the mean number of bleeding days in the first month of treatment, which returned to baseline by the second month and declined thereafter. Although the number of spotting days also increased during the first month of treatment, these declined with continued use but remained elevated relative to baseline during the first year of treatment. In women with HMB, the LNG-IUS is associated with an initial increase in number of B/S days that improve over time. Copyright © 2013 Elsevier Inc. All rights reserved.

  15. Feasibility of postpartum placement of the levonorgestrel intrauterine system more than six hours after vaginal birth

    PubMed Central

    Stuart, Gretchen S.; Bryant, Amy G.; O'Neill, Erica; Doherty, Irene A.

    2011-01-01

    Background The objective of this study was to determine the feasibility of postpartum LNG-IUS placement on the postpartum ward. Study Design This case-series study took place in a teaching hospital in North Carolina. Women were followed for six months and data on method satisfaction, study design satisfaction and expulsion were collected. Descriptive statistics were used. Results Forty women enrolled. Twenty-nine women (73%) received the LNG-IUS at a median of 20 h (range 7– 48h) after delivery, and all reported they would recommend this method of contraception to a friend. Eleven women had a spontaneous expulsion [38% (95% confidence interval 21, 58)]. Conclusion Placement of LNG-IUS more than 6 h postpartum was acceptable to women in this study. The expulsion rate of 38% had statistical instability and should be interpreted with caution. However, our report may assist with individual counseling of women interested in postpartum LNG-IUS placement, or in future study designs. PMID:22067759

  16. Measuring the Productivity of First-Term Navy Enlistees

    DTIC Science & Technology

    1984-04-01

    tMlnland, M>art S., "A SoMahat DIffarant Vla« of Tha Optlaal Naval Postura ," 37 pp., Jun 1978 (Prasantad at ftn 1976 Convantlon of 1tm Hmrican Political...Sclanca Associa- tion (APSA/IUS Panal on "Oianglng Stratagle Raqulramnts and Military Postura "), Chicago, III., Saptaaibar 2, 1976), fO AOSe 228 PP

  17. STS-6 sixth Space Shuttle mission. First flight of the Challenger

    NASA Technical Reports Server (NTRS)

    1983-01-01

    A prelaunch summary of the sixth Space Shuttle mission is provided. The Challenger orbiter; launching; uprated engines; lighter weight boosters; lightweight tank; external tank reduction; landing; the tracking and data relay satellite system (TDRSS), TDRS-1 deployment; the inertial upper stage (IUS), the spacewalk;electrophoresis, monodisperse latex reactor, night time/day time optical survey of lightning, and getaway special experiments are described.

  18. The New Cosmopolitan Monolingualism: On Linguistic Citizenship in Twenty-First Century Germany

    ERIC Educational Resources Information Center

    Gramling, David

    2009-01-01

    In the early years of the twenty-first century, being German has become a matter of linguistic competence and performance. An acute shift in citizenship statutes at the end of the 1990s brought about a peripatetic departure from Germany's "right of blood" ("ius sanguinis") toward a French-inspired "right of territory"…

  19. Role of the levonorgestrel intrauterine system in effective contraception

    PubMed Central

    Attia, Abdelhamid M; Ibrahim, Magdy M; Abou-Setta, Ahmed M

    2013-01-01

    Norgestrel, a synthetic progestin chemically derived from 19-nortestosterone, is six times more potent than progesterone, with variable binding affinity to various steroid receptors. The levonorgestrel-releasing intrauterine system (LNG IUS) provides a long-acting, highly effective, and reversible form of contraception, with a pearl index of 0.18 per 100 women-years. The locally released hormone leads to endometrial concentrations that are 200–800 times those found after daily oral use and a plasma level that is lower than that with other forms of levonorgestrel-containing contraception. The contraceptive effect of the LNG IUS is achieved mainly through its local suppressive effect on the endometrium, leading to endometrial thinning, glandular atrophy, and stromal decidualization without affecting ovulation. The LNG IUS is generally well tolerated. The main side effects are related to its androgenic activity, which is usually mild and transient, resolving after the first few months. Menstrual abnormalities are also common but well tolerated, and even become desirable (eg, amenorrhea, hypomenorrhea, and oligomenorrhea) with proper counseling of the patient during the choice of the method of contraception. The satisfaction rates after 3 years of insertion are high, reaching between 77% and 94%. The local effect of the LNG IUS on the endometrium and low rates of systemic adverse effects have led to its use in other conditions rather than contraception, as for the treatment of endometrial hyperplasia, benign menorrhagia, endometriosis, adenomyosis, and uterine fibroids. PMID:23990713

  20. Airborne Missions in the Mediterranean, 1942-1945

    DTIC Science & Technology

    1955-09-01

    the K uriates around ’Vlalta and from - within effec tive attack d istance of a chosen drop there to Sampieri * on the Sicilian coast. Samp ieri,’ zone...b u t h a d dec lined t o miles west of Sampieri , as their entry point. Evidence as tothe r iuse and signifi cance of this discrepancy is lacking

  1. STS-44 Atlantis, OV-104, payload bay (PLB) configuration

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-44 Atlantis, Orbiter Vehicle (OV) 104, payload bay (PLB) configuration is illustrated in a labeled computer graphic representation with the Interim Operational Contamination Monitor (IOCM), Protective Cover Removal System (PCRS), Defense Support Program (DSP), and the Inertial Upper Stage (IUS) booster identified. Illustration was produced using the PLAID graphic system.

  2. 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.

  3. The efficacy of long-term maintenance therapy with a levonorgestrel-releasing intrauterine system for prevention of ovarian endometrioma recurrence.

    PubMed

    Kim, Mi-La; Cho, Yeon Jean; Kim, Mi Kyoung; Jung, Yong Wook; Yun, Bo Seong; Seong, Seok Ju

    2016-09-01

    To evaluate the cumulative recurrence rates of ovarian endometrioma among patients using a levonorgestrel-releasing intrauterine system (LNG-IUS) after conservative laparoscopic surgery. A retrospective review was conducted of premenopausal women who underwent conservative laparoscopic surgery for ovarian endometrioma and subsequent treatment with LNG-IUS at two gynecologic surgery centers in South Korea between January 1, 2007, and September 30, 2014. Eligible patients had no residual ovarian lesions before LNG-IUS insertion, underwent insertion within 12 months of primary surgery, and were followed up for at least 6 months afterwards. Recurrence was defined as a cystic mass (≥2 cm in diameter) detected by transvaginal ultrasonography. Overall, 61 patients were included. The mean duration of follow-up was 42.9 ± 22.0 months (range 8-98). Recurrence of ovarian endometrioma was detected among 7 (11%) of the patients. On Kaplan-Meier analysis, the cumulative recurrence rates were 4.0%, 6.3%, and 25.5% at 24, 36, and 60 months after surgery, respectively. In multivariate analysis, nulliparity at surgery was the only risk factor for recurrence (hazard ratio 5.892, 95% confidence interval 1.139-30.484; P=0.034). Long-term maintenance therapy with LNG-IUS after conservative surgery might be a treatment option to consider to prevent ovarian endometrioma recurrence among premenopausal women. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  4. Art concept of Magellan spacecraft deployment from OV-104 during STS-30

    NASA Technical Reports Server (NTRS)

    1988-01-01

    In this artist concept, Magellan spacecraft mounted on inertial upper stage (IUS) drifts away from Atlantis, Orbiter Vehicle (OV) 104, just after deployment during mission STS-30. Magellan, named after the 16th century Portuguese explorer, is shown with solar panels stowed. View provided by the Jet Propulsion Laboratory (JPL) with alternate number P33264.

  5. Integrated Utility Systems Feasibility Study and Conceptual Design at the University of Florida. Executive Summary.

    ERIC Educational Resources Information Center

    Kirmse, Dale W.; Manyimo, Steve B.

    This executive summary presents a brief analysis of findings and recommendations. The concept of the Integrated Utility System (IUS) is to consider the interaction and mutual support of five utility subsystems needed by a campus complex of buildings. The subsystems are: (1) Electric power service; (2) Heating - ventilating - air conditioning and…

  6. Mutual-information-corrected tumor displacement using intraoperative ultrasound for brain shift compensation in image-guided neurosurgery

    NASA Astrophysics Data System (ADS)

    Ji, Songbai; Hartov, Alex; Roberts, David; Paulsen, Keith

    2008-03-01

    Intraoperative ultrasound (iUS) has emerged as a practical neuronavigational tool for brain shift compensation in image-guided tumor resection surgeries. The use of iUS is optimized when coregistered with preoperative magnetic resonance images (pMR) of the patient's head. However, the fiducial-based registration alone does not necessarily optimize the alignment of internal anatomical structures deep in the brain (e.g., tumor) between iUS and pMR. In this paper, we investigated and evaluated an image-based re-registration scheme to maximize the normalized mutual information (nMI) between iUS and pMR to improve tumor boundary alignment using the fiducial registration as a starting point for optimization. We show that this scheme significantly (p<<0.001) reduces tumor boundary misalignment pre-durotomy. The same technique was employed to measure tumor displacement post-durotomy, and the locally measured tumor displacement was assimilated into a biomechanical model to estimate whole-brain deformation. Our results demonstrate that the nMI re-registration pre-durotomy is critical for obtaining accurate measurement of tumor displacement, which significantly improved model response at the craniotomy when compared with stereopsis data acquired independently from the tumor registration. This automatic and computationally efficient (<2min) re-registration technique is feasible for routine clinical use in the operating room (OR).

  7. Defining Distinct Negative Beliefs about Uncertainty: Validating the Factor Structure of the Intolerance of Uncertainty Scale

    ERIC Educational Resources Information Center

    Sexton, Kathryn A.; Dugas, Michel J.

    2009-01-01

    This study examined the factor structure of the English version of the Intolerance of Uncertainty Scale (IUS; French version: M. H. Freeston, J. Rheaume, H. Letarte, M. J. Dugas, & R. Ladouceur, 1994; English version: K. Buhr & M. J. Dugas, 2002) using a substantially larger sample than has been used in previous studies. Nonclinical…

  8. Chesapeake Bay Future Conditions Report. Volume 11. Biota.

    DTIC Science & Technology

    1977-12-01

    Odocoileus ~ Trginianus Game Endangered species Shortnose sturgeon Acipenser brevirostrum. Potomac River . Atlantic sturgeon Acipenser o~~ihynchus...minuta Littorina irrorata Mangelia guarani. Mangella plicosa Melanel].a conoidea Mitrellã lunata Murex fulvescens Nassar ius obsoletus Nassarius vibex

  9. Postoperative levonorgestrel-releasing intrauterine system versus oral contraceptives after gonadotropin-releasing hormone agonist treatment for preventing endometrioma recurrence.

    PubMed

    Cho, Sihyun; Jung, Ji Ann; Lee, Yousun; Kim, Hye Yeon; Seo, Seok Kyo; Choi, Young Sik; Lee, Ji Sung; Lee, Byung Seok

    2014-01-01

    Although the levonorgestrel-releasing intrauterine system (LNG-IUS) is effective in reducing the recurrence of endometriosis-associated pain, its efficacy in preventing endometrioma recurrence is questionable. We compared the efficacy of postoperative use of LNG-IUS with oral contraceptives (OC) for preventing endometrioma recurrence. A retrospective cohort study. Medical university hospital. Ninety-nine women with endometriomas. A chart review was performed of women of reproductive age who had undergone laparoscopic surgery for endometrioma followed by three cycles of gonadotropin-releasing hormone agonist (leuprolide acetate) treatment. Women were categorized into two groups: a group that had postoperative LNG-IUS placement (n = 42) and a group that received postoperative, cyclic, low-dose, monophasic, OCs (n = 57). Main outcome measures. Endometrioma recurrence was analyzed according to several clinical variables and postoperative treatment modalities. During the follow-up period (median 17 months), recurrent endometriomas were detected in eight women (8.1%). Patients with LNG-IUS had a recurrence rate of 4.8% (2/42), whereas women receiving OC had a recurrence rate of 10.5% (6/57). Cumulative recurrence-free survival assessment revealed that mean disease-free survival times for both groups were similar, but that for LNG-IUS was slightly longer than that for OC, with statistical significance (34.4 ± 1.0 months, 95% confidence interval 32.3–36.5, vs. 33.4 ± 1.3 months, 95% confidence interval 30.8–36.0, p = 0.045). Univariate analysis revealed a hazard ratio of 0.178 (95% confidence interval 0.029–1.075) (p = 0.060) for postoperative LNG-IUS use and endometrioma recurrence. However, for the multivariate regression analysis, only postoperative serum CA 125 levels were significantly associated with endometrioma recurrence (hazard ratio 1.012, p = 0.010). Postoperative LNG-IUS use seemed to be comparable to the use of cyclic OC in preventing endometrioma

  10. Use of a levonorgestrel-containing intrauterine system with supplemental estrogen improves symptoms in perimenopausal women: a pilot study.

    PubMed

    Santoro, Nanette; Teal, Stephanie; Gavito, Christina; Cano, Sandra; Chosich, Justin; Sheeder, Jeanelle

    2015-12-01

    The aim of this study was to compare perimenopausal symptomatology using a levonorgestrel-containing intrauterine system (LNG-IUS) + low-dose transdermal estradiol (TDE) with LNG-IUS alone. The trial was a double-blind, randomized, controlled pilot trial. Regularly cycling women aged 38 to 52 years, with at least one self-reported symptom (hot flashes, bloating, headache, adverse mood, or poor sleep), were randomized to either LNG-IUS + low-dose TDE gel (intervention) or LNG-IUS alone (control). TDE was administered once daily as a 0.06% gel containing 0.75 mg of TDE for 50 days. LNG-IUS was placed at least 90 days before TDE or placebo gel treatment to assure stable circulating LNG. Participants completed the Center for Epidemiologic Studies Depression scale (CESD), Hot Flash Related Daily Interference scale (HFRDIS), Pittsburgh Sleep Quality Index (PSQI), and Fatigue Severity Scale (FSS) at the time of LNG-IUS placement, at 90 days (the time of randomization to TDE/placebo), and 140 days (end of study). TDE and placebo groups were compared using repeated-measures analysis of variance. Thirty-eight women aged 42.9 ± 2.7 years, with a mean BMI of 24.7 ± 3.3 kg/m², were enrolled; 20 were randomized to TDE. Women receiving TDE had significantly improved FSS scores between days 90 and 140 (mean difference TDE: -0.8 ± 1.2 vs placebo: 0.1 ± 0.7; P = 0.026) and borderline significant improvement in HFRDIS scores (mean difference TDE: -5.5 ± 15.3 vs placebo: 4.2 ± 13.1; P = 0.076). Women who reported hot flashes at baseline and who received TDE had a significant decrease in HFRDIS scores between days 90 and 140 (n = 9, P = 0.035). CESD and PSQI scores were not associated with TDE use. A brief, low-dose estrogen intervention, combined with a LNG-IUS, led to significant improvement of some common perimenopausal symptoms. Such a "minimalist" approach to management of the perimenopause holds promise for reducing common

  11. Levonorgestrel intrauterine system versus medical therapy for menorrhagia.

    PubMed

    Gupta, Janesh; Kai, Joe; Middleton, Lee; Pattison, Helen; Gray, Richard; Daniels, Jane

    2013-01-10

    Menorrhagia is a common problem, yet evidence to inform decisions about therapy is limited. In a pragmatic, multicenter, randomized trial, we compared the levonorgestrel-releasing intrauterine system (levonorgestrel-IUS) with usual medical treatment in women with menorrhagia who presented to their primary care providers. We randomly assigned 571 women with menorrhagia to treatment with levonorgestrel-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined estrogen-progestogen, or progesterone alone). The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) (ranging from 0 to 100, with lower scores indicating greater severity), assessed over a 2-year period. Secondary outcomes included general quality-of-life and sexual-activity scores and surgical intervention. MMAS scores improved from baseline to 6 months in both the levonorgestrel-IUS group and the usual-treatment group (mean increase, 32.7 and 21.4 points, respectively; P<0.001 for both comparisons). The improvements were maintained over a 2-year period but were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group (mean between-group difference, 13.4 points; 95% confidence interval, 9.9 to 16.9; P<0.001). Improvements in all MMAS domains (practical difficulties, social life, family life, work and daily routine, psychological well-being, and physical health) were significantly greater in the levonorgestrel-IUS group than in the usual-treatment group, and this was also true for seven of the eight quality-of-life domains. At 2 years, more of the women were still using the levonorgestrel-IUS than were undergoing the usual medical treatment (64% vs. 38%, P<0.001). There were no significant between-group differences in the rates of surgical intervention or sexual-activity scores. There were no significant differences in serious adverse events between groups. In women with menorrhagia who presented to primary care providers

  12. Why perimenopausal women should consider to use a levonorgestrel intrauterine system.

    PubMed

    Wildemeersch, Dirk

    2016-08-01

    The use of a levonorgestrel intrauterine system (LNG-IUS) is useful in preventing pregnancy and for the treatment of menstrual disturbances. A smooth or symptom-free transition to and through menopause is possible when LNG-IUS is combined with estrogen therapy. Unfortunately the majority of physicians are generally unaware of this usefulness combined hormonal therapy in the pre-, peri- and postmenopausal women. Based on long-term clinical experience with LNG-IUS in the form of Femilis®, 104 women where followed from the premenopause through the menopausal transition into the postmenopause. These perimenopausal women received supplemental 17 β-estradiol by gel or patch, or orally as estradiol valerate. Patients received one or two separate Femilis insertions at 5 year intervals. Main outcome measures included acceptability and continued use of the combined regimen for the treatment of climacteric symptoms and for prevention of cardiovascular disease, osteoporosis and other adverse effects caused by estrogen deprivation. The average age at insertion was 48 years (range 28-58) and the total duration of use was 137 months (range 80-161). The Femilis LNG-IUS was well tolerated as the number of removals for LNG-IUS-related reasons was low. The LNG-IUS was well retained in the uterine cavity as no expulsions were observed. Seven women were lost to follow-up. Eighty-six women (82%) opted for replacement of an LNG-IUS at expiry after 5 years and continued with the estrogen therapy. Intrauterine progestogen delivery for endometrial suppression in combination with estrogen therapy in the symptomatic perimenopausal women is highly practical as it combines the benefits of prevention of endometrial proliferation and treatment of menorrhagia and hyperplasia, if present. In addition, the contraceptive effect of locally administered LNG is highly desirable as many perimenopausal women run considerable risk of unintended pregnancy. For these reasons, the author views this regimen

  13. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders

    PubMed Central

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-01-01

    ABSTRACT Background: The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public‐sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. Methods: We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. Results: The direct service delivery cost of Medicines360’s LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product’s non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation

  14. Expanding Access to a New, More Affordable Levonorgestrel Intrauterine System in Kenya: Service Delivery Costs Compared With Other Contraceptive Methods and Perspectives of Key Opinion Leaders.

    PubMed

    Rademacher, Kate H; Solomon, Marsden; Brett, Tracey; Bratt, John H; Pascual, Claire; Njunguru, Jesse; Steiner, Markus J

    2016-08-11

    The levonorgestrel intrauterine system (LNG IUS) is one of the most effective forms of contraception and offers important non-contraceptive health benefits. However, it is not widely available in developing countries, largely due to the high price of existing products. Medicines360 plans to introduce its new, more affordable LNG IUS in Kenya. The public-sector transfer price will vary by volume between US$12 to US$16 per unit; for an order of 100,000 units, the public-sector transfer price will be approximately US$15 per unit. We calculated the direct service delivery cost per couple-years of protection (CYP) of various family planning methods. The model includes the costs of contraceptive commodities, consumable supplies, instruments per client visit, and direct labor for counseling, insertion, removal, and resupply, if required. The model does not include costs of demand creation or training. We conducted interviews with key opinion leaders in Kenya to identify considerations for scale-up of a new LNG IUS, including strategies to overcome barriers that have contributed to low uptake of the copper intrauterine device. The direct service delivery cost of Medicines360's LNG IUS per CYP compares favorably with other contraceptive methods commonly procured for public-sector distribution in Kenya. The cost is slightly lower than that of the 3-month contraceptive injectable, which is currently the most popular method in Kenya. Almost all key opinion leaders agreed that introducing a more affordable LNG IUS could increase demand and uptake of the method. They thought that women seeking the product's non-contraceptive health benefits would be a key market segment, and most agreed that the reduced menstrual bleeding associated with the method would likely be viewed as an advantage. The key opinion leaders indicated that myths and misconceptions among providers and clients about IUDs must be addressed, and that demand creation and provider training should be prioritized

  15. Randomized placebo-controlled trial of CDB-2914 in new users of a levonorgestrel-releasing intrauterine system shows only short-lived amelioration of unscheduled bleeding

    PubMed Central

    Warner, P.; Guttinger, A.; Glasier, A.F.; Lee, R.J.; Nickerson, S.; Brenner, R.M.; Critchley, H.O.D.

    2010-01-01

    BACKGROUND The levonorgestrel-releasing intrauterine system (LNG-IUS) is a highly effective contraceptive. However, during early months of use unscheduled vaginal bleeding is common, sometimes leading to discontinuation. This study aimed to determine whether intermittent administration of progesterone receptor modulator CDB-2914 would suppress unscheduled bleeding during the first 4 months after insertion of the LNG-IUS. METHODS CDB-2914 150 mg, in divided doses, or placebo tablets, were administered over three consecutive days starting on Days 21, 49 and 77 after LNG-IUS insertion, in a double-blind randomized controlled trial of women aged 19–49 years, newly starting use of LNG-IUS. Daily bleeding diaries were completed for 6 months, and summarized across blocks as percentage days bleeding/spotting (BS%). RESULTS Of 69 women randomized to receive CDB-2914, and 67 placebo, 61 and 55, respectively, completed the trial. BS% decreased with time in both arms, but showed a much steeper treatment-phase gradient in the placebo arm (P < 0.0001), so that a benefit of CDB-2914 in the 28 days after first treatment (−11% points, 95% CI −19 to −2), converted to a disadvantage by 64 days after the third treatment (+10% points, 95% CI 1–18). CONCLUSIONS The effect of CDB-2914 on BS% was initially beneficial but then by third treatment was disadvantageous. Nevertheless, only 3% (4/136) of all women discontinued LNG-IUS. These findings give insight into possible mechanisms and suggest future research directions. ISRCTN Trial no. ISRCTN58283041; EudraCT no. 2006-006511-72. PMID:19897857

  16. The effect of hysterectomy or levonorgestrel-releasing intrauterine system on premenstrual symptoms in women treated for menorrhagia: secondary analysis of a randomized controlled trial.

    PubMed

    Leminen, Henri; Heliövaara-Peippo, Satu; Halmesmäki, Karoliina; Teperi, Juha; Grenman, Seija; Kivelä, Aarre; Tuppurainen, Marjo; Paavonen, Jorma; Hurskainen, Ritva

    2012-03-01

    To study the effect of hysterectomy or levonorgestrel-releasing intrauterine system (LNG-IUS) on premenstrual symptoms in women treated for menorrhagia. Secondary analysis of a randomized controlled trial. Five university hospitals in Finland. A cohort of 236 women, aged 35-49 years (mean 43 years) referred for menorrhagia between 1994 and 1997. Women were not diagnosed with premenstrual syndrome. Women were randomized to treatment by hysterectomy (n=117) or LNG-IUS (n=119). Analyses were performed using the intention-to-treat and actual treatment principles. Women using estrogen therapy and women who underwent bilateral salpingo-oophorectomy were excluded from the analyses. The occurrence of premenstrual symptoms evaluated by questionnaires at baseline and at follow-up visits six and 12 months after the treatment and five years after the randomization. Premenstrual symptoms decreased significantly in both groups by six months (p≤0.028) without significant differences between the groups, except that in the LNG-IUS group the decrease of breast tenderness was seen first by 12 months (p=0.048). Even though 42% of the women assigned to treatment with LNG-IUS were hysterectomized during the follow-up period, the results of intention-to-treat and actual treatment analyses were comparable. Both hysterectomy and LNG-IUS seem to alleviate premenstrual symptoms of women treated for menorrhagia, while the effect of these treatments on premenstrual syndrome remains unsettled. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

  17. Analysis of the levonorgestrel-releasing intrauterine system in women with endometriosis.

    PubMed

    Lan, Shen; Ling, Liu; Jianhong, Zhao; Xijing, Jiang; Lihui, Wang

    2013-06-01

    To compare the efficacy, safety and other clinical benefits of the levonorgestrel-releasing intrauterine system (LNG-IUS) and gonadotropin-releasing hormone analogues (GnRH-a) in women with endometriosis. A systematic search was carried out using the Cochrane Central Register of Controlled Trials, PubMed, MEDLINE™ and EMBASE databases for all randomized controlled trials (RCTs) that evaluated the use of the LNG-IUS and GnRH-a in premenopausal women with endometriosis. Five RCTs studies were identified. A meta-analysis showed that, in women with endometriosis, both the LNG-IUS and GnRH-a reduced pain visual analogue scale scores (weighted mean difference [WMD] 0.03 [95% confidence interval [CI] -0.53, 0.59]), serum levels of CA125 (WMD -12.29 [95% CI -29.90, 3.32]), and American Society of Reproductive Medicine staging scores (WMD 1.10 [95% CI -27.98, 30.18]). Psychological and general wellbeing index scores were increased (WMD 1.50 [95% CI -6.19, 9.19]). Levels of low-density lipoprotein cholesterol were also significantly reduced in patients treated with the LNG-IUS (WMD 39.30 [95% CI 6.74, 71.86]). The LNG-IUS had clinical efficacy equivalent to that of GnRH-a but may have some clinical advantages over GnRH-a in the treatment of endometriosis-associated symptoms. These observations will require further verification in additional studies employing larger patient populations.

  18. Levonorgestrel-Releasing Intrauterine System vs. Usual Medical Treatment for Menorrhagia: An Economic Evaluation Alongside a Randomised Controlled Trial

    PubMed Central

    Sanghera, Sabina; Roberts, Tracy Elizabeth; Barton, Pelham; Frew, Emma; Daniels, Jane; Middleton, Lee; Gennard, Laura; Kai, Joe; Gupta, Janesh Kumar

    2014-01-01

    Objective To undertake an economic evaluation alongside the largest randomised controlled trial comparing Levonorgestrel-releasing intrauterine device (‘LNG-IUS’) and usual medical treatment for women with menorrhagia in primary care; and compare the cost-effectiveness findings using two alternative measures of quality of life. Methods 571 women with menorrhagia from 63 UK centres were randomised between February 2005 and July 2009. Women were randomised to having a LNG-IUS fitted, or usual medical treatment, after discussing with their general practitioner their contraceptive needs or desire to avoid hormonal treatment. The treatment was specified prior to randomisation. For the economic evaluation we developed a state transition (Markov) model with a 24 month follow-up. The model structure was informed by the trial women's pathway and clinical experts. The economic evaluation adopted a UK National Health Service perspective and was based on an outcome of incremental cost per Quality Adjusted Life Year (QALY) estimated using both EQ-5D and SF-6D. Results Using EQ-5D, LNG-IUS was the most cost-effective treatment for menorrhagia. LNG-IUS costs £100 more than usual medical treatment but generated 0.07 more QALYs. The incremental cost-effectiveness ratio for LNG-IUS compared to usual medical treatment was £1600 per additional QALY. Using SF-6D, usual medical treatment was the most cost-effective treatment. Usual medical treatment was both less costly (£100) and generated 0.002 more QALYs. Conclusion Impact on quality of life is the primary indicator of treatment success in menorrhagia. However, the most cost-effective treatment differs depending on the quality of life measure used to estimate the QALY. Under UK guidelines LNG-IUS would be the recommended treatment for menorrhagia. This study demonstrates that the appropriate valuation of outcomes in menorrhagia is crucial. PMID:24638071

  19. Endometrial Synovial-like Metaplasia Associated With Levonorgestrel-releasing Intrauterine System.

    PubMed

    Stewart, Colin J R; Leake, Robyn

    2015-11-01

    The levonorgestrel-releasing intrauterine system (L-IUS) is widely used in contraception and in the treatment of menorrhagia, dysmenorrhea, adenomyosis, and endometriosis. L-IUS is also increasingly considered in the management of endometrial neoplasia and its precursors. Histologic changes in the endometrium can be due to the effects of high-dose progestogen or may be caused by the local irritant or mechanical effects of an intrauterine foreign body. In the present study, we describe a novel endometrial alteration associated with L-IUS that most closely resembles synovial metaplasia reported at other extra-articular anatomic sites. Eleven cases were identified with a mean age of 49.6 yr. In most patients L-IUS was used for management of menorrhagia or endometrial hyperplasia. Endometrial synovial-like metaplasia was always a focal finding and was associated with areas of surface epithelial erosion. The synovial-like cells showed a distinctive palisaded arrangement with orientation perpendicular to the endometrial surface. Multinucleate cells were present in 2 cases, but granulomas were not identified. The synovial-like cells were vimentin immunoreactive and a variable proportion of cells expressed CD68. Only focal CD10 staining was seen and there was no expression of estrogen receptor, progesterone receptor, or cytokeratin. In summary, L-IUS may be associated with a distinctive synovial-like metaplastic alteration which most likely represents a stromal reaction to an intrauterine foreign body following endometrial surface erosion. The synovial-like cells appear to comprise histiocytes and modified fibroblasts or stromal cells similar to this process in other sites.

  20. Influence of contraceptive choice on vaginal bacterial and fungal microflora.

    PubMed

    Donders, G; Bellen, G; Janssens, D; Van Bulck, B; Hinoul, P; Verguts, J

    2017-01-01

    The influence of contraception on vaginal microflora can have a major impact on the risk of developing acute or recurrent vaginal infections, but also may influence the risk of acquiring sexually transmissible infections (STI) such as HIV. A cohort of 248 women presenting for levonorgestrel-releasing intrauterine system (LNG-IUS) insertion or reinsertion were stratified according to their current contraceptive method. Information concerning their menstrual pattern and data about the medical history were collected. The composition of their vaginal microflora was studied by detailed phase contrast microscopy of fresh vaginal fluid, and aerobic cultures were taken to detect enteric bacterial growth and fungal colonisation. LNG-IUS and progesterone-only-pill (POP) users had significantly lower blood loss (p < 0.001) than other women. Regardless of the type of contraception used, all women reported similar rates of symptomatic lower genital tract infection during the preceding year. Women using combined oral contraception (COC) and long-term LNG-IUS had the same bacterial composition of vaginal microflora as non-contraceptive users, even when infections were combined. Both hormonal and non-hormonal intrauterine device users had an increased tendency to have more vaginal colonisation with Candida. Women on POPs or subcutaneous implants had a tendency towards increased vaginal atrophy, but had a lower Candida carriage rate compared to IUCD users (LNG-IUS and Copper-IUCD, p = 0.037). Women with an increased risk of acquiring STIs or recurrent BV could benefit from LNG-IUS or COC due to a well-preserved vaginal bacterial flora. Women with a susceptibility for RVVC should prefer POPs, and avoid intrauterine contraception.

  1. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system

    PubMed Central

    2017-01-01

    Objective To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). Methods We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Results Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. Conclusion To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal. PMID:27670255

  2. Dilatation and curettage is more accurate than endometrial aspiration biopsy in early-stage endometrial cancer patients treated with high dose oral progestin and levonorgestrel intrauterine system.

    PubMed

    Kim, Da Hee; Seong, Seok Ju; Kim, Mi Kyoung; Bae, Hyo Sook; Kim, Mi La; Yun, Bo Seong; Jung, Yong Wook; Shim, Jeong Yun

    2017-01-01

    To determine whether less invasive endometrial (EM) aspiration biopsy is adequately accurate for evaluating treatment outcomes compared to the dilatation and curettage (D&C) biopsy in early-stage endometrial cancer (EC) patients treated with high dose oral progestin and levonorgestrel intrauterine system (LNG-IUS). We conducted a prospective observational study with patients younger than 40 years who were diagnosed with clinical stage IA, The International Federation of Gynecology and Obstetrics grade 1 or 2 endometrioid adenocarcinoma and sought to maintain their fertility. The patients were treated with medroxyprogesterone acetate 500 mg/day and LNG-IUS. Treatment responses were evaluated every 3 months. EM aspiration biopsy was conducted after LNG-IUS removal followed D&C. The tissue samples were histologically compared. The diagnostic concordance rate of the two tests was examined with κ statistics. Twenty-eight pairs of EM samples were obtained from five patients. The diagnostic concordance rate of D&C and EM aspiration biopsy was 39.3% (κ value=0.26). Of the seven samples diagnosed as normal with D&C, three (42.8%) were diagnosed as normal by using EM aspiration biopsy. Of the eight samples diagnosed with endometrioid adenocarcinoma by using D&C, three (37.5%) were diagnosed with endometrioid adenocarcinoma by using EM aspiration biopsy. Of the 13 complex EM hyperplasia samples diagnosed with the D&C, five (38.5%) were diagnosed with EM hyperplasia by using EM aspiration biopsy. Of the samples obtained through EM aspiration, 46.4% were insufficient for histological evaluation. To evaluate the treatment responses of patients with early-stage EC treated with high dose oral progestin and LNG-IUS, D&C should be conducted after LNG-IUS removal.

  3. Levonorgestrel-Releasing Intrauterine Systems Versus Oral Cyclic Medroxyprogesterone Acetate in Endometrial Hyperplasia Therapy: A Meta-Analysis.

    PubMed

    Yuk, Jin-Sung; Song, Jae Yen; Lee, Jung Hun; Park, Won I; Ahn, Hyeong Sik; Kim, Hyun Jung

    2017-05-01

    This study aimed to compare the levonorgestrel-releasing intrauterine system (LNG-IUS) with oral cyclic medroxyprogesterone acetate (MPA) in endometrial hyperplasia therapy using randomized controlled trials (RCTs). The study searched MEDLINE, EMBASE, CENTRAL, and other databases. All regression outcomes were calculated for dichotomous outcomes in terms of relative risk (RR) and 95% confidence intervals (CIs) using a Mantel-Haenszel random effects model. The search found 543 articles but selected 342 articles after the removal of duplicates. A meta-analysis found five RCTs (377 patients). The study did not analyze RR for total outcome because of high heterogeneity (I (2) = 87%). In a subgroup analysis of studies with non-obese women, the LNG-IUS treatment appeared to have a higher regression rate than oral MPA (RR 1.41; 95% CI 1.23-1.62; 4 trials, 265 patients; I (2) = 0%). In a subgroup analysis of studies with obese women, LNG-IUS appeared to have a regression rate similar to that of oral MPA (RR 1.03; 95% CI 0.94-1.13; 1 trial, 60 patients). In a subgroup analysis according to histology in the non-obese group, the LNG-IUS treatment appeared to have a higher regression rate than oral cyclic MPA in a meta-analysis of women with non-atypical endometrial hyperplasia (RR 1.36; 95% CI 1.07-1.73; 2 trials, 92 patients; I (2) = 6%) and mixed endometrial hyperplasia (atypical and non-atypical) (RR 1.44; 95% CI 1.21-1.71; 2 trials, 173 patients; I (2) = 0%). The LNG-IUS treatment has a higher regression rate than cyclic MPA in non-atypical endometrial hyperplasia and mixed endometrial hyperplasia therapy for non-obese women but has a similar regression rate, albeit limited, for obese women.

  4. Uterine Length in Adolescents with Developmental Disability: Are Ultrasound Examinations Necessary before Insertion of the Levonorgestrel Intrauterine System?

    PubMed

    Whyte, Helena; Pecchioli, Yael; Oyewumi, Lamide; Kives, Sari; Allen, Lisa M; Kirkham, Yolanda A

    2016-12-01

    (1) To determine if there are any differences in uterine length between adolescents with developmental disability (DD) compared with their normally developing (ND) peers that might necessitate ultrasonography before insertion of levonorgestrel intrauterine system (LNG-IUS) in patients with DD; and (2) to characterize the LNG-IUS insertion procedure in adolescents with disabilities. This was a retrospective cohort study of 223 female adolescents with or without DDs. Seventy-five adolescents had DD; 33 underwent intrauterine system insertion in the operating room and 42 did not. A comparative cohort of 148 ND adolescents who had pelvic ultrasound examinations for abnormal uterine bleeding were included. The study period was between January 2006 and July 2013 at the Hospital for Sick Children, Toronto, Canada. Cases were identified from surgical databases and medical records. Mean uterine length on pelvic ultrasound, demographic characteristics (age, age at menarche, time from menarche to ultrasound, weight), and descriptive statistics on intrauterine system insertion. There was a statistically significant difference (P = .03) in uterine length between adolescents with and without DD (6.7 vs 7.1 cm). However, this was not a clinically significant difference because insertion of the LNG-IUS in patients with DD was successful in patients with uteri more than 5 cm long. There was no difference (P = .97) in uterine length of adolescents with DD whether they had LNG-IUS insertion or not (6.7 cm). Adolescents with DD were younger than adolescents without DD at time of ultrasound examination (P = .01). However, among patients with DD, those who underwent intrauterine system insertion were older (P = .001). Incidence of uterine anomaly in patients with DD is low (2.7%) and was the same as in ND adolescents. Rates of complications and expulsions were low and there were no failures of LNG-IUS insertion in adolescents with DD. Routine pelvic ultrasound examinations

  5. Does levonorgestrel-releasing intrauterine system increase breast cancer risk in peri-menopausal women? An HMO perspective.

    PubMed

    Siegelmann-Danieli, Nava; Katzir, Itzhak; Landes, Janet Vesterman; Segal, Yaakov; Bachar, Rachel; Rabinovich, Hadas Rotem; Bialik, Martin; Azuri, Joseph; Porath, Avi; Lomnicky, Yossef

    2017-09-14

    To evaluate the association between levonorgestrel-releasing intrauterine system (LNG-IUS) use and breast cancer (BC) risk. A cohort of all Maccabi Healthcare Services (MHS) female members aged 40-50 years between 1/2003 and 12/2013 was used to identify LNG-IUS users as "cases," and 2 age-matched non-users as "controls." Exclusion criteria included: prior BC diagnosis, prior (5 years pre-study) and subsequent treatment with other female hormones or prophylactic tamoxifen. Invasive tumors were characterized by treatments received (chemotherapy, hormonal therapy, trastuzumab, or combination thereof). The analysis included 13,354 LNG-IUS users and 27,324 controls (mean age: 44.1 ± 2.6 vs. 44.9 ± 2.8 years; p < 0.0001). No significant differences in 5-year Kaplan-Meier (KM) estimates for overall BC risk or ductal carcinoma in situ occurrence were observed between groups. There was a trend towards higher risk for invasive BC in LNG-IUS users (5-year KM-estimate: 1.06% vs. 0.93%; p = 0.051). This difference stemmed primarily from the younger women (40-45 years; 0.88% vs. 0.69%, p = 0.014), whereas in older women (46-50 years), it was non-significant (1.44% vs. 1.21%; p = 0.26). Characterization of invasive BC by treatment demonstrated that LNG-IUS users had similar proportions of tumors treated with hormonal therapy, less tumors treated with trastuzumab, (7.5% vs. 14.5%) and more tumors treated with chemotherapy alone (25.8% vs. 14.9%; p = 0.041). In peri-menopausal women, LNG-IUS was not associated with an increased total risk of BC, although in the subgroup of women in their early 40's, it was associated with a slightly increased risk for invasive tumors.

  6. Non-hormonal and hormonal intrauterine contraception: survey of patients' perceptions in four Latin American countries.

    PubMed

    Silva-Filho, Agnaldo Lopes da; Lira, Josefina; Rocha, Ana Luiza Lunardi; Ferreira, Márcia Cristina França; Lamaita, Rívia Mara; Cândido, Eduardo Batista; Carneiro, Márcia Mendonça

    2016-06-01

    This study sought to understand women's perceived barriers to the use of hormonal and non-hormonal intrauterine contraception in Latin America. We developed an online survey for women in Argentina, Brazil, Colombia and Mexico who were seeking contraception. The questions aimed at evaluating patient awareness of negative stories and statements, as well as perceived barriers to the copper intrauterine device (IUD) and the levonorgestrel-releasing intrauterine system (LNG-IUS). The survey was mailed to 2300 women. A total of 1953 responses were received from Argentina (n = 465), Brazil (n = 380), Colombia (n = 613) and Mexico (n = 495). More women reported having heard negative stories about the copper IUD than about the LNG-IUS. More women believed that the copper IUD, rather than the LNG-IUS, was suitable only for those who had already had children. More women believed that weight gain (14.3% vs. 38.2%; p < 0.001), mood swings (14.1% vs. 38.7%; p < 0.001) and infertility (16.3% vs. 19.9%; p = 0.016) were possible side effects of the LNG-IUS. By contrast, more women believed that abortion (36% vs. 22.7%; p < 0.001), pelvic infections (42.1% vs. 15.7%; p < 0.001) and ectopic pregnancy (43.5% vs 23.5%; p < 0.001) were side effects more associated with the copper IUD. More believed the copper IUD was associated with less pain during placement and removal compared with the LNG-IUS (42.8% vs. 31.2%; p < 0.001). The perception of increased risk of contracting a sexual transmitted disease did not differ between the methods (IUD vs. LNG-IUS, 21.7% vs. 20.3%; p = 0.388). Respondents to a web-based survey in four Latin American countries have misperceptions regarding the adverse effects and risks of intrauterine contraception, which may hamper the use of these safe and efficient contraceptive methods. Education about the true risks and benefits involved is fundamental to improving patient acceptance and compliance as well as

  7. 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

  8. [Application of levonorgestrel-releasing intrauterine system in early pregnancy: a case report].

    PubMed

    Gardyszewska, Agnieszka; Czajkowski, Krzysztof

    2012-12-01

    Intrauterine device is a popular cost-effective method of contraception known worldwide. It is extremely effective, with pregnancy rates comparable to tubal ligation (5-year cumulative rate varying from 0.5 to 1.1). LNG-IUS increases in popularity and may be used as the method of choice for adults because it offers non-contraceptive benefits: slight menstrual bleeding, decreased number of incidents of dysmenorrhea, and reduced pain associated with endometriosis. The levonorgestrel-releasing intrauterine system (LNG-IUS) provides a release rate of 20 microg/24 h of levonorgestrel. The hormone released from the intrauterine device causes some systemic changes, however local effects, such as glandular atrophy and stromal decidualization, in addition to foreign body reaction, are dominant. According to the Food and Drug Administration regulations, category X was assigned to LNG. The use of the product is contraindicated in women who are or may become pregnant. We report a case of a 30-year old woman who has already been pregnant before the insertion of a levonorgestrel -releasing intrauterine system (LNG-IUS). The patient was lactating after the previous pregnancy the first menstruation had not appeared yet. The patient planned to have the IUD inserted but she missed her appointed visits twice. The third visit took place 8 weeks postpartum. During that visit, the doctor asked her about the possibility of being pregnant, but the patient denied. The gynecologist inserted the intrauterine device and performed transvaginal ultrasound examination. The location of LNG-IUS was proper and there was no gestation sac in the uterine cavity. After the next six weeks, transvaginal ultrasonography and manual examination showed an intrauterine pregnancy at 8 weeks of gestation. The intrauterine device was not detectable in the uterine cavity by ultrasound, and the IUD strings were not visualized in the vagina. It was impossible to remove the device without causing miscarriage. Other

  9. Liftoff of STS-26

    NASA Image and Video Library

    1988-09-29

    The Space Shuttle Discovery takes off from Launch Pad 39B at the Kennedy Space Center, Florida, to being Mission STS-26 on 29 September 1988,11:37:00 a.m. EDT. The 26th shuttle mission lasted four days, one hour, zero minutes, and 11 seconds. Discovery landed 3 October 1988, 9:37:11 a.m. PDT, on Runway 17 at Edwards Air Force Base, California. Its primary payload, NASA Tracking and Data Relay Satellite-3 (TDRS-3) attached to an Inertial Upper Stage (IUS), became the second TDRS deployed. After deployment, IUS propelled the satellite to a geosynchronous orbit. The crew consisted of Frederick H. Hauck, Commander; Richard O. Covey, Pilot; John M. Lounge, Mission Specialist 1; George D. Nelson, Mission Specialist 2; and David C. Hilmers, Mission Specialist 3.

  10. User benefits and funding strategies. [technology assessment and economic analysis of the space shuttles and NASA Programs

    NASA Technical Reports Server (NTRS)

    Archer, J. L.; Beauchamp, N. A.; Day, C. F.

    1975-01-01

    The justification, economic and technological benefits of NASA Space Programs (aside from pure scientific objectives), in improving the quality of life in the United States is discussed and outlined. Specifically, a three-step, systematic method is described for selecting relevant and highly beneficial payloads and instruments for the Interim Upper Stage (IUS) that will be used with the space shuttle until the space tug becomes available. Viable Government and private industry cost-sharing strategies which would maximize the number of IUS payloads, and the benefits obtainable under a limited NASA budget were also determined. Charts are shown which list the payload instruments, and their relevance in contributing to such areas as earth resources management, agriculture, weather forecasting, and many others.

  11. United States orbital transfer vehicle programs

    NASA Astrophysics Data System (ADS)

    Gunn, Charles R.

    1989-10-01

    Five U.S. orbital transfer vehicles carrying spacecraft to higher energy orbits than achievable by the Space Shuttle or various expandable launch vehicles are studied. These vehicles are the Payload Assist Module-Delta (PAM-D), an upgraded version designated PAM-DII, the Inertial Upper Stage (IUS), the U.S. Transfer Orbit Stage (TOS), and the Orbital Maneuvering Vehicle (OMV). Capabilities range from providing spacecraft with only a preprogrammed perigee velocity additions to man-in-the-loop remote controlled spacecraft rendezvous, docking, retrieval, and return to a space base. The PAM-D, PAM-DII, and IUS are mature vehicles currently available for mission support. Characteristics, flight records, and costs are defined. The TOS is being commercially developed while the OMV is government developed. The TOS and OMV capabilities, constraints, and costs are reviewed.

  12. United States orbital transfer vehicle programs

    NASA Technical Reports Server (NTRS)

    Gunn, Charles R.

    1989-01-01

    Five U.S. orbital transfer vehicles carrying spacecraft to higher energy orbits than achievable by the Space Shuttle or various expandable launch vehicles are studied. These vehicles are the Payload Assist Module-Delta (PAM-D), an upgraded version designated PAM-DII, the Inertial Upper Stage (IUS), the U.S. Transfer Orbit Stage (TOS), and the Orbital Maneuvering Vehicle (OMV). Capabilities range from providing spacecraft with only a preprogrammed perigee velocity additions to man-in-the-loop remote controlled spacecraft rendezvous, docking, retrieval, and return to a space base. The PAM-D, PAM-DII, and IUS are mature vehicles currently available for mission support. Characteristics, flight records, and costs are defined. The TOS is being commercially developed while the OMV is government developed. The TOS and OMV capabilities, constraints, and costs are reviewed.

  13. Progestin-Containing Contraceptives Alter Expression of Host Defense-Related Genes of the Endometrium and Cervix

    PubMed Central

    Goldfien, Gabriel A.; Barragan, Fatima; Chen, Joseph; Takeda, Margaret; Irwin, Juan C.; Perry, Jean; Greenblatt, Ruth M.; Smith-McCune, Karen K.

    2015-01-01

    Epidemiological studies indicate that progestin-containing contraceptives increase susceptibility to HIV, although the underlying mechanisms involving the upper female reproductive tract are undefined. To determine the effects of depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) on gene expression and physiology of human endometrial and cervical transformation zone (TZ), microarray analyses were performed on whole tissue biopsies. In endometrium, activated pathways included leukocyte chemotaxis, attachment, and inflammation in DMPA and LNG-IUS users, and individual genes included pattern recognition receptors, complement components, and other immune mediators. In cervical TZ, progestin treatment altered expression of tissue remodeling and viability but not immune function genes. Together, these results indicate that progestins influence expression of immune-related genes in endometrium relevant to local recruitment of HIV target cells with potential to increase susceptibility and underscore the importance of the upper reproductive tract when assessing the safety of contraceptive products. PMID:25634912

  14. KSC-99pp0620

    NASA Image and Video Library

    1999-06-01

    In the Vertical Processing Facility, the Chandra X-ray Observatory is lifted from its workstand in order to move it to the Inertial Upper Stage (IUS) nearby. After being mated, the two components will then undergo testing to validate the IUS/Chandra connections and check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  15. KSC-99pp0625

    NASA Image and Video Library

    1999-06-04

    Workers in the Vertical Processing Facility observe the lower end of the Inertial Upper Stage (IUS) that will be mated with the Chandra X-ray Observatory (out of sight above it). After the two components are mated, they will undergo testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  16. KSC-99pp0624

    NASA Image and Video Library

    1999-06-01

    In the Vertical Processing Facility, the Chandra X-ray Observatory is revealed with its protective cover removed. Chandra is ready for mating with the Inertial Upper Stage (IUS) beneath it, to be followed by testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  17. KSC-99pp0626

    NASA Image and Video Library

    1999-06-04

    STS-93 Mission Specialists Catherine Coleman (left) and Michel Tognini of France (right), representing the Centre National d'Etudes Spatiales (CNES), look over material on the mission payload behind them, the Chandra X-ray Observatory. Chandra is being mated with the Inertial Upper Stage (IUS) before testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  18. KSC-99pp0627

    NASA Image and Video Library

    1999-06-04

    STS-93 Mission Specialists Catherine Coleman (left) and Michel Tognini of France (right), who represents the Centre National d'Etudes Spatiales (CNES), look over the controls for the Chandra X-ray Observatory. Chandra is being mated with the Inertial Upper Stage (IUS) before testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  19. STS-93 Mission Specialists Coleman and Tognini check out the Chandra X-ray Observatory

    NASA Technical Reports Server (NTRS)

    1999-01-01

    STS-93 Mission Specialists Catherine Coleman (left) and Michel Tognini of France (right), representing the Centre National d'Etudes Spatiales (CNES), look over material on the mission payload behind them, the Chandra X-ray Observatory. Chandra is being mated with the Inertial Upper Stage (IUS) before testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93.

  20. STS-93 Mission Specialists Coleman and Tognini check out a control panel for the Chandra X-ray Obser

    NASA Technical Reports Server (NTRS)

    1999-01-01

    STS-93 Mission Specialists Catherine Coleman (left) and Michel Tognini of France (right), who represents the Centre National d'Etudes Spatiales (CNES), look over the controls for the Chandra X-ray Observatory. Chandra is being mated with the Inertial Upper Stage (IUS) before testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93.

  1. 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

  2. KSC-99pp0623

    NASA Image and Video Library

    1999-06-01

    In the Vertical Processing Facility, the Chandra X-ray Observatory is lowered onto the Inertial Upper Stage (IUS) beneath it. After the two components are mated, they will undergo testing to validate the IUS/Chandra connections and to check the orbiter avionics interfaces. Following that, an end-to-end test (ETE) will be conducted to verify the communications path to Chandra, commanding it as if it were in space. With the world's most powerful X-ray telescope, Chandra will allow scientists from around the world to see previously invisible black holes and high-temperature gas clouds, giving the observatory the potential to rewrite the books on the structure and evolution of our universe. Chandra is scheduled for launch July 22 aboard Space Shuttle Columbia, on mission STS-93

  3. Mission summary: Halley flyby/Tempel-2 rendezvous

    NASA Technical Reports Server (NTRS)

    Atkins, K.

    1979-01-01

    A unique dual-comet flight opportunity exists in mid-1985 which includes flyby of the large and active comet Halley en route to rendezvous with second comet, Tempel-2. This mission will utilize ion propulsion at a modest performance level, based on proven technology. The Project is planned for FY81 start. Launch occurs in July 1985 via the Shuttle/IUS twin stage. Following IUS injection, the ion propulsion stage provides continuous thrust virtually throughout the 3-year flight until the Tempel-2 rendezvous in 1988. En route, a probe is deployed for encounter with Halley about 4 months after launch at a point 73 days before its perihelion. Rendezvous with Tempel-2 occurs about 60 days before the comet's perihelion during the summer of 1988 and continues for about 1 year. Earth will be in favorable relative positions for observing both the flyby and the rendezvous.

  4. TRW Video News: Chandra X-ray Observatory

    NASA Technical Reports Server (NTRS)

    1999-01-01

    This NASA Kennedy Space Center sponsored video release presents live footage of the Chandra X-ray Observatory prior to STS-93 as well as several short animations recreating some of its activities in space. These animations include a Space Shuttle fly-by with Chandra, two perspectives of Chandra's deployment from the Shuttle, the Chandra deployment orbit sequence, the Initial Upper Stage (IUS) first stage burn, and finally a "beauty shot", which represents another animated view of Chandra in space.

  5. GPS/IGS Design Analysis Report. Volume 1

    DTIC Science & Technology

    1982-11-15

    Cooponent Temperatures - Hot Case (IGS/SCT Configuration) . . . . . . . .. . 215 Xii. som opmu" sfr •/uuosig dn& Rockwell SjsfI5,gm.n Oew IntematIl LIST OF...The GPS equipment qualification limits are more restrictive. In particular, the cesium clock and rubidium frequency standard temperature variation must...Systems Division 01% International "-Y NUTATION DAMPER GPS REF S ENCO R . ON IUS SCT\\ ... / U~l \\ CONe IG . .. . ... __ (NOT ON IGS ONLY CONFIG) CESIUM

  6. Recipient Wound Bed Characteristics Affect Scarring and Skin Graft Contraction

    DTIC Science & Technology

    2015-02-13

    Recipient wound bed characteristics affect scarring and skin graft contraction Lloyd F. Rose, PhD; Jesse C. Wu, MS; Anders H. Carlsson, PhD; David I...use of autograft skin is essential in the treatment of full thickness burns and large cutaneous defects. Both autograft thickness and condition of the... skin grafting onto hypodermis vs. onto fascia. Compared to autografts grafted onto fascia, identical thickness autografts grafted onto fat demonstrated

  7. Estimated disability-adjusted life years averted by free-of-charge provision of the levonorgestrel-releasing intrauterine system over a 9-year period in Brazil.

    PubMed

    Ferreira, Jessica M; Monteiro, Ilza; Fernandes, Arlete; Bahamondes, Maria V; Pitoli, Ana; Bahamondes, Luis

    2017-07-01

    The objective was to analyse the contribution of the provision at no cost to users of the 20 µg/day levonorgestrel-releasing intrauterine system (LNG-IUS) towards disability-adjusted life years (DALY) averted over a 9-year period. We analysed data from 15 030 new users of the LNG-IUS who had the device inserted at 26 Brazilian teaching hospitals between January 2007 and December 2015. The devices came from the International Contraceptive Access Foundation (ICA), a not-for-profit foundation that donates the devices to developing countries for use by low-income women who desire long-term contraception and who freely choose to use this device. Estimation of the DALY averted included live births averted, maternal morbidity and mortality, child mortality and unsafe abortions averted. A total of 15 030 women chose the LNG-IUS as a contraceptive method during the study period. Over the 9 years of evaluation, the estimated cumulative contribution of the Brazilian program in terms of DALY averted consisted of 486 live births, 14 cases of combined maternal mortality and morbidity, 143 cases of child mortality and 410 unsafe abortions. Provision of the LNG-IUS at no cost to low-income Brazilian women reduced unwanted pregnancies and probably averted maternal mortality and morbidity, child mortality and unsafe abortions. Family planning programs, policymakers and stakeholders based in low-resource settings could take advantage of the information that the provision of this contraceptive at no cost, or at affordable cost to a publicly-insured population, is an effective policy to help promote women's health. © Faculty of Sexual and Reproductive Healthcare of the Royal College of Obstetricians and Gynaecologists (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  8. Cardiovascular risk markers among obese women using the levonorgestrel-releasing intrauterine system: A randomised controlled trial.

    PubMed

    Zueff, Lucimara Facio Nobre; Melo, Anderson Sanches de; Vieira, Carolina S; Martins, Wellington P; Ferriani, Rui A

    2017-07-07

    According to international guidelines, women with obesity without other comorbidities can safely use any hormonal contraceptive (HC). However, limited information is available about contraceptive safety for women with obesity since obesity is an exclusion criterion of most contraceptive clinical trials. As such little is known about the possible risks of HC exposure for women with obesity without comorbidities. One way to assess possible long-term risks in this population, even prior to the development of any clinical disease, is to measure alterations in subclinical atherosclerosis markers. We evaluated the effects of the levonorgestrel-releasing intrauterine system (LNG-IUS) on subclinical markers of cardiovascular risk in women with obesity. This is a randomised clinical trial in which 106 women with obesity [body mass index (BMI)≥30kg/m(2)] were randomised to the LNG-IUS (n=53) or to non-hormonal methods (n=53) and followed for 12 months. We evaluated waist circumference (WC), blood pressure, blood glucose, insulin, lipid profile, and endothelial function markers (carotid intima-media thickness, brachial artery flow-mediated dilation, and carotid arterial stiffness). At 12 months, BMI (p=0.005), WC (p=0.045), and glucose levels (p=0.015) were significantly lower in the LNG-IUS group than in the control group. We did not find any clinically relevant changes in subclinical markers of cardiovascular risk among with obesity women at 12 months after LNG-IUS placement compared to users of non-hormonal contraceptive methods. Copyright © 2017 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  9. Immunologic evaluation of the endometrium with a levonorgestrel intrauterine device in solid organ transplant women and healthy controls.

    PubMed

    Kim, Caron R; Martinez-Maza, Otoniel; Magpantay, Larry; Magyar, Clara; Gornbein, Jeffrey; Rible, Radhika; Sullivan, Peggy

    2016-11-01

    The objective was to describe the endometrial milieu of stable transplant patients and healthy women before and after levonorgestrel intrauterine system (LNG-IUS) insertion. Women between 18 and 45 years of age desiring LNG-IUS insertion were enrolled with a 2:1 ratio of healthy to stable solid organ transplant patients. The first visit entailed a blood draw, uterine lavage and endometrial biopsy followed by LNG-IUS insertion. Follow-up visit involved a repeat serum draw, uterine lavage and endometrial biopsy. Cytokine levels were measured in the uterine lavage and serum by quantifying inflammatory biomarkers. Immunohistochemistry staining was performed on the endometrial tissue to measure macrophage levels. Statistical analysis included a nonparametric analysis that compared medians of the marker levels before and after intrauterine device (IUD) insertion within the group and between the two groups. Sixteen participants completed the study: 5 solid organ transplant patients and 11 healthy patients. For the serum, there were no marked changes in the cytokines or soluble receptor levels in either group after IUD insertion. However, in the uterine lavage, there was an increase in cytokine levels post-IUD insertion for both healthy and transplant women. For the endometrial tissue, there was evidence of macrophage activity in both groups after device insertion. This pilot study investigated the uterine environment of the transplant patient population. Findings have pointed to the strong local inflammatory response following LNG-IUS insertion for the transplant recipients. In addition, these preliminary findings will help power a larger study that can investigate the safety and effectiveness of the IUD in this patient population. Findings from this pilot study suggest that the IUD is inducing a local inflammatory reaction in the uterus of the transplant patient as in the healthy control. A larger study can build on these preliminary results to pursue the efficacy and

  10. Lithuanian Freedom Fighters’ Tactics Resisting the Soviet Occupation 1944-1953

    DTIC Science & Technology

    2012-12-14

    Nazi efforts to recruit Lithuanian SS battalions, organizing an underground nationalistic press, etc., the overall goal of clandestine...assign SS -related tasks to the newly formed unit, General Povilas Plechavičius refused to comply. Therefore, soon after creation of the Lithuanian...Territorial Defense Force the Germans realized that the unit was pro-Lithuanian and posed a threat to the Nazi regime. As a result, the Germans arrested

  11. ASTROCAM: An Offner Re-imaging 1024 x 1024 InSb Camera for Near-Infrared Astrometry on the USNO 1.55-m Telescope

    DTIC Science & Technology

    2003-01-01

    Kosakowskif, C. C. Dudleya and Kenneth Johnstoni aNaval Research Laboratory, Remote Sensing Division, Washington, DC, USA bU.S. Naval Observatory ...Flagstaff Station, PO Box 1149, Flagstaff, AZ, USA cMauna Kea Infrared, LLC, 159 Kalanikoa St, Hilo, HI USA dUniversity of Chicago Engineering Center...gApplied Designs, 3001 Specific Heights Rd, Honolulu, HI, USA hCAD Services, 1158 Mowai St, Kailua, HI, USA iU.S. Naval Observatory , 3450 Massachusetts

  12. IUE observations of periodic comets Tempel-2, Kopff, and Tempel-1

    NASA Technical Reports Server (NTRS)

    Feldman, Paul D.; Festou, Michel C.

    1992-01-01

    We summarize the results of observations made between 10 Jun. - 18 Dec. 1988 with the International Ultraviolet Explorer (IUS) of comet P/Tempel-2 during its 1988 appearance. The derived water production rate and relative gas/dust ratio are compared with those of P/Halley, observed with IUE in 1985-86, and other potential Comet Rendezvous/Asteroid Flyby (CRAF) target comets, P/Kopff and P/Tempel-1, both observed with IUE in 1983.

  13. Draft Environmental Impact Report/Environmental Impact Statement, Bel Marin Keys Unit 5.

    DTIC Science & Technology

    1982-09-01

    and Loan Association has applied to the U. S. Army, Corps of Engineers , San Francisco District, for a permit under Section 10 of the River and Harbor...Corps of Engineers Project construction requires a Department of the Army permit under Section 10 of the River and Harbor Act (RHA) of 1899 (33 U.S.C...Marin County Planning Department IUS. Army Corps of Engineers I .44* ~September 1982 IT TORREY & TORREY INC. environmental /urban planning and

  14. Modification of Bell Canyon Test (BCT) of 1-FF Grout.

    DTIC Science & Technology

    1983-09-01

    these were done to an age of 1 year. Compressive strength and expansion data were determined beyond (Cont inued) DO/, FORM AN 73 1473 EDITION OF I...used to determine consistency measurements during casting of the mixtures. The flow of water was run before each sample as a reference. Flows were 3...13. Data for the four cements, three fly ashes, and the silica fume determined by chemical and physical tests are shown in Tables 1 and 2. Since

  15. (abstract) Final Galileo Propulsion System In-Flight Characterization (Extended Abstract)

    NASA Technical Reports Server (NTRS)

    Barber, Todd J.; Renner, Klaus Peter; Krug, Friedrich A.

    1997-01-01

    The Galileo Retropropulsion Module (RPM) has performed excellently during nearly seven years of Galileo mission operations. The RPM was provided by the Federal Republic of Germany to NASA to provide directed impulse to the Galileo spacecraft during all phases of the Galileo mission following Inertial Upper Stage (IUS) jettison. This paper documents the in-flight performance of the Galileo propulsion system since July 1993.

  16. 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.

  17. 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

  18. STS-29 tracking and data relay satellite D (TDRS-D) mating at KSC VPF

    NASA Image and Video Library

    1988-12-29

    S89-27383 (29 Dec 1988) --- This wide shot of a test cell in KSC's Vertical Processing Facility affords an overall scene of the mating process of the STS 29 tracking and data relay satellite (TDRS-D, in foreground) with its inertial upper stage (IUS-9, in lower part of frame). Later the tandem will be loaded into the cargo bay of Discovery.

  19. Mitigation of Shore Damage Attributed to the Federal Navigation Structures at Hammond Bay Harbor.

    DTIC Science & Technology

    1976-11-01

    arkansara calamint sweet gale S. 7 ths oacidenta7lis but tonbush ’,d’.’W eah .c zyoulata leather leaf rL,, ’roenlandicum Labrador tea ’,noviilfa 7ongifol...ia reed grass A,.;mop£oqo n aop{2rIus little bluestem .’uu~ t~ar~i~a sand cherry ,1 ,m’"sia a’Uata tall wormwood :.i o hispiz hairy goldenrod f lten:i

  20. Levonorgestrel releasing intrauterine system (Mirena) versus endometrial ablation (Novasure) in women with heavy menstrual bleeding: a multicentre randomised controlled trial

    PubMed Central

    2013-01-01

    Background Heavy menstrual bleeding is an important health problem. Two frequently used therapies are the levonorgestrel intra-uterine system (LNG-IUS) and endometrial ablation. The LNG-IUS can be applied easily by the general practitioner, which saves costs, but has considerable failure rates. As an alternative, endometrial ablation is also very effective, but this treatment has to be performed by a gynaecologist. Due to lack of direct comparison of LNG-IUS with endometrial ablation, there is no evidence based preferred advice for the use of one of these treatment possibilities. Method/design A multicenter randomised controlled trial, organised in a network infrastructure in the Netherlands in which general practitioners and gynaecologists collaborate. Women ≥ 34 years with heavy menstrual bleeding, a Pictorial Blood Assessment Chart (PBAC) score exceeding 150 points and no future child wish can participate in the trial. After informed consent, women will be randomised to a strategy starting with a levonorgestrel releasing intrauterine system or a strategy starting with endometrial ablation. The primary outcome is the PBAC score at 24 months of follow-up. Secondary outcomes are patient satisfaction, complications, number of re-interventions, menstrual bleeding pattern, quality of life, sexual function, sick leave and costs. As predictors of effect of intervention we also meaure level of coagulation factors. Discusson This study, considering both effectiveness and cost effectiveness of LNG-IUS versus endometrial ablation may well improve care for women with heavy menstrual bleeding. Trial registration Dutch trial register, number NTR2984 PMID:23927387

  1. The effectiveness of the levonorgestrel intrauterine system in obese women with heavy menstrual bleeding.

    PubMed

    Shaw, Valentina; Vandal, Alain C; Coomarasamy, Christin; Ekeroma, Alec J

    2016-12-01

    To evaluate the effectiveness of the levonorgestrel intrauterine system (LNG-IUS) in obese women with heavy menstrual bleeding in Counties Manukau Auckland area, New Zealand. Prospective observational study in a tertiary teaching hospital. Twenty women with heavy menstrual bleeding (HMB) who agreed to treatment with the LNG-IUS and had a body mass index (BMI) of >30 kg/m(2) were recruited between May and December 2014. The women completed two validated tools (Menstrual Impact Questionnaire and the Pictorial Bleeding Assessment Chart) at recruitment, 6 and 12 months follow-up. Demographic, medical and laboratory variables were obtained from the relevant CMH databases. Data on side effects and satisfaction were obtained from the women at 12 months. The median age (range) and BMI of the 20 women were 40.5 years (27-52 years) and 40.6 kg/m(2) (30-68), respectively. Three LNG-IUS were removed due to infection and pain and these women were subsequently booked for a hysterectomy. The reduction in menstrual loss was estimated at 19.7% per month (95% CI (12.5%, 26.2%); P < 0.001), which translates to 73.2% per period of 6 months (95% CI (55.3%, 83.9%)) and 92.8% per period of 12 months (95% CI (80.0%, 97.4%)). The six items in the quality of life measure improved significantly in 14 women but only 12 women were satisfied with the treatment. The LNG-IUS was an effective treatment for 67% of obese women with heavy menstrual bleeding over a 12-month period, as assessed by the reduction in menstrual bleeding and the improvement in the quality of life measures. © 2016 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  2. Draft Genome Sequence of the Cyanobacterium Aphanizomenon flos-aquae Strain 2012/KM1/D3, Isolated from the Curonian Lagoon (Baltic Sea).

    PubMed

    Šulčius, Sigitas; Alzbutas, Gediminas; Kvederavičiūtė, Kotryna; Koreivienė, Judita; Zakrys, Linas; Lubys, Arvydas; Paškauskas, Ričardas

    2015-01-15

    We report here the de novo genome assembly of a cyanobacterium, Aphanizomenon flos-aquae strain 2012/KM1/D3, a harmful bloom-forming species in temperate aquatic ecosystems. The genome is 5.7 Mb with a G+C content of 38.2%, and it is enriched mostly with genes involved in amino acid and carbohydrate metabolism. Copyright © 2015 Šulčius et al.

  3. Combined Oral Medroxyprogesterone/Levonorgestrel-Intrauterine System Treatment for Women With Grade 2 Stage IA Endometrial Cancer.

    PubMed

    Hwang, Ji Young; Kim, Da Hee; Bae, Hyo Sook; Kim, Mi-La; Jung, Yong Wook; Yun, Bo Seong; Seong, Seok Ju; Shin, Eunah; Kim, Mi Kyoung

    2017-05-01

    The aim of this study was to evaluate the oncologic and pregnancy outcomes of combined oral medroxyprogesterone acetate (MPA)/levonorgestrel-intrauterine system (LNG-IUS) treatment in young women with grade 2-differentiated stage IA endometrial adenocarcinoma who wish to preserve fertility. We retrospectively reviewed the medical records of patients with grade 2 stage IA endometrial adenocarcinoma who had received fertility-sparing treatment at CHA Gangnam Medical Center between 2011 and 2015. All of the patients were treated with combined oral MPA (500 mg/d)/LNG-IUS, and follow-up dilatation and curettage were performed every 3 months. A total of 5 patients were included in the study. The mean age was 30.4 ± 5.3 years (range, 25-39 years). After a mean treatment duration of 11.0 ± 6.2 months (range, 6-18 months), complete response (CR) was shown in 3 of the 5 patients, with partial response (PR) in the other 2 patients. One case of recurrence was reported 14 months after achieving CR. This patient was treated again with combined oral MPA/LNG-IUS and achieved CR by 6 months. The average follow-up period was 44.4 ± 26.2 months (range, 12-71 months). There were no cases of progressive disease. No treatment-related complications arose. Combined oral MPA/LNG-IUS treatment is considered to be a reasonably effective fertility-sparing treatment of grade 2 stage IA endometrial cancer. Although our results are encouraging, it is preliminary and should be considered with experienced oncologists in well-defined protocol and with close follow-up.

  4. Magellan Prelaunch Mission Operations Report

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The Magellan spacecraft will be launched from Kennedy Space Center (KSC) within a 31-day overall launch period extending from April 28 to May 28, 1989. The launch will use the Shuttle Orbiter Atlantis to lift an Inertial Upper Stage (IUS) and the Magellan Spacecraft into low Earth orbit. After the Shuttle achieves its parking orbit, the IUS and attached Magellan spacecraft are deployed from the payload bay. After a short coast time, the two-stage IUS is fired to inject the Magellan spacecraft into an Earth-Venus transfer trajectory. The Magellan spacecraft is powered by single degree of freedom, sun-tracking, solar panels charging a set of nickel-cadmium batteries. The spacecraft is three-axis stabilized by reaction wheels using gyros and a star sensor for attitude reference. The spacecraft carries a solid rocket motor for Venus Orbit Insertion (VOI). A hydrazine propulsion system allows trajectory correction and prevents saturation of the reaction wheels. Communication with Earth through the Deep Space Network (DSN) is provided by S- and X-band telemetry channels, through alternatively a low, medium, or 3.7 m high-gain parabolic antenna rigidly attached to the spacecraft. The high-gain antenna also serves as the radar and radiometer antenna during orbit around Venus.

  5. Temperature Change Induces the Expression of vuuA Encoding Vulnibactin Receptor and crp Encoding Cyclic AMP Receptor Protein in Vibrio vulnificus.

    PubMed

    Kim, Choon-Mee; Ahn, Young-Joon; Kim, Seong-Jung; Yoon, Dae-Heung; Shin, Sung-Heui

    2016-07-01

    Upon entering the human body, Vibrio vulnificus, a gram-negative marine bacterium, must withstand a temperature change (TC) from 25 to 37 °C. This bacterium acquires iron mainly via the vulnibactin receptor (VuuA)-mediated iron uptake system (IUS), which is under the positive control of cyclic AMP receptor protein (CRP), a global regulator responsible for catabolite repression. In this study, we examined the effect of TC on the expression of vuuA and crp, and the reciprocal relation between VuuA-mediated IUS and CRP under iron-limited conditions. Iron limitation increased vuuA expression but decreased crp expression. TC resulted in increased vuuA and crp expression. A crp or vuuA mutation reciprocally decreased vuuA or crp expression. TC could increase vuuA or crp expression even in a crp- or vuuA-mutated background. These results indicate that TC increases the expression of both vuuA and crp by facilitating metabolism under iron-limited conditions, and that CRP and VuuA-mediated IUS interact coordinately toward optimal metabolism in V. vulnificus.

  6. Non-contraceptive benefits of intrauterine levonorgestrel administration: why not?

    PubMed

    Sabbioni, Lorenzo; Petraglia, Felice; Luisi, Stefano

    2017-06-06

    Levonorgestrel intrauterine systems (LNG-IUS) represent a modern therapy for an array of preexisting gynecological conditions, though they were first marketed in Finland in 1990. However, there are countries in which their use is extremely limited by social and cultural factors. This manuscript describes the possible reasons for this misuse, taking in consideration the clinical noncontraceptive benefits of intrauterine levonorgestrel in routinary practice. Medical diseases in which LNG-IUS represent a treatment include abnormal uterine bleeding, iron-deficiency anemia, endometrial hyperplasia, uterine fibroids, adenomyosis, endometriosis, and coagulopathies. The advantage of reducing the need for more radical treatments such as surgery or hysterectomy is well demonstrated, with remarkable benefits for patients. However, in many countries, surgery is still used as a first-line treatment and there is a need to define who could benefit from a less invasive option. It seems clear that such a reduced use of LNG-IUS depends on factors that imply both patients and practitioners, and that the role of counseling is becoming a key component in the decision-making process to reach the ultimate goal of compliance.

  7. Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder.

    PubMed

    Kim, Min Kuk; Lee, Kang Soo; Kim, Borah; Choi, Tai Kiu; Lee, Sang-Hyuk

    2016-03-01

    Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder. We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI). There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001). IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder.

  8. Levonorgestrel intrauterine system in adjuvant tamoxifen treatment: balance of breast risks and endometrial benefits--systematic review of literature.

    PubMed

    Gizzo, Salvatore; Di Gangi, Stefania; Bertocco, Anna; Noventa, Marco; Fagherazzi, Simone; Ancona, Emanuele; Saccardi, Carlo; Patrelli, Tito Silvio; D'Antona, Donato; Nardelli, Giovanni Battista

    2014-04-01

    Levonorgestrel intrauterine system (LNG-IUS) is used in patients with breast patients taking tamoxifen (TAM) to prevent endometrial proliferation. The benefits (on endometrium), the side effects (on breast), and the patients suitable for this treatment are not still clear. Aim of this systematic review is to define the breast risks and endometrial benefits in TAM-treated women using Mirena and to define which patients could benefit from LNG-IUS use. In all, 3 studies on LNG-IUS effects on endometrium in TAM-treated women and 4 studies on breast cancer recurrence were selected for the study. All studies described a reduction in benign endometrial pathologies among Mirena users, but controversial data showed malignant disease and breast cancer recurrence. So it is mandatory to define hormonal status before TAM treatment. In selected patients Mirena was proven to protect endometrium. Perspective clinical trials on Mirena pharmacological features are necessary to establish whether systemic levels of progesterone could increase breast cancer recurrence in such patients.

  9. Impact of Mindfulness-Based Cognitive Therapy on Intolerance of Uncertainty in Patients with Panic Disorder

    PubMed Central

    Kim, Min Kuk; Lee, Kang Soo; Kim, Borah; Choi, Tai Kiu

    2016-01-01

    Objective Intolerance of uncertainty (IU) is a transdiagnostic construct in various anxiety and depressive disorders. However, the relationship between IU and panic symptom severity is not yet fully understood. We examined the relationship between IU, panic, and depressive symptoms during mindfulness-based cognitive therapy (MBCT) in patients with panic disorder. Methods We screened 83 patients with panic disorder and subsequently enrolled 69 of them in the present study. Patients participating in MBCT for panic disorder were evaluated at baseline and at 8 weeks using the Intolerance of Uncertainty Scale (IUS), Panic Disorder Severity Scale-Self Report (PDSS-SR), and Beck Depression Inventory (BDI). Results There was a significant decrease in scores on the IUS (p<0.001), PDSS (p<0.001), and BDI (p<0.001) following MBCT for panic disorder. Pre-treatment IUS scores significantly correlated with pre-treatment PDSS (p=0.003) and BDI (p=0.003) scores. We also found a significant association between the reduction in IU and PDSS after controlling for the reduction in the BDI score (p<0.001). Conclusion IU may play a critical role in the diagnosis and treatment of panic disorder. MBCT is effective in lowering IU in patients with panic disorder. PMID:27081380

  10. STS-43 TDRS-E during preflight processing at KSC's VPF

    NASA Technical Reports Server (NTRS)

    1991-01-01

    STS-43 Tracking and Data Relay Satellite E (TDRS-E) undergoes preflight processing in the Kennedy Space Center's (KSC's) Vertical Processing Facility (VPF) before being loaded into a payload canister for transfer to the launch pad and eventually into Atlantis', Orbiter Vehicle (OV) 104's, payload bay (PLB). This side of the TDRS-E will rest at the bottom of the PLB therefore the airborne support equipment (ASE) forward frame keel pin (at center of spacecraft) and the umbilical boom running between the two ASE frames are visible. The solar array panels are covered with protective TRW shields. Above the shields the stowed antenna and solar sail are visible. The inertial upper stage (IUS) booster is the white portion of the spacecraft and rests in the ASE forward frame and ASE aft frame tilt actuator (AFTA) frame (at the bottom of the IUS). The IUS booster nozzle extends beyond the AFTA frame. View provided by KSC with alternate number KSC-91PC-1079.

  11. Management of Endometrial Hyperplasia: A Survey of Members of the Korean Gynecologic Oncology Group.

    PubMed

    Kim, Mi Kyoung; Seong, Seok Ju; Kim, Jae-Weon; Bae, Duk-Soo; Jeon, Seob; Kwon, Sang-Hoon; Lee, Taek Sang

    2015-09-01

    This study aimed to investigate the current management of endometrial hyperplasia (EH) in Korea. This was an electronic survey, which included 40 questions, that was distributed to the members of the Korean Gynecologic Oncology Group in 2014. In total, 50 (69%) of 72 members responded to the survey. The oral progestogens were the most popular choices for managing EH without atypia (simple hyperplasia(SH), 64%; complex hyperplasia (CH), 52%). In the case of CH with atypia, most of the gynecologist respondents would perform hysterectomy (95.9%). For fertility preservation, the oral progestogens were the most popular choices (SH, 75.5%; CH, 56.3%), followed by the levonorgestrel-releasing intrauterine system (LNG-IUS). More than 70% of the respondents reported use of dilatation and curettage as a follow-up method. Our survey results show that most of Korean gynecologic oncologists still prefer oral progestogens for conservative management of EH, notwithstanding the many successful reports on the LNG-IUS. As a follow-up evaluation method, dilatation and curettage is mostly used. To identify the optimum therapy, a randomized controlled trial comparing the LNG-IUS with continuous oral progestogens is required. Furthermore, a large-scale prospective study to confirm the most reliable technique for follow-up evaluation is necessary.

  12. Comparison of the levonorgestrel-releasing intrauterine system, hysterectomy, and endometrial ablation for heavy menstrual bleeding in a decision analysis model.

    PubMed

    Louie, Michelle; Spencer, Jennifer; Wheeler, Stephanie; Ellis, Victoria; Toubia, Tarek; Schiff, Lauren D; Siedhoff, Matthew T; Moulder, Janelle K

    2017-08-10

    A better understanding of the relative risks and benefits of common treatment options for abnormal uterine bleeding (AUB) can help providers and patients to make balanced, evidence-based decisions. To provide comparative estimates of clinical outcomes after placement of levonorgestrel-releasing intrauterine system (LNG-IUS), ablation, or hysterectomy for AUB. A PubMED search was done using combinations of search terms related to abnormal uterine bleeding, LNG-IUS, hysterectomy, endometrial ablation, cost-benefit analysis, cost-effectiveness, and quality-adjusted life years. Full articles published in 2006-2016 available in English comparing at least two treatment modalities of interest among women of reproductive age with AUB were included. A decision tree was generated to compare clinical outcomes in a hypothetical cohort of 100 000 premenopausal women with nonmalignant AUB. We evaluated complications, mortality, and treatment outcomes over a 5-year period, calculated cumulative quality-adjusted life years (QALYs), and conducted probabilistic sensitivity analysis. Levonorgestrel-releasing intrauterine system had the highest number of QALYs (406 920), followed by hysterectomy (403 466), non-resectoscopic ablation (399 244), and resectoscopic ablation (395 827). Ablation had more treatment failures and complications than LNG-IUS and hysterectomy. Findings were robust in probabilistic sensitivity analysis. Levonorgestrel-releasing intrauterine system and hysterectomy outperformed endometrial ablation for treatment of AUB. © 2017 International Federation of Gynecology and Obstetrics.

  13. Clinicians' views on low-lying intrauterine devices or systems.

    PubMed

    Golightly, Ellen; Gebbie, Ailsa E

    2014-04-01

    There is a lack of consensus and very little published guidance on the management of a low-lying or malpositioned intrauterine contraceptive device (IUD) or system (IUS). A short e-mail questionnaire sent to senior medical staff working in contraceptive services confirmed the variation in views and management of this clinical area. Almost all respondents would replace an IUD/IUS lying either totally or partially in the cervical canal. The nearer the device was to the fundus the more likely respondents were to leave it in situ and there was less concern if the device was an IUS, presumably in view of the hormonal action. In the presence of abnormal bleeding or pain, most respondents would look for other causes rather than assume that the low-lying device was to blame. Respondents expressed uncertainty as to whether low-lying devices were more likely to fail or not and around half the respondents felt that low-lying devices could migrate upwards within the cavity. This survey highlighted the need for accurate evidence-based guidance to assist in this area of clinical contraceptive practice.

  14. STS-43 TDRS-E during preflight processing at KSC's VPF

    NASA Image and Video Library

    1991-06-13

    STS-43 Tracking and Data Relay Satellite E (TDRS-E) undergoes preflight processing in the Kennedy Space Center's (KSC's) Vertical Processing Facility (VPF) before being loaded into a payload canister for transfer to the launch pad and eventually into Atlantis', Orbiter Vehicle (OV) 104's, payload bay (PLB). This side of the TDRS-E will rest at the bottom of the PLB therefore the airborne support equipment (ASE) forward frame keel pin (at center of spacecraft) and the umbilical boom running between the two ASE frames are visible. The solar array panels are covered with protective TRW shields. Above the shields the stowed antenna and solar sail are visible. The inertial upper stage (IUS) booster is the white portion of the spacecraft and rests in the ASE forward frame and ASE aft frame tilt actuator (AFTA) frame (at the bottom of the IUS). The IUS booster nozzle extends beyond the AFTA frame. View provided by KSC with alternate number KSC-91PC-1079.

  15. The Inertial Upper Stage - A space transportation system element nearing first flight

    NASA Technical Reports Server (NTRS)

    Rohrbaugh, D. J.; Redd, F. J.; Van Rensselaer, F.

    1981-01-01

    The Inertial Upper Stage (IUS) developed by the USAF and NASA is a highly reliable, cost-effective solid propellant upper stage, with inherent flexibility and adaptability for integration with the Space Shuttle. The propulsion system is simple, utilizing safe, solid rocket motors with extremely light-weight nonmetallic cases and nozzles. The IUS can deliver 2268 kg from the Shuttle to geosynchronous altitude; it consists of a 9700 kg propellant weight first stage, an interstage structure, a 2720 kg propellant weight second stage, and an equipment support section. The avionics system includes the electronic and electrical hardware used to perform all signal conditioning, data processing, and software formatting associated with navigation, guidance, control, data management, and redundancy management. The generic thermal design of the IUS is suited to a wide range of thermal environments; the software design provides for selectable thermal maneuvers (rotisserie, reciprocating, toasting, space facing, sun facing) to satisfy different payload thermal requirements. A 1982 launch with the Titan 34D and a 1983 launch with the Shuttle Orbiter are planned.

  16. Use of levonorgestrel-releasing intrauterine system in the prevention and treatment of endometrial hyperplasia.

    PubMed

    Ewies, Ayman A A; Alfhaily, Fadi

    2012-11-01

    Endometrial hyperplasia is a commonly seen gynecological condition that affects women of all age groups. Whereas hysterectomy is the most preferred treatment option for complex endometrial hyperplasia with atypia, there is no consensus regarding the first-line management of women with hyperplasia without cytological atypia. Oral progestogen therapy was used with some success. Nonetheless, it may be plausible to argue that women with endometrial hyperplasia need continuous treatment and high level of compliance to ensure complete regression, which may not be guaranteed with oral therapy. Observational studies suggested that levonorgestrel-releasing intrauterine system (LNG-IUS) has been successfully used to treat endometrial hyperplasia without cytological atypia and selected cases of atypical endometrial hyperplasia. Furthermore, there is strong evidence from randomized controlled trials that LNG-IUS prevents the development of endometrial hyperplasia in exogenous estrogen users; however, its protective role and safety in tamoxifen-treated breast cancer survivors remain uncertain. This article evaluates the current evidence for the use of LNG-IUS, releasing 20 μg of LNG per day, in the prevention and treatment of endometrial hyperplasia.

  17. Development of endometrioid adenocarcinoma despite Levonorgestrel-releasing intrauterine system: a case report with discussion and review of the RCOG/BSGE Guideline on the Management of Endometrial Hyperplasia.

    PubMed

    van der Meer, A C L; Hanna, L S

    2017-02-01

    Obesity is a significant risk factor for the development of endometrial hyperplasia and cancer. More conservative prevention and management strategies are attractive due to the increased surgical risk and complication rates associated with obesity. The Levonorgestrel-releasing intrauterine system (LNG-IUS, Mirena) has been shown to reduce the risk of developing endometrial cancer. The recent joint Green Top Guideline on the Management of Endometrial Hyperplasia published by the Royal College of Obstetricians and Gynaecologists (RCOG) with the British Society for Gynaecological Endoscopy (BSGE) recommends the LNG-IUS for the medical management of endometrial hyperplasia without atypia. This case study reports on the development of endometrioid adenocarcinoma despite the presence of an LNG-IUS following a negative hysteroscopy in a 56-year-old woman with morbid obesity. This report highlights the need for patients and clinicians to remain vigilant to the early warning signs of developing endometrial cancer, especially in those at an increased risk secondary to obesity. © 2016 World Obesity Federation.

  18. Safety and comfort of long-term continuous combined transdermal estrogen and intrauterine levonorgestrel administration for postmenopausal hormone substitution - a review.

    PubMed

    Wildemeersch, D

    2016-08-01

    To review the endometrial safety and patient acceptability of long-term use of continuous transdermal estrogen substitution combined with intrauterine release of levonorgestrel (LNG) in postmenopausal women. One-hundred and fifty-three women who utilized the regimen for 2 IUD cycles were followed-up for a period of 10 years. Histology of the endometrium was evaluated at the end of this period to assess endometrial safety and the acceptability of the method was assessed based on the replacement rate of the LNG-IUS and continuation of ET. The regimen, administered over a 10-year period, was very well tolerated and the IUD was retained well and no expulsions occurred. The dominant endometrial histologic picture was that of inactive endometrium characterized by glandular atrophy and stroma decidualization (Kurman classification 5b). No cases of endometrial hyperplasia were found. The low systemic absorption of LNG could be desirable, thus allowing for maximization of the beneficial effects of ET on organ tissues (e.g. cardiovascular tissues and breast). Repeat LNG-IUS is associated with high patient satisfaction. If started before the age of 60, this regimen could be advised for lifelong prevention of cardiovascular disease and other prevention measures. The LNG-IUS was shown to effectively oppose the secondary effects of systemic estrogen on the endometrium tissue resulting in strong suppression during the entire period of EPT.

  19. Correlation between uterine artery Doppler indices and menstrual irregularities among levonorgestrel releasing intrauterine system and depot medroxyprogesterone acetate users: a prospective observational study.

    PubMed

    Rezk, Mohamed; Al-Halaby, Alaa; Emarh, Mohamed; Shawky, Mohamed

    2017-08-01

    To ascertain whether menstrual irregularities among users of levonorgestrel releasing intrauterine system (LNG-IUS) and depot medroxyprogesterone acetate (DMPA), were associated with changes in uterine artery Doppler indices or not. This three-year prospective observational study included 102 women using LNG-IUS and 104 women using DMPA for contraception. Participants were followed at regular intervals over three years with performance of transvaginal ultrasound to measure uterine artery pulsatility index (PI) and resistance index (RI) before starting the method and at six months, 12 months, two and three years thereafter. Data was collected and tabulated. Significant changes in uterine artery PI and RI were detected. PI indices were reduced after six months of use in both groups and elevated significantly at 12 months in both groups compared to initial values (p < .001) while RI significantly reduced after six months in both groups and elevated significantly at 12 months, two and three years in both groups compared to initial values (p < .001). Both PI and RI significantly reduced in women suffered abnormal uterine bleeding and significantly elevated in women experienced amenorrhea irrespective of the method used (p < .001). LNG-IUS and DMPA induce hemodynamic changes in the uterine arteries denoting positive correlation with menstrual irregularities. Larger multicentre studies are warranted to potentiate our findings.

  20. Timing of insertion of levonorgestrel-releasing intrauterine system: a randomised controlled trial.

    PubMed

    van der Heijden, Pahh; Geomini, Pmaj; Herman, M C; Veersema, S; Bongers, M Y

    2017-01-01

    The objective was to assess whether patient-perceived pain during the insertion of the levonorgestrel-releasing intrauterine system (LNG-IUS) depends on the timing during the menstrual cycle. A stratified two-armed non-inferiority randomised controlled trial. Large teaching hospital in Veldhoven, the Netherlands. From October 2013 to May 2014, 60 nulliparous and 60 multiparous women were randomised. Eight women withdrew after randomisation and before insertion took place: therefore, data from 112 women were collected and analysed. Women were randomised to the groups 'during menstruation' (i.e. days 1-7 of menstruation) or 'outside menstruation' (i.e. any day of the cycle after menstruation without the presence of vaginal blood loss) in a ratio of 1 : 1. The primary outcome was pain during insertion, measured by the visual analogue scale (VAS, 0-100 mm). Second, we analysed ease of insertion, bleeding pattern, satisfaction, pregnancy, and expulsion rate. The follow-up time was 3 months. The mean VAS score for nulliparous women was 74 mm (95% confidence interval, 95% CI 67-81) in the 'during menstruation' group, compared with 66 mm (95% CI 59-74) in the 'outside menstruation' group (P = 0.14). The mean VAS score for multiparous women was 30 mm (95% CI 20-40) in the 'during menstruation group', compared with 43 mm (95% CI 32-53) in the 'outside menstruation' group (P = 0.08). There was no difference between the stratified 'during menstruation' group and the 'outside menstruation' group with regards to ease of insertion, satisfaction, bleeding pattern, and median spotting and bleeding days for the use of the LNG-IUS 3 months after insertion. As we did not find that the level of pain perceived during insertion was higher during menstruation, compared with outside menstruation, we conclude that the LNG-IUS can be inserted at any time during the menstrual cycle, especially in the case of nulliparous women. We conducted an RCT on time of insertion of

  1. New frameless and framed intrauterine devices and systems - an overview.

    PubMed

    Wildemeersch, Dirk

    2007-06-01

    There is a need for new, improved birth control methods which are easier to use, with less side effects and which avoid daily action, such as the pill. Perfect use requires consistent daily use or use at every act of intercourse. Long-acting methods eliminate the need for specific action at the time of coitus, or for daily action. Developing a new contraceptive is a major challenge. It is generally estimated that it takes 10-15 years to develop a new method and bring it to the market, at a cost of 200-300 million US dollars, and the industry is reluctant to take the risk of such long-term investment. However, both risk and investment can be reduced by taking small steps. Slight improvements of existing contraceptives could result in a giant step forward. The development of frameless intrauterine systems (IUS) is an attempt to improve the performance and acceptability of intrauterine contraception. Both the frameless GyneFix IUD and the frameless FibroPlant levonorgestrel (LNG)-IUS possess features which may solve the main problems encountered with conventional IUDs (e.g., expulsion, abnormal or excessive bleeding and pain). The performance of frameless devices, however, is dependent on correct anchoring of the device, which requires technical skill. Becoming a proficient GyneFix(R) or FibroPlant provider is easily acquired if the provider follows the procedural instruction strictly. For the less technically skilled provider, the Femilis LNG-IUS, using the new, simplified insertion technique, could be an excellent contraceptive option. It is usually not necessary to provide pain relief for insertion of an IUD/IUS, particularly in parous women. IUD providers should, however, realize that no woman likes to suffer from the insertion of an IUD. Severe discomfort may create a negative attitude towards the method. If the woman is anxious and fears pain (as most nulliparous women do), probably the most convenient, safe and effective method is to use local (intracervical

  2. From speech to thought: the neuronal basis of cognitive units in non-experimental, real-life communication investigated using ECoG

    PubMed Central

    Derix, Johanna; Iljina, Olga; Weiske, Johanna; Schulze-Bonhage, Andreas; Aertsen, Ad; Ball, Tonio

    2014-01-01

    Exchange of thoughts by means of expressive speech is fundamental to human communication. However, the neuronal basis of real-life communication in general, and of verbal exchange of ideas in particular, has rarely been studied until now. Here, our aim was to establish an approach for exploring the neuronal processes related to cognitive “idea” units (IUs) in conditions of non-experimental speech production. We investigated whether such units corresponding to single, coherent chunks of speech with syntactically-defined borders, are useful to unravel the neuronal mechanisms underlying real-world human cognition. To this aim, we employed simultaneous electrocorticography (ECoG) and video recordings obtained in pre-neurosurgical diagnostics of epilepsy patients. We transcribed non-experimental, daily hospital conversations, identified IUs in transcriptions of the patients' speech, classified the obtained IUs according to a previously-proposed taxonomy focusing on memory content, and investigated the underlying neuronal activity. In each of our three subjects, we were able to collect a large number of IUs which could be assigned to different functional IU subclasses with a high inter-rater agreement. Robust IU-onset-related changes in spectral magnitude could be observed in high gamma frequencies (70–150 Hz) on the inferior lateral convexity and in the superior temporal cortex regardless of the IU content. A comparison of the topography of these responses with mouth motor and speech areas identified by electrocortical stimulation showed that IUs might be of use for extraoperative mapping of eloquent cortex (average sensitivity: 44.4%, average specificity: 91.1%). High gamma responses specific to memory-related IU subclasses were observed in the inferior parietal and prefrontal regions. IU-based analysis of ECoG recordings during non-experimental communication thus elicits topographically- and functionally-specific effects. We conclude that segmentation of

  3. Levonorgestrel-releasing intrauterine system vs oral progestins for non-atypical endometrial hyperplasia: a systematic review and metaanalysis of randomized trials.

    PubMed

    Abu Hashim, Hatem; Ghayaty, Essam; El Rakhawy, Mohamed

    2015-10-01

    We sought to evaluate the therapeutic efficacy of levonorgestrel-releasing intrauterine system (LNG-IUS) with oral progestins for treatment of non-atypical endometrial hyperplasia (EH). Searches were conducted on PubMed, SCOPUS, and CENTRAL databases to August 2014, and reference lists of relevant articles were screened. The search was limited to articles conducted on human beings and females. The PRISMA Statement was followed. Seven randomized controlled trials (n = 766 women) were included. Main outcome measures were the therapeutic effect rate (histological response) after 3, 6, 12, and 24 months of treatment; rate of irregular vaginal bleeding; and the hysterectomy rate per woman randomized. The Cochrane Collaboration risk of bias tool was used for quality assessment. Metaanalysis was performed with fixed effects model. LNG-IUS achieved a highly significant therapeutic response rate compared with oral progestins after 3 months of treatment (odds ratio [OR], 2.30; 95% confidence interval [CI], 1.39-3.82; P = .001, 5 trials, I(2) = 0%, n = 376), after 6 months of treatment (OR, 3.16; 95% CI, 1.84-5.45; P < .00001, 4 trials, I(2) = 0%, n = 397), after 12 months of treatment (OR, 5.73; 95% CI, 2.67-12.33; P < .00001, 2 trials, I(2) = 0%, n = 224), and after 24 months of treatment (OR, 7.46; 95% CI, 2.55-21.78; P = .0002, 1 trial, n = 104). Subgroup analysis showed evidence of highly significant therapeutic response following LNG-IUS compared with oral progestins for non-atypical simple as well as complex EH (OR, 2.51; 95% CI, 1.14-5.53; P = .02, 6 trials, I(2) = 0%, n = 290; and OR, 3.31; 95% CI, 1.62-6.74; P = .001, 4 trials, I(2) = 0%, n = 216, respectively). Compared with oral progestins, LNG-IUS achieved significantly fewer hysterectomies (OR, 0.26; 95% CI, 0.15-0.45; P < .00001, 3 trials, n = 362, I² = 42%). No difference was observed in the rate of irregular vaginal bleeding between both groups (OR, 1.12; 95% CI, 0.54-2.32; P = .76, 2 trials, n = 207, I

  4. The influence of intrauterine contraception on the prevalence and severity of dysmenorrhea: a longitudinal population study.

    PubMed

    Lindh, Ingela; Milsom, Ian

    2013-07-01

    Does intrauterine contraception influence the prevalence and severity of dysmenorrhea? In this longitudinal study, a copper intrauterine device (Cu-IUD) did not influence the severity of dysmenorrhea, whereas the levonorgestrel-releasing intrauterine system (LNG-IUS) reduced dysmenorrhea severity. Dysmenorrhea is a common problem among young women. The LNG-IUS has been reported to be associated with less painful menstruation, although more long-term studies are necessary. In contrast Cu-IUDs have been reported to exacerbate dysmenorrhea. A longitudinal population study. The prevalence and severity of dysmenorrhea was compared in a longitudinal analysis of variance performed in the same women when using either intrauterine contraception (Cu-IUD or LNG-IUS) or combined oral contraceptives (COCs) with other methods of contraception or no contraception. Random samples of 19-year-old women born in 1962 (n = 656), 1972 (n = 780) and 1982 (n = 666) assessed at 5-year intervals between 1981 and 2001. Current severity of dysmenorrhea was assessed on each occasion by a verbal multidimensional scoring system (VMS) and by a visual analog scale (VAS). Dysmenorrhea severity was unchanged in the same woman when using a Cu-IUD compared with using other methods (= condom use, barrier methods, natural family planning, coitus interruptus and sterilization)/no method of contraception in the longitudinal analysis of factors influencing dysmenorrhea severity (VMS score: +0.05 units/VAS: -0.3 mm, both NS). LNG-IUS and COC use were associated with reduced dysmenorrhea severity compared with other methods/no method (LNG-IUS use, VMS score: -0.4 units/VAS: -13 mm, both P < 0.01; COC use, VMS score: -0.4 units/VAS: -11 mm, both P < 0.0001). Childbirth reduced dysmenorrhea (VMS score: -0.3 units, P < 0.05/VAS: -16 mm, P < 0.001). Dysmenorrhea severity decreased between the ages of 19 and 44 years. There was a decline in the response rate over time during the 20 years of this longitudinal

  5. Uterine perforation caused by intrauterine devices: clinical course and treatment.

    PubMed

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

    2013-06-01

    What are the symptoms of uterine perforation caused by modern copper intrauterine devices (Cu-IUDs) and the levonorgestrel-releasing intrauterine system (LNG-IUS); how is perforation detected and what are the findings in abdominal surgery? Symptoms are mostly mild and ∼30% of women are asymptomatic. Surgical findings are mainly minimal; no visceral complications were found in this study. However, adhesions as well as pregnancies seem to be more common among women using Cu-IUDs. Prior studies and case reports have suggested that uterine perforation by modern IUDs/IUSs is rarely serious. A retrospective study of 75 patients (54 LNG-IUS and 21 Cu-IUD) treated surgically for uterine perforation between 1996 and 2009. The patients treated for uterine perforation by an IUD/IUS at clinics of the Helsinki and Uusimaa Hospital District were identified using the National Care Register for Health Institutions in Finland. The clinical data were collected from individual patient records. The majority of patients (n = 53; 71%) had mild symptoms of abnormal bleeding or abdominal pain or both, in combination with missing IUD/IUS threads. Asymptomatic patients (n = 22; 29%) were examined because of missing threads or pregnancy. Failure to remove the IUD/IUS by pulling visible threads was the reason for referral in seven women (9%) requesting removal of the device. Eleven women (15%) were pregnant. Misplaced IUDs/IUSs were localized by a combination of vaginal ultrasonography (US) and X-ray, hysteroscopy or curettage. Only after this were patients treated by means of laparoscopy. The majority (n = 44; 65%) of the 68 intra-abdominal devices were located in the omentum, the remaining 24 (35%) around the uterus. Partial perforation or myometrial embedding was diagnosed in all seven cases (9%) with visible threads, but unsuccessful removal by pulling. During laparoscopy, filmy adhesions were found in 21 patients (30%). Pregnancy (33 versus 7%, P = 0.009) and intra-abdominal adhesions

  6. Fast-track vs. delayed insertion of the levonorgestrel-releasing intrauterine system after early medical abortion - a randomized trial.

    PubMed

    Korjamo, Riina; Mentula, Maarit; Heikinheimo, Oskari

    2017-08-05

    To compare levonorgestrel (LNG) 52-mg intrauterine system (IUS) expulsion rates with fast-track (≤3 days) or delayed (2-4 weeks) insertion following mifepristone and misoprostol medical abortion. In this pilot trial, we randomized 108 women at ≤63 days' gestation to fast-track (n=55) or delayed (n=53) insertion. Follow-up visits occurred at 2-4 weeks, 3 months and 1 year. We assessed total and partial expulsion at 3 months and 1 year, adverse effects and bleeding profiles. We had follow-up data at 3 months and 1 year for 41 (74.5%) and 37 (69.8%) women in the fast-track group and 31 (56.4%) and 28 (52.8%) women in the delayed group. By 3 months, expulsion occurred in six (12.5%) women after fast-track and one (2.3%) woman after delayed insertion [risk ratio (RR) 5.50, 95% confidence interval (CI) 0.69-43.90]; most (n=5) of these were partial expulsions in the fast-track group. By 1 year, expulsion had occurred in seven (14.6%) and five (11.5%) women in the fast-track and delayed groups, respectively (RR 1.28, 95% CI 0.44-3.75). We found no differences in rates of vacuum aspiration, residual tissue, infection and bleeding or bleeding patterns within 3 months of insertion. Fast-track insertion of the LNG 52-mg IUS after medical abortion is feasible but may result in higher expulsion rates compared to delayed insertion. Due to lack of statistical power and high lost-to-follow-up rates, we were unable to fully address this question. Fast-tract initiation of LNG 52-mg IUS contraception after medical abortion is feasible. It results in higher expulsion rates than delayed insertion but may improve postabortal intrauterine contraception uptake. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Different bleeding patterns with the use of levonorgestrel intrauterine system: are they associated with changes in uterine artery blood flow?

    PubMed

    Bastianelli, Carlo; Farris, Manuela; Rapiti, Stefania; Vecchio, Roberta Bruno; Benagiano, Giuseppe

    2014-01-01

    Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS) are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I), amenorrheic women (Group II), and women with prolonged bleedings (Group III). Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI) and resistance index (RI) in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing--within subjects of Group III--mean PI and RI mean values before and after insertion. The LNG-IUS not only altered endometrial thickness, but--in women with prolonged bleedings--also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates.

  8. Orbital Evidence for Clay and Acidic Sulfate Assemblages on Mars and Mineralogical Analogs from Rio Tinto, Spain

    NASA Astrophysics Data System (ADS)

    Kaplan, H. H.; Milliken, R.; Fernandez-Remolar, D. C.; Amils, R.; Robertson, K.; Knoll, A. H.

    2015-12-01

    A suite of enigmatic near-infrared reflectance spectra with a 'doublet' absorption between 2.2 and 2.3 µm is observed in CRISM (Compact Reconnaissance Imaging Spectrometer for Mars) hyperspectral images over Ius and Melas Chasma on Mars. The doublet-bearing deposits are found alongside other hydrated minerals including clays, sulfates, and silica, but the mineral(s) responsible for the spectral signature has yet to be identified. Reflectance spectra of rocks and sediments at Rio Tinto, Spain exhibit similar absorptions at airborne, field, and lab spatial scales. Coupled X-ray diffraction and reflectance spectra of these terrestrial examples indicate the absorption arises from a mixture of jarosite, a ferric sulfate, and Al-phyllosilicates (illite/muscovite). Detailed analysis of CRISM data over Ius and Melas Chasma suggests that these deposits also contain mixtures of jarosite and Al-phyllosilicate, where the latter may include halloysite, kaolinite and/or montmorillonite in addition to illite/muscovite. This interpretation is supported because (1) the two absorptions in the doublet feature vary independently, implying the presence of two or more phases, (2) the position of the absorptions is consistent with Al-OH and Fe-OH vibrations in both the Rio Tinto and CRISM spectra and (3) Al-phyllosilicates and jarosite are identified separately in nearby regions. Multiple formation mechanisms are proposed based on stratigraphy in Ius Chasma, where the strength of absorptions varies within a single stratigraphic unit as well as between different units. Mechanisms include authigenic formation of jarosite, which would indicate locally acidic and oxidizing conditions, mixed with detrial Al-phyllosilicates, or authigenic formation of Al-phyllosilicates and jarosite. Each implies different conditions in terms of aqueous geochemistry, redox, and sediment transport. Results from the field, lab, and CRISM analysis will be presented to discuss how placing these spectral

  9. Magellan Post Launch Mission Operation Report

    NASA Technical Reports Server (NTRS)

    1982-01-01

    Magellan was successfully launched by the Space Shuttle Atlantis from the Kennedy Space Center at 2:47 p.m. EDT on May 4, 1989. The Inertial Upper Stage (IUS) booster and attached Magellan Spacecraft were successfully deployed from Atlantis on Rev. 5 as planned, at 06:14 hrs Mission Elapsed Time (MET). The two IUS propulsion burns which began at 07:14 hrs MET and were completed at 07:22 hrs MET, placed the Magellan Spacecraft almost perfectly on its preplanned trajectory to Venus. The IUS was jettisoned at 07:40 hrs MET and Magellan telemetry was immediately acquired by the Deep Space Network (DSN). A spacecraft trajectory correction maneuver was performed on May 21 and the spacecraft is in the planned standard cruise configuration with all systems operating nominally. An initial attempt was made to launch Atlantis on April 28, 1989, but the launch was scrubbed at T-31 sec due to a failure of the liquid hydrogen recirculation pump on Space Shuttle Main Engine #1. The countdown had proceeded smoothly until T-20 min when the Magellan radio receiver "locked-on" the MIL 71 Unified S-Band (USB) transmission as the transmitter power was increased fro 2 kw to 10 kw in support of the orbiter launch. During the planned hold at T-9 min, the USB was confirmed as the source of the receiver "lock" and Magellan's launch readiness was reaffirmed. In addition a five-minute extension of the T-9 hold occurred when a range safety computer went off-line, creating a loss of redundancy in the range safety computer network. Following resumption of the countdown, both the orbiter and Magellan flows proceeded smoothly until the launch was scrubbed at T-31 sec.

  10. 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

  11. Adolescent Experiences With Intrauterine Devices: A Qualitative Study.

    PubMed

    Schmidt, Elizabeth O; James, Aimee; Curran, K Michele; Peipert, Jeffrey F; Madden, Tessa

    2015-10-01

    The purpose of this study was to improve understanding of adolescents' reasons for choosing an intrauterine device (IUD) and to explore experiences that led to continuation or discontinuation of the levonorgestrel intrauterine system (LNG-IUS) and the copper IUD (copper IUD). We conducted focus groups (FGs) with adolescents and young women who were current or former IUD users stratified by IUD type and 12-month IUD continuation or discontinuation. All subjects were participants from the Contraceptive CHOICE Project. FG data were supplemented with in-depth interviews (IDIs). Data collection was continued until thematic saturation was reached. Transcripts were independently coded by two researchers, and interrater reliability was calculated using a Kappa coefficient. Analysis followed a standard text-analysis approach. Thirteen FGs and seven IDIs were conducted with 43 young women. Effectiveness, duration of use, convenience, and potential bleeding changes emerged as themes for both choosing and continuing IUDs. Some women chose the LNG-IUS to achieve amenorrhea, whereas copper IUD users wanted a nonhormonal method and continued menses. Copper IUD users cited expulsion and bleeding irregularities as reasons for discontinuation, whereas LNG-IUS users reported bleeding irregularities and continued pain as reasons for removal. IUD users noted an adjustment period of weeks to months in which side effects were present before lessening. Effectiveness, duration of use, convenience, and potential changes in bleeding patterns drove adolescents' choice and continuation of an IUD. Bleeding changes and pain contributed to IUD discontinuation. Discussion of effectiveness, duration and convenience, and anticipatory guidance regarding post-insertion side effects may be important in counseling young women about IUDs. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  12. Complications and continuation rates associated with two types of long-acting contraception

    PubMed Central

    Berenson, Abbey B.; Tan, Alai; Hirth, Jacqueline M.

    2015-01-01

    Objectives To compare complication and continuation rates of the levonorgestrel intrauterine system (LNG-IUS) with the subdermal etonogestrel (ENG) implant across the US among women 15 – 44 years of age. Study Design A retrospective study of health insurance claims records from 2007–2011 identified a cohort of women who had LNG-IUS (n=79,920) or ENG implants (n=7,374) inserted and had insurance coverage for 12 months post-insertion. Claims for complications were examined 12 months after insertion, or until removal of either device within each of three age groups. Results After its introduction in 2007, the frequency of ENG implants increased each year and almost 1/3 of all insertions were in teenagers. However, among women ≤ 24 years old who had delivered an infant in the prior 8 weeks, a LNG-IUS was more likely to be inserted than an ENG implant (P < .05). The most frequent complications with both methods were related to abnormal menstruation, which was more likely to occur among ENG implant users. Overall, 83–88% of the entire sample used their chosen method for at least 12 months. The odds of continuation were similar for both methods among teenagers, but ENG implants were more likely to be removed prematurely among women 20 – 24 years old (OR 1.21, 95% CI: 1.06–1.39) and 25 – 44 years old (OR 1.49, 95% CI: 1.35–1.64). Conclusions Both of these long-acting contraceptive methods are well tolerated among women of all ages, and demonstrate high continuation rates. PMID:25555662

  13. Different Bleeding Patterns with the Use of Levonorgestrel Intrauterine System: Are They Associated with Changes in Uterine Artery Blood Flow?

    PubMed Central

    Bastianelli, Carlo; Rapiti, Stefania; Bruno Vecchio, Roberta; Benagiano, Giuseppe

    2014-01-01

    Objective. Evaluate if different bleeding patterns associated with the use of the levonorgestrel intrauterine system (LNG-IUS) are associated with different uterine and endometrial vascularization patterns, as evidenced by ultrasound power Doppler analysis. Methodology. A longitudinal study, with each subject acting as its own control was conducted between January 2010 and December 2012. Healthy volunteers with a history of heavy but cyclic and regular menstrual cycles were enrolled in the study. Ultrasonographic examination was performed before and after six months of LNG-IUS placement: uterine volume, endometrial thickness, and subendometrial and myometrial Doppler blood flow patterns have been evaluated. Results. A total of 32 women were enrolled out of 186 initially screened. At six months of follow-up, all subjects showed a reduction in menstrual blood loss; for analysis, they were retrospectively divided into 3 groups: normal cycling women (Group I), amenorrheic women (Group II), and women with prolonged bleedings (Group III). Intergroup analysis documented a statistically significant difference in endometrial thickness among the three groups; in addition, mean pulsatility index (PI) and resistance index (RI) in the spiral arteries were significantly lower in Group I and Group III compared to Group II. This difference persisted also when comparing—within subjects of Group III—mean PI and RI mean values before and after insertion. Conclusions. The LNG-IUS not only altered endometrial thickness, but—in women with prolonged bleedings—also significantly changed uterine artery blood flow. Further studies are needed to confirm these results and enable gynecologists to properly counsel women, improving initial continuation rates. PMID:24868549

  14. IBIS: an OR ready open-source platform for image-guided neurosurgery.

    PubMed

    Drouin, Simon; Kochanowska, Anna; Kersten-Oertel, Marta; Gerard, Ian J; Zelmann, Rina; De Nigris, Dante; Bériault, Silvain; Arbel, Tal; Sirhan, Denis; Sadikot, Abbas F; Hall, Jeffery A; Sinclair, David S; Petrecca, Kevin; DelMaestro, Rolando F; Collins, D Louis

    2017-03-01

    Navigation systems commonly used in neurosurgery suffer from two main drawbacks: (1) their accuracy degrades over the course of the operation and (2) they require the surgeon to mentally map images from the monitor to the patient. In this paper, we introduce the Intraoperative Brain Imaging System (IBIS), an open-source image-guided neurosurgery research platform that implements a novel workflow where navigation accuracy is improved using tracked intraoperative ultrasound (iUS) and the visualization of navigation information is facilitated through the use of augmented reality (AR). The IBIS platform allows a surgeon to capture tracked iUS images and use them to automatically update preoperative patient models and plans through fast GPU-based reconstruction and registration methods. Navigation, resection and iUS-based brain shift correction can all be performed using an AR view. IBIS has an intuitive graphical user interface for the calibration of a US probe, a surgical pointer as well as video devices used for AR (e.g., a surgical microscope). The components of IBIS have been validated in the laboratory and evaluated in the operating room. Image-to-patient registration accuracy is on the order of [Formula: see text] and can be improved with iUS to a median target registration error of 2.54 mm. The accuracy of the US probe calibration is between 0.49 and 0.82 mm. The average reprojection error of the AR system is [Formula: see text]. The system has been used in the operating room for various types of surgery, including brain tumor resection, vascular neurosurgery, spine surgery and DBS electrode implantation. The IBIS platform is a validated system that allows researchers to quickly bring the results of their work into the operating room for evaluation. It is the first open-source navigation system to provide a complete solution for AR visualization.

  15. A 60-month non-comparative study on bleeding profiles with the levonorgestrel intrauterine system from the late transition period to estrogen supplemented menopause.

    PubMed

    Depypere, Herman T; Hillard, Timothy; Erkkola, Risto; Lukkari-Lax, Eeva; Kunz, Michael; Rautiainen, Pia; Schram, Jan H N

    2010-12-01

    The primary aim of this study was to assess the transition from using the levonorgestrel-releasing intrauterine system (LNG IUS, 20 μg LNG/24 h) for reproductive-age contraception to using it as menopausal-age endometrial protection during estrogen replacement therapy (ERT). The transfer process was evaluated by assessment of the vaginal bleeding pattern. Continuation rates were also recorded. Open, multicentre, non-comparative study was conducted in 11 menopausal centres in Finland (3), The Netherlands (4), Belgium (2) and UK (2). Three hundred and ninety-four healthy women aged 46-51 years at entry with regular menstrual cycles, but without any climacteric symptoms, and who were willing to start oral or transdermal estrogen treatment for climacteric symptoms. If by 48 months a woman was not menopausal, she was not eligible for the ERT phase. Bleeding patterns were recorded in 90-day reference periods. One hundred and sixty-eight women were eligible for the ERT phase. The mean ± SD number of bleeding/spotting days was highest (49 ± 19 days) in the first 90-day reference period in the contraceptive phase. For subjects who switched to ERT this number was 10 ± 13 days in the last contraceptive reference period and decreased to 9 ± 12 days in the first and 6 ± 10 days in the last 90-day reference period of the ERT phase. For both spotting and bleeding days there was no statistically significant difference between the last contraceptive and the first reference period of the ERT phase. In general, the results indicate that continuing with the LNG IUS from contraception to ERT has no adverse effects on the vaginal bleeding profile, and show a positive effect of the combined estrogen and LNG IUS treatment on the quality of life. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  16. Effects of combined oral contraceptives, depot medroxyprogesterone acetate and the levonorgestrel-releasing intrauterine system on the vaginal microbiome.

    PubMed

    Brooks, J Paul; Edwards, David J; Blithe, Diana L; Fettweis, Jennifer M; Serrano, Myrna G; Sheth, Nihar U; Strauss, Jerome F; Buck, Gregory A; Jefferson, Kimberly K

    2017-04-01

    Prior studies suggest that the composition of the vaginal microbiome may positively or negatively affect susceptibility to sexually transmitted infections (STIs) and bacterial vaginosis (BV). Some female hormonal contraceptive methods also appear to positively or negatively influence STI transmission and BV. Therefore, changes in the vaginal microbiome that are associated with different contraceptive methods may explain, in part, effects on STI transmission and BV. We performed a retrospective study of 16S rRNA gene survey data of vaginal samples from a subset of participants from the Human Vaginal Microbiome Project at Virginia Commonwealth University. The subset included 682 women who reported using a single form of birth control that was condoms, combined oral contraceptives (COCs), depot medroxyprogesterone acetate (DMPA) or the levonorgestrel-releasing intrauterine system (LNG-IUS). Women using COCs [adjusted odds ratio (aOR) 0.29, 95% confidence interval (CI) 0.13-0.64] and DMPA (aOR 0.34, 95% CI 0.13-0.89), but not LNG-IUS (aOR 1.55, 95% CI 0.72-3.35), were less likely to be colonized by BV-associated bacteria relative to women who used condoms. Women using COCs (aOR 1.94, 95% CI 1.25-3.02) were more likely to be colonized by beneficial H2O2-producing Lactobacillus species compared with women using condoms, while women using DMPA (aOR 1.09, 95% CI 0.63-1.86) and LNG-IUS (aOR 0.74, 95% CI 0.48-1.15) were not. Use of COCs is significantly associated with increased vaginal colonization by healthy lactobacilli and reduced BV-associated taxa. COC use may positively influence gynecologic health through an increase in healthy lactobacilli and a decrease in BV-associated bacterial taxa. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Adolescent Experiences with IUDs: a Qualitative Study

    PubMed Central

    Schmidt, Elizabeth O.; James, Aimee; Curran, K. Michele; Peipert, Jeffrey; Madden, Tessa

    2015-01-01

    Purpose To improve understanding of adolescents’ reasons for choosing an intrauterine device (IUD) and to explore experiences that led to continuation or discontinuation of the levonorgestrel intrauterine system (LNG-IUS) and the copper intrauterine device (copper IUD). Methods We conducted focus groups with adolescents and young women who were current or former IUD users stratified by IUD type and 12-month IUD continuation or discontinuation. All subjects were participants from the Contraceptive CHOICE Project. Focus group data was supplemented with in-depth interviews. Data collection was continued until thematic saturation was reached. Transcripts were independently coded by two researchers and inter-rater reliability was calculated using a Kappa coefficient. Analysis followed a standard text-analysis approach. Results Thirteen focus groups and 7 in-depth interviews were conducted with 43 young women. Effectiveness, duration of use, convenience and potential bleeding changes emerged as themes for both choosing and continuing IUDs. Some women chose the LNG-IUS to achieve amenorrhea, while copper IUD users wanted a non-hormonal method and continued menses. Copper IUD users cited expulsion and bleeding irregularities as reasons for discontinuation, whereas LNG-IUS users reported bleeding irregularities and continued pain as reasons for removal. IUD users noted an adjustment period of weeks to months in which side effects were present before lessening. Conclusions Effectiveness, duration of use, convenience, and potential bleeding changes drove adolescents’ choice and continuation of an IUD. Bleeding changes and pain contributed to IUD discontinuation. Discussion of effectiveness, duration and convenience, and anticipatory guidance regarding post-insertion side effects may be important in counseling young women about IUDs. PMID:26126950

  18. Planetary mission requirements, technology and design considerations for a solar electric propulsion stage

    NASA Technical Reports Server (NTRS)

    Cork, M. J.; Hastrup, R. C.; Menard, W. A.; Olson, R. N.

    1979-01-01

    High energy planetary missions such as comet rendezvous, Saturn orbiter and asteroid rendezvous require development of a Solar Electric Propulsion Stage (SEPS) for augmentation of the Shuttle-IUS. Performance and functional requirements placed on the SEPS are presented. These requirements will be used in evolution of the SEPS design, which must be highly interactive with both the spacecraft and the mission design. Previous design studies have identified critical SEPS technology areas and some specific design solutions which are also presented in the paper.

  19. A Dynamic Model of the Initial Spares Support List Development Process

    DTIC Science & Technology

    1979-06-01

    fill the demands of the .* base sector. DIM" 11151A DFO•K(fOI• ) (DFOLK) I0FOU.KI tIl11•NOlE 0 -CFO PT FRACTION ODR WRtOTE PEGS -DEPOT FRACTION MMDRE I...Use Rate. QPEI 11371L REI,K:RE.J4I)T) (EIRR.JK-EIFR.JKI l4INCOTE RE! -READY END lIEKS II4ZSNQTE 9T - DETA TIRE ti45aNOTE EIRR -END ITER REPAIR RATE

  20. JSC Mission Control Center (MCC) personnel watch STS-26 landing in FCR

    NASA Technical Reports Server (NTRS)

    1988-01-01

    During STS-26 Discovery, Orbiter Vehicle (OV) 103, landing, personnel in JSC's Mission Control Center (MCC) Bldg 30 flight control room (FCR) monitor heading alignment cone (HAC) diagram and OV-103 runway touch down displayed on front screens. In the foreground is the Specialists Console (BOOSTER, EVA, PDRS, RMS, PAM, IUS) with Mission Operations Directorate (MOD) console next to it. At the MOD console are Flight Crew Operations Directorate (FCOD) Deputy Chief Henry Hartsfield, JSC Director Aaron Cohen, and MOD Director Eugene F. Kranz. In the background, Public Affairs Office (PAO) photographer Andrew R. 'Pat' Patnesky takes a photograph of the FCR activity.

  1. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling.

    PubMed

    Costescu, Dustin J

    2016-01-01

    Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception.

  2. MS Peterson and MS Musgrave in payload bay (PLB) during EVA

    NASA Image and Video Library

    1983-04-07

    STS006-10-417 (7 April 1983) --- Astronauts F. Story Musgrave, left, and Donald H. Peterson float about in the cargo bay of the Earth-orbiting space shuttle Challenger during their April 7, 1983, extravehicular activity (EVA). Their "floating about" is restricted via tethers to safety slide wires. Thanks to the tether/slide wire combination, Peterson is able to translate along the port side hand rails. Musgrave is near the Airborne Support Equipment (ASE) for the now vacated Inertial Upper Stage (IUS). Clouds can be seen in the background. Photo credit: NASA

  3. A Model for the Management of Technical Risk in New Technology Development Programs

    DTIC Science & Technology

    1989-09-01

    ACTIONjNO TEST FOR TERMINAL 1 xCUTE ACTION AND RECEIVE ACTION IINFORMATION ABOUT COft/PONE.VT YCS CARACTERISTICS ME-LSUPEO DETERM.INLE PAYOFF £.nD 1’E...34one horse to ride." And after you have gone a year or two 200 downstream, you find you’re on the high risk horse . If you could, you could fund the...and Logistics, Air Force Institute of Technology (AU), Wright-Patterson AFB OH, Spring Quarter 1989. 4. Air Force Space Division. "IUS Anomaly Board

  4. Satellite Altimetry for Naval Oceanography

    DTIC Science & Technology

    1990-11-01

    mesoscale map. H. Beresford and E. McNutt assisted with analses of An added capability of the SSH residual is the ability herod ad.uttaSs alyesofd to...wave energy. It should be gnd) Gulf of Mexico vmidoon. tal Da, 1536. ihi Day 0󈧴. lei Da. noted that a more sophisticated technioue for determiring...the 1560. (d) Day 1572. lei Day 1602 For contour interval. ee Figure A KINDLF SAMPLING STRArEGiIUS AND Mot As iSMitt IioN of A L risit IRI( D.I A _ (a

  5. Fertility and endocrine effects of intra-abdominally misplaced intrauterine system for more than 2 years: a case report and review of the literature.

    PubMed

    Botros, George; Haddad, Nabil

    2009-06-01

    This case report shows with documented evidence that a misplaced Mirena intrauterine system in the abdominal cavity had an endocrine and contraceptive effect causing amenorrhea and infertility for 2 years and 5 months. This had been proved by a negative hysteroscopy in November 2004 and an abdominal X-ray showing the device which was done in May 2007. Intraabdominal misplacement of the LNG-IUS has been reported in the literature with variable consequences and effects. In this case report, we reviewed the literature and assessed the fertility and endocrine consequences.

  6. Kinematic and Dynamic Analysis of High-Speed Intermittent-Motion Mechanisms.

    DTIC Science & Technology

    1984-01-16

    NUMBER 4. TITLE (and Subtitle) 5. TYPE OF REPORT & PERIOD COVERED Kinematic and Dynamic Analysis of Final Report Hig-Sped ntemiten-MoionMecanims12/1/80...mesh generator for finite-element approach is presented for the Geneva wheel, although not simple, due to the complicated geometry of the wheel. The...k#b~t ~ -SPEED Final Re~port 74, W. Lee I D.*",rY 16, 1984 *~ IU.S. Army Research Office I Contract Number I DAA29-1-K-016 Sa Aefo qe lirvg~ nee ring

  7. Earth orbital assessment of solar electric and solar sail propulsion systems

    NASA Technical Reports Server (NTRS)

    Teeter, R. R.

    1977-01-01

    The earth orbital applications potential of Solar Electric (Ion Drive) and Solar Sail low-thrust propulsion systems are evaluated. Emphasis is placed on mission application in the 1980s. The two low-thrust systems are compared with each other and with two chemical propulsion Shuttle upper stages (the IUS and SSUS) expected to be available in the 1980s. The results indicate limited Earth orbital application potential for the low-thrust systems in the 1980s (primarily due to cost disadvantages). The longer term potential is viewed as more promising. Of the two systems, the Ion Drive exhibits better performance and appears to have better overall application potential.

  8. Development of Vault Toilet Waste Treatment Systems.

    DTIC Science & Technology

    1978-06-01

    wi nd turbine used was a Savoniut’ Wing Rotor, a vertical axis rotor developed by S. J. Savonius in the early 1920’s and used exten- sively in the...one aoove the other on a common sha rt wi th the upper rotor S. J. Savonius , The Wind Rotor in Theory and P ractice (Savon ius Co. , Finland, 1928...Ben F. Blackwe l l, Wind Tunnel Perfov’mcotce Data for 2~o— ~ id Three— Bucket Savonius Rotors, (Sandia Laboratories, July 1977). 16 _ _ _ _ _ • “I

  9. 3D intra-operative ultrasound and MR image guidance: pursuing an ultrasound-based management of brainshift to enhance neuronavigation.

    PubMed

    Riva, Marco; Hennersperger, Christoph; Milletari, Fausto; Katouzian, Amin; Pessina, Federico; Gutierrez-Becker, Benjamin; Castellano, Antonella; Navab, Nassir; Bello, Lorenzo

    2017-04-08

    Brainshift is still a major issue in neuronavigation. Incorporating intra-operative ultrasound (iUS) with advanced registration algorithms within the surgical workflow is regarded as a promising approach for a better understanding and management of brainshift. This work is intended to (1) provide three-dimensional (3D) ultrasound reconstructions specifically for brain imaging in order to detect brainshift observed intra-operatively, (2) evaluate a novel iterative intra-operative ultrasound-based deformation correction framework, and (3) validate the performance of the proposed image-registration-based deformation estimation in a clinical environment. Eight patients with brain tumors undergoing surgical resection are enrolled in this study. For each patient, a 3D freehand iUS system is employed in combination with an intra-operative navigation (iNav) system, and intra-operative ultrasound data are acquired at three timepoints during surgery. On this foundation, we present a novel resolution-preserving 3D ultrasound reconstruction, as well as a framework to detect brainshift through iterative registration of iUS images. To validate the system, the target registration error (TRE) is evaluated for each patient, and both rigid and elastic registration algorithms are analyzed. The mean TRE based on 3D-iUS improves significantly using the proposed brainshift compensation compared to neuronavigation (iNav) before (2.7 vs. 5.9 mm; [Formula: see text]) and after dural opening (4.2 vs. 6.2 mm, [Formula: see text]), but not after resection (6.7 vs. 7.5 mm; [Formula: see text]). iUS depicts a significant ([Formula: see text]) dynamic spatial brainshift throughout the three timepoints. Accuracy of registration can be improved through rigid and elastic registrations by 29.2 and 33.3%, respectively, after dural opening, and by 5.2 and 0.4%, after resection. 3D-iUS systems can improve the detection of brainshift and significantly increase the accuracy of the navigation in a real

  10. Design and Specification of Low Pressure Sewer Systems for Recreation Areas.

    DTIC Science & Technology

    1985-02-01

    i " pt I ON A I mU IUS S"IWS IrNi ijpipiit Vu(INi( j I a I’ mit theI’ irStl IIt I-oni. For g’rierai! 1) 1 irui;nig ilirli 5S , t iS 1 .I .\\ri tt[if)It...how used I I (ot Il tiJl i 1 wit h mna Itifa rt [Irert:s i n f rrna t. i on to inaike app1,rop1rIiateu ds ign der (I , lori s -0 18(0. lTre nrrost

  11. Jupiter Orbiter and Probe project - Synthesis of the mission design

    NASA Technical Reports Server (NTRS)

    Beckman, J. C.; Roberts, P. H., Jr.

    1977-01-01

    The Jupiter Orbiter Probe (JOP), scheduled to be launched by the Shuttle IUS in 1981, is described in terms of its scientific mission objectives. These include: analysis of the chemical composition and physical state of Jupiter's atmosphere, the chemical composition and physical state of Ganymede and Callisto, and the topology and behavior of the magnetic field and energetic particle fluxes. Attention is given to an atmospheric probe which will be launched from the main probe, and to the navigation requirements necessary to 'bounce' the JOP around the Jovian moons.

  12. An Analytical and Experimental Investigation of Planar Discontinuities in Coaxial Waveguides.

    DTIC Science & Technology

    1981-03-01

    AOORESS(JI dflfeent Irm ConItlinhi Office) 1. SECURITY CLASS. (o tlis port) Unclassified OCAS FICATION/00OUNGRAING 0CEDULE ISi . OTS44NM4UIISTATE[ME[NT (at...PEAK AMP -5.749 o.479 % b -.164 x c - .534S5 9..3~ g.2 2 2 k -.8195~ h -SS3e FRONT PLATE co0. W M PmR5c o-t 0.0 .2 a. . . 1.0 bROO IUS NORMA ~LIZED BY

  13. The Theory and Practice of the h-p Version of Finite Element Method.

    DTIC Science & Technology

    1987-04-01

    1Wr-194 ’The problem with none-hmogeneous Dirichlet problem is to find the finite element solution u. £ data was studied by Babuika, Guo.im- 4401 The h...implemented in the coasmercial code PROOE . by Noetic Tech., St. Louis. See (27,281. The commer- IuS -u 01 1 C(SIS2)Z(u0,HI,S1) (2.3) cial program FIESTA...collaboration with govern- ment agencies such as the National Bureau of Standards. o To be an international center of study and research for foreign

  14. Laboratory Transmission of Venezuelan Equine Encephalomyelitis Virus by the Tick Hyalomma Truncatum

    DTIC Science & Technology

    1994-01-01

    equine On day 21 after infestation of the first guinea-pig, none encephalomyelitis virus by the tick of 95 unfed nv mphs sampled contained virus...Epi/ootic strains oft Venezuelan equine encephalo- nymphs [minimum infection rate =2 200 1% I"( 1 contained inveliti. \\EE’ virus Alp/tavirus. family...Togaviridae virus mean titre= 102 1 1PFU ’. About 200 unfed nymphs ý:iuse serious disease tin horse % and humans throughout were placed on a guinea-pig at

  15. Anopheles Maculatus (Diptera: Culicidae) from the Type Locality of Hong Kong and Two New Species of the Maculatus Complex from the Philippines

    DTIC Science & Technology

    1990-12-01

    504 pp. Cagampang-Ramos, A. and R.F. Darsie , Jr . 1970. IlIus- trated keys to the Anopheles mosquitoes of the Philip- pine I&r& USAF F...Health 16:139-140. Darsie , R.F., Jr . and A. Cagampang-Ramos. 1971. Ano- pheline mosquitoes of the Lanao Plateau, Philippines, and status of the local...bionomics); Darsie and Cagampang-Ramos 1971:388, 389 (Lana0 Plateau, Mindanao; L bionomics); Catangui 198590 (Philippines; med. imp., A, L

  16. A SYSTEMATIC REVIEW COMPARING HYSTERECTOMY TO LESS INVASIVE TREATMENTS FOR ABNORMAL UTERINE BLEEDING

    PubMed Central

    Matteson, Kristen A.; Abed, Husam; Wheeler, Thomas L.; Sung, Vivian W.; Rahn, David D.; Schaffer, Joseph I.; Balk, Ethan M.

    2011-01-01

    Study Objective To compare hysterectomy and less invasive alternatives for abnormal uterine bleeding (AUB) in 7 clinically important domains Design Systematic review Setting Randomized clinical trials (RCTs) comparing bleeding, quality of life, pain, sexual health, satisfaction, need for subsequent surgery, and/or adverse events between hysterectomy and less invasive treatment options Patients Women with AUB, predominantly from ovulatory disorders and endometrial causes Interventions Systematic review of the literature (from inception to January 2011) comparing hysterectomy to alternatives for AUB treatment. Eligible trials were extracted into standardized forms. Trials were graded using a predefined 3-level rating and the strengths of evidence for each outcome were evaluated with the GRADE system. Measurements and Main Results Nine RCTs (18 articles) were eligible. Endometrial ablation, levonorgestrel intrauterine system (LNG-IUS), and medications were associated with lower risk of adverse events but higher risk of additional treatments treatments than hysterectomy. Compared to ablation, hysterectomy had superior long-term pain and bleeding control. Compared to LNG-IUS, hysterectomy had superior control of bleeding. No other differences between treatments were found. Conclusion Less invasive treatment options for AUB result in improvement in quality of life but carry significant risk of retreatment secondary to unsatisfactory results. While hysterectomy is the most effective treatment for AUB, it carries the highest risk for adverse events. PMID:22078015

  17. Official STS-6 Crew Patch/Insignia

    NASA Image and Video Library

    1982-11-12

    S82-39531 (December 1982) --- This is the official insignia for space shuttle mission STS-6. The crew members for this mission are astronauts Paul J. Weitz, commander; Karol J. Bobko, pilot; F. Story Musgrave, mission specialist; and Donald H. Peterson, mission specialist. The sixth space shuttle flight is represented by the hexagonal shape of the insignia and the six stars, in the portrayed constellation Virgo. The sign Virgo is also symbolic of the first flight of the space shuttle Challenger. Depicted above the spacecraft?s open cargo bay is the combined Inertial Upper Stage (IUS) and a Tracking and Data Relay Satellite. This is the first shuttle flight of the IUS rocket, which will carry the first TDRS to a geosynchronous orbit of 24,000 statute miles. The NASA insignia design for space shuttle flights is reserved for use by the astronauts and for other official use as the NASA Administrator may authorize. Public availability has been approved only in the forms of illustrations by the various news media. When and if there is any change in this policy, which is not anticipated, the change will be publicly announced. Photo credit: NASA

  18. Intolerance of uncertainty correlates with insula activation during affective ambiguity

    PubMed Central

    Simmons, Alan; Matthews, Scott C.; Paulus, Martin P.; Stein, Murray B.

    2009-01-01

    Intolerance of uncertainty (IU), or the increased affective response to situations with uncertain outcomes, is an important component process of anxiety disorders. Increased IU is observed in panic disorder (PD), obsessive compulsive disorder (OCD) and generalized anxiety disorder (GAD), and is thought to relate to dysfunctional behaviors and thought patterns in these disorders. Identifying what brain systems are associated with IU would contribute to a comprehensive model of anxiety processing, and increase our understanding of the neurobiology of anxiety disorders. Here, we used a behavioral task, Wall of Faces (WOF), during functional magnetic resonance imaging (fMRI), which probes both affect and ambiguity, to examine the neural circuitry of IU in fourteen (10 females) college age (18.8 yrs) subjects. All subjects completed the Intolerance of Uncertainty Scale (IUS), Anxiety Sensitivity Index (ASI), and a measure of neuroticism (i.e. the NEO-N). IUS scores but neither ASI nor NEO-N scores, correlated positively with activation in bilateral insula during affective ambiguity. Thus, the experience of IU during certain types of emotion processing may relate to the degree to which bilateral insula processes uncertainty. Previously observed insula hyperactivity in anxiety disorder individuals may therefore be directly linked to altered processes of uncertainty. PMID:18079060

  19. Impact of a new levonorgestrel intrauterine system, Levosert(®), on heavy menstrual bleeding: results of a one-year randomised controlled trial.

    PubMed

    Mawet, Marie; Nollevaux, Fabrice; Nizet, Dominique; Wijzen, Fabienne; Gordenne, Valérie; Tasev, Niso; Segedi, Dimitrije; Marinescu, Bogdan; Enache, Andreea; Parhomenko, Vadim; Frankenne, Francis; Foidart, Jean-Michel

    2014-06-01

    To evaluate a new levonorgestrel-releasing intrauterine system (LNG-IUS) called Levosert(®) for the treatment of heavy menstrual bleeding (HMB) in comparison to the reference product Mirena(®). A multicentre, randomised, controlled trial, in non-menopausal women diagnosed with functional HMB (defined as menstrual blood loss [MBL] ≥ 80 mL) randomised to either Levosert(®) or Mirena(®) and followed for up to one year. MBL was evaluated using a validated modified version of the Wyatt pictogram. A total of 280 women were randomised (141 to Levosert(®) and 139 to Mirena(®)). During the one-year treatment period, both Levosert(®) and Mirena(®) dramatically decreased MBL and increased haemoglobin and ferritin levels. There were no statistically significant differences between Levosert(®) and Mirena(®) regarding any of the parameters evaluated during the study. Similar bleeding patterns were observed in both groups. Levosert(®) was inserted with the same ease as Mirena(®). Both treatments were associated with identical expulsion rates and no perforations occurred in either treatment group. Levosert(®), a new LNG-IUS designed to release the same daily amount of LNG as Mirena(®), is highly effective in the treatment of HMB. No differences were observed between Levosert(®) and Mirena(®) regarding all evaluated outcomes, including safety profile.

  20. A randomised controlled trial of the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system in primary care against standard treatment for menorrhagia: the ECLIPSE trial.

    PubMed

    Gupta, Janesh K; Daniels, Jane P; Middleton, Lee J; Pattison, Helen M; Prileszky, Gail; Roberts, Tracy E; Sanghera, Sabina; Barton, Pelham; Gray, Richard; Kai, Joe

    2015-10-01

    Heavy menstrual bleeding (HMB) is a common problem, yet evidence to inform decisions about initial medical treatment is limited. To assess the clinical effectiveness and cost-effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) (Mirena®, Bayer) compared with usual medical treatment, with exploration of women's perspectives on treatment. A pragmatic, multicentre randomised trial with an economic evaluation and a longitudinal qualitative study. Women who presented in primary care. A total of 571 women with HMB. A purposeful sample of 27 women who were randomised or ineligible owing to treatment preference participated in semistructured face-to-face interviews around 2 and 12 months after commencing treatment. LNG-IUS or usual medical treatment (tranexamic acid, mefenamic acid, combined oestrogen-progestogen or progesterone alone). Women could subsequently swap or cease their allocated treatment. The primary outcome was the patient-reported score on the Menorrhagia Multi-Attribute Scale (MMAS) assessed over a 2-year period and then again at 5 years. Secondary outcomes included general quality of life (QoL), sexual activity, surgical intervention and safety. Data were analysed using iterative constant comparison. A state transition model-based cost-utility analysis was undertaken alongside the randomised trial. Quality-adjusted life-years (QALYs) were derived from the European Quality of Life-5 Dimensions (EQ-5D) and the Short Form questionnaire-6 Dimensions (SF-6D). The intention-to-treat analyses were reported as cost per QALY gained. Uncertainty was explored by conducting both deterministic and probabilistic sensitivity analyses. The MMAS total scores improved significantly in both groups at all time points, but were significantly greater for the LNG-IUS than for usual treatment [mean difference over 2 years was 13.4 points, 95% confidence interval (CI) 9.9 to 16.9 points; p < 0.001]. However, this difference between groups was reduced

  1. Contraception for the HIV-Positive Woman: A Review of Interactions between Hormonal Contraception and Antiretroviral Therapy

    PubMed Central

    Robinson, Jennifer A.; Jamshidi, Roxanne; Burke, Anne E.

    2012-01-01

    Background. Preventing unintended pregnancy in HIV-positive women can significantly reduce maternal-to-child HIV transmission as well as improve the woman's overall health. Hormonal contraceptives are safe and effective means to avoid unintended pregnancy, but there is concern that coadministration of antiretroviral drugs may alter contraceptive efficacy. Materials and Methods. We performed a literature search of PubMed and Ovid databases of articles published between January 1980 and February 2012 to identify English-language reports of drug-drug interactions between hormonal contraceptives (HCs) and antiretroviral drugs (ARVs). We also reviewed the FDA prescribing information of contraceptive hormone preparations and antiretrovirals for additional data and recommendations. Results. Twenty peer-reviewed publications and 42 pharmaceutical package labels were reviewed. Several studies of combined oral contraceptive pills (COCs) identified decreased serum estrogen and progestin levels when coadministered with certain ARVs. The contraceptive efficacy of injectable depot medroxyprogesterone acetate (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) were largely unaffected by ARVs, while data on the contraceptive patch, ring, and implant were lacking. Conclusions. HIV-positive women should be offered a full range of hormonal contraceptive options, with conscientious counseling about possible reduced efficacy of COCs and the contraceptive implant when taken with ARVs. DMPA and the LNG-IUS maintain their contraceptive efficacy when taken with ARVs. PMID:22927715

  2. An exploration of Intolerance of Uncertainty and memory bias.

    PubMed

    Francis, Kylie; Dugas, Michel J; Ricard, Nathalie C

    2016-09-01

    Research suggests that individuals high in Intolerance of Uncertainty (IU) have information processing biases, which may explain the close relationship between IU and worry. Specifically, high IU individuals show an attentional bias for uncertainty, and negatively interpret uncertain information. However, evidence of a memory bias for uncertainty among high IU individuals is limited. This study therefore explored the relationship between IU and memory for uncertainty. In two separate studies, explicit and implicit memory for uncertain compared to other types of words was assessed. Cognitive avoidance and other factors that could influence information processing were also examined. IUS Factor 1 was a significant positive predictor of explicit memory for positive words, and IUS Factor 2 a significant negative predictor of implicit memory for positive words. Stimulus relevance and vocabulary were significant predictors of implicit memory for uncertain words. Cognitive avoidance was a significant predictor of both explicit and implicit memory for threat words. Female gender was a significant predictor of implicit memory for uncertain and neutral words. Word stimuli such as those used in these studies may not be the optimal way of assessing information processing biases related to IU. In addition, the predominantly female, largely student sample may limit the generalizability of the findings. Future research focusing on IU factors, stimulus relevance, and both explicit and implicit memory, was recommended. The potential role of cognitive avoidance on memory, information processing, and worry was explored. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. United States orbital transfer vehicle programs

    NASA Astrophysics Data System (ADS)

    Gunn, Charles R.

    The United States will rely on five orbital transfer vehicles to carry spacecraft to higher energy orbits than achievable by the Space Shuttle or various Expendable Launch Vehicles (ELV). These vehicles are the Payload Assist Module-Delta (PAM-D), an upgraded version designated PAM-DII, the Inertial Upper Stage (IUS), the Transfer Orbit Stage (TOS), and the Orbital Maneuvering Vehicle (OMV). Development of these vehicles have evolved through contrasting cultures of government and commercial management. The spectrum of their capabilities range from providing spacecraft with only a preprogrammed perigee velocity additions to man-in-the-loop remote controlled spacecraft rendezvous, docking, retrieval and return to a space base; either the Shuttle or the Space Station Freedom. The PAM-D, PAM-DII, and IUS are now nearing maturity. Their characteristics, flight record, costs, and projected future uses are defined. The TOS and OMV are currently in development with first uses scheduled in 1992 and 1993, respectively. The TOS is being commercially developed while the OMV is government developed. The TOS and OMV capabilities, constraints, and costs are reviewed.

  4. Final safety analysis report for the Galileo Mission: Volume 2: Summary

    SciTech Connect

    Not Available

    1988-12-15

    The General Purpose Heat Source Radioisotope Thermoelectric Generator (GPHS-RTG) will be used as the prime source of electric power for the spacecraft on the Galileo mission. The use of radioactive material in these missions necessitates evaluations of the radiological risks that may be encountered by launch complex personnel and by the Earth's general population resulting from postulated malfunctions or failures occurring in the mission operations. The purpose of the Final Safety Analysis Report (FSAR) is to present the analyses and results of the latest evaluation of the nuclear safety potential of the GPHS-RTG as employed in the Galileo mission. This evaluation is an extension of earlier work that addressed the planned 1986 launch using the Space Shuttle Vehicle with the Centaur as the upper stage. This extended evaluation represents the launch by the Space Shuttle/IUS vehicle. The IUS stage has been selected as the vehicle to be used to boost the Galileo spacecraft into the Earth escape trajectory after the parking orbit is attained.

  5. Objective Assessment of Cervical Stiffness after Administration of Misoprostol for Intrauterine Contraceptive Insertion

    PubMed Central

    Badir, S.; Mazza, E.; Bajka, M.

    2016-01-01

    Purpose: The goal of this study was to objectively quantify cervical stiffness in misoprostol users prior to IUC insertion and at follow-up consultation to evaluate the feasibility of assessing cervical stiffness and to study the influence of misoprostol on cervical softening. Materials and Methods: This was a cross-sectional study that evaluated 40 women who wished to use the LNG IUS. These women were evaluated immediately before LNG IUS insertion and 6 weeks later at follow-up consultation. Participants received 200 μg of misoprostol combined with 75 mg of diclofenac in a single tablet orally (Arthrotec forte 75/200®, Pfizer, USA) 6–12 h prior to insertion in “off label” use. On both occasions, cervical stiffness was determined using a novel medical device based on the aspiration technique. The Wilcoxon rank-sum and the Wilcoxon signed-rank test were applied to compare cervical stiffness assessments at insertion of the IUD and at follow-up. Results: For the first time, cervical stiffness was quantitatively assessed in misoprostol users prior to IUD insertion, proving that the aspiration technique enables detection of pharmacologically induced cervical changes, and also that misoprostol has a detectable softening effect on cervical tissue. Conclusion: The clinical value of the detected cervical softening after misoprostol administration remains unclear. Aspiration measurements could be helpful in searching for the ideal candidate, the appropriate route, dosage and interval of misoprostol intake prior to IUC insertion. PMID:27689173

  6. Toward a definition of intolerance of uncertainty: a review of factor analytical studies of the Intolerance of Uncertainty Scale.

    PubMed

    Birrell, Jane; Meares, Kevin; Wilkinson, Andrew; Freeston, Mark

    2011-11-01

    Since its emergence in the early 1990s, a narrow but concentrated body of research has developed examining the role of intolerance of uncertainty (IU) in worry, and yet we still know little about its phenomenology. In an attempt to clarify our understanding of this construct, this paper traces the way in which our understanding and definition of IU have evolved throughout the literature. This paper also aims to further our understanding of IU by exploring the latent variables measures by the Intolerance of Uncertainty Scale (IUS; Freeston, Rheaume, Letarte, Dugas & Ladouceur, 1994). A review of the literature surrounding IU confirmed that the current definitions are categorical and lack specificity. A critical review of existing factor analytic studies was carried out in order to determine the underlying factors measured by the IUS. Systematic searches yielded 9 papers for review. Two factors with 12 consistent items emerged throughout the exploratory studies, and the stability of models containing these two factors was demonstrated in subsequent confirmatory studies. It is proposed that these factors represent (i) desire for predictability and an active engagement in seeking certainty, and (ii) paralysis of cognition and action in the face of uncertainty. It is suggested that these factors may represent approach and avoidance responses to uncertainty. Further research is required to confirm the construct validity of these factors and to determine the stability of this structure within clinical samples.

  7. Impact of a new levonorgestrel intrauterine system, Levosert®, on heavy menstrual bleeding: results of a one-year randomised controlled trial

    PubMed Central

    Nollevaux, Fabrice; Nizet, Dominique; Wijzen, Fabienne; Gordenne, Valérie; Tasev, Niso; Segedi, Dimitrije; Marinescu, Bogdan; Enache, Andreea; Parhomenko, Vadim; Frankenne, Francis; Foidart, Jean-Michel

    2014-01-01

    Objective To evaluate a new levonorgestrel-releasing intrauterine system (LNG-IUS) called Levosert® for the treatment of heavy menstrual bleeding (HMB) in comparison to the reference product Mirena®. Methods A multicentre, randomised, controlled trial, in non-menopausal women diagnosed with functional HMB (defined as menstrual blood loss [MBL] ≥ 80 mL) randomised to either Levosert® or Mirena® and followed for up to one year. MBL was evaluated using a validated modified version of the Wyatt pictogram. Results A total of 280 women were randomised (141 to Levosert® and 139 to Mirena®). During the one-year treatment period, both Levosert® and Mirena® dramatically decreased MBL and increased haemoglobin and ferritin levels. There were no statistically significant differences between Levosert® and Mirena® regarding any of the parameters evaluated during the study. Similar bleeding patterns were observed in both groups. Levosert® was inserted with the same ease as Mirena®. Both treatments were associated with identical expulsion rates and no perforations occurred in either treatment group. Conclusion Levosert®, a new LNG-IUS designed to release the same daily amount of LNG as Mirena®, is highly effective in the treatment of HMB. No differences were observed between Levosert® and Mirena® regarding all evaluated outcomes, including safety profile. PMID:24666176

  8. Intolerance of Uncertainty in Eating Disorders: A Systematic Review and Meta-Analysis.

    PubMed

    Brown, Melanie; Robinson, Lauren; Campione, Giovanna Cristina; Wuensch, Kelsey; Hildebrandt, Tom; Micali, Nadia

    2017-09-01

    Intolerance of uncertainty is an empirically supported transdiagnostic construct that may have relevance in understanding eating disorders. We conducted a meta-analysis and systematic review of intolerance of uncertainty in eating disorders using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We calculated random-effects standardised mean differences (SMD) for studies utilising the Intolerance of Uncertainty Scale (IUS) and summarised additional studies descriptively. Women with eating disorders have significantly higher IUS scores compared with healthy controls (SMD = 1.90; 95% C.I. 1.24 to 2.56; p < 0.001). Post hoc meta-analysis revealed significant differences when comparing women with anorexia nervosa with controls (SMD = 2.16; 95% C.I. 1.14 to 3.18; p < 0.001) and women with bulimia nervosa with controls (SMD = 2.03; 95% C.I. 1.30 to 2.75; p < 0.001). Our synthesis of findings suggests that intolerance of uncertainty may represent a vulnerability and maintenance factor for eating disorders and potential target of cognitive, behavioural, interoceptive and affective symptoms. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association. Copyright © 2017 John Wiley & Sons, Ltd and Eating Disorders Association.

  9. [How safe is magnetic resonance imaging in patients with contraceptive implants?].

    PubMed

    Mühler, M; Taupitz, M

    2006-07-01

    When patients with an implanted contraceptive device undergo MRI, it must be ensured that the examination involves no risk to the patient (MR safety) and that the diagnosis is not affected by artifacts or the function of the device compromised (MR compatibility). Two basic types of intrauterine devices can be distinguished: the metal-containing/metal-free intrauterine device (IUD) and the hormone-containing implant, the fully metal-free intrauterine system (IUS), as well as the ESSURE insert made of stainless steel, which has been approved for use in Europe since February 2001. The metal-containing and metal-free IUDs and ESSURE are MRI compatible up to a magnetic field strength of 1.5 T. They do not interact in any relevant way with the external magnetic or high-frequency field and the temperature increase is within the physiologic range. The implants merely produce a local signal void with a shape that depends on their orientation relative to the magnetic field lines. At 3 T, only the metal-free IUD and the IUS are MRI safe in terms of the material used. In contrast, metal-containing IUDs and the ESSURE have not yet been fully evaluated in the 3 T field, which is why they represent a contraindication to MRI. No data are available on the MRI compatibility at 3 T for any of these devices.

  10. A clinical study assessing the efficacy of a new variant of the levonorgestrel intrauterine system for abnormal uterine bleeding.

    PubMed

    Gopimohan, Rajmohan; Chandran, Amrutha; Jacob, Joyce; Bhaskar, Sunil; Aravindhakshan, Rajeev; Aprem, Abi S

    2015-05-01

    To evaluate the efficacy and safety of a new variant of the levonorgestrel-intrauterine system (LNG-IUS)-Emily-for the treatment of abnormal uterine bleeding (AUB). A prospective, multicenter, single-arm, phase 4 study was conducted at six centers in India between July 2012 and August 2013. Eligible women were aged 30-50years, had completed their family, had AUB, and a pictorial bleeding assessment chart (PBAC) score of at least 100. After screening (visit 1) and insertion of the device (visit 2), participants were followed up at 1week, 1month, 3months, and 6months. The primary outcomes were menstrual blood loss (assessed by PBAC) and quality of life (assessed by the EQ-5D-3L questionnaire). Among 63 participants, 45 (71%) completed the study. Mean PBAC score decreased from 238.0±128.7 at screening to 13.1±19.2 at 6months (P<0.001). EQ-5D-3L score increased from 79.0±14.1 at visit 2 to 86.3±9.0 at 6months (P=0.003). No serious adverse events related to the device were reported. Among women with AUB, use of the Emily LNG-IUS significantly reduces menstrual bleeding and improves quality of life. Clinical Trials Registry of India: CTRI/2012/07/002843. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Europinė Sarmatija ankstyvojoje kartografijoje

    NASA Astrophysics Data System (ADS)

    Girkus, Romualdas; Lukoševičius, Viktoras

    2010-01-01

    Straipsnio tikslas - analizuojant kartografiniuose fonduose esančius senųjų autorių žemėlapius ir jų aprašymus ie\\vskoti argumentų, kuriais galima būtų pagrįsti hipotezę, kad Lietuva kaip geografinė teritorija egzistavo ne prieš vieną, o prieš kelis tūkstančius metų. Tiesiog ji tuo metu buvo žymima kaip Europinė Sarmatija. Straipsnyje pristatomi žemėlapių, kuriuose atvaizduota Sarmatija, kūrėjai ir sudarytojai, pateikiamos žemėlapių charakteristikos: leidimo metai, atvaizduoti teritoriniai vienetai, geografiniai objektai, genčių bendruomenių apgyventos vietovės, kaimynai ir kt. Apibendrindami tyrimo rezultatus autoriai daro išvadą, kad senoviniai žemėlapiai, kuriuose žymima Europinė Sarmatija, yra puikūs istorijos liudytojai, padedantys suvokti ilgą ir sudėtingą Lietuvos valstybės formavimosi procesą, tačiau, siekiant atskleisti naują mūsų priešistorės koncepciją, vien tik jų analizės neužtenka.

  12. Intolerance of uncertainty correlates with insula activation during affective ambiguity.

    PubMed

    Simmons, Alan; Matthews, Scott C; Paulus, Martin P; Stein, Murray B

    2008-01-10

    Intolerance of uncertainty (IU), or the increased affective response to situations with uncertain outcomes, is an important component process of anxiety disorders. Increased IU is observed in panic disorder (PD), obsessive compulsive disorder (OCD) and generalized anxiety disorder (GAD), and is thought to relate to dysfunctional behaviors and thought patterns in these disorders. Identifying what brain systems are associated with IU would contribute to a comprehensive model of anxiety processing, and increase our understanding of the neurobiology of anxiety disorders. Here, we used a behavioral task, Wall of Faces (WOFs), during functional magnetic resonance imaging (fMRI), which probes both affect and ambiguity, to examine the neural circuitry of IU in 14 (10 females) college age (18.8 years) subjects. All subjects completed the Intolerance of Uncertainty Scale (IUS), Anxiety Sensitivity Index (ASI), and a measure of neuroticism (i.e. the NEO-N). IUS scores but neither ASI nor NEO-N scores, correlated positively with activation in bilateral insula during affective ambiguity. Thus, the experience of IU during certain types of emotion processing may relate to the degree to which bilateral insula processes uncertainty. Previously observed insula hyperactivity in anxiety disorder individuals may therefore be directly linked to altered processes of uncertainty.

  13. Internet use and misuse. Preliminary findings from a new assessment instrument.

    PubMed

    Rotunda, Robert J; Kass, Steven J; Sutton, Melanie A; Leon, David T

    2003-09-01

    The internet is an affordable and easily accessible technology that has many potential applications to psychology. Interactive technologies engage users psychologically and may facilitate adaptive and maladaptive behaviors. This research explored the Internet-use patterns, psychological characteristics, and negative consequences associated with online activities of 393 college students using the Internet Use Survey (IUS), a self-report instrument designed to administer online. Results indicated that participants spent an average of 3.3 total hours per day on the Internet during the past 12 months and used the medium for multiple purposes. Although participants reported the occurrence of some potentially negative consequences related to Internet use, the prevalence rates for most problematic behaviors were generally low. Exploratory principal component analysis of the IUS subscale that attempts to measure Internet-related impairment revealed four factors: absorption, negative consequences, disrupted sleep, and deception. All of these factors were then significantly related to a measure of boredom proneness. This research supports the necessity for multidimensional assessment (e.g., frequency and context) of Internet usage to enhance our understanding of how this new technology interfaces with users psychologically and behaviorally.

  14. Antioxidant effect on urinary excretion of malondialdehyde in non-athletes during aerobic training.

    PubMed

    Hadley, M; Visser, M F; Vander Steen, T

    2009-01-01

    Conditions in the body during aerobic exercise increase the level of lipid peroxidation (LP). LP is associated with elevated concentration of modified low-density lipoproteins that are implicated in development of cardiovascular disease. Supplementation with antioxidant vitamin E to athletes at 267 mg (400 IUs) or greater has been reported to reduce levels of LP associated with exercise. Little is currently known about the effects of modest supplementation of vitamin E on previously sedentary adults who initiate an aerobic fitness program. In the present study, sedentary subjects (n = 14) kept 24-hour diet records to establish antioxidant intake of vitamins E and C and collected 24-hour urine samples that were used to determine baseline urinary malondialdehyde (MDA) concentrations, one measure of in vivo LP. No significant differences were noted in the parameters between groups. Seven subjects were randomly selected and supplemented daily with 133 mg (200 IUs) of vitamin E. All subjects participated in moderate-intensity aerobic training for 8 weeks. Post-training, non-supplemented subjects excreted significantly more MDA (p<0.05) and consumed significantly fewer antioxidants than the supplemented group. Vitamin E supplementation appears to suppress elevated LP associated with beginning an aerobic exercise regimen in previously sedentary subjects.

  15. Mutual-information-based image to patient re-registration using intraoperative ultrasound in image-guided neurosurgery

    PubMed Central

    Ji, Songbai; Wu, Ziji; Hartov, Alex; Roberts, David W.; Paulsen, Keith D.

    2008-01-01

    An image-based re-registration scheme has been developed and evaluated that uses fiducial registration as a starting point to maximize the normalized mutual information (nMI) between intraoperative ultrasound (iUS) and preoperative magnetic resonance images (pMR). We show that this scheme significantly (p⪡0.001) reduces tumor boundary misalignment between iUS pre-durotomy and pMR from an average of 2.5 mm to 1.0 mm in six resection surgeries. The corrected tumor alignment before dural opening provides a more accurate reference for assessing subsequent intraoperative tumor displacement, which is important for brain shift compensation as surgery progresses. In addition, we report the translational and rotational capture ranges necessary for successful convergence of the nMI registration technique (5.9 mm and 5.2 deg, respectively). The proposed scheme is automatic, sufficiently robust, and computationally efficient (<2 min), and holds promise for routine clinical use in the operating room during image-guided neurosurgical procedures. PMID:18975707

  16. Chandra X-Ray Observatory Pointing Control System Performance During Transfer Orbit and Initial On-Orbit Operations

    NASA Technical Reports Server (NTRS)

    Quast, Peter; Tung, Frank; West, Mark; Wider, John

    2000-01-01

    The Chandra X-ray Observatory (CXO, formerly AXAF) is the third of the four NASA great observatories. It was launched from Kennedy Space Flight Center on 23 July 1999 aboard the Space Shuttle Columbia and was successfully inserted in a 330 x 72,000 km orbit by the Inertial Upper Stage (IUS). Through a series of five Integral Propulsion System burns, CXO was placed in a 10,000 x 139,000 km orbit. After initial on-orbit checkout, Chandra's first light images were unveiled to the public on 26 August, 1999. The CXO Pointing Control and Aspect Determination (PCAD) subsystem is designed to perform attitude control and determination functions in support of transfer orbit operations and on-orbit science mission. After a brief description of the PCAD subsystem, the paper highlights the PCAD activities during the transfer orbit and initial on-orbit operations. These activities include: CXO/IUS separation, attitude and gyro bias estimation with earth sensor and sun sensor, attitude control and disturbance torque estimation for delta-v burns, momentum build-up due to gravity gradient and solar pressure, momentum unloading with thrusters, attitude initialization with star measurements, gyro alignment calibration, maneuvering and transition to normal pointing, and PCAD pointing and stability performance.

  17. An executive review of sludge pretreatment by sonication.

    PubMed

    Le, Ngoc Tuan; Julcour-Lebigue, Carine; Delmas, Henri

    2015-11-01

    Ultrasonication (US), which creates hydro-mechanical shear forces in cavitation, is an advanced technology in sludge pretreatment. However, there are many factors affecting the efficacy of cavitation and ultrasonication disintegration of sludge as a consequence. The objective of this work is to present an extensive review of evaluation approaches of sludge US pretreatment efficiency. Besides, optimization methodologies of related parameters, the differences of optimum values and the similarities of affecting trends on cavitation and sludge pretreatment efficiency were specifically pointed out, including ambient conditions, ultrasonic properties, and sludge characteristics. The research is a prerequisite for optimization of sludge US pretreatment efficiency in lab-scale and practical application. There is not-yet a comprehensive method to evaluate the efficiency of sludge US pretreatment, but some main parameters commonly used for this purpose are degree of sludge disintegration, proteins, particle size reduction, etc. Regarding US parameters, power input PUS, intensity IUS, and frequency FS seem to have significant effects. However, the magnitude of the effect of PUS and probe size in terms of IUS has not been clearly detailed. Investigating very low FS seems interesting but has not yet been taken into consideration. In addition, static pressure effect has been marginally studied only and investigation on the effect of pH prior to US process has been restricted. Their effects therefore should be varied separately and simultaneously with other related parameters, i.e. process conditions, ultrasonic properties, and sludge characteristics, to optimize sludge US pretreatment process.

  18. 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

  19. Levonorgestrel release rates over 5 years with the Liletta® 52-mg intrauterine system.

    PubMed

    Creinin, Mitchell D; Jansen, Rolf; Starr, Robert M; Gobburu, Joga; Gopalakrishnan, Mathangi; Olariu, Andrea

    2016-10-01

    To understand the potential duration of action for Liletta®, we conducted this study to estimate levonorgestrel (LNG) release rates over approximately 5½years of product use. Clinical sites in the U.S. Phase 3 study of Liletta collected the LNG intrauterine systems (IUSs) from women who discontinued the study. We randomly selected samples within 90-day intervals after discontinuation of IUS use through 900days (approximately 2.5years) and 180-day intervals for the remaining duration through 5.4years (1980days) to evaluate residual LNG content. We also performed an initial LNG content analysis using 10 randomly selected samples from a single lot. We calculated the average ex vivo release rate using the residual LNG content over the duration of the analysis. We analyzed 64 samples within 90-day intervals (range 6-10 samples per interval) through 900days and 36 samples within 180-day intervals (6 samples per interval) for the remaining duration. The initial content analysis averaged 52.0±1.8mg. We calculated an average initial release rate of 19.5mcg/day that decreased to 17.0, 14.8, 12.9, 11.3 and 9.8mcg/day after 1, 2, 3, 4 and 5years, respectively. The 5-year average release rate is 14.7mcg/day. The estimated initial LNG release rate and gradual decay of the estimated release rate are consistent with the target design and function of the product. The calculated LNG content and release rate curves support the continued evaluation of Liletta as a contraceptive for 5 or more years of use. Liletta LNG content and release rates are comparable to published data for another LNG 52-mg IUS. The release rate at 5years is more than double the published release rate at 3years with an LNG 13.5-mg IUS, suggesting continued efficacy of Liletta beyond 5years. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Use of mixed-treatment-comparison methods in estimating efficacy of treatments for heavy menstrual bleeding

    PubMed Central

    2013-01-01

    Background A variety of pharmacological and surgical treatments have been developed for heavy menstrual bleeding (HMB), which can have negative physical, social, psychological, and economic consequences. We conducted a systematic literature review and mixed-treatment-comparison (MTC) meta-analysis of available data from randomized controlled trials (RCTs) to derive estimates of efficacy for 8 classes of treatments for HMB, to inform health-economic analysis and future studies. Methods A systematic review identified RCTs that reported data on menstrual blood loss (MBL) at baseline and one or more follow-up times. Eight treatment classes were considered: COCs, danazol, endometrial ablation, LNG-IUS, placebo, progestogens given for less than 2 weeks out of 4 during the menstrual cycle, progestogens given for close to 3 weeks out of 4, and TXA. The primary measure of efficacy was the proportion of women who achieved MBL < 80 mL per cycle (month), as measured by the alkaline hematin method. A score less than 100 on an established pictorial blood-loss assessment chart (PBAC) was considered an acceptable substitute for MBL < 80 mL. Estimates of efficacy by treatment class and time were obtained from a Bayesian MTC model. The model also included effects for treatment class, study, and the combination of treatment class and study and an adjustment for baseline mean MBL. Several methodological challenges complicated the analysis. Some trials reported various summary statistics for MBL or PBAC, requiring estimation (with less precision) of % MBL < 80 mL or % PBAC < 100. Also, reported follow-up times varied substantially. Results The evidence network involved 34 RCTs, with follow-up times from 1 to 36 months. Efficacy at 3 months of follow-up (estimated as the posterior median) ranged from 87.5% for the levonorgestrel-releasing intrauterine system (LNG-IUS) to 14.2% for progestogens administered for less than 2 weeks out of 4 in the menstrual cycle. The 95% credible intervals

  1. Chandra X-Ray Observatory Arrives at KSC for Processing

    NASA Astrophysics Data System (ADS)

    1999-04-01

    The Chandra X-ray Observatory, scheduled to launch aboard Space Shuttle Columbia on mission STS-93, arrived at 2:45 p.m. EST today at the Kennedy Space Center's Shuttle Landing Facility aboard an Air Force C-5 Galaxy airplane. The telescope was shipped from the TRW plant in Redondo Beach, CA, with departure from Los Angeles International Airport occurring earlier this morning. A second airplane also brought the necessary ground support equipment to KSC for the campaign of final prelaunch integration and testing. The ground support equipment is being off loaded today. The Chandra Observatory is to be taken off the airplane early Friday morning and transported to the Vertical Processing Facility located in the KSC Industrial Area. There, the telescope will undergo final installation of associated electronic components, be tested, fueled, and mated with the Inertial Upper Stage (IUS) booster. A set of integrated tests will follow. A major milestone is the test using the Cargo Integrated Test Equipment (CITE) to verify that Chandra and the Inertial Upper Stage will have the ability to receive and reply to commands once aboard the Space Shuttle. Also, an end-to-end test will verify the communications systems of the payload and its ability to communicate through the Tracking and Data Relay Satellite system with Mission Control in Houston and the Chandra ground station located in Cambridge, MA. The Chandra/IUS combination will then be ready to go to the launch pad. Once in the payload changeout room at Pad 39-B, the protective cocoon will be removed from around the telescope and it will be installed into Space Shuttle Columbia. An Integrated Verification Test will be conducted to check all of the electrical connections and the ability of the astronauts to send and receive commands from Columbia's flight deck. The end-to-end test will be repeated at the pad. Finally the IUS will go through a simulated countdown to verify its readiness for launch. Chandra will use the world

  2. Levonorgestrel-releasing intrauterine system for atypical endometrial hyperplasia.

    PubMed

    Luo, Li; Luo, Bing; Zheng, Ying; Zhang, Heng; Li, Jing; Sidell, Neil

    2013-06-05

    Endometrial carcinoma is the most common gynaecologic malignancy in the world and develops through preliminary stages of endometrial hyperplasia. Typical endometrial hyperplasia suggests a significant pre-malignant state with frank progression to endometrial carcinoma. Because atypical endometrial hyperplasia tends to occur at a young age, it has become increasingly important and necessary to find a safe and effective fertility-sparing treatment with better tolerability and fewer side effects than the options for treatment that are currently available. The levonorgestrel-releasing intrauterine system has already been used to provide endometrial protection in women with breast cancer who are on adjuvant tamoxifen. The antiproliferative function of levonorgestrel is thought to reduce the risk of endometrial hyperplasia. To determine the efficacy and safety of the levonorgestrel-releasing intrauterine system in reversing atypical endometrial hyperplasia. In November 2012 we searched the Cochrane Menstrual Disorders and Subfertility Review Group Specialised Register; Cochrane Central Register of Controlled Trials (CENTRAL) in The Cochrane Library; MEDLINE; EMBASE; and the China National Knowledge Infrastructure for relevant trials. Attempts were made to identify trials from references in published studies. We also searched for ongoing trials in five major clinical trials registries. Randomised controlled trials (RCTs) of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus progestin therapy in women with a confirmed histological diagnosis of simple or complex endometrial hyperplasia with atypia. No eligible study was found. We did not identify any studies which met our full inclusion criteria. There is no evidence available from randomised controlled trials regarding the efficacy and safety of the levonorgestrel-releasing intrauterine system (LNG-IUS) for atypical endometrial hyperplasia. RCTS are

  3. Concerning the Concept of the Central Mountain Foehn

    DTIC Science & Technology

    1982-01-19

    distribution unlimited. .. .... 7- II _ J lit - UD-MDRSIT-l661඙ 19 January 1982 P𔃻CROFICH MR rTD-8 2-C-00004 4 I CONCERNING h CONCEPT OF T": CENTRAL...POSITION TR ANSLATIOM DIVISION- OTH7 FOREIGNTECHNLOYI FOREIGN TECHNOLOGY DIVISION f-TD- ii )(RS)T1661-81 Date 19 Jn 1-9-82 -L! |I CONCE~" ING THE CONCEPT...al’low a distinct difference to appear be- v; ~ ~ ~ ~ C i nAi-, - 04 31 Sr ..4 . : II Bu k rd r (--- mi6 6 - b4 ius S nnebfg-t (uj 1) fr 1 m’ - s F U- vers

  4. Centaur Propellant Thermal Conditioning Study

    NASA Technical Reports Server (NTRS)

    Blatt, M. H.; Pleasant, R. L.; Erickson, R. C.

    1976-01-01

    A wicking investigation revealed that passive thermal conditioning was feasible and provided considerable weight advantage over active systems using throttled vent fluid in a Centaur D-1s launch vehicle. Experimental wicking correlations were obtained using empirical revisions to the analytical flow model. Thermal subcoolers were evaluated parametrically as a function of tank pressure and NPSP. Results showed that the RL10 category I engine was the best candidate for boost pump replacement and the option showing the lowest weight penalty employed passively cooled acquisition devices, thermal subcoolers, dry ducts between burns and pumping of subcooler coolant back into the tank. A mixing correlation was identified for sizing the thermodynamic vent system mixer. Worst case mixing requirements were determined by surveying Centaur D-1T, D-1S, IUS, and space tug vehicles. Vent system sizing was based upon worst case requirements. Thermodynamic vent system/mixer weights were determined for each vehicle.

  5. Florida, Empty Payload Bay and Earth Limb

    NASA Image and Video Library

    1991-08-11

    STS043-83-082 (2-11 Aug 1991) --- Having bade farewell to its Tracking and Data Relay Satellite/IUS payload, Atlantis' cargo bay appears somewhat vacant in this scene, backdropped over the southern two-thirds of the Florida peninsula. Important activity in the payload bay continues, however, with the operation of Space Station Heat Pipe Advanced Radiator Element (SHARE II), an experiment carried on the starboard side (lower left quadrant of frame). Purpose of the SHARE experiment is to demonstrate microgravity thermal vacuum performance of a heat pipe radiator for heat rejection as a prelude to development of a Space Station heat rejection system. The foil covered ring and horseshoe shaped objects aft in the payload bay served as restraint devices for the TDRS-E prior to its deployment six hours after Atlantis lifted off from Kennedy Space Center's Launch Pad 39A.

  6. Cooperative Extension Service’s Mission and Federal Role Need Congressional Clarification.

    DTIC Science & Technology

    1981-08-21

    and h’ o ( 00iiL proI’:ar, in1 t)r .21rilv ru ral r li : o~noion Service a .rp .-Ino:d ainJ ’L, y’c!;c ie in rural , urbain , and suburban c(l ..2iltL...7CYAND) SYA17T2 C’!,,"TS Co 0 ukd’The U.S. o-~Ar~t Agriculture -nlthc director o)L cxtonsion of each of tho .ix Stt,2 in ’.,ich it :-’’it- s i...used as efficiently, as possible. SCOr’ AND GRONITH OF T-lE ET-2SIO1 SMRVICE Originally, the Extension Service focused on agriculture and assistance

  7. Tug fleet and ground operations schedules and controls. Volume 2: part 1

    NASA Technical Reports Server (NTRS)

    1975-01-01

    This Tug Fleet and Ground Operations Schedules and Controls Study addresses both ground operational data and technical requirements that span the Tug planning phase and operations phase. A similar study covering mission operations (by others) provides the complimentary flight operations details. The two studies provide the planning data requirements, resource allocation, and control milestones for supporting the requirements of the STS program. This Tug Fleet and Ground Operations Schedules and Controls Study incorporates the basic ground operations requirements and concepts provided by previous studies with the interrelationships of the planning, IUS transition, and Tug fleet operations phases. The interrelationships of these phases were studied as a system to optimize overall program benefits and minimize operational risk factors.

  8. Levonorgestrel-releasing intrauterine systems for long-acting contraception: current perspectives, safety, and patient counseling

    PubMed Central

    Costescu, Dustin J

    2016-01-01

    Unintended pregnancy is a significant global problem. In 2008, there were over 100 million unplanned pregnancies worldwide, representing approximately 41% of global conceptions. Family planning strategies in many countries are shifting from increasing the uptake of contraception among nonusers to increasing the uptake of the most effective methods among users of less effective methods. One of the most effective and acceptable methods of contraception is the levonorgestrel-releasing intrauterine system (LNG IUS); however, its uptake varies widely by country. This article reviews the currently available LNG IUSs, the rationale for increasing uptake of these methods, and evidence regarding safety, and discusses counseling strategies to best inform women about this option for contraception. PMID:27785107

  9. Views of EVA performed during STS-6

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Two STS-6 mission specialists busy near the aft bulkhead were photographed with a 70mm camera. Astronauts F. Story Musgrave (at winch device near center) and Donald H. Peterson are setting up winch operations at the aft bulkhead as a simulation for a contingency extravehicular activity (EVA). The orbital maneuvering system (OMS) pods are seen in the background (30211); Musgrave translates down the Challenger's payload bay door hinge line with a bag of latch tools. In the lower left foreground are three canisters containing three getaway special (GAS) experiments. Part of the starboard wing and OMS pod are seen in the background. The gold-foil protected object on the right is the airborne support equipment for the inertial upper stage (IUS) (30212); Peterson (starboard side) and Musgrave evaluate the handrail system on the starboard longeron and aft bulkhead during an EVA. Behind them the vertical stabilizer and OMS pods frame a portion of Mexico's state of Jalisco (30213); Musgrave sus

  10. STS-43 Space Shuttle mission report

    NASA Technical Reports Server (NTRS)

    Fricke, Robert W.

    1991-01-01

    The STS-43 Space Shuttle Program Mission Report contains a summary of the vehicle subsystem operations during the forty-second flight of the Space Shuttle Program and the ninth flight of the Orbiter Vehicle Atlantis (OV-104). In addition to the Atlantis vehicle, the flight vehicle consisted of the following: an External Tank (ET) designated as ET-47 (LWT-40); three Space Shuttle main engines (SSME's) (serial numbers 2024, 2012, and 2028 in positions 1, 2, and 3, respectively); and two Solid Rocket Boosters (SRB's) designated as BI-045. The primary objective of the STS-43 mission was to successfully deploy the Tracking and Data Relay Satellite-E/Inertial Upper Stage (TDRS-E/IUS) satellite and to perform all operations necessary to support the requirements of the Shuttle Solar Backscatter Ultraviolet (SSBUV) payload and the Space Station Heat Pipe Advanced Radiator Element (SHARE-2).

  11. STS-26 Discovery, OV-103, OASIS equipment is mounted in payload bay (PLB)

    NASA Image and Video Library

    1988-04-18

    S88-37764 (18 April 1988) --- OASIS, instrumentation which will record the environment experienced by Discovery during the STS-26 Space Shuttle mission, is lowered into position for attachment to the orbiter's aft port sill. Instrumentation sensors in the payload bay which are connected to the tape recorder module will document a variety of environmental measurements during various phases of the flight including temperature, pressure, vibration, sounds, acceleration, stress, and strain. OASIS will also record data during the Flight Readiness Firing. NASA is flying OASIS aboard Discovery in support of the Inertial Upper Stage (IUS) program office of the Air Force Space Division. The system was developed by Lockheed under a NASA contract, funded by the Air Force.

  12. Second Shuttle Join NASA's STS Fleet: Challenger Launches First New Tracking Satellite

    NASA Technical Reports Server (NTRS)

    1983-01-01

    NASA made a major stride in readying a second delivery vehicle for its Space Transportation System (STS) fleet with the perfect landing of Shuttle Orbiter Challenger at Edwards Air Force Base, California, April 9, 1983. Besides being the first flight test of Challenger's performance, the mission marked the orbiting of the first spacecraft in NASA's new Tracking and Data Relay Satellite System (TDRSS). The new family of orbiting space communications platforms is essential to serve future Shuttle missions. Although the Inertial Upper Stage (IUS) second stage engine firing failed to place TDRS in its final 35,888 kilometer (22,300 mile) geosynchronous orbit, its release from the orbiter cargo bay went as planned. Launch officials were confident they can achieve its planned orbit in a matter of weeks.

  13. Effects of Depth on Dredging Frequency. Report 3. Evaluation of Advance Maintenance Projects.

    DTIC Science & Technology

    1985-04-01

    to 1)rovide a p rede te rmi ned amiis’t () If L-;) Lhint c a pa( I it v he Ilow les jgz dtepth.i ItL is exclIus ive of the alIlIowah Ie ulre-lg Iig t...p roject s wh ichi infl tdod advance ma LI t ellal ce w Ii 11 h u h s wh I did ( to . Dlat I. used wv e of) Lb a I ned f rom p red redcge- aInd postdr...was conducted during the period 1978 to 1982 under the di- rection of Messrs. H. B. Simmons and F. A. Herrmann , Jr., former and present Chiefs of the

  14. Education in Sustainable Energy by European Projects

    NASA Astrophysics Data System (ADS)

    Stanescu, Corina; Stefureac, Crina

    2010-05-01

    completion. Students also show a great deal of interest towards this course. More information are available on www.school4energy.net/ , www.ises.org/schools/ - The newest is the project "Intelligent Use of Energy in School", starting in this school year. This European project is part of Intelligent Energy program, aims to promote a more efficient way of using energy in every day life among secondary schools students and teachers. IUSES will show secondary school students the basic principles of energy efficiency and give a comprehensive guide to saving energy in their everyday lives. IUSES is currently developing a behaviour-oriented educational kit including: handbooks, multimedia animations and experiment tool-kit. The educational kit will be freely available for downloading on this web site. The project will also include the launch of the European Energy Saving Award in 14 different countries which will reward schools and students that improve their energy efficiency. More information is available on www.iuses.eu or www.iuses.ro

  15. Reflected view of the TDRS in the STS-6 Challengers payload bay

    NASA Image and Video Library

    1983-04-04

    STS006-38-844 (4 April 1983) --- The stowed tracking and data relay satellite (TDRS) and its inertial upper stage (IUS) are seen in duplicate in this 70mm frame taken by the STS-6 crew aboard the Earth-orbiting space shuttle Challenger on its first day in space. A reflection in the aft window of the flight deck resulted in the mirage effect of the “second” TDRS. The three canisters in the aft foreground contain experiments of participants in NASA’s STS getaway special (GAS) program. Onboard the second reusable shuttle for this five-day flight were astronauts Paul J. Weitz, Karol J. Bobko, Dr. F. Story Musgrave and Donald H. Peterson. Photo credit: NASA

  16. Technology status of a fluorine-hydrazine propulsion system for planetary spacecraft

    NASA Technical Reports Server (NTRS)

    Bond, D. L.

    1979-01-01

    The basic technology exists and a system integration program is well underway to allow incorporation of a fluorine-hydrazine propulsion system into future spacecraft required for unmanned planetary missions. These spacecraft would be inserted in earth orbit using the Space Transportation System Shuttle and given its initial sendoff by the Inertial Upper Stage (IUS). The design of a typical propulsion system, assessment of thermal and structural impacts on a selected spacecraft and comparative studies with conventional propulsion systems have been completed. A major part of the current JPL Program involves assembly of a 3650 N thrust demonstration system using titanium tanks, flight weight components and structure. This system will be used to demonstrate the state-of-the-art throughout a representative flight system's qualification.

  17. STS-41 mission charts, computer-generated and artist concept drawings, photos

    NASA Technical Reports Server (NTRS)

    1990-01-01

    STS-41 related charts, computer-generated and artist concept drawings, and photos of the Ulysses spacecraft and mission flight path provided by the European Space Agency (ESA). Charts show the Ulysses mission flight path and encounter with Jupiter (45980, 45981) and sun (illustrating cosmic dust, gamma ray burst, magnetic field, x-rays, solar energetic particles, visible corona, interstellar gas, plasma wave, cosmic rays, solar radio noise, and solar wind) (45988). Computer-generated view shows the Ulysses spacecraft (45983). Artist concept illustrates Ulysses spacecraft deploy from the space shuttle payload bay (PLB) with the inertial upper stage (IUS) and payload assist module (PAM-S) visible (45984). Ulysses spacecraft is also shown undergoing preflight testing in the manufacturing facility (45985, 45986, 45987).

  18. In-flight rescue of stranded TDRS-1 spacecraft

    NASA Technical Reports Server (NTRS)

    Schmeichel, H.; Ehlers, B. J.

    1984-01-01

    On April 4, 1983, the first Tracking and Data Relay Satellite (TDRS-1), one of six to be built for SPACECOM and NASA, was launched by the Space Shuttle Challenger. During the ascent to geosynchronous orbit, the Inertial Upper Stage (IUS) booster malfunctioned, leaving TDRS stranded in a low, elliptical orbit. This report describes the amazing satellite recovery from a wild tumble and the dramatic three-month rescue effort to move TDRS into synchronous orbit. It took a total burn time of 44 hours from a pair of tiny one-pound thrusters, about 800 pounds of propellant, an adaptable, robust attitude control system and much resourcefulness from ground operators to accomplish this feat. TDRS-1 reached its proper earth orbit on June 29, 1983 and then began its ten-year mission as a data relay satellite.

  19. Atmospheric entry systems for advanced Mars missions

    NASA Technical Reports Server (NTRS)

    Butts, A. J.; French, J. R.

    1979-01-01

    A study of estimates of the mass and performance characteristics of entry system designs for advanced Mars missions is presented. The missions were: (1) a Mars Surface Sample Return Mission (MSSR), (2) a Mars Hard Lander, and (3) a Mars Aircraft Mission, and Viking technology or its extensions were used for these entry system conceptual designs. For the MSSR mission, various mission combinations were evaluated including different Mars Ascent Vehicle masses and the use of 2 through 4 stages of the IUS launch vehicle. The constraints for this Mars mission were the Shuttle payload bay geometry limitation and its massive requirements. Requirements for the simple Hard Lander Mission including entry and deceleration, using a parachute and a solid rocket are discussed. A design requirement for the Mars Aircraft Mission to minimize the total entry capsule/aircraft mass by combining entry functions and hardware into the aircraft system was described, and various approaches for supporting the folded aircraft within the aeroshell were examined.

  20. Final safety analysis report for the Galileo Mission: Volume 2, Book 2: Accident model document: Appendices

    SciTech Connect

    Not Available

    1988-12-15

    This section of the Accident Model Document (AMD) presents the appendices which describe the various analyses that have been conducted for use in the Galileo Final Safety Analysis Report II, Volume II. Included in these appendices are the approaches, techniques, conditions and assumptions used in the development of the analytical models plus the detailed results of the analyses. Also included in these appendices are summaries of the accidents and their associated probabilities and environment models taken from the Shuttle Data Book (NSTS-08116), plus summaries of the several segments of the recent GPHS safety test program. The information presented in these appendices is used in Section 3.0 of the AMD to develop the Failure/Abort Sequence Trees (FASTs) and to determine the fuel releases (source terms) resulting from the potential Space Shuttle/IUS accidents throughout the missions.

  1. The electric rail gun for space propulsion

    NASA Technical Reports Server (NTRS)

    Bauer, D. P.; Barber, J. P.; Vahlberg, C. J.

    1981-01-01

    An analytic feasibility investigation of an electric propulsion concept for space application is described. In this concept, quasistatic thrust due to inertial reaction to repetitively accelerated pellets by an electric rail gun is used to propel a spacecraft. The study encompasses the major subsystems required in an electric rail gun propulsion system. The mass, performance, and configuration of each subsystem are described. Based on an analytic model of the system mass and performance, the electric rail gun mission performance as a reusable orbital transfer vehicle (OTV) is analyzed and compared to a 30 cm ion thruster system (BIMOD) and a chemical propulsion system (IUS) for payloads with masses of 1150 kg and 2300 kg. For system power levels in the range from 25 kW(e) to 100 kW(e) an electric rail gun OTV is more attractive than a BIMOD system for low Earth orbit to geosynchronous orbit transfer durations in the range from 20 to 120 days.

  2. STS-121: Discovery Spacewalk Overview Briefing

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The briefing began with the introduction of Tomas Gonzalez-Torres (Lead Extra Vehicular Activity Officer). The spacewalk team included Pierce Sellers (EV-1), Mike Fossum (EV-2) and Mark Kelly (coordinator and pilot). Three new EMU's (space suits) were provided with hardware upgrades (warning systems). The 1st EVA would take place on flight day 5 and would include the exchange of the 3 EMU's. The 1st task was the installation of the blade locker, a device used to prevent severing of cables. The team will also install the Interface Umbilical System (IUS) which is an extension cord for the mobile transporter. EVA-2 task will be to replace the old Trailing Umbilical System (TUS) with a new one.

  3. STS-121: Discovery Spacewalk Overview Briefing

    NASA Technical Reports Server (NTRS)

    2006-01-01

    The briefing began with the introduction of Tomas Gonzalez-Torres (Lead Extra Vehicular Activity Officer). The spacewalk team included Pierce Sellers (EV-1), Mike Fossum (EV-2) and Mark Kelly (coordinator and pilot). Three new EMU's (space suits) were provided with hardware upgrades (warning systems). The 1st EVA would take place on flight day 5 and would include the exchange of the 3 EMU's. The 1st task was the installation of the blade locker, a device used to prevent severing of cables. The team will also install the Interface Umbilical System (IUS) which is an extension cord for the mobile transporter. EVA-2 task will be to replace the old Trailing Umbilical System (TUS) with a new one.

  4. STS-34 Galileo processing at KSC's SAEF-2 planetary spacecraft facility

    NASA Image and Video Library

    1989-07-21

    At the Kennedy Space Center's (KSC's) Spacecraft and Assembly Encapsulation Facility 2 (SAEF-2), the planetary spacecraft checkout facility, clean-suited technicians work on the Galileo spacecraft prior to moving it to the Vehicle Processing Facility (VPF) for mating with the inertial upper stage (IUS). Galileo is scheduled for launch aboard Atlantis, Orbiter Vehicle (OV) 104, on Space Shuttle Mission STS-34 in October 1989. It will be sent to the planet Jupiter, a journey which will taken more than six years to complete. In December 1995 as the two and one half ton spacecraft orbits Jupiter with its ten scientific instruments, a probe will be released to parachute into the Jovian atmosphere. NASA's Jet Propulsion Laboratory (JPL) manages the Galileo project. View provided by KSC.

  5. A Structural Weight Estimation Program (SWEEP) for Aircraft. Volume VI - Wing and Empennage Module. Appendix E: Program Listings, Overlays (8,0), (14, 0), (15,0), (16,0), and (17,0)

    DTIC Science & Technology

    1974-06-01

    c c c c c ••4DC AIWOh. CCIPTIC"NIS tO WlllllltrG M[A••• ••Ill ... IMIM:MROCX•• •1_, tcJIIICIGNI C4 .C...m•••-nrrn• nrrcat•nrrc~•nna._tnncet nrrcllt .. nrrce•..m~ __ , ____ _ ....... -to_,. e>-•D lfG IUS STAIICIO C4 .C u:. " _I .. c:ao.rs. IR...rttt mi m« m» m* niT m« nif nrHian Mmm MriNtM nruiM« nrui«« MTMM nruiH« nniiMC nruiiN nrHina romi i is nrwnt nrwiit WHIIM muio

  6. OAST Space Theme Workshop. Volume 2: Theme summary. 6: Advanced transportation systems. A: Theme statement. B. 26 April 1976 presentation. C. Theme summary. D. Initiative actions

    NASA Technical Reports Server (NTRS)

    1976-01-01

    Technology requirements for an integrated space transportation system capability which will allow the nation to use space efficiently, reliably, and routinely in the years between 1985 and 2000 with a significant return on invested resources will build on the currently defined space transportation system using shuttle, the IUS, and the advanced upper stage such as the solar electric propulsion system. Contributing technologies should include those which support (1) total reusability with minimal refurbishment; (2) responsiveness to high launch rate requirements when operation and energy are the predominant recurring costs; and (3) maximum flexibility in operation between earth and LEO and between LEO and GEO. Initiatives undertaken to advance the heavy lift to launch vehicles, single stage to orbit vehicles, and orbit transfer vehicles are listed.

  7. Space tug/shuttle interface compatibility study. Volume 1: Executive summary

    NASA Technical Reports Server (NTRS)

    1975-01-01

    Shuttle interfaces required for space tug accommodation are primarily involved with supporting and servicing the tug during launch countdown, flight, and postlanding; deploying and retrieving the tug on orbit; and maintaining control over the tug when it is in or near the orbiter. Each of these interface areas was investigated to determine the best physical and operational method of accomplishing the required functions, with an overriding goal of establishing simple and flexible orbiter interface requirements suitable for tug, tug payloads, IUS and other cargo. It is concluded the orbiter payload accommodations and the MSFC baseline tug are generally interface compatible. Specific minor changes to tug and orbiter interfaces were identified to provide full compatibility. A system concept for supporting and deploying tug from orbiter is described.

  8. STS-34 crewmembers during Galileo pre-deployment exercises on flight deck

    NASA Technical Reports Server (NTRS)

    1989-01-01

    Having been in space only a few hours, three of the STS-34 astronaut crew prepare for pre-deployment exercises involving one of the most prominent 'passengers' of the flight -- the Galileo payload which was lying in Atlantis', Orbiter Vehicle (OV) 104's, payload bay (PLB). Pictured, left to right, are Mission Specialist (MS) Ellen S. Baker, MS Shannon W. Lucid, and Commander Donald E. Williams who guided OV-104's course during the exercise. Baker and Lucid communicated with ground controllers while juggling other Galileo-related chores. Both Baker and Lucid are equipped with SONY Walkmans and are wearing headsets. Lucid wears a pair of sungalsses with brightly colored frames. A tethered inertial upper stage (IUS) deploy checklist (C/L) floats between the two and a spotmeter is velcroed to an onorbit station control panel.

  9. Artist concept of STS-35 ASTRO-1 and BBXRT in Columbia's, OV-102's, payload bay

    NASA Technical Reports Server (NTRS)

    1990-01-01

    Artist concept shows STS-35 Astronomy Laboratory 1 (ASTRO-1) and Broad Band X-Ray Telescope (BBXRT) in Columbia's, OV-102's, payload bay (PLB). ASTRO-1 spacelab pallet in the forward PLB includes three ultraviolet telescopes - Hopkins Ultraviolet Telescope (HUT), Wisconsin Ultraviolet Photo-Polarimeter Experiment (WUPPE), and Ultraviolet Imaging Telescope (UIT) - mounted on the instrument pointing system (IUS). In the aft PLB is the BBXRT mounted on a two-axis pointing system (TAPS). ASTRO-1 instruments will explore the invisible ultraviolet and x-ray universe in greater depth and detail than ever before. Like ground observatories, this new facility will be used by scientists to investigate a variety of astronomical questions. Ultraviolet and x-ray observations will identify hot and energetic sources in the Universe, including astronomical targets within the solar system; individual stars, stellar systems, and nebulae; and distant galactic systems, quasars, and clusters of galaxies. Dr

  10. STS-93: Crew Interview - Cady Coleman

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Live footage of a preflight interview with Mission Specialist Catherine G. Coleman is presented. The interview addresses many different questions including why Coleman wanted to be an astronaut, why she wanted to become a chemist, and how this historic flight (first female Commander of a mission) will influence little girls. Other interesting information that this one-on-one interview discusses is the deployment of the Chandra satellite, why people care about x ray energy, whether or not Chandra will compliment the other X Ray Observatories currently in operation, and her responsibilities during the major events of this mission. Coleman mentions the Inertial Upper Stage (IUS) rocket that will deploy Chandra, and the design configuration of Chandra that will allow for the transfer of information. The Southwest Research Ultraviolet Imaging System (SWUIS) Telescope on board Columbia, the Plant Growth Investigation in Microgravity (PGIM) experiment, and the two observatories presently in orbit (Gamma Ray Observatory, and Hubble Space Telescope) are also discussed.

  11. Art concept of Magellan spacecraft in cruise configuration

    NASA Technical Reports Server (NTRS)

    1988-01-01

    Magellan spacecraft cruise configuration is illustrated in this artist concept. With solar panels deployed and having jettisoned the inertial upper stage (IUS), Magellan approaches the sun which it will orbit approximately 1.6 times before encountering Venus. Magellan, named after the 16th century Portuguese explorer, will orbit Venus about once every three hours, acquiring radar data for 37 minutes of each orbit when it is closest to the surface. Using an advanced instrument called a synthetic aperture radar (SAR), it will map more than 90 per cent of the surface with resolution ten times better than the best from prior spacecraft. Magellan is managed by the Jet Propulsion Laboratory (JPL); Martin Marietta Aerospace is developing the spacecraft and Hughes Aircraft Company, the advanced imaging radar. Magellan will be deployed from payload bay (PLB) of Atlantis, Orbiter Vehicle (OV) 104, during the STS-30 mission.

  12. STS-93: Crew Interview - Cady Coleman

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Live footage of a preflight interview with Mission Specialist Catherine G. Coleman is presented. The interview addresses many different questions including why Coleman wanted to be an astronaut, why she wanted to become a chemist, and how this historic flight (first female Commander of a mission) will influence little girls. Other interesting information that this one-on-one interview discusses is the deployment of the Chandra satellite, why people care about x ray energy, whether or not Chandra will compliment the other X Ray Observatories currently in operation, and her responsibilities during the major events of this mission. Coleman mentions the Inertial Upper Stage (IUS) rocket that will deploy Chandra, and the design configuration of Chandra that will allow for the transfer of information. The Southwest Research Ultraviolet Imaging System (SWUIS) Telescope on board Columbia, the Plant Growth Investigation in Microgravity (PGIM) experiment, and the two observatories presently in orbit (Gamma Ray Observatory, and Hubble Space Telescope) are also discussed.

  13. Solar electric propulsion combined with earth gravity assist - A new potential for planetary exploration

    NASA Technical Reports Server (NTRS)

    Atkins, K. L.; Sauer, C. G.; Flandro, G. A.

    1976-01-01

    The need to shorten mission time (travel time to target planet) in missions to the outer planets prompts a search for alternatives to one-way minimum-energy transfers while continuing to minimize on-power thrusts. Gravity assists via swing-bys of inner planets are examined, with emphasis on a projected Venus-earth gravity assist (VEGA) and a combined solar electric propulsion and earth gravity assist (SEEGA). Gravity assists are also examined as essential for missions with sample returns back to earth. Possible use of such techniques in the Shuttle Interim Upper Stage (IUS) program is considered. Various SEEGA and VEGA trajectories are discussed and charted, and time lost in the launch orbit to earth re-encounter time is weighed against time gained by faster speed toward the mission destination.

  14. Shuttle Atlantis to deploy Galileo probe toward Jupiter

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The objectives of Space Shuttle Mission STS-34 are described along with major flight activities, prelaunch and launch operations, trajectory sequence of events, and landing and post-landing operations. The primary objective of STS-34 is to deploy the Galileo planetary exploration spacecraft into low earth orbit. Following deployment, Galileo will be propelled on a trajectory, known as Venus-Earth-Earth Gravity Assist (VEEGA), by an inertial upper stage (IUS). The objectives of the Galileo mission are to study the chemical composition, state, and dynamics of the Jovian atmosphere and satellites, and investigate the structure and physical dynamics of the Jovian magnetosphere. Secondary STS-34 payloads include the Shuttle Solar Backscatter Ultraviolet (SSBUV) instrument; the Mesoscale Lightning Experiment (MLE); and various other payloads involving polymer morphology, the effects of microgravity on plant growth hormone, and the growth of ice crystals.

  15. STS-6 - PREFLIGHT - PAYLOADS - SHUTTLE (TRACKING DATA & RELAY SATELLITE [TDRS]) - KSC

    NASA Image and Video Library

    1982-12-09

    S82-41171 (29 Nov. 1982) --- NASA?s tracking and data relay satellite (TDRS) is gently mated to its inertial upper stage (IUS), which will propel the satellite to a higher geosynchronous orbit after it is ejected from the Challenger?s cargo bay during STS-6. Another TDRS will be placed in orbit on a later shuttle mission. The two will provide communications between orbiting shuttle mission craft and the ground, resulting in increased real-time communication and eliminating the need for much of NASA?s extensive world-wide system of ground tracking stations. A more distant plan is to launch other TDRS to be used for commercial telecommunications and for handling peak loads. Photo credit: NASA

  16. Hepatic ablation with multiple interstitial ultrasound applicators: initial ex vivo and computational studies

    NASA Astrophysics Data System (ADS)

    Prakash, Punit; Salgaonkar, Vasant A.; Burdette, E. Clif; Diederich, Chris J.

    2011-03-01

    Radiofrequency (RF) ablation has emerged as an effective method for treating liver tumors under 3 cm in diameter. Multiple applicator devices and techniques - using RF, microwave and other modalities - are under development for thermal ablation of large and irregularly-shaped liver tumors. Interstitial ultrasound (IUS) applicators, comprised of linear arrays of independently powered tubular transducers, enable 3D control of the spatial power deposition profile and simultaneous ablation with multiple applicators. We evaluated IUS applicator configurations (parallel, converging and diverging implants) suitable for percutaneous and laparascopic placement with experiments in ex vivo bovine tissue and computational models. Ex vivo ablation zones measured 4.6+/-0.5 x 4.2+/-0.5 × 3.3+/-0.5 cm3 and 5.6+/-0.5 × 4.9+/-0.5 x 2.8+/-0.3 cm3 using three parallel applicators spaced 2 and 3 cm apart, respectively, and 4.0+/-0.3 × 3.2+/-0.4 × 2.9+/-0.2 cm3 using two parallel applicators spaced 2 cm apart. Computational models indicate in vivo ablation zones up to 4.5 × 4.4 × 5.5 cm3 and 5.7 × 4.8 × 5.2 cm3, using three applicators spaced 2 and 3 cm apart, respectively. Converging and diverging implant patterns can also be employed for conformal ablation of irregularly-shaped tumor margins by tailoring power levels along each device. Simultaneously powered interstitial ultrasound devices can create tailored ablation zones comparable to currently available RF devices and similarly sized microwave antennas.

  17. Contamination Measurements During The Firing Of The Solid Propellant Apogee Insertion Motor On The P78-2 (SCATHA) Spacecraft

    NASA Astrophysics Data System (ADS)

    Fote, Alfred A.; Hall, David F.

    1983-06-01

    The solid propellant apogee insertion motor (AIM) on board the United States Air Force P78-2 SCATHA (spacecraft charging at high altitudes) satellite is of the same general design as that of the inertial upper stage (IUS) that will raise payloads from space shuttle orbits to higher altitudes. Therefore, contamination effects arising from the firing of the AIM would be of interest to those concerned with the IUS or other solid propellant rockets as possible sources of contamination. Several of the contamination detectors on the P78-2 satellite were operating prior to, during, and following the AIM burn. These detectors consist of (1) two trays of eight calorimetrically mounted thermal control coatings (TCCs), (2) a temperature controlled quartz crystal microbalance (TQCM), and (3) a retarding potential analyzer (RPA). The data from these sensors have been analyzed to look for contamination due to the firing of the AIM. No contamination was detected with either the TCCs or the TQCM. Some anomalies were noted in the data from the RPA. However, these anomalies, if they actually correspond to AIM-related contamination, represent an upper limit of only 0.8 ng/cm2 at the detector location. Although these instruments are sensitive to molecular contamination, they are relatively insensitive to contamination in the form of particulates. Furthermore, the instruments were not optimally located on the vehicle to detect AIM products. The data do set upper bounds on the condensable molecular contamination that reached two locations on a typically configured satellite during the firing of an intermediate sized solid propellant motor.

  18. Photobiology of vitamin D in mushrooms and its bioavailability in humans

    PubMed Central

    Keegan, Raphael-John H.; Lu, Zhiren; Bogusz, Jaimee M.; Williams, Jennifer E.; Holick, Michael F.

    2013-01-01

    Mushrooms exposed to sunlight or UV radiation are an excellent source of dietary vitamin D2 because they contain high concentrations of the vitamin D precursor, provitamin D2. When mushrooms are exposed to UV radiation, provitamin D2 is converted to previtamin D2. Once formed, previtamin D2 rapidly isomerizes to vitamin D2 in a similar manner that previtamin D3 isomerizes to vitamin D3 in human skin. Continued exposure of mushrooms to UV radiation results in the production of lumisterol2 and tachysterol2. It was observed that the concentration of lumisterol2 remained constant in white button mushrooms for up to 24 h after being produced. However, in the same mushroom tachysterol2 concentrations rapidly declined and were undetectable after 24 h. Shiitake mushrooms not only produce vitamin D2 but also produce vitamin D3 and vitamin D4. A study of the bioavailability of vitamin D2 in mushrooms compared with the bioavailability of vitamin D2 or vitamin D3 in a supplement revealed that ingestion of 2000 IUs of vitamin D2 in mushrooms is as effective as ingesting 2000 IUs of vitamin D2 or vitamin D3 in a supplement in raising and maintaining blood levels of 25-hydroxyvitamin D which is a marker for a person's vitamin D status. Therefore, mushrooms are a rich source of vitamin D2 that when consumed can increase and maintain blood levels of 25-hydroxyvitamin D in a healthy range. Ingestion of mushrooms may also provide the consumer with a source of vitamin D3 and vitamin D4. PMID:24494050

  19. Menstrual management in developmentally delayed adolescent females.

    PubMed

    Chuah, Irene; McRae, Alexandra; Matthews, Kim; Maguire, Ann M; Steinbeck, Katharine

    2017-06-01

    Requests for assistance in menstrual management and menstrual suppression are a common, emotive and sometimes controversial aspect of adolescent disability care. To review the uptake and outcomes of menstrual suppression among adolescent patients with developmental delay. A retrospective review of the medical records of adolescent females with intellectual disability referred for menstrual management to the Paediatric and Adolescent Gynaecology Clinic, Children's Hospital at Westmead, Sydney, for the three-year period between January 1, 2010 and January 1, 2013. Eighty adolescent patients with developmental delay were identified. A third (n = 28) of the patients were pre-menarcheal at first review with parent/caregivers seeking anticipatory advice. Of the post-menarcheal patients, the median age of menarche was 12 years (range 10-15 years). First and second line interventions were documented as were reasons for change where applicable. The combined oral contraceptive pill (COCP) was the most frequently used therapy (67%), and 19 patients in total had a levonorgestrel releasing intrauterine system (LNG-IUS) inserted (31%). Our study population differs from similar previously published groups in the marked absence of the use of depot medroxyprogesterone acetate or the subdermal etonogestrel releasing device. As a paediatrician, it is important to address menstrual management issues and allay caregiver concerns with appropriate advice. Our study supports the use of the COCP as sound first line management in achieving menstrual suppression. The LNG-IUS appears to be a favourable second line option. Further investigation into longer-term outcomes and potential complications of device insertion is recommended. © 2017 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  20. Prenatal Substance Exposure: What Predicts Behavioral Resilience by Early Adolescence?

    PubMed Central

    Liebschutz, Jane; Crooks, Denise; Rose-Jacobs, Ruth; Cabral, Howard J; Heeren, Timothy C; Gerteis, Jessie; Appugliese, Danielle P.; Heymann, Orlaith D.; Lange, Allison V.; Frank, Deborah A.

    2015-01-01

    Understanding behavioral resilience among at-risk adolescents may guide public policy decisions and future programs. We examined factors predicting behavioral resilience following intrauterine substance exposure (IUSE) in a prospective longitudinal birth-cohort study of 136 early adolescents (age 12.4–15.9) at-risk for poor behavioral outcomes. We defined behavioral resilience as a composite measure of lack of early substance use initiation (before age 14), lack of risky sexual behavior, or lack of delinquency. IUSEs included in this analysis were cocaine (IUCE), tobacco (IUTE), alcohol (IUAE), and marijuana (IUME). We recruited participants from Boston Medical Center as mother-infant dyads between 1990 and 1993. The majority of the sample was African-American/Caribbean (88%) and 49% female. In bivariate analyses, none and lower IUCE level predicted resilience compared to higher IUCE, but this effect was not found in an adjusted model. Instead, strict caregiver supervision (adjusted odds ratio (AOR)=6.02, 95% confidence interval (CI)=1.90–19.00, p=0.002), lower violence exposure (AOR=4.07, 95% CI=1.77–9.38, p<0.001), and absence of intrauterine tobacco exposure (AOR=3.71, 95% CI= 1.28–10.74, p=0.02) predicted behavioral resilience. In conclusion, caregiver supervision in early adolescence, lower violence exposure in childhood, and lack of intrauterine tobacco exposure predict behavioral resilience among a cohort of early adolescents with significant social and environmental risk. Future interventions should work to enhance parental supervision as a way to mitigate the effects of adversity on high-risk groups of adolescents. PMID:26076097

  1. Orbital evidence for clay and acidic sulfate assemblages on Mars based on mineralogical analogs from Rio Tinto, Spain

    NASA Astrophysics Data System (ADS)

    Kaplan, Hannah H.; Milliken, Ralph E.; Fernández-Remolar, David; Amils, Ricardo; Robertson, Kevin; Knoll, Andrew H.

    2016-09-01

    Outcrops of hydrated minerals are widespread across the surface of Mars, with clay minerals and sulfates being commonly identified phases. Orbitally-based reflectance spectra are often used to classify these hydrated components in terms of a single mineralogy, although most surfaces likely contain multiple minerals that have the potential to record local geochemical conditions and processes. Reflectance spectra for previously identified deposits in Ius and Melas Chasma within the Valles Marineris, Mars, exhibit an enigmatic feature with two distinct absorptions between 2.2 and 2.3 μm. This spectral 'doublet' feature is proposed to result from a mixture of hydrated minerals, although the identity of the minerals has remained ambiguous. Here we demonstrate that similar spectral doublet features are observed in airborne, field, and laboratory reflectance spectra of rock and sediment samples from Rio Tinto, Spain. Combined visible-near infrared reflectance spectra and X-ray diffraction measurements of these samples reveal that the doublet feature arises from a mixture of Al-phyllosilicate (illite or muscovite) and jarosite. Analyses of orbital data from the Compact Reconnaissance Imaging Spectrometer for Mars (CRISM) shows that the martian spectral equivalents are also consistent with mixtures of Al-phyllosilicates and jarosite, where the Al-phyllosilicate may also include kaolinite and/or halloysite. A case study for a region within Ius Chasma demonstrates that the relative proportions of the Al-phyllosilicate(s) and jarosite vary within one stratigraphic unit as well as between stratigraphic units. The former observation suggests that the jarosite may be a diagenetic (authigenic) product and thus indicative of local pH and redox conditions, whereas the latter observation may be consistent with variations in sediment flux and/or fluid chemistry during sediment deposition.

  2. Parametric imaging using subharmonic signals from ultrasound contrast agents in patients with breast lesions.

    PubMed

    Eisenbrey, John R; Dave, Jaydev K; Merton, Daniel A; Palazzo, Juan P; Hall, Anne L; Forsberg, Flemming

    2011-01-01

    Parametric maps showing perfusion of contrast media can be useful tools for characterizing lesions in breast tissue. In this study we show the feasibility of parametric subharmonic imaging (SHI), which allows imaging of a vascular marker (the ultrasound contrast agent) while providing near complete tissue suppression. Digital SHI clips of 16 breast lesions from 14 women were acquired. Patients were scanned using a modified LOGIQ 9 scanner (GE Healthcare, Waukesha, WI) transmitting/receiving at 4.4/2.2 MHz. Using motion-compensated cumulative maximum intensity (CMI) sequences, parametric maps were generated for each lesion showing the time to peak (TTP), estimated perfusion (EP), and area under the time-intensity curve (AUC). Findings were grouped and compared according to biopsy results as benign lesions (n = 12, including 5 fibroadenomas and 3 cysts) and carcinomas (n = 4). For each lesion CMI, TTP, EP, and AUC parametric images were generated. No significant variations were detected with CMI (P = .80), TTP (P = .35), or AUC (P = .65). A statistically significant variation was detected for the average pixel EP (P = .002). Especially, differences were seen between carcinoma and benign lesions (mean ± SD, 0.10 ± 0.03 versus 0.05 ± 0.02 intensity units [IU]/s; P = .0014) and between carcinoma and fibroadenoma (0.10 ± 0.03 versus 0.04 ± 0.01 IU/s; P = .0044), whereas differences between carcinomas and cysts were found to be nonsignificant. In conclusion, a parametric imaging method for characterization of breast lesions using the high contrast to tissue signal provided by SHI has been developed. While the preliminary sample size was limited, results show potential for breast lesion characterization based on perfusion flow parameters.

  3. The Challenging Intrauterine Contraceptive: In-office Hysteroscopic Approach.

    PubMed

    Di Spiezio Sardo, Attilio; da Cunha Vieira, Mariana; Scognamiglio, Marianna; Zizolfi, Brunella; Nappi, Carmine; de Angelis, Carlo

    2016-01-01

    To describe 3 cases of misplaced or retained Intrauterine Contraceptive (IUC) that were successfully resolved by hysteroscopy performed in an ambulatory setting using miniaturized electrosurgical and mechanical operative instruments. Step-by-step description of the technique using slides, pictures, and video (educative video) (Canadian Task Force classification III). Misplaced or retained IUC may be related to several causes; incorrect insertion is the leading cause. In these cases, patients may complain of abnormal bleeding, pelvic pain, or pregnancy or they may remain asymptomatic. When a displaced IUC is suspected, transvaginal ultrasonography is the primary investigation followed by radiography in cases in which the IUC is not seen within the uterus. Additional imaging such as computed tomographic scanning or magnetic resonance imaging may be needed. Hysteroscopy represents the gold standard for diagnostic clarification and management of a dislocated or embedded IUC. The hysteroscopic approach of the 3 cases was the following: removal of a partially perforating IUD in the cesarean scar pouch, repositioning of a dislocated IUS in the isthmocele, and removal of an embedded IUS in the cornual area. The procedures were performed in an ambulatory setting using a 5-mm continuous flow hysteroscope and vaginoscopic approach without any analgesia and/or anesthesia. The alternate use of mechanical and electrosurgical 5F instruments allowed us to separate the IUC from the myometrial uterine wall, respecting the healthy myometrium and without causing significant patient discomfort or complications. The possibility of using miniaturized electrosurgical and mechanical instruments with small-diameter hysteroscopes offers the possibility of an effective, safe, cost-efficient, and well-tolerated removal or repositioning of a misplaced or retained IUC. This minimally invasive approach can be performed in an office setting to avoid more invasive and traumatic approaches

  4. Considerations for the use of progestin-only contraceptives.

    PubMed

    Freeman, Sarah; Shulman, Lee P

    2010-02-01

    To highlight the characteristics of progestin-only contraceptives (POCs) currently available in the United States, and to explore the potential of these agents as first-line contraceptive options for women seeking health promotion by prevention of an unwanted pregnancy. The progestin-only pills (Micronor and Ovrette), depot medroxyprogesterone acetate (DMPA) injections (Depo-Provera and depo-subQ provera 104), levonorgestrel intrauterine system (IUS) (Mirena), and etonogestrel implant (Implanon) will be reviewed. The use of levonorgestrel (Plan B) as an emergency contraceptive will also be considered briefly. Worldwide medical literature and the prescribing information for the specified products. A number of POCs are currently available for routine birth control in the United States, ranging from the daily progestin-only pill to nondaily contraceptive options such as injectable DMPA, the levonorgestrel-releasing IUS, and the etonogestrel-releasing contraceptive implant. Each of these methods has specific advantages, but also specific drawbacks that can result in discontinuation of treatment if users are not given adequate information about what to expect in terms of side effects. It is critical that clinicians provide adequate and accurate information along with detailed counseling to women who are considering using POCs, as well as providing periodic reinforcement of the information at regular clinic visits for those already using POCs. Given that a large number of pregnancies are unplanned and create a significant impact on social, economic, and health outcomes, it is important for the clinician to have a vast knowledge of contraceptive options. POCs offer significant choices in contraception. By proactively addressing common concerns (such as potential effects on weight, mood, menstrual bleeding patterns, and bone mineral density), clinicians may improve the likelihood of adherence and continuation with POCs for routine birth control.

  5. Knowledge and attitudes of Latin American obstetricians and gynecologists regarding intrauterine contraceptives

    PubMed Central

    Bahamondes, Luis; Makuch, Maria Y; Monteiro, Ilza; Marin, Victor; Lynen, Richard

    2015-01-01

    Background Intrauterine contraceptives (IUCs), including the copper intrauterine device and the levonorgestrel-releasing intrauterine system (LNG-IUS), are among the reversible contraceptive methods with high effectiveness. However, use is low in many settings, including some Latin American countries, mainly due to the influences of myths, fears, and negative attitudes, not only of users and potential users, but also of different cadres of health care professionals. The purpose of this study was to assess the knowledge and attitudes of a group of Latin American obstetricians and gynecologists regarding IUCs. Methods A survey was conducted during a scientific meeting organized in Chile in 2014 to present and discuss updated information about contraception. Obstetricians and gynecologists from 12 Latin American countries, who reported that they provide daily contraception services in both the public and private sectors, participated in the meeting. Participants who agreed to take part in the survey responded to a multiple-choice questionnaire on issues regarding knowledge, use, and attitudes about IUCs. Results Of the 210 obstetricians and gynecologists participating in the meeting, the respondents to each question varied from 168 (80.0%) to 205 (97.6%). Almost 50% recognized that the failure rate of combined oral contraceptives, patches, and vaginal rings is 8%–10%. Furthermore, 10% of the participants did not recognize the high contraceptive effectiveness of long-acting reversible contraceptive methods. Additionally, almost 80% of the respondents answered that they did not offer IUCs to nulligravidas and almost 10% did not offer IUCs to adolescents, albeit almost 90% of the respondents reported that nulligravidas are candidates for an LNG-IUS. Conclusion Some deficiencies and contradictions in terms of knowledge and attitudes were identified from the answers of the Latin American obstetricians and gynecologists who participated in the survey. The knowledge and

  6. 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

  7. The use of coenzyme Q10 and DHEA during IUI and IVF cycles in patients with decreased ovarian reserve.

    PubMed

    Gat, Itai; Blanco Mejia, Sonia; Balakier, Hanna; Librach, Clifford L; Claessens, Anne; Ryan, Edward A J

    2016-07-01

    The objective of this study is to compare the combination of dehydroepiandrosterone (DHEA) and coenzyme Q10 (CoQ10) (D + C) with DHEA alone (D) in intrauterine insemination (IUI) and in vitro fertilization (IVF) cycles among patients with decreased ovarian reserve. We retrospectively extracted data from patients charts treated by DHEA with/without CoQ10 during IUI or IVF between February 2006 and June 2014. Prestimulation parameters included age, BMI, day 3 FSH and antral follicular count (AFC). Ovarian response parameters included total gonadotropins dosage, peak serum estradiol, number of follicles > 16 mm and fertilization rate. Clinical outcomes included clinical and ongoing pregnancy rates. Three hundred and thirty IUI cycles involved D + C compared with 467 cycles of D; 78 IVF cycles involved D + C and 175 D. In both IUI and IVF, AFC was higher with D + C compared with D (7.4 ± 5.7 versus 5.9 ± 4.7, 8.2 ± 6.3 versus 5.2 ± 5, respectively, p < 0.05). D + C resulted in a more follicles > 16 mm during IUI cycles (3.3 ± 2.3 versus 2.9 ± 2.2, respectively, p = 0.01), while lower mean total gonadotropin dosage was administered after D + C supplementation compared with D (3414 ± 1141 IUs versus 3877 ± 1143 IUs respectively, p = 0.032) in IVF cycles. Pregnancy and delivery rates were similar for both IUI and IVF. D + C significantly increases AFC and improves ovarian responsiveness during IUI and IVF without a difference in clinical outcome.

  8. Ethylene vinyl acetate (EVA) as a new drug carrier for 3D printed medical drug delivery devices.

    PubMed

    Genina, Natalja; Holländer, Jenny; Jukarainen, Harri; Mäkilä, Ermei; Salonen, Jarno; Sandler, Niklas

    2016-07-30

    The main purpose of this work was to investigate the printability of different grades of ethylene vinyl acetate (EVA) copolymers as new feedstock material for fused-deposition modeling (FDM™)-based 3D printing technology in fabrication of custom-made T-shaped intrauterine systems (IUS) and subcutaneous rods (SR). The goal was to select an EVA grade with optimal properties, namely vinyl acetate content, melting index, flexural modulus, for 3D printing of implantable prototypes with the drug incorporated within the entire matrix of the medical devices. Indomethacin was used as a model drug in this study. Out of the twelve tested grades of the EVA five were printable. One of them showed superior print quality and was further investigated by printing drug-loaded filaments, containing 5% and 15% indomethacin. The feedstock filaments were fabricated by hot-melt extrusion (HME) below the melting point of the drug substance and the IUS and SR were successfully printed at the temperature above the melting point of the drug. As a result, the drug substance in the printed prototypes showed to be at least partly amorphous, while the drug in the corresponding HME filaments was crystalline. This difference affected the drug release profiles from the filaments and printed prototype products: faster release from the prototypes over 30days in the in vitro tests. To conclude, this study indicates that certain grades of EVA were applicable feedstock material for 3D printing to produce drug-loaded implantable prototypes. Copyright © 2015 Elsevier B.V. All rights reserved.

  9. 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

  10. Cost-effectiveness of diagnostic strategies for the management of abnormal uterine bleeding (heavy menstrual bleeding and post-menopausal bleeding): a decision analysis.

    PubMed

    Cooper, Natalie A M; Barton, Pelham M; Breijer, Maria; Caffrey, Orla; Opmeer, Brent C; Timmermans, Anne; Mol, Ben W J; Khan, Khalid S; Clark, T Justin

    2014-04-01

    Heavy menstrual bleeding (HMB) and post-menopausal bleeding (PMB) together constitute the commonest gynaecological presentation in secondary care and impose substantial demands on health service resources. Accurate diagnosis is of key importance to realising effective treatment, reducing morbidity and, in the case of PMB, reducing mortality. There are many tests available, including transvaginal scan (TVS), endometrial biopsy (EBx), saline infusion sonography and outpatient hysteroscopy (OPH); however, optimal diagnostic work-up is unclear. To determine the most cost-effective diagnostic testing strategy for the diagnosis and treatment of (i) HMB and (ii) PMB. Parameter inputs were derived from systematic quantitative reviews, individual patient data (IPD) from existing data sets and focused searches for specific data. In the absence of data estimates, the consensus view of an expert clinical panel was obtained. Two clinically informed decision-analytic models were constructed to reflect current service provision for the diagnostic work-up of women presenting with HMB and PMB. The model-based economic evaluation took the form of a cost-effectiveness analysis from the perspective of the NHS in a contemporary, 'one-stop' secondary care clinical setting, where all indicated testing modalities would be available during a single visit. Two potentially cost-effective testing strategies for the initial investigation of women with HMB were identified: OPH alone or in combination with EBx. Although a combination testing strategy of OPH + EBx was marginally more effective, the incremental cost-effectiveness ratio (ICER) was approximately £21,000 to gain one more satisfied patient, whereas for OPH it was just £360 when compared with treatment with the levonorgestrel intrauterine system (LNG-IUS) without investigation. Initial testing with OPH was the most cost-effective testing approach for women wishing to preserve fertility and for women with symptoms refractory to

  11. Reflectance Spectra Comparison of Orbital Debris, Intact Spacecraft, and Intact Rocket Bodies in the GEO Regime

    NASA Astrophysics Data System (ADS)

    Albercromby, Kira J.; Abell, Paul; Barker, Ed

    2009-03-01

    A key objective of NASA's Orbital Debris program office at Johnson Space Center (JSC) is to characterize the debris environment by way of assessing the physical properties (type, mass, density, and size) of objects in orbit. Knowledge of the geosynchronous orbit (GEO) debris environment in particular can be used to determine the hazard probability at specific GEO altitudes and aid predictions of the future environment. To calculate an optical size from an intensity measurement of an object in the GEO regime, a 0.175 albedo is assumed currently. However, identification of specific material type or types could improve albedo accuracy and yield a more accurate size estimate for the debris piece. Using spectroscopy, it is possible to determine the surface materials of space objects. The study described herein used the NASA Infrared Telescope Facility (IRTF) to record spectral data in the ~ 0.65 to 2.5 micron regime on eight catalogued space objects. For comparison, all of the objects observed were in GEO or near-GEO. The eight objects consisted of two intact spacecraft, three rocket bodies, and three catalogued debris pieces. Two of the debris pieces stemmed from Titan 3C transtage breakup and the third is from COSMOS 2054. The reflectance spectra of the Titan 3C pieces share similar slopes (increasing with wavelength) and lack any strong absorption features. The COSMOS debris spectrum has a slight slope and has no absorption features. In contrast, the intact spacecraft show classic absorption features due to solar cells with a strong band gap feature near 1 micron. The two spacecraft were spin-stabilized objects and therefore have solar panels surrounding the outer surface. Two of the three rocket bodies are inertial upper stage (IUS) rocket bodies and have similar looking spectra. The slopes flatten out near 1.5 microns with absorption features in the near-infrared that are similar to that of white paint. The third rocket body has a similar flattening of slope but

  12. Reflectance Spectra Comparison of Orbital Debris, Intact Spacecraft, and Intact Rocket Bodies in the GEO Regime

    NASA Technical Reports Server (NTRS)

    Barker, Ed; Abercromby, Kira J.; Abell, Paul

    2009-01-01

    A key objective of NASA s Orbital Debris program office at Johnson Space Center (JSC) is to characterize the debris environment by way of assessing the physical properties (type, mass, density, and size) of objects in orbit. Knowledge of the geosynchronous orbit (GEO) debris environment in particular can be used to determine the hazard probability at specific GEO altitudes and aid predictions of the future environment. To calculate an optical size from an intensity measurement of an object in the GEO regime, a 0.175 albedo is assumed currently. However, identification of specific material type or types could improve albedo accuracy and yield a more accurate size estimate for the debris piece. Using spectroscopy, it is possible to determine the surface materials of space objects. The study described herein used the NASA Infrared Telescope Facility (IRTF) to record spectral data in the 0.6 to 2.5 micron regime on eight catalogued space objects. For comparison, all of the objects observed were in GEO or near-GEO. The eight objects consisted of two intact spacecraft, three rocket bodies, and three catalogued debris pieces. Two of the debris pieces stemmed from Titan 3C transtage breakup and the third is from COSMOS 2054. The reflectance spectra of the Titan 3C pieces share similar slopes (increasing with wavelength) and lack any strong absorption features. The COSMOS debris spectra is flat and has no absorption features. In contrast, the intact spacecraft show classic absorption features due to solar panels with a strong band gap feature near 1 micron. The two spacecraft are spin-stabilized objects and therefore have solar panels surrounding the outer surface. Two of the three rocket bodies are inertial upper stage (IUS) rocket bodies and have similar looking spectra. The slopes flatten out near 1.5 microns with absorption features in the near-infrared that are similar to that of white paint. The third rocket body has a similar flattening of slope but with fewer

  13. Achieving cost-neutrality with long-acting reversible contraceptive methods⋆

    PubMed Central

    Trussell, James; Hassan, Fareen; Lowin, Julia; Law, Amy; Filonenko, Anna

    2014-01-01

    Objectives This analysis aimed to estimate the average annual cost of available reversible contraceptive methods in the United States. In line with literature suggesting long-acting reversible contraceptive (LARC) methods become increasingly cost-saving with extended duration of use, it aimed to also quantify minimum duration of use required for LARC methods to achieve cost-neutrality relative to other reversible contraceptive methods while taking into consideration discontinuation. Study design A three-state economic model was developed to estimate relative costs of no method (chance), four short-acting reversible (SARC) methods (oral contraceptive, ring, patch and injection) and three LARC methods [implant, copper intrauterine device (IUD) and levonorgestrel intrauterine system (LNG-IUS) 20 mcg/24 h (total content 52 mg)]. The analysis was conducted over a 5-year time horizon in 1000 women aged 20–29 years. Method-specific failure and discontinuation rates were based on published literature. Costs associated with drug acquisition, administration and failure (defined as an unintended pregnancy) were considered. Key model outputs were annual average cost per method and minimum duration of LARC method usage to achieve cost-savings compared to SARC methods. Results The two least expensive methods were copper IUD ($304 per women, per year) and LNG-IUS 20 mcg/24 h ($308). Cost of SARC methods ranged between $432 (injection) and $730 (patch), per women, per year. A minimum of 2.1 years of LARC usage would result in cost-savings compared to SARC usage. Conclusions This analysis finds that even if LARC methods are not used for their full durations of efficacy, they become cost-saving relative to SARC methods within 3 years of use. Implications Previous economic arguments in support of using LARC methods have been criticized for not considering that LARC methods are not always used for their full duration of efficacy. This study calculated that cost-savings from LARC

  14. Morphology, stratigraphy, and mineralogical composition of a layered formation covering the plateaus around Valles Marineris, Mars: Implications for its geological history

    NASA Astrophysics Data System (ADS)

    Le Deit, L.; Bourgeois, O.; Mège, D.; Hauber, E.; Le Mouélic, S.; Massé, M.; Jaumann, R.; Bibring, J.-P.

    2010-08-01

    An extensive layered formation covers the high plateaus around Valles Marineris. Mapping based on HiRISE, CTX and HRSC images reveals these layered deposits (LDs) crop out north of Tithonium Chasma, south of Ius Chasma, around West Candor Chasma, and southwest of Juventae Chasma and Ganges Chasma. The estimated area covered by LDs is ˜42,300 km 2. They consist of a series of alternating light and dark beds, a 100 m in total thickness that is covered by a dark unconsolidated mantle possibly resulting from their erosion. Their stratigraphic relationships with the plateaus and the Valles Marineris chasmata indicate that the LDs were deposited during the Early- to Late Hesperian, and possibly later depending on the region, before the end of the backwasting of the walls near Juventae Chasma, and probably before Louros Valles sapping near Ius Chasma. Their large spatial coverage and their location mainly on highly elevated plateaus lead us to conclude that LDs correspond to airfall dust and/or volcanic ash. The surface of LDs is characterized by various morphological features, including lobate ejecta and pedestal craters, polygonal fractures, valleys and sinuous ridges, and a pitted surface, which are all consistent with liquid water and/or water ice filling the pores of LDs. LDs were episodically eroded by fluvial processes and were possibly modified by sublimation processes. Considering that LDs correspond to dust and/or ash possibly mixed with ice particles in the past, LDs may be compared to Dissected Mantle Terrains currently observed in mid- to high latitudes on Mars, which correspond to a mantle of mixed dust and ice that is partially or totally dissected by sublimation. The analysis of CRISM and OMEGA hyperspectral data indicates that the basal layer of LDs near Ganges Chasma exhibits spectra with absorption bands at ˜1.4 μm, and ˜1.9 μm and a large deep band between ˜2.21 and ˜2.26 μm that are consistent with previous spectral analysis in other regions

  15. An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit

    PubMed Central

    2013-01-01

    Background A growing interest in frailty syndrome exists because it is regarded as a major predictor of co-morbidities and mortality in older populations. Nevertheless, frailty assessment has been controversial, particularly when identifying this syndrome in a community setting. Performance tests such as the 30-second chair stand test (30-s CST) are a cornerstone for detecting early declines in functional independence. Additionally, recent advances in body-fixed sensors have enhanced the sensors’ ability to automatically and accurately evaluate kinematic parameters related to a specific movement performance. The purpose of this study is to use this new technology to obtain kinematic parameters that can identify frailty in an aged population through the performance the 30-s CST. Methods Eighteen adults with a mean age of 54 years, as well as sixteen pre-frail and thirteen frail patients with mean ages of 78 and 85 years, respectively, performed the 30-s CST while threir trunk movements were measured by a sensor-unit at vertebra L3. Sit-stand-sit cycles were determined using both acceleration and orientation information to detect failed attempts. Movement-related phases (i.e. impulse, stand-up, and sit-down) were differentiated based on seat off and seat on events. Finally, the kinematic parameters of the impulse, stand-up and sit-down phases were obtained to identify potential differences across the three frailty groups. Results For the stand-up and sit-down phases, velocity peaks and “modified impulse” parameters clearly differentiated subjects with different frailty levels (p < 0.001). The trunk orientation range during the impulse phase was also able to classify a subject according to his frail syndrome (p < 0.001). Furthermore, these parameters derived from the inertial units (IUs) are sensitive enough to detect frailty differences not registered by the number of completed cycles which is the standard test outcome. Conclusions This study shows

  16. An evaluation of the 30-s chair stand test in older adults: frailty detection based on kinematic parameters from a single inertial unit.

    PubMed

    Millor, Nora; Lecumberri, Pablo; Gómez, Marisol; Martínez-Ramírez, Alicia; Izquierdo, Mikel

    2013-08-01

    A growing interest in frailty syndrome exists because it is regarded as a major predictor of co-morbidities and mortality in older populations. Nevertheless, frailty assessment has been controversial, particularly when identifying this syndrome in a community setting. Performance tests such as the 30-second chair stand test (30-s CST) are a cornerstone for detecting early declines in functional independence. Additionally, recent advances in body-fixed sensors have enhanced the sensors' ability to automatically and accurately evaluate kinematic parameters related to a specific movement performance. The purpose of this study is to use this new technology to obtain kinematic parameters that can identify frailty in an aged population through the performance the 30-s CST. Eighteen adults with a mean age of 54 years, as well as sixteen pre-frail and thirteen frail patients with mean ages of 78 and 85 years, respectively, performed the 30-s CST while their trunk movements were measured by a sensor-unit at vertebra L3. Sit-stand-sit cycles were determined using both acceleration and orientation information to detect failed attempts. Movement-related phases (i.e. impulse, stand-up, and sit-down) were differentiated based on seat off and seat on events. Finally, the kinematic parameters of the impulse, stand-up and sit-down phases were obtained to identify potential differences across the three frailty groups. For the stand-up and sit-down phases, velocity peaks and "modified impulse" parameters clearly differentiated subjects with different frailty levels (p < 0.001). The trunk orientation range during the impulse phase was also able to classify a subject according to his frail syndrome (p < 0.001). Furthermore, these parameters derived from the inertial units (IUs) are sensitive enough to detect frailty differences not registered by the number of completed cycles which is the standard test outcome. This study shows that IUs can enhance the information gained from

  17. Achieving cost-neutrality with long-acting reversible contraceptive methods.

    PubMed

    Trussell, James; Hassan, Fareen; Lowin, Julia; Law, Amy; Filonenko, Anna

    2015-01-01

    This analysis aimed to estimate the average annual cost of available reversible contraceptive methods in the United States. In line with literature suggesting long-acting reversible contraceptive (LARC) methods become increasingly cost-saving with extended duration of use, it aimed to also quantify minimum duration of use required for LARC methods to achieve cost-neutrality relative to other reversible contraceptive methods while taking into consideration discontinuation. A three-state economic model was developed to estimate relative costs of no method (chance), four short-acting reversible (SARC) methods (oral contraceptive, ring, patch and injection) and three LARC methods [implant, copper intrauterine device (IUD) and levonorgestrel intrauterine system (LNG-IUS) 20 mcg/24 h (total content 52 mg)]. The analysis was conducted over a 5-year time horizon in 1000 women aged 20-29 years. Method-specific failure and discontinuation rates were based on published literature. Costs associated with drug acquisition, administration and failure (defined as an unintended pregnancy) were considered. Key model outputs were annual average cost per method and minimum duration of LARC method usage to achieve cost-savings compared to SARC methods. The two least expensive methods were copper IUD ($304 per women, per year) and LNG-IUS 20 mcg/24 h ($308). Cost of SARC methods ranged between $432 (injection) and $730 (patch), per women, per year. A minimum of 2.1 years of LARC usage would result in cost-savings compared to SARC usage. This analysis finds that even if LARC methods are not used for their full durations of efficacy, they become cost-saving relative to SARC methods within 3 years of use. Previous economic arguments in support of using LARC methods have been criticized for not considering that LARC methods are not always used for their full duration of efficacy. This study calculated that cost-savings from LARC methods relative to SARC methods, with discontinuation rates

  18. Internet-based cognitive behavioural therapy (iCBT) for posttraumatic stress disorder versus waitlist control: study protocol for a randomised controlled trial.

    PubMed

    Allen, Adrian R; Newby, Jill M; Smith, Jessica; Andrews, Gavin

    2015-12-01

    This randomised controlled trial (RCT) with two parallel arms will evaluate the efficacy of an internet-delivered six-lesson 10-week cognitive behavioural therapy (iCBT) intervention for posttraumatic stress disorder (PTSD). It will also investigate the association between changes in PTSD symptoms, intolerance of uncertainty (IU) and emotion regulation. Patients with PTSD will be recruited via the research arm of a not-for-profit clinical and research unit in Australia and randomised to a treatment group or waitlist control group. The minimum sample size for each group (alpha 0.05, power 0.80 for a g of 0.47) was identified as 72, but 10 % more will be recruited to hedge against expected attrition. PTSD diagnosis will be determined using the PTSD module from the Mini International Neuropsychiatric Interview version 5.0.0. The PTSD Checklist - Civilian version (PCL-C) will be used to measure PTSD symptoms (the primary outcome measure), with the Intolerance of Uncertainty Scale 12-item version (IUS-12) and the Emotion Regulation Questionnaire (ERQ) used to measure intolerance of uncertainty and emotion regulation, respectively. The PCL-C will be administered to the treatment group before each lesson of the PTSD program and at 3-month follow-up. The IUS-12 and ERQ will be administered before lessons 1 and 4, at post-treatment and at 3-month follow-up. The waitlist control group will complete these measures at week 1, week 5 and week 11 of the waitlist period. PTSD program efficacy will be determined using intent-to-treat mixed models. Maintenance of gains will be assessed at 3-month follow-up. Mediation analyses using PROCESS will be used to examine the association between change in PTSD symptoms over treatment and change in each of IU and emotion regulation ability in separate analyses. The current RCT seeks to replicate previous efficacy findings of iCBT for PTSD in a formally assessed PTSD sample from the general population. Findings may point to future lines of

  19. Remote Sensing to study soil-management systems in Itaí-SP

    NASA Astrophysics Data System (ADS)

    Soares da Silva, Natália; Máximo Sánchez-Román, Rodrigo; Marchamalo Sacristán, Miguel; Rodríguez-Sinobas, Leonor

    2017-04-01

    Nowadays, there is a worldwide concern to develop sustainable technologies for agriculture and a correct soil management is one of the principles toward the ecological production of crops. Soil covering is one of the most important tecniques to reduce erosion because the barrier on the surface prevents the direct impact of the rain drops. This technique improves soil fertility, keeps the soil moisture, reduces the evaporation losses and reduces the need of irrigation by 20%. The species used to cover the soil depends on the aim of the work, but is always important to know previously the availability of the material in the area and the possibility to use material of previous crops. In São Paulo State some studies are trying undertand how different soil-covering-systems affect plant production, especially for common bean, very important nutritionally and economically in Brazil. Nowadays, remote sensing could is used to study spatial dynamics, and to understand data in any place on the globe easily. For that, images of Earth freely obtained on the Internet are analyzed and interpreted to understand the dinamic of a specific local by the interaction between an electromagnetic radiation and different covering-vegetation. The aim of this study was monitoring by remote sensing an area of bean production with straw-covered-soil and straw-incorporated in the soil. The experimental site is in Itaí, São Paulo, Brazil, irrigated by central pivot. Images of different satellites (Landsat 7 and Landsat 8) were downloaded and analyzed by determining the soil moisture index (IUS) as a function of the normalized difference vegetation index (NDVI) for both straw-systems. There was correlation between IUS and NDVI data, and the highest value obtained was 0.98 for both systems and the lower one was 0.59 in the straw-covering system and 0.61 in the straw-incoporated system. Thus, the sensors were not sensitive to detect differences between the systems, and further studies are needed

  20. Influence of Vitamin D Status and Vitamin D3 Supplementation on Genome Wide Expression of White Blood Cells: A Randomized Double-Blind Clinical Trial

    PubMed Central

    Hossein-nezhad, Arash; Spira, Avrum; Holick, Michael F.

    2013-01-01

    Background Although there have been numerous observations of vitamin D deficiency and its links to chronic diseases, no studies have reported on how vitamin D status and vitamin D3 supplementation affects broad gene expression in humans. The objective of this study was to determine the effect of vitamin D status and subsequent vitamin D supplementation on broad gene expression in healthy adults. (Trial registration: ClinicalTrials.gov NCT01696409). Methods and Findings A randomized, double-blind, single center pilot trial was conducted for comparing vitamin D supplementation with either 400 IUs (n = 3) or 2000 IUs (n = 5) vitamin D3 daily for 2 months on broad gene expression in the white blood cells collected from 8 healthy adults in the winter. Microarrays of the 16 buffy coats from eight subjects passed the quality control filters and normalized with the RMA method. Vitamin D3 supplementation that improved serum 25-hydroxyvitamin D concentrations was associated with at least a 1.5 fold alteration in the expression of 291 genes. There was a significant difference in the expression of 66 genes between subjects at baseline with vitamin D deficiency (25(OH)D<20 ng/ml) and subjects with a 25(OH)D>20 ng/ml. After vitamin D3 supplementation gene expression of these 66 genes was similar for both groups. Seventeen vitamin D-regulated genes with new candidate vitamin D response elements including TRIM27, CD83, COPB2, YRNA and CETN3 which have been shown to be important for transcriptional regulation, immune function, response to stress and DNA repair were identified. Conclusion/Significance Our data suggest that any improvement in vitamin D status will significantly affect expression of genes that have a wide variety of biologic functions of more than 160 pathways linked to cancer, autoimmune disorders and cardiovascular disease with have been associated with vitamin D deficiency. This study reveals for the first time molecular finger prints that help explain the

  1. Trends in family planning and counselling for women with sickle cell disease in the UK over two decades.

    PubMed

    Eissa, Asma A; Tuck, Susan M; Rantell, Khadija; Stott, Daniel

    2015-04-01

    Pregnancies in women with sickle cell disease (SCD) are known to have high rates of maternal and fetal mortality and morbidity. Given these pregnancy-associated problems for women with SCD, advice both about pregnancy planning and about effective contraception are of paramount importance. This study sought to discover the contraception methods used by women with SCD, what complications women with SCD encounter with contraception, and their experiences of pre-pregnancy counselling and pregnancy planning, and how such issues may have changed over the past two decades. The study was a multicentre, interview-based, cross-sectional study. Interviews were carried out with 102 women with SCD, in north and central London during 2010, concerning their current and previous contraceptive use, their pregnancy history, their menstrual history, and the advice they received concerning pregnancy planning and contraception. Patient information was anonymised and ethical approval was obtained. These data were compared with data from a similar study undertaken in 1993. There were significant differences in a number of key areas: the number of unplanned pregnancies decreased from 64% in 1993 to 53% in 2010. The number of women with SCD who were advised not to become pregnant also fell, from 36% to 15%. The use of combined oral contraceptive pills declined, from 45% of the women in 1993 to 31% in 2010. Conversely the use of depot medroxyprogesterone acetate contraception (DMPA) and the levonorgestrel intrauterine system (LNG-IUS) both increased. Significant changes in the contraceptive methods used by women with SCD are demonstrated in the London population. LNG-IUS use in SCD has not been investigated before. There has been an encouraging decrease in the number of women with SCD who are advised not to become pregnant, perhaps reflecting an improvement in their overall health. Although the number of unplanned pregnancies has fallen, it remains high - emphasising the continuing need for

  2. Immediate postabortion initiation of levonorgestrel implants reduces the incidence of births and abortions at 2 years and beyond.

    PubMed

    Rose, Sally B; Garrett, Susan M; Stanley, James

    2015-07-01

    The aims of this study were to compare immediate postabortion uptake of recently subsidized (no-cost) levonorgestrel-releasing implants with already available intrauterine and shorter-acting methods and to compare the incidence of subsequent pregnancies (ending in birth or abortion) within 2 years. Retrospective chart review of 4698 women attending a New Zealand public hospital abortion clinic over 2 years (2010-2012) to describe postabortion contraceptive choice, with follow-up via clinic and national births records to assess subsequent pregnancies at 12, 24, 36, and 48 months. Twenty percent of the cohort (934/4698) received an implant, 26% an intrauterine method (927 copper intrauterine device, 301 levonorgestrel-releasing intrauterine system [LNG-IUS]), and 54% chose other shorter-acting methods (2536/4698). Method choice was significantly associated with age, ethnicity, and pregnancy history (p < .001). At 24 months, the unadjusted incidence of subsequent abortion for implant users was 3.8% (95% confidence interval [CI] = 2.5-5.0) and 11.6% (95% CI = 10.3-12.8) for those choosing other short-acting methods. By 48 months, 6.6% of implant users had a subsequent abortion (compared with 18.3% for short-acting methods). The incidence of continued pregnancy at 24 months was 6.3% (95% CI = 4.4-8.1) for implant users and 15.7% (95% CI = 14-17.2) for those choosing other short-acting methods. Adjusted hazard ratios (HRs) for subsequent abortion were lowest for women initiating an implant (HR = 0.26, 95% CI = 0.20-0.35) or LNG-IUS (HR = 0.26, 0.16-0.44, reference group: short-acting methods). Immediate postabortion insertion of an implant significantly reduced rates of subsequent pregnancy for at least 2 years. Abortion service providers should ensure women have barrier-free access to all long-acting reversible contraceptions to delay or prevent pregnancy. Initiation of an levonorgestrel implant immediately postabortion was associated with a 74% reduction in subsequent

  3. To Venus with spare parts

    NASA Astrophysics Data System (ADS)

    Bell, Peter M.

    The Jet Propulsion Laboratory (JPL) is studying the possibilities of developing a special spacecraft to fly to Venus to replace the more costly Venus Orbiting Imaging Radar (VOIR) mission. According to a recent JPL Newsletter, the new Venus Radar Mapper (VRM) spacecraft is to be constructed mainly of spare parts left over from other missions. The VRM is to be landed in the spring of 1988 by means of either the space shuttle/ two-stage inertial upper-stage (IUS) combination or, preferably, with the much more powerful shuttle/Centaur upper-stage rocket. Once boosted into orbit around Venus, the scientific objections of VRM are clear. Venus has about the same mass and composition as the earth, and yet little is known about its geology. It will be possible for the VRM to map Venus by radar from an elliptical orbit, which is a lower cost option than would have been possible with the VOIR. VRM will carry a synthetic aperture radar (SAR) that operates with variable angles ranging from 51° for the lowest altitudes (250 km) to 24° for the highest altitudes (1900 km). A total of about 92% of Venus' surface will be mapped at a resolution of 1 km/line or better.

  4. Intolerance of uncertainty and transdiagnostic group cognitive behavioral therapy for anxiety.

    PubMed

    Talkovsky, Alexander M; Norton, Peter J

    2016-06-01

    Recent evidence suggests intolerance of uncertainty (IU) is a transdiagnostic variable elevated across anxiety disorders. No studies have investigated IU's response to transdiagnostic group CBT for anxiety (TGCBT). This study evaluated IU outcomes following TGCBT across anxiety disorders. 151 treatment-seekers with primary diagnoses of social anxiety disorder, panic disorder, or GAD were evaluated before and after 12 weeks of TGCBT and completed self-report questionnaires at pre-, mid-, and post-treatment. IU decreased significantly following treatment. Decreases in IU predicted improvements in clinical presentation across diagnoses. IU interacted with time to predict improvement in clinical presentation irrespective of primary diagnosis. IU also interacted with time to predict improvement in clinical presentation although interactions of time with diagnosis-specific measures did not. IUS interacted with time to predict reduction in anxiety and fear symptoms, and inhibitory IU interacted with time to predicted reductions in anxiety symptoms but prospective IU did not. IU appears to be an important transdiagnostic variable in CBT implicated in both initial presentation and treatment change. Further implications are discussed. Published by Elsevier Ltd.

  5. Anxiety and depression mediate the role of low self-esteem and low self-directedness in the development of eating disorders.

    PubMed

    Aloi, Matteo; Segura-García, Cristina

    2016-10-14

    Low self-esteem and low self-directedness (SD) are considered a risk factor for the development of eating disorders (EDs). The aim of this study was to test the hypothesis that low self-esteem and low SD lead to a higher risk for EDs through the mediation of anxiety and depression. Seventy-seven female teenagers answered the Eating Disorder Inventory 3 (EDI-3), the Intolerance of Uncertainty Scale (IUS), the Temperament and Character Inventory-Revised (TCI-R), the Rosenberg Self-Esteem Scale (RSES), and the State and Trait Anxiety Inventory (STAI), and the Symptom Checklist-90-Revised (SCL-90-R). To test the hypothesis, a structural equation model (SEM) was used. According to the EDI3-EDRC scores, 23/77 (29.9%) participants demonstrated positive results in the screening. Participants who had positive results in the screening had significantly higher scores on trait and state anxiety, depression, and IU, and lower means of self-esteem and SD. The SEM demonstrated good fit indices and all paths were significant in the predicted directions, confirming the hypothesized model. The current results confirm the role of self-esteem and SD in the development of an ED among adolescent females through the mediating action of IU, anxiety, and depression.

  6. STS-93: Crew Interview - Steve Hawley

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Live footage of a preflight interview with Mission Specialist Steven A. Hawley is presented. The interview addresses many different questions including why Hawley wanted to be an astronaut, his career path, and how this historic flight (first female Commander of a mission) draws attention from the media. Other interesting information that this one-on-one interview discusses is the deployment of the Chandra satellite, why people care about x ray energy, whether or not Chandra will compliment the other X Ray Observatories currently in operation, and his responsibilities during the major events of this mission. Hawley mentions the Inertial Upper Stage (IUS) rocket that will deployed the Chandra Telescope, and the design configuration of Chandra to gather and transfer information. The Southwest Research Ultraviolet Imaging System (SWUIS) Telescope on board Columbia, the Plant Growth Investigation in Microgravity (PGIM) and Gelation of Sols: Applied Microgravity Research (GOSAMR) experiments, and the two observatories presently in orbit (Gamma Ray Observatory, and Hubble Space Telescope) are also discussed.

  7. Satellite operations support expert system

    NASA Technical Reports Server (NTRS)

    1985-01-01

    The Satellite Operations Support Expert System is an effort to identify aspects of satellite ground support activity which could profitably be automated with artificial intelligence (AI) and to develop a feasibility demonstration for the automation of one such area. The hydrazine propulsion subsystems (HPS) of the International Sun Earth Explorer (ISEE) and the International Ultraviolet Explorer (IUS) were used as applications domains. A demonstration fault handling system was built. The system was written in Franz Lisp and is currently hosted on a VAX 11/750-11/780 family machine. The system allows the user to select which HPS (either from ISEE or IUE) is used. Then the user chooses the fault desired for the run. The demonstration system generates telemetry corresponding to the particular fault. The completely separate fault handling module then uses this telemetry to determine what and where the fault is and how to work around it. Graphics are used to depict the structure of the HPS, and the telemetry values displayed on the screen are continually updated. The capabilities of this system and its development cycle are described.

  8. Factors affecting the age-C resident fish community along shorelines of the Hanford Reach of the Columbia River

    USGS Publications Warehouse

    Gadomski, D.M.; Wagner, P.G.

    2009-01-01

    The Hanford Reach is one of the few remaining unimpounded sections of the Columbia River. However, because of flow management at upstream dams, there are often large fluctuations in water level. To determine how environmental conditions might affect age-0 resident fishes in the Hanford Reach, we evaluated species composition, distribution, abundance, and standard lengths of larval and juvenile fishes along shoreline habitats during July and August 1998, 1999, and 2000. Catches in beach seine hauls during all three years were highly variable. The four most abundant taxa collected were three cyprinids, peamouth (Mylocheilus caurinus), northern pikeminnow (Plychocheilus oregonensis), and redside shiner (Richardson ius balteatus); and suckers (Catostoinus spp.). Highest overall catches were in sloughs of the Hanford Reach in 1999, a year with high flows, lower water level fluctuations, and more vegetation. Mean shoreline summer water temperatures were higher in 1998 than in 1999 and 2000, and mean lengths of the four most abundant taxa in late August were also greater in 1998, due presumably to enhanced growth or an earlier spawning season. In spite of flow fluctuations, overall catches of age-0 resident fishes were greater in the riverine Hanford Reach compared to past catches in a more lentic Columbia River reservoir. High abundances of age-0 resident fishes in the Hanford Reach could be due to more spawning and rearing habitat in this structurally complex area, and may mitigate for negative effects of variable flow regimes.

  9. An analytic-geometric model of the effect of spherically distributed injection errors for Galileo and Ulysses spacecraft - The multi-stage problem

    NASA Technical Reports Server (NTRS)

    Longuski, James M.; Mcronald, Angus D.

    1988-01-01

    In previous work the problem of injecting the Galileo and Ulysses spacecraft from low earth orbit into their respective interplanetary trajectories has been discussed for the single stage (Centaur) vehicle. The central issue, in the event of spherically distributed injection errors, is what happens to the vehicle? The difficulties addressed in this paper involve the multi-stage problem since both Galileo and Ulysses will be utilizing the two-stage IUS system. Ulysses will also include a third stage: the PAM-S. The solution is expressed in terms of probabilities for total percentage of escape, orbit decay and reentry trajectories. Analytic solutions are found for Hill's Equations of Relative Motion (more recently called Clohessy-Wiltshire Equations) for multi-stage injections. These solutions are interpreted geometrically on the injection sphere. The analytic-geometric models compare well with numerical solutions, provide insight into the behavior of trajectories mapped on the injection sphere and simplify the numerical two-dimensional search for trajectory families.

  10. Final safety analysis report for the Galileo Mission: Volume 1, Reference design document

    SciTech Connect

    Not Available

    1988-05-01

    The Galileo mission uses nuclear power sources called Radioisotope Thermoelectric Generators (RTGs) to provide the spacecraft's primary electrical power. Because these generators contain nuclear material, a Safety Analysis Report (SAR) is required. A preliminary SAR and an updated SAR were previously issued that provided an evolving status report on the safety analysis. As a result of the Challenger accident, the launch dates for both Galileo and Ulysses missions were later rescheduled for November 1989 and October 1990, respectively. The decision was made by agreement between the DOE and the NASA to have a revised safety evaluation and report (FSAR) prepared on the basis of these revised vehicle accidents and environments. The results of this latest revised safety evaluation are presented in this document (Galileo FSAR). Volume I, this document, provides the background design information required to understand the analyses presented in Volumes II and III. It contains descriptions of the RTGs, the Galileo spacecraft, the Space Shuttle, the Inertial Upper Stage (IUS), the trajectory and flight characteristics including flight contingency modes, and the launch site. There are two appendices in Volume I which provide detailed material properties for the RTG.

  11. Materials, Processes and Manufacturing in Ares 1 Upper Stage: Integration with Systems Design and Development

    NASA Technical Reports Server (NTRS)

    Bhat, Biliyar N.

    2008-01-01

    Ares I Crew Launch Vehicle Upper Stage is designed and developed based on sound systems engineering principles. Systems Engineering starts with Concept of Operations and Mission requirements, which in turn determine the launch system architecture and its performance requirements. The Ares I-Upper Stage is designed and developed to meet these requirements. Designers depend on the support from materials, processes and manufacturing during the design, development and verification of subsystems and components. The requirements relative to reliability, safety, operability and availability are also dependent on materials availability, characterization, process maturation and vendor support. This paper discusses the roles and responsibilities of materials and manufacturing engineering during the various phases of Ares IUS development, including design and analysis, hardware development, test and verification. Emphasis is placed how materials, processes and manufacturing support is integrated over the Upper Stage Project, both horizontally and vertically. In addition, the paper describes the approach used to ensure compliance with materials, processes, and manufacturing requirements during the project cycle, with focus on hardware systems design and development.

  12. Upper stages using liquid propulsion and metallized propellants

    NASA Technical Reports Server (NTRS)

    Palaszewski, Bryan A.

    1992-01-01

    Metallized propellants are liquid propellants with a metal additive suspended in a gelled fuel. Typically, aluminum particles are the metal additive. These propellants increase the density and/or the specific impulse of the propulsion system. Using metallized propellants for volume- and mass-constrained upper stages can deliver modest increases in performance for low Earth orbit to geosynchronous Earth orbit (LEO-GEO) and other Earth-orbital transfer missions. However, using metallized propellants for planetary missions can deliver great reductions in flight time with a single-stage, upper-stage system. Tradeoff studies comparing metallized propellant stage performance with nonmetallized upper stages and the Inertial Upper Stage (IUS) are presented. These upper stages, launched from the STS and STS-C, are both one- and two-stage vehicles that provide the added energy to send payloads to high altitude orbits and onto interplanetary trajectories that are unattainable with only the Space Transportation System (STS) and the Space Transportation System-Cargo (STS-C). The stage designs are controlled by the volume and the mass constraints of the STS and STS-C launch vehicles. The influences of the density and specific impulse increases enabled by metallized propellants are examined for a variety of different stage and propellant combinations.

  13. Spacecraft environmental interactions: A joint Air Force and NASA research and technology program

    NASA Technical Reports Server (NTRS)

    Pike, C. P.; Purvis, C. K.; Hudson, W. R.

    1985-01-01

    A joint Air Force/NASA comprehensive research and technology program on spacecraft environmental interactions to develop technology to control interactions between large spacecraft systems and the charged-particle environment of space is described. This technology will support NASA/Department of Defense operations of the shuttle/IUS, shuttle/Centaur, and the force application and surveillance and detection missions, planning for transatmospheric vehicles and the NASA space station, and the AFSC military space system technology model. The program consists of combined contractual and in-house efforts aimed at understanding spacecraft environmental interaction phenomena and relating results of ground-based tests to space conditions. A concerted effort is being made to identify project-related environmental interactions of concern. The basic properties of materials are being investigated to develop or modify the materials as needed. A group simulation investigation is evaluating basic plasma interaction phenomena to provide inputs to the analytical modeling investigation. Systems performance is being evaluated by both groundbased tests and analysis.

  14. Euthanasia of companion animals: a legal and ethical analysis.

    PubMed

    Passantino, Annamaria; Fenga, Carmela; Morciano, Cristina; Morelli, Chiara; Russo, Maria; Di Pietro, Carlotta; Passantino, Michele

    2006-01-01

    In Italy, the conditions under which euthanasia of small pets is justified are only partially regulated by law n. 281/1991, article 2 n. 6 and 9, by the later Ministry Circular n. 9 made on 10/03/1992 and by law n. 189/2004. Law n. 281/1991, besides delegating the job of birth control in cat and dog populations to the regions, has made it statutory that stray dogs may only be euthanised when they are 'seriously or incurably ill or proven to be dangerous'. The Ministry Circular underlines the fact that 'euthanasia of dogs is prohibited except in special justified cases'. On the other hand, due to the legal classification of animals as property, the owner has the right of ownership over his animal so that he can sell it and kill it (ius vitae ac necis). In this view a request for euthanasia is licit, whatever the animal's state of health may be. The authors feel that further legislation to regulate the question more completely would be opportune and thus they analyse the problems of legal-ethics and public health that a veterinarian faces when carrying out euthanasia, also bearing in mind the laws and codes of professional ethics. They suggest possible solutions which could be adopted by the competent authorities.

  15. A prospective cohort study of pain with intrauterine device insertion among women with and without vaginal deliveries.

    PubMed

    Allen, R H; Carey, M S; Raker, C; Goyal, V; Matteson, K

    2014-04-01

    The purpose of this prospective cohort study was to compare pain during IUD insertion between women with a history of vaginal delivery and women without a history of vaginal delivery. First-time IUD users chose either the CuT380A or the levonorgestrel IUS. We enrolled 49 women with previous vaginal delivery and 49 women with no history of vaginal delivery (either only caesarean deliveries or nulliparous). The mean pain score on a 0-100 mm visual analog scale during insertion in the vaginal delivery group was 34.7 (SD 31.6) compared with 51.2 (SD 29.2) in the group without previous vaginal delivery (p = 0.009). In multivariable analysis controlling for age, breast-feeding, expected pain, baseline anxiety, insertion timing (6-12 weeks postpartum, 2-4 weeks post-abortion or interval), and insertion difficulty, history of vaginal delivery was associated with a 15.5 point reduction in pain (95% CI, -27.4, -3.7). Other significant predictors of pain were 'expected pain' and 'insertion difficulty'.

  16. Draft environmental impact statement for the Galileo Mission (Tier 2)

    NASA Technical Reports Server (NTRS)

    1988-01-01

    This Draft Environmental Impact Statement (DEIS) addresses the environmental impacts which may be caused by the preparation and operation of the Galileo spacecraft, including its planned launch on the Space Transportation System (STS) Shuttle and the alternative of canceling further work on the mission. The launch configuration will use the STS/Inertial Upper Stage (IUS)/Payload Assist Module-Special (PAM-S) combination. The Tier 1 EIS included a delay alternative which considered the Titan 4 launch vehicle as an alternative booster stage for launch in 1991 or later. However, the U.S. Air Force, which procures the Titan 4 for NASA, could not provide a Titan 4 vehicle for the 1991 launch opportunity because of high priority Department of Defense requirements. The only expected environmental effects of the proposed action are associated with normal Shuttle launch operations. These impacts are limited largely to the near-field at the launch pad, except for temporary stratospheric ozone effects during launch and occasional sonic boom effects near the landing site. These effects have been judged insufficient to preclude Shuttle launches. In the event of: (1) an accident during launch, or (2) reentry of the spacecraft from earth orbit, there are potential adverse health and environmental effects associated with the possible release of plutonium dioxide from the spacecraft's radioisotope thermoelectric generators (RTG).

  17. Drift-free position estimation for periodic movements using inertial units.

    PubMed

    Millor, Nora; Lecumberri, Pablo; Gomez, Marisol; Martinez-Ramirez, Alicia; Izquierdo, Mikel

    2014-07-01

    Latest advances in microelectromechanical systems have made inertial units (IUs) a powerful tool for human motion analysis. However, difficulties in handling their output signals must be overcome. The purpose of this study was to develop the novel "PB-algorithm" based on polynomial data fitting, splines interpolation, and the wavelet transform, one after the other, to cancel drift disturbances in position estimation for periodic movements. High-accuracy position measurements from an optical system (Vicon Nexus 1.0) were used to validate the proposed method and comparison with another drift-correction algorithm was provided. Results indicate the accuracy with respect to the Vicon's reference signal (euclidean error lower than 54.62 × 10(-3) m and correlation coefficient higher than 0.968). A reduction of the root-mean-square error of 68.74% was obtained when the proposed two-step method was compared with a modified-band limited Fourier linear combiner. All methods were applied to data from the 30-s chair stand test, which is one of the most used clinical tests dealing with lower body strength assessment, falls prediction, and gait disorders in older adults. The relevance of this study is that after cancelling drift disturbances, and obtaining an accurate Z-position estimation, it is possible to evaluate the sit-to-stand and stand-to-sit transitions from the whole test.

  18. Sniff and mimic - Intranasal oxytocin increases facial mimicry in a sample of men.

    PubMed

    Korb, Sebastian; Malsert, Jennifer; Strathearn, Lane; Vuilleumier, Patrik; Niedenthal, Paula

    2016-08-01

    The neuropeptide oxytocin (OT) has many potential social benefits. For example, intranasal administration of OT appears to trigger caregiving behavior and to improve the recognition of emotional facial expressions. But the mechanism for these effects is not yet clear. Recent findings relating OT to action imitation and to the visual processing of the eye region of faces point to mimicry as a mechanism through which OT improves processing of emotional expression. To test the hypothesis that increased levels of OT in the brain enhance facial mimicry, 60 healthy male participants were administered, in a double-blind between-subjects design, 24 international units (IUs) of OT or placebo (PLA) through nasal spray. Facial mimicry and emotion judgments were recorded in response to movie clips depicting changing facial expressions. As expected, facial mimicry was increased in the OT group, but effects were strongest for angry infant faces. These findings provide further evidence for the importance of OT in social cognitive skills, and suggest that facial mimicry mediates the effects of OT on improved emotion recognition.

  19. Young women's attitudes towards, and experiences of, long-acting reversible contraceptives.

    PubMed

    Bracken, Jennifer; Graham, Cynthia A

    2014-08-01

    To identify factors involved in women's decisions to choose particular contraceptive methods and more specifically, incentives and disincentives to use three long-acting reversible contraceptive (LARC) methods: injectables, implants, and intrauterine devices/systems (IUDs/IUSs). A total of 502 women aged 18 to 30 completed a cross-sectional online questionnaire. The three most important factors in choosing a contraceptive method were: high efficacy at preventing pregnancy, protection against sexually transmitted infections, and non-interference with sexual intercourse. The most common incentives for LARC use were the high efficacy and long duration of action. Disincentives included the possibility of irregular bleeding and concerns about effects on fertility; fear of needles and pain was a particular disincentive for IUD/IUS use. Only 93 (18%) of the participants reported ever having used a LARC. Reported disincentives to LARC use (e.g., concern about effects on future fertility) indicated that many young women hold inaccurate beliefs about these methods. The relatively high proportions of women who held neutral attitudes about LARCs (21-40%, depending on the method) highlight the importance of education and contraceptive counselling to improve knowledge about the advantages of these methods.

  20. Droplet Size and Liquid Water Characteristics of the USAAEFA (CH-47) Helicopter Spray System and Natural Clouds as Sampled by a JUH-1H Helicopter.

    DTIC Science & Technology

    1980-08-01

    2 AF +n7 u*rL-nl I.1521nI 5. 32. 30 *2eiuE+07 *Q’J7L,(’b *’J02L>01 *13𔃻E- P1 S. 4J3. 33 .22E#)7 *773F*Ot . a 3ft-o I . Ius[ -f0I 5.*1 3o .11IE4(𔄁...P + t .30f -n I . 13 0 F- 01 a.64. 6 0 *3 92 E + .19 bF # 5 . ail 3F-0 1 .2211-n2 5. b9. 81itt+ 3e 64#a .363E-01 8l2f -02 4. 73. 100 A* P1 4 5 . 4 3’*1...MASSG(’-1) FAASS(GM-3J-1 PERCLNI cum PjwctfNI 3 .244JE+08 .(413f*07 .IUSF-cs �F-03 0. 0, Illf +0Q .34ts *0’.950f - P1 .1501-01 s. it. t’Q4L+*0m .?Ib

  1. Intrauterine devices and intrauterine systems.

    PubMed

    2008-01-01

    From a public health viewpoint, the intrauterine device (IUD) is the most widely used contraceptive method in the world. Prevalence rates range among countries from 2 to 80% of contraceptive users. During 5 years of IUD use, pregnancy occurs in less than 2 per 100 insertions. Bleeding and pain are the most common reasons for removal rates of 10% in the first year and up to 50% within 5 years. The contraceptive effects of IUDs may be due to a sterile inflammatory reaction in the endometrial cavity which interferes with sperm function, so that fertilization is less likely to occur. IUDs also interfere with implantation but the extent to which this contributes to their contraceptive action is unknown. In nulliparous women rates of expulsion and removal for bleeding and/or pain are higher than in parous women. Effective use of IUDs for up to 10 years has the same pregnancy rate as tubal interruption. Thus, the IUD may be an alternative to female sterilization, especially in younger women who are more likely to experience regret after sterilization. The levonorgestrel intrauterine system (LNG-IUS) reduces bleeding and dysmenorrhoea, provides superior effectiveness to copper IUDs, and may be a useful treatment for endometriosis or an alternative to hysterectomy for menorrhagia.

  2. Intrauterine devices and adolescents.

    PubMed

    Gold, Melanie A; Johnson, Lisa M

    2008-10-01

    The purpose of this review is to inform the reader of new information published on intrauterine devices (IUDs) and adolescents. There are few studies on the use of IUDs in adolescents. The article reviews topics related to IUD use such as adolescents' knowledge of and attitudes toward IUDs, mechanism of action of copper-releasing and levonorgestrel-releasing IUDs, benefits of using IUDs with adolescents, safety, side effects, as well as noncontraceptive benefits such as management of menstrual disorders and endometriosis using IUDs. IUDs are a safe and effective long-term contraceptive method with no increase in risk of pelvic inflammatory disease, tubal infertility or ectopic pregnancies. IUDs are underutilized in the United States, especially by adolescents. Because adolescents contribute disproportionately to the epidemic of unintended pregnancy, IUDs should be considered as a first-line contraceptive choice regardless of parity. The levonorgestrel-releasing intrauterine system (LNG IUS) is a particularly good choice for adolescents because of associated noncontraceptive benefits such as decreased menstrual bleeding, dysmenorrhea and pain associated with endometriosis. There is a clear need for further studies in the use of the IUD among adolescents.

  3. The Intrauterine Device in Women with Diabetes Mellitus Type I and II: A Systematic Review

    PubMed Central

    Goldstuck, Norman D.; Steyn, Petrus S.

    2013-01-01

    Background. Women with diabetes mellitus type I and type II need effective contraception for personal and medical reasons. Long acting reversible contraceptive (LARC) methods are among the most efficient and cost-effective methods. Study Design. We searched the Popline, PubMed, and clinicaltrials.gov databases from 1961 to March 2013 for studies on the efficacy of the IUD in diabetic women and the possible changes it may produce in laboratory parameters. Studies of at least 30 subjects with DM1 or DM2 who were studied for 6 to 12 months depending on the method of analysis were eligible. Results. The search produced seven articles which gave event rate efficacy evaluable results and three which evaluated the effect of the IUD on laboratory parameters. One of the earlier efficacy studies showed an abnormally high pregnancy rate which sparked a controversy which is discussed in the Introduction section. The remaining 6 studies produced acceptable pregnancy rates. The three laboratory studies showed that the copper and levonorgestrel releasing IUD/IUS do not affect the diabetic state in any way. Conclusions. The copper bearing and levonorgestrel releasing IUDs are safe and effective in women with diabetes type I and diabetes type II although the evidence in the latter is limited. PMID:24396605

  4. Dollar Summary of Prime Contract Awards by Contractor, State or Country, and Place. Part 3 (E&E Reisen - Hiawatha Rubber Co)

    DTIC Science & Technology

    1990-01-01

    a I- . 0 ɜ M-4 0 I IL IL LC L 0 00.m 4 U 0 C I- U . 4 4I Iw wg 0- .L- . 0 U. U U 94 W K, - 000000 w. -i-i - .4 .2 .4 ex ac I.-a :. to ~000 a . 0w L...44 4 Mat 0 i 0 aC a =0 ’a Mc’z. a . aP M- oC .4 - . 4c c s 0 a 3 a ~ o Ma > L 4 0 C* -- 2002 a a 0 & 1 94 - c - 4- a01 aA-C 14000m c 0 A - a 0 w . 0...Cc -Cli. c c GO I Ius . I. 0II.WW LAAWL0 0 C 94 - LWWWW4Cwa.. 0 L 01 Lw L& I w U.~ U.wU0wwww .U wU U . w4~4 wlE-O 1. L . - C w a .wwwww -U .w . U L

  5. Final Environmental Impact Statement for the Galileo Mission (Tier 2)

    NASA Technical Reports Server (NTRS)

    1989-01-01

    This Final Environmental Impact Statement (FEIS) addresses the proposed action of completing the preparation and operation of the Galileo spacecraft, including its planned launch on the Space Transportation System (STS) Shuttle in October 1989, and the alternative of canceling further work on the mission. The Tier 1 (program level) EIS (NASA 1988a) considered the Titan IV launch vehicle as an alternative booster stage for launch in May 1991 or later. The May 1991 Venus launch opportunity is considered a planetary back-up for the Magellan (Venus Radar Mapper) mission, the Galileo mission, and the Ulysses mission. Plans were underway to enable the use of a Titan IV launch vehicle for the planetary back-up. However, in November 1988, the U.S. Air Force, which procures the Titan IV for NASA, notified NASA that it could not provide a Titan IV vehicle for the May 1991 launch opportunity due to high priority Department of Defense requirements. Consequently, NASA terminated all mission planning for the Titan IV planetary back-up. A minimum of 3 years is required to implement mission-specific modifications to the basic Titan IV launch configuration; therefore, insufficient time is available to use a Titan IV vehicle in May 1991. Thus, the Titan IV launch vehicle is no longer a feasible alternative to the STS/Inertial Upper Stage (IUS) for the May 1991 launch opportunity.

  6. STS-41 Space Shuttle mission report

    NASA Technical Reports Server (NTRS)

    Camp, David W.; Germany, D. M.; Nicholson, Leonard S.

    1990-01-01

    The STS-41 Space Shuttle Program Mission Report contains a summary of the vehicle subsystem activities on this thirty-sixth flight of the Space Shuttle and the eleventh flight of the Orbiter vehicle, Discovery (OV-103). In addition to the Discovery vehicle, the flight vehicle consisted of an External Tank (ET) (designated as ET-39/LWT-32), three Space Shuttle main engines (SSME's) (serial numbers 2011, 2031, and 2107), and two Solid Rocket Boosters (SRB's), designated as BI-040. The primary objective of the STS-41 mission was to successfully deploy the Ulysses/inertial upper stage (IUS)/payload assist module (PAM-S) spacecraft. The secondary objectives were to perform all operations necessary to support the requirements of the Shuttle Backscatter Ultraviolet (SSBUV) Spectrometer, Solid Surface Combustion Experiment (SSCE), Space Life Sciences Training Program Chromosome and Plant Cell Division in Space (CHROMEX), Voice Command System (VCS), Physiological Systems Experiment (PSE), Radiation Monitoring Experiment - 3 (RME-3), Investigations into Polymer Membrane Processing (IPMP), Air Force Maui Optical Calibration Test (AMOS), and Intelsat Solar Array Coupon (ISAC) payloads. The sequence of events for this mission is shown in tabular form. Summarized are the significant problems that occurred in the Orbiter subsystems during the mission. The official problem tracking list is presented. In addition, each Orbiter problem is cited in the subsystem discussion.

  7. Astronaut Story Musgrave during STS-6 EVA

    NASA Image and Video Library

    1983-04-07

    STS006-45-124 (7 April 1983) --- Astronaut F. Story Musgrave, STS-6 mission specialist, translates down the Earth-orbiting space shuttle Challenger’s payload bay door hinge line with a bag of latch tools. This photograph is among the first five still frames that recorded the April 7 extravehicular activity (EVA) of Dr. Musgrave and Donald H. Peterson, the flight’s other mission specialist. It was photographed with a handheld 70mm camera from inside the cabin by one of two crew members who remained on the flight deck during the EVA. Dr. Musgrave’s task here was to evaluate the techniques required to move along the payload bay’s edge with tools. In the lower left foreground are three canisters containing three getaway special (GAS) experiments. Part of the starboard wind and orbital maneuvering system (OMS) pod are seen back dropped against the blackness of space. The gold-foil protected object partially out of frame on the right is the airborne support equipment for the now vacated inertial upper stage (IUS) which aided the deployment of the tracking and data relay satellite on the flight’s first day. Astronauts Paul J. Weitz, command and Karol J. Bobko, pilot, remained inside the Challenger during the EVA. Photo credit: NASA

  8. The combined GnRH-agonist and intrauterine levonorgestrel-releasing system treatment of complicated atypical hyperplasia and endometrial cancer: a pilot study.

    PubMed

    Pashov, Alexandr I; Tskhay, Vitaly B; Ionouchene, Svetlana V

    2012-07-01

    In this article, we present the results of organ-preserving treatment applied in 24 patients of reproductive age with atypical endometrial hyperplasia or early-stage endometrial cancer. All of them would like to preserve their reproductive potential. Thirteen women with atypical endometrial hyperplasia were treated with the combination of six intramuscular injections of 3.75 mg gonadotropin-releasing hormone agonist (GnRHa)--leuproreline acetate depot every 4 weeks. After the third injection of 3.75 mg of leuproreline acetate, the levonorgestrel intrauterine hormonal system containing 52 mg levonorgestrel (Mirena®, Bayer, Germany) was inserted for at least 6 months. In 11 women with stage IA well-differentiated endometrial adenocarcinoma, hormonal therapy included nine intramuscular injections of 3.75 mg of GnRHa every 4 weeks. After the third injection of 3.75 mg of GnRHa, we also inserted a GnRH-IUS (Mirena®) for at least 12 months. This type of therapy was effective for all these patients and may be offered to be used as an alternative to surgery in women with atypical endometrial hyperplasia or early stage 1A well-differentiated endometrial cancer in women of reproductive age. Three women with endometrial cancer became pregnant and two of them delivered at term and one has an ongoing pregnancy.

  9. STS-93: Crew Interview - Steve Hawley

    NASA Technical Reports Server (NTRS)

    1999-01-01

    Live footage of a preflight interview with Mission Specialist Steven A. Hawley is presented. The interview addresses many different questions including why Hawley wanted to be an astronaut, his career path, and how this historic flight (first female Commander of a mission) draws attention from the media. Other interesting information that this one-on-one interview discusses is the deployment of the Chandra satellite, why people care about x ray energy, whether or not Chandra will compliment the other X Ray Observatories currently in operation, and his responsibilities during the major events of this mission. Hawley mentions the Inertial Upper Stage (IUS) rocket that will deployed the Chandra Telescope, and the design configuration of Chandra to gather and transfer information. The Southwest Research Ultraviolet Imaging System (SWUIS) Telescope on board Columbia, the Plant Growth Investigation in Microgravity (PGIM) and Gelation of Sols: Applied Microgravity Research (GOSAMR) experiments, and the two observatories presently in orbit (Gamma Ray Observatory, and Hubble Space Telescope) are also discussed.

  10. The past and present role of the Sabin-Feldman dye test in the serodiagnosis of toxoplasmosis.

    PubMed Central

    Reiter-Owona, I.; Petersen, E.; Joynson, D.; Aspöck, H.; Dardé, M. L.; Disko, R.; Dreazen, O.; Dumon, H.; Grillo, R.; Gross, U.; Hayde, M.; Holliman, R.; Ho-Yen, D. O.; Janitschke, K.; Jenum, P. A.; Naser, K.; Olszewski, M.; Thulliez, P.; Seitz, H. M.

    1999-01-01

    The dye test for the detection of Toxoplasma-specific antibodies was first described by Sabin and Feldman 50 years ago. The test is highly specific and sensitive and considerable information is available on the development and persistence of dye test antibodies after primary Toxoplasma infection. However, the test uses live Toxoplasma gondii and is now only employed in a few laboratories. It is still the reference method for the serodiagnosis of toxoplasmosis, and a multicentre study comparing dye test results between different laboratories was much needed. We report in this article the results of a multicentre evaluation of the test involving nineteen laboratories in eight countries. The study revealed overall satisfactory standardization between the laboratories, but there were differences in the test protocols, the use of reference/standard preparations and the interpretation of results. There is still no agreement on the level of dye test values which reflect infection with the parasite, and conversion from titres to international units (IUs) did not improve standardization. However, the results indicated that a value of > 4 IU or a titre of 1:16 met the definition of positivity of most participants. We recommend that the dye test be retained as a reference method and that interlaboratory standardization be improved by the use of a common protocol and the expression of results in titres. PMID:10612889

  11. STS-44 Space Shuttle mission report

    NASA Technical Reports Server (NTRS)

    Fricke, Robert W.

    1992-01-01

    The STS-44 Space Shuttle Program Mission Report is a summary of the vehicle subsystem operations during the forty-fourth flight of the Space Shuttle Program and the tenth flight of the Orbiter vehicle Atlantis (OV-104). In addition to the Atlantis vehicle, the flight vehicle consisted of the following: an External Tank (ET) designated as ET-53 (LWT-46); three Space Shuttle main engines (SSME's) (serial numbers 2015, 2030, and 2029 in positions 1, 2, and 3, respectively); and two Solid Rocket Boosters (SRB's) designated as BI-047. The lightweight redesigned Solid Rocket Motors (RSRM's) installed in each one of the SRB's were designated as 360L019A for the left SRB and 360W019B for the right SRB. The primary objective of the STS-44 mission was to successfully deploy the Department of Defense (DOD) Defense Support Program (DSP) satellite/inertial upper stage (IUS) into a 195 nmi. earth orbit at an inclination of 28.45 deg. Secondary objectives of this flight were to perform all operations necessary to support the requirements of the following: Terra Scout, Military Man in Space (M88-1), Air Force Maui Optical System Calibration Test (AMOS), Cosmic Radiation Effects and Activation Monitor (CREAM), Shuttle Activation Monitor (SAM), Radiation Monitoring Equipment-3 (RME-3), Visual Function Tester-1 (VFT-1), and the Interim Operational Contamination Monitor (IOCM) secondary payloads/experiments.

  12. Synthesis and characterization of covalently bound benzocaine graphite oxide derivative

    NASA Astrophysics Data System (ADS)

    Kabbani, Ahmad; Kabbani, Mohamad; Safadi, Khadija

    2015-09-01

    Graphite oxide (GO) derived materials include chemically functionalize or reduced graphene oxide (exfoliated from GO) sheets, assembled paper-like forms , and graphene-based composites GO consists of intact graphitic regions interspersed with sp3-hybridized carbons containing hydroxyl and epoxide functional groups on the top and bottom surfaces of each sheet and sp2-hybridized carbons containing carboxyl and carbonyl groups mostly at the sheet edges. Hence, GO is hydrophilic and readily disperses in water to form stable colloidal suspensions Due to the attached oxygen functional groups, GO was used to prepare different derivatives which result in some physical and chemical properties that are dramatically different from their bulk counterparts .The present work discusses the covalent cross linking of graphite oxide to benzocaine or ethyl ester of para-aminobenzoic acid,structure I,used in many over-the-counter ointment drug.Synthesis is done via diazotization of the amino group.The product is characterized via IR,Raman, X-ray photoelectron spectroscopy as well as electron microscopy.

  13. Modeling of Landslides in Valles Marineris, Mars, and Implications for Initiation Mechanism

    NASA Astrophysics Data System (ADS)

    Tsige, Meaza; Ruiz, Javier; del Río, Ian A.; Jiménez-Díaz, Alberto

    2016-06-01

    The Valles Marineris canyon system in Mars shows large landslides across its walls, which can be 40 km wide and up to 60 km long, with fall scarps height as high as 7 km. These landslides were produced through a large mass movement at high speed by gravity across the trough floor. Although the triggering factors are unclear, several mechanisms have been proposed as, among others, large amounts of subsurface water, quake produced through normal faulting close to the canyon walls, and meteoritic impacts. In this work we examine the limit equilibrium slope stability of three landslides (placed respectively at Ius, Candor, and Melas Chasmata), which can be considered representative, with the aims of constraining their formation conditions. Our results suggest that external factors (as high pore fluid pressure, seismic loading or rock mass disturbance) do not seem necessary for the failure of slopes if they are composed of unconsolidated materials, while high pore water pressure or ground acceleration are needed to trigger slides in slopes composed of strong basaltic-like materials. Moreover, the presence of sub-surface ice would contribute to slope stability. As a whole, our findings point to ground shaking due to meteorite impacts as the main triggering force for most landslides in the Valles Marineris.

  14. Shuttle Atlantis Returning to Kennedy Space Center after 10-Month Refurbishment

    NASA Technical Reports Server (NTRS)

    1998-01-01

    launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  15. STS-35 Leaves Dryden on 747 Shuttle Carrier Aircraft (SCA) Bound for Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    1990-01-01

    scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  16. Shuttle Atlantis Returning to Kennedy Space Center after 10 Month Refurbishment

    NASA Technical Reports Server (NTRS)

    1998-01-01

    fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  17. Shuttle Discovery Being Unloaded from SCA-747 at Palmdale, California, Maintenance Facility

    NASA Technical Reports Server (NTRS)

    1995-01-01

    facilities for several specialists to conduct experiments in such fields as medicine, astronomy, and materials manufacturing. Some types of satellites deployed by Space Shuttles include those involved in environmental and resources protection, astronomy, weather forecasting, navigation, oceanographic studies, and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden

  18. Shuttle Atlantis Returning to Kennedy Space Center after 10 Month Refurbishment

    NASA Technical Reports Server (NTRS)

    1998-01-01

    , and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  19. Shuttle Atlantis in Mate-Demate Device Being Loaded onto SCA-747 for Return to Kennedy Space Center

    NASA Technical Reports Server (NTRS)

    1996-01-01

    . The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  20. Shuttle Atlantis Returning to Kennedy Space Center after 10-Month Refurbishment

    NASA Technical Reports Server (NTRS)

    1998-01-01

    , and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  1. Economic and epidemiological modelling of full-length antihaemophilic factor (recombinant), plasma/albumin-free method, in previously treated patients with haemophilia A : comparison with B-domain deleted rFVIII, and value of potential viral transmission reduction due to plasma/albumin-free status.

    PubMed

    Sclar, David A; Evans, Marc A; Skaer, Tracy L; Robison, Linda M; Chung, Karen C; Poulios, Nick S

    2005-01-01

    To the extent that current recombinant clotting factor concentrates contain even trace amounts of human or animal protein, there is continuing potential for transmission of nonenveloped viruses, including hepatitis A, and parvovirus, and the theoretical potential for transmission of relatively unknown agents, such as prions (Creutzfeldt-Jakob disease, or its variant). Full-length antihaemophilic factor (recombinant), plasma/albumin-free method (rAHF-PFM; Advate), represents a novel pharmacotherapeutic option for the management of haemophilia A. This investigation was designed to discern: (i) the efficacy-based use pattern (International Units [IUs]) of rAHF-PFM versus B-domain deleted rFVIII (BDDrFVIII; ReFacto) required to resolve a bleeding episode (event) among previously treated patients with haemophilia A employing on-demand treatment; (ii) the health service expenditure pattern (percentage differential; payor's perspective) associated with use of rAHF-PFM versus BDDrFVIII among previously treated patients with haemophilia A employing on-demand treatment; and (iii) the fiscal utility attributable to the plasma/albumin-free status of rAHF-PFM under the assumed emergence of a novel and infectious blood (plasma)-borne virus. Data stemming from phase II/phase III clinical trials of rAHF-PFM, together with published literature on BDDrFVIII, afforded calculation of the probability of occurrence for specific endpoints of interest (e.g. non-response to first infusion). Monte Carlo simulation, a decision-analytical framework parameterised with stochastic (random) and deterministic (fixed) components (10 000 iterations per month [or year] of age examined [3, 6, 9 months; years 1 through 19; and years 20, 30, 40, 50, 60, 70 and 80]) was used to compare: (i) the efficacy-based use pattern by treatment option; and (ii) the health service utilisation-based expenditure pattern by treatment option, accounting for the need for subsequent infusion(s), and potential

  2. Shuttle Enterprise Mated to 747 SCA for Delivery to Smithsonian

    NASA Technical Reports Server (NTRS)

    1983-01-01

    Spacelab, provide facilities for several specialists to conduct experiments in such fields as medicine, astronomy, and materials manufacturing. Some types of satellites deployed by Space Shuttles include those involved in environmental and resources protection, astronomy, weather forecasting, navigation, oceanographic studies, and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary

  3. Shuttle Columbia Post-landing Tow - with Reflection in Water

    NASA Technical Reports Server (NTRS)

    1982-01-01

    manufacturing. Some types of satellites deployed by Space Shuttles include those involved in environmental and resources protection, astronomy, weather forecasting, navigation, oceanographic studies, and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. MartinMarietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site with Dryden remaining as the principal alternate landing site.

  4. STS-68 747 SCA Ferry Flight Takeoff for Delivery to Kennedy Space Center, Florida

    NASA Technical Reports Server (NTRS)

    1994-01-01

    , provide facilities for several specialists to conduct experiments in such fields as medicine, astronomy, and materials manufacturing. Some types of satellites deployed by Space Shuttles include those involved in environmental and resources protection, astronomy, weather forecasting, navigation, oceanographic studies, and other scientific fields. The Space Shuttles can also launch spacecraft into orbits higher than the Shuttle's altitude limit through the use of Inertial Upper Stage (IUS) propulsion units. After release from the Space Shuttle payload bay, the IUS is ignited to carry the spacecraft into deep space. The Space Shuttles are also being used to carry elements of the International Space Station into space where they are assembled in orbit. The Space Shuttles were built by Rockwell International's Space Transportation Systems Division, Downey, California. Rockwell's Rocketdyne Division (now part of Boeing) builds the three main engines, and Thiokol, Brigham City, Utah, makes the solid rocket booster motors. Martin Marietta Corporation (now Lockheed Martin), New Orleans, Louisiana, makes the external tanks. Each orbiter (Space Shuttle) is 121 feet long, has a wingspan of 78 feet, and a height of 57 feet. The Space Shuttle is approximately the size of a DC-9 commercial airliner and can carry a payload of 65,000 pounds into orbit. The payload bay is 60 feet long and 15 feet in diameter. Each main engine is capable of producing a sea level thrust of 375,000 pounds and a vacuum (orbital) thrust of 470,000 pounds. The engines burn a mixture of liquid oxygen and liquid hydrogen. In orbit, the Space Shuttles circle the earth at a speed of 17,500 miles per hour with each orbit taking about 90 minutes. A Space Shuttle crew sees a sunrise or sunset every 45 minutes. When Space Shuttle flights began in April 1981, Dryden Flight Research Center, Edwards, California, was the primary landing site for the Shuttles. Now Kennedy Space Center, Florida, is the primary landing site

  5. NOTCH signalinio kelio ir ginekologinių piktybinių navikų sąsaja

    PubMed Central

    Lachej, Nadežda; Dabkevičienė, Daiva; Sasnauskienė, Aušra; Trimonytė, Rūta Marija; Kanopienė, Daiva; Kazbarienė, Birutė; Didžiapetrienė, Janina

    2017-01-01

    Įvadas. Organizmo ląstelėse vykstančius procesus kontroliuoja įvairūs signaliniai keliai. Vienas iš jų yra NOTCH signalinis kelias. Nustatyta, kad dalinis NOTCH funkcijos praradimas arba nenormalus NOTCH signalo aktyvinimas susijęs su įvairiais žmogaus vystymosi sutrikimais ir ligomis. Medžiaga ir metodika. Pagrindinis informacijos šaltinis ieškant duomenų – PubMed duomenų bazė. Rezultatai. Straipsnyje nagrinėjama onkologinių ligų bei NOTCH signalinio kelio dalyvių sąsaja. NOTCH signalas, vystantis vėžiui, gali veikti dvejopai: kaip onkogenas ir kaip naviko augimo slopiklis. Tikslus tokio poveikio mechanizmas dar nėra žinomas. NOTCH signalinio kelio tyrimai svarbūs siekiant atrasti naujus vėžio gydymo būdus, farmakologiniais ir genetiniais metodais valdant NOTCH signalinį kelią. Šioje apžvalgoje daugiausia dėmesio skiriama ginekologiniams piktybiniams navikams, ypač gimdos kūno vėžiui. Išvados. Pastarųjų metų mokslinių tyrimų duomenys rodo, kad NOTCH signalinis kelias yra neabejotinai svarbus formuojantis gimdos kūno vėžiui, todėl jo komponentai gali būti potencialūs prognoziniai biožymenys ir molekuliniai terapiniai taikiniai. Siekiant patikslinti NOTCH signalinio kelio dalyvių reikšmę bei jų sąveiką su kitų signalinių kelių dalyviais, kurie taip pat gali būti svarbūs formuojantis ir progresuojant gimdos kūno vėžiui, reikalingi tolesni šios srities moksliniai tyrimai. PMID:28630591

  6. Intranasal anti-rabies DNA immunization promotes a Th1-related cytokine stimulation associated with plasmid survival time.

    PubMed

    Feria-Romero, Iris Angélica; Chávez-Rueda, Karina; Orozco-Suárez, Sandra; Blanco-Favela, Francisco; Calzada-Bermejo, Fernando; Chávez-Sánchez, Luis; Manuel-Apolinar, Leticia; Hernández-González, Rafael; Aguilar-Setién, Alvaro; Tesoro-Cruz, Emiliano

    2011-10-01

    DNA vaccination has a great potential to decrease infectious diseases worldwide, such as rabies. Here we showed the effects of a single anti-rabies DNA vaccination applied intranasally (IN) on plasmid survival time, neutralizing antibody (NA) titers, G-protein expression and Th1/Th2-related cytokines. Only one 50-μg dose of an anti-rabies DNA vaccine was IN administered to 160 Balb/c mice. Twenty mice were used for the neutralizing antibody study, 35 for the proliferation assay, 35 for Th1/Th2-related cytokines, 35 for glycoprotein expression by immunocytochemistry, and 35 for pGQH detection and G-protein mRNA expression. Th1-type related cytokines from spleen cells (IFN-γ, TNF-α, and IL-2) were detected. Rabies NA titers were ≥0.6 IUs from day 30 onward in the IN DNA-vaccinated group. The plasmid was identified in brains and lungs from days 3-15. The mRNA transcript was amplified in brains and lungs from days 3-30, and G-protein expression was observed in spleens, brains and lungs on days 3, 8, and 15. In all cases, a gradual decrease was observed on days 30 and 45 and absent on day 60. We found that Th1-type related cytokines (IL-2, IFN-γ, and TNF-α) were stimulated during the first month after DNA vaccination, correlating with the proliferation assays. Also, it was associated with the plasmid survival time remaining in lungs and brains prior to its degradation. Copyright © 2011 IMSS. All rights reserved.

  7. Bemfola(®) fixed dose pens potentially reduce drug wastage and associated costs of infertility treatment.

    PubMed

    Foxon, Graham; Mitchell, Paul; Turner, Nikki; McConnell, Anne; Kendrew, Helen; Jenkins, Julian

    2017-05-26

    Bemfola(®) is a recombinant follicle-stimulating hormone (FSH) used during infertility treatment. One main differentiator between FSH products is their delivery device; consisting of multi-dose pens (Gonal-f(®)), vials or multi-dose preparations (Menopur(®)), or adjustable daily disposable dose pens (Bemfola(®)). To determine the potential impact of delivery device on drug wastage during infertility treatment this study retrospectively analysed Gonal-f(®) and Menopur(®) prescription and usage data from five UK clinics. Incurred drug wastage was then compared to potential Bemfola(®) drug wastage. Data collected included: (i) number of treatment cycles; (ii) daily FSH dose; (iii) length of treatment; (iv) dose adjustment following ultrasound scan; (v) FSH formulation(s) prescribed and (vi) agonist/antagonist protocol used. Treatment with Gonal-f(®) (4078 cycles) and Menopur(®) (646 cycles) resulted in an average drug wastage of 160 and 294 IU per treatment cycle. Use of Bemfola(®) instead of Gonal-f(®) and Menopur(®) may reduce the wastage to 104 and 61 IU per cycle, respectively. The use of Bemfola(®), across all 4724 cycles, could result in a drug wastage reduction of up to 376,800 IUs with an associated cost saving of £100,011. Bemfola(®) is a viable alternative to Gonal-f(®) and Menopur(®) with its drug delivery system potentially reducing drug wastage and associated costs during infertility treatment.

  8. One million cubic kilometers of fossil ice in Valles Marineris: Relicts of a 3.5 Gy old glacial landsystem along the Martian equator

    NASA Astrophysics Data System (ADS)

    Gourronc, Marine; Bourgeois, Olivier; Mège, Daniel; Pochat, Stéphane; Bultel, Benjamin; Massé, Marion; Le Deit, Laetitia; Le Mouélic, Stéphane; Mercier, Denis

    2014-01-01

    Self-consistent landform assemblages suggest that Valles Marineris, the giant valley system that stretches along the Martian equator, was entirely glaciated during Late Noachian to Early Hesperian times and still contains huge volumes of fossil ice. Some of these glacial landform assemblages are illustrated here, with representative examples selected in three regions: Ius Chasma, Central Candor Chasma and the junction between Coprates Chasma and Capri Chasma. A morphological boundary separating an upper spur-and-gully morphology from a smooth basal escarpment has been spectacularly preserved along valley walls throughout Valles Marineris. The boundary winds around topographic obstacles and displays long-wavelength variations in elevation. It is associated with lateral benches, hanging valleys and truncated spurs. Comparisons with terrestrial analogs indicate that it is most reasonably interpreted as a glacial trimline. Chasma floors are covered by various kinds of terrains, including hummocky terrains, platy terrains, lateral banks, layered benches and a draping mantle. Landforms in these terrains and their spatial relationship with the interpreted trimline suggest that they correspond to various disintegration stages of an ancient glacial fill, currently protected by a superficial cover of ablation till. Altogether, these landforms and terrains compose a full glacial landsystem with wet-based glaciers that were able to flow and slide over their beds. It was most probably fed by ice accumulating at low elevations directly from the atmosphere onto valley floors and walls, with only minor contributions from tributary glaciers flowing down from higher elevations. Similar fossil glacial landsystems dating back from the early Martian history are to be expected in many other low-latitude troughs such as chasmata, chaos, valleys, impact craters and other basins.

  9. Enabling Field Experiences in Introductory Geoscience Classes through the Use of Immersive Virtual Reality

    NASA Astrophysics Data System (ADS)

    Moysey, S. M.; Smith, E.; Sellers, V.; Wyant, P.; Boyer, D. M.; Mobley, C.; Brame, S.

    2015-12-01

    Although field experiences are an important aspect of geoscience education, the opportunity to provide physical world experiences to large groups of introductory students is often limited by access, logistical, and financial constraints. Our project (NSF IUSE 1504619) is investigating the use of immersive virtual reality (VR) technologies as a surrogate for real field experiences in introductory geosciences classes. We are developing a toolbox that leverages innovations in the field of VR, including the Oculus Rift and Google Cardboard, to enable every student in an introductory geology classroom the opportunity to have a first-person virtual field experience in the Grand Canyon. We have opted to structure our VR experience as an interactive game where students must explore the Canyon to accomplish a series of tasks designed to emphasize key aspects of geoscience learning. So far we have produced two demo products for the virtual field trip. The first is a standalone "Rock Box" app developed for the iPhone, which allows students to select different rock samples, examine them in 3D, and obtain basic information about the properties of each sample. The app can act as a supplement to the traditional rock box used in physical geology labs. The second product is a fully functioning VR environment for the Grand Canyon developed using satellite-based topographic and imagery data to retain real geologic features within the experience. Players can freely navigate to explore anywhere they desire within the Canyon, but are guided to points of interest where they are able to complete exercises that will be aligned with specific learning goals. To this point we have integrated elements of the "Rock Box" app within the VR environment, allowing players to examine 3D details of rock samples they encounter within the Grand Canyon. We plan to provide demos of both products and obtain user feedback during our presentation.

  10. STS-70 Space Shuttle Mission Report - September 1995

    NASA Technical Reports Server (NTRS)

    Fricke, Robert W., Jr.

    1995-01-01

    The STS-70 Space Shuttle Program Mission Report summarizes the Payload activities as well as the Orbiter, External Tank (ET), Solid Rocket Booster (SRB), Reusable Solid Rocket Motor (RSRM), and the Space Shuttle main engine (SSME) systems performance during the seventieth flight of the Space Shuttle Program, the forty-fifth flight since the return-to-flight, and the twenty-first flight of the Orbiter Discovery (OV-103). In addition to the Orbiter, the flight vehicle consisted of an ET that was designated ET-71; three SSMEs that were designated as serial numbers 2036, 2019, and 2017 in positions 1, 2, and 3, respectively; and two SRBs that were designated 81-073. The RSRMs, designated RSRM-44, were installed in each SRB and were designated as 36OL044A for the left SRB, and 36OL044B for the right SRB. The primary objective of this flight was to deploy the Tracking and Data Relay Satellite-G/Inertial Upper Stage (TDRS-G/IUS). The secondary objectives were to fulfill the requirements of the Physiological and Anatomical Rodent Experiment/National Institutes of Health-Rodents (PARE/NIH-R); Bioreactor Demonstration System (BDS); Commercial Protein Crystal Growth (CPCG) experiment; Space Tissue Loss/National Institutes of Health - Cells (STL/NIH-C) experiment; Biological Research in Canisters (BRIC) experiment; Shuttle Amateur Radio Experiment-2 (SAREX-2); Visual Function Tester-4 (VFT-4); Hand-Held, Earth-Oriented, Real-Time, Cooperative, User-Friendly Location-Targeting and Environmental System (HERCULES); Microencapsulation in Space-B (MIS-B) experiment; Window Experiment (WINDEX); Radiation Monitoring Equipment-3 (RME-3); and the Military Applications of Ship Tracks (MAST) payload.

  11. High Estradiol Concentrations Induce Heat Shock Protein 70 Expression and Suppress Nuclear Factor Kappa B Activation in Human Endometrial Epithelial Cells.

    PubMed

    Chen, Chin-Der; Chen, Shee-Uan; Chou, Chia-Hung; Chen, Mei-Jou; Wen, Wen-Fen; Wu, Szu-Yuan; Yang, Yu-Shih; Yang, Jehn-Hsiahn

    2016-09-07

    The high serum estradiol (E2) concentrations induced during in vitro fertilization are detrimental to endometrial receptivity and may result in lower embryo implantation rates. We have previously found that high E2 concentrations inhibit the activation of nuclear factor kappa B (NF-kappa B), which led to endometrial epithelial cells (EECs) apoptosis. The objective of this study is to investigate the signaling pathways through which high E2 results in NF-kappa B downregulation in EECs. Isolated human EECs were cultured in different concentrations of E2 (10(-10), 10(-9), 10(-8), 10(-7) M). The expression of heat shock protein 70 (Hsp70) and heat shock factor 1 (HSF-1) were upregulated under supraphysiological E2 (10(-7) M) concentration, whereas phosphorylated inhibitory kappa B-alpha (pI kappa B-alpha) and NF-kappa B p65 subunits were downregulated. Immunohistochemistry of C57BL/6 mouse EECs, that were exposed in vivo to high serum E2 from the administration of 20 IUs of equine chorionic gonadotropin, also demonstrated the same increase in HSF-1 and Hsp70 expression, and decrease in NF-kappa B. Immunoprecipitation of the induced Hsp70 proteins was achieved with the addition of inhibitory kappa B kinase gamma (IKK-gamma) antibodies, and elimination of this reaction occurred after addition of hsp70 siRNA. In conclusion, high E2 concentrations enhance HSF-1 and Hsp70 expression in EECs. The induced Hsp70 forms a complex with IKK-gamma and inhibits pI kappa B-alpha, which consequently suppresses NF-kappa B activation.

  12. A Geoscience Workforce Model for Non-Geoscience and Non-Traditional STEM Students

    NASA Astrophysics Data System (ADS)

    Liou-Mark, J.; Blake, R.; Norouzi, H.; Vladutescu, D. V.; Yuen-Lau, L.

    2016-12-01

    The Summit on the Future of Geoscience Undergraduate Education has recently identified key professional skills, competencies, and conceptual understanding necessary in the development of undergraduate geoscience students (American Geosciences Institute, 2015). Through a comprehensive study involving a diverse range of the geoscience academic and employer community, the following professional scientist skills were rated highly important: 1) critical thinking/problem solving skills; 2) effective communication; 3) ability to access and integrate information; 4) strong quantitative skills; and 5) ability to work in interdisciplinary/cross cultural teams. Based on the findings of the study above, the New York City College of Technology (City Tech) has created a one-year intensive training program that focusses on the development of technical and non-technical geoscience skills for non-geoscience, non-traditional STEM students. Although City Tech does not offer geoscience degrees, the primary goal of the program is to create an unconventional pathway for under-represented minority STEM students to enter, participate, and compete in the geoscience workforce. The selected cohort of STEM students engage in year-round activities that include a geoscience course, enrichment training workshops, networking sessions, leadership development, research experiences, and summer internships at federal, local, and private geoscience facilities. These carefully designed programmatic elements provide both the geoscience knowledge and the non-technical professional skills that are essential for the geoscience workforce. Moreover, by executing this alternate, robust geoscience workforce model that attracts and prepares underrepresented minorities for geoscience careers, this unique pathway opens another corridor that helps to ameliorate the dire plight of the geoscience workforce shortage. This project is supported by NSF IUSE GEOPATH Grant # 1540721.

  13. Integrated Surveys of Neglected Tropical Diseases in Southern Sudan: How Much Do They Cost and Can They Be Refined?

    PubMed Central

    Kolaczinski, Jan H.; Hanson, Kara; Robinson, Emily; Picon, Diana; Sabasio, Anthony; Mpakateni, Martin; Lado, Mounir; Moore, Stephen; Petty, Nora; Brooker, Simon

    2010-01-01

    Background Increasing emphasis on integrated control of neglected tropical diseases (NTDs) requires identification of co-endemic areas. Integrated surveys for lymphatic filariasis (LF), schistosomiasis and soil-transmitted helminth (STH) infection have been recommended for this purpose. Integrated survey designs inevitably involve balancing the costs of surveys against accuracy of classifying areas for treatment, so-called implementation units (IUs). This requires an understanding of the main cost drivers and of how operating procedures may affect both cost and accuracy of surveys. Here we report a detailed cost analysis of the first round of integrated NTD surveys in Southern Sudan. Methods and Findings Financial and economic costs were estimated from financial expenditure records and interviews with survey staff using an ingredients approach. The main outcome was cost per IU surveyed. Uncertain variables were subjected to univariate sensitivity analysis and the effects of modifying standard operating procedures were explored. The average economic cost per IU surveyed was USD 40,206 or USD 9,573, depending on the size of the IU. The major cost drivers were two key categories of recurrent costs: i) survey consumables, and ii) personnel. Conclusion The cost of integrated surveys in Southern Sudan could be reduced by surveying larger administrative areas for LF. If this approach was taken, the estimated economic cost of completing LF, schistosomiasis and STH mapping in Southern Sudan would amount to USD 1.6 million. The methodological detail and costing template provided here could be used to generate cost estimates in other settings and readily compare these to the present study, and may help budget for integrated and single NTDs surveys elsewhere. PMID:20644619

  14. Alternative routes to the leader male role in a multi-level society: follower vs. solitary male strategies and outcomes in hamadryas baboons.

    PubMed

    Pines, Mathew; Saunders, Julian; Swedell, Larissa

    2011-07-01

    The nested one-male units (OMUs) of the hamadryas baboon are part of a complex social system in which "leader" males achieve near exclusive mating access by forcibly herding females into permanent consortships. Within this multi-level social system (troops, bands, clans and OMUs) are two types of prereproductive males--the follower and solitary male--whose different trajectories converge on the leader role. Here we compare OMU formation strategies of followers, who associate with a particular OMU and may have social access to females, with those of solitary males, who move freely within the band and do not associate regularly with OMUs. Data were derived from 42 OMU formations (16 by followers and 26 by solitary males) occurring over 8 years in a hamadryas baboon band at the Filoha site in Ethiopia. "Initial units" (IUs) with sexually immature females (IU strategy) were formed by 44% of followers and 46% of solitary males. The remaining followers took over mature females when their leader was deposed (challenge strategy) or disappeared (opportunistic strategy), or via a seemingly peaceful transfer (inheritance strategy). Solitary males took over mature females from other clans and bands, but mainly from old, injured or vanished leaders within their clan (via both the challenge and opportunistic strategies). Former followers of an OMU were more successful at taking over females from those OMUs than any other category of male. Despite this advantage enjoyed by ex-follower leaders, ex-solitary leaders were equally capable of increasing their OMU size at a comparable rate in their first 2 years as a leader. These results demonstrate the potential for males to employ both multiple roles (follower vs. solitary male) and multiple routes (IU, inheritance, challenge, opportunistic) to acquire females and become a leader male in a mating system characterized by female defense polygyny in a competitive arena. © 2011 Wiley-Liss, Inc.

  15. Impact of having a high-risk pregnancy on future postpartum contraceptive method choice.

    PubMed

    Kiykac Altinbas, Sadiman; Bayoglu Tekin, Yesim; Dilbaz, Berna; Kilic, Selim; Khalil, Susan S; Kandemir, Omer

    2014-12-01

    To compare the knowledge and preference of preconceptional contraception to future postpartum contraceptive method choice in high-risk pregnancies. Does a high-risk pregnancy condition affect future postpartum contraceptive method choice? Women hospitalised at the High Risk Pregnancy unit of a tertiary research and training hospital were asked to complete a self-reported questionnaire that included demographic characteristics, presence of unintended pregnancy, contraceptive method of choice before the current pregnancy, plans for contraceptive use following delivery and requests for any contraceptive counselling in the postpartum period. A total of 655 pregnant women were recruited. The mean age, gravidity and parity of the women were 27.48 ± 6.25 years, 2.81 ± 2.15 and 1.40 ± 1.77, respectively. High-risk pregnancy indications included 207 (31.6%) maternal, 396 (60.5%) foetal and 52 (7.9%) uterine factors. All postpartum contraceptive choices except for combined oral contraceptives (COCs) usage were significantly different from preconceptional contraceptive preferences (p<0.001). High-risk pregnancy indications, future child bearing, ideal number of children, income and education levels were the most important factors influencing postpartum contraceptive choices. While the leading contraceptive method in the postpartum period was long-acting reversible contraceptive methods (non-hormonal copper intrauterine device Cu-IUD, the levonorgestrel-releasing intrauterine system (LNG-IUS) (40%), the least preferred method was COCs use (5.2%) and preference of COCs use showed no difference between the preconceptional and postpartum periods (p=0.202). Overall 73.7% of the women wanted to receive contraceptive counselling before their discharge. A high-risk pregnancy condition may change the opinion and preference of contraceptive use, and also seems to affect the awareness of family planning methods. Copyright © 2014 Australian College of Midwives. All rights reserved.

  16. Thin-skinned deformation of sedimentary rocks in Valles Marineris, Mars

    USGS Publications Warehouse

    Metz, Joannah; Grotzinger, John P.; Okubo, Chris; Milliken, Ralph

    2010-01-01

    Deformation of sedimentary rocks is widespread within Valles Marineris, characterized by both plastic and brittle deformation identified in Candor, Melas, and Ius Chasmata. We identified four deformation styles using HiRISE and CTX images: kilometer-scale convolute folds, detached slabs, folded strata, and pull-apart structures. Convolute folds are detached rounded slabs of material with alternating dark- and light-toned strata and a fold wavelength of about 1 km. The detached slabs are isolated rounded blocks of material, but they exhibit only highly localized evidence of stratification. Folded strata are composed of continuously folded layers that are not detached. Pull-apart structures are composed of stratified rock that has broken off into small irregularly shaped pieces showing evidence of brittle deformation. Some areas exhibit multiple styles of deformation and grade from one type of deformation into another. The deformed rocks are observed over thousands of kilometers, are limited to discrete stratigraphic intervals, and occur over a wide range in elevations. All deformation styles appear to be of likely thin-skinned origin. CRISM reflectance spectra show that some of the deformed sediments contain a component of monohydrated and polyhydrated sulfates. Several mechanisms could be responsible for the deformation of sedimentary rocks in Valles Marineris, such as subaerial or subaqueous gravitational slumping or sliding and soft sediment deformation, where the latter could include impact-induced or seismically induced liquefaction. These mechanisms are evaluated based on their expected pattern, scale, and areal extent of deformation. Deformation produced from slow subaerial or subaqueous landsliding and liquefaction is consistent with the deformation observed in Valles Marineris.

  17. Comparison of two quantitative real-time CMV-PCR tests calibrated against the 1st WHO international standard for viral load monitoring of renal transplant patients.

    PubMed

    Mannonen, Laura; Loginov, Raisa; Helanterä, Ilkka; Dumoulin, Alexis; Vilchez, Regis A; Cobb, Bryan; Hirsch, Hans H; Lautenschlager, Irmeli

    2014-04-01

    Cytomegalovirus (CMV) replication in organ transplant recipients is commonly diagnosed by quantitative PCR methods. However, there has been a poor inter-laboratory correlation of viral load values due to the lack of an international reference standard. In a recent study, the COBAS® AmpliPrep/COBAS® TaqMan® (CAP/CTM) CMV test calibrated to the 1st WHO CMV standard, showed good reproducibility in CMV load values across multiple laboratories. Fifty-seven follow-up plasma specimens from 10 kidney transplant recipients with CMV replication were examined using the new quantitative CAP/CTM CMV test and the "in-house" quantitative CMV real-time PCR method, also calibrated against the 1st WHO CMV standard for their clinical applicability for monitoring CMV load in renal transplant patients. By CAP/CTM CMV test 49/57 specimens were CMV-DNA positive compared to 44/57 by the "in-house" PCR test. The "in-house" PCR and CAP/CTM CMV test correlated well in monitoring individual kidney transplant patients. Conversion of the CMV-DNA copies to IUs made the results of the "in-house" PCR and CAP/CTM CMV test less uniform in analysis of the patient samples. In specimens of one patient, significant underquantification of CMV load with "in-house" PCR emerged during follow-up due to a point mutation in the "in-house" PCR primer sequence. The CAP/CTM CMV test was found suitable for diagnosing and monitoring CMV replication in renal transplant patients. Multicenter studies are needed to provide more information of the commutability of the 1st WHO CMV standard and to define the clinical thresholds. © 2013 Wiley Periodicals, Inc.

  18. Societal challenges-oriented data-rich undergraduate teaching resources for geoscience classrooms and field courses

    NASA Astrophysics Data System (ADS)

    Pratt-Sitaula, B. A.; Walker, B.; Douglas, B. J.; Crosby, B. T.; Charlevoix, D. J.; Crosby, C. J.; Shervais, K.

    2016-12-01

    The NSF-funded GEodesy Tools for Societal Issues (GETSI) project is developing modules for use in introductory and majors-level courses that emphasize a broad range of geodetic data and quantitative skills applied to societally important issues of climate change, natural hazards, and water resources (serc.carleton.edu/getsi). The modules fill gaps in existing undergraduate curricula, which seldom include geodetic methods. Published modules are "Ice mass and sea level changes", "Imaging active tectonics with LiDAR and InSAR", "Measuring water resources with GPS, gravity, and traditional methods", "Surface process hazards", and "GPS, strain, and earthquakes". The GETSI Field Collection features geodetic field techniques. The field-oriented module "Analyzing high resolution topography with terrestrial laser scanning (TLS) and structure from motion (SfM)" is already published and "High precision positioning with static and kinematic GPS" will be published in 2017. Modules are 1-3 weeks long and include student exercises, data analysis, and extensive supporting materials. For field modules, prepared data sets are provided for courses that cannot collect field data directly. All modules were designed and developed by teams of faculty and content experts and underwent rigorous review and classroom testing. Collaborating institutions are UNAVCO (which runs NSF's Geodetic Facility), Indiana University, Mt San Antonio College, and Idaho State University. Science Education Resource Center (SERC) is providing assessment and evaluation expertise. If future funding is successful, the topic range will be expanded (e.g., volcanic hazards, more water resources, and ecological applications of geodesy). Funding to date has been provided by NSF's TUES (Transforming Undergraduate Education in STEM) and IUSE (Improving Undergraduate STEM Education).

  19. Draft Environmental Impact Statement for the Ulysses Mission (Tier 2)

    NASA Technical Reports Server (NTRS)

    1990-01-01

    This Draft Environmental Impact Statement (DEIS) addresses the environmental impacts which may be caused by the preparation and operation of the Ulysses spacecraft, including its planned launch on the Space Transportation System (STS) Shuttle and the alternative of canceling further work on the mission. The launch configuration will use the STS/Inertial Upper Stage (IUS)/Payload Assist Module-Special(PAM-S) combination. The Tier 1 EIS included a delay alternative which considered the Titan 4 launch vehicle as an alternative booster stage for launch in 1991 or later. However, the U.S. Air Force, which procures the Titan 4 for NASA, could not provide a Titan 4 vehicle for the 1991 launch opportunity because of high priority Department of Defense requirements. The only expected environmental effects of the proposed action are associated with normal Shuttle launch operations. These impacts are limited largely to the near-field at the launch pad, except for temporary stratospheric ozone effects during launch and occasional sonic boom effects near the landing site. These effects have been judged insufficient to preclude Shuttle launches. In the event of (1) an accident during launch, or (2) reentry of the spacecraft from earth orbit, there are potential adverse health and environmental effects associated with the possible release of plutonium dioxide from the spacecraft's radioisotope thermoelectric generators (RTG). The potential effects considered in this EIS include risks of air and water quality impacts, local land area contamination, adverse health and safety impacts, the disturbance of biotic resources, impacts on wetland areas or areas containing historical sites, and socioeconomic impacts. Intensive analysis of the possible accidents associated with the proposed action are underway and preliminary results indicate small health or environmental risks. The results of a Final Safety Analysis Report will be available for inclusion into the final EIS.

  20. Final safety analysis report for the Galileo Mission: Volume 2: Book 1, Accident model document

    SciTech Connect

    Not Available

    1988-12-15

    The Accident Model Document (AMD) is the second volume of the three volume Final Safety Analysis Report (FSAR) for the Galileo outer planetary space science mission. This mission employs Radioisotope Thermoelectric Generators (RTGs) as the prime electrical power sources for the spacecraft. Galileo will be launched into Earth orbit using the Space Shuttle and will use the Inertial Upper Stage (IUS) booster to place the spacecraft into an Earth escape trajectory. The RTG's employ silicon-germanium thermoelectric couples to produce electricity from the heat energy that results from the decay of the radioisotope fuel, Plutonium-238, used in the RTG heat source. The heat source configuration used in the RTG's is termed General Purpose Heat Source (GPHS), and the RTG's are designated GPHS-RTGs. The use of radioactive material in these missions necessitates evaluations of the radiological risks that may be encountered by launch complex personnel as well as by the Earth's general population resulting from postulated malfunctions or failures occurring in the mission operations. The FSAR presents the results of a rigorous safety assessment, including substantial analyses and testing, of the launch and deployment of the RTGs for the Galileo mission. This AMD is a summary of the potential accident and failure sequences which might result in fuel release, the analysis and testing methods employed, and the predicted source terms. Each source term consists of a quantity of fuel released, the location of release and the physical characteristics of the fuel released. Each source term has an associated probability of occurrence. 27 figs., 11 tabs.