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Carbetocin for Postpartum Haemorrhage Prophylaxis in All Births: A Retrospective Cohort Study Following Policy Change in Routine Uterotonic Use
No full textABSTRACTObjectiveTo compare postpartum haemorrhage (PPH) outcomes following a change in routine prophylactic uterotonic from Oxytocin to Carbetocin.DesignA retrospective cohort study with a before‐after design.SettingA large tertiary maternity service in Melbourne, Australia.SampleAll births that met the inclusion criteria (n = 6235) from January to June 2020 and 2021.MethodsClinical outcome data for all births in the two 6‐month periods were retrieved from the electronic medical records and manually checked for accuracy. Data were statistically analysed using univariate tests and binary logistic regression.Main Outcome MeasureWeighed blood loss (mL) and prevalence of moderate (≥ 500 mL) and severe (≥ 1000 mL) PPH. Secondary outcomes included use of additional uterotonics, blood transfusions, admission to the high‐dependency care unit, and length of stay.ResultsCarbetocin was associated with significantly lower average blood loss (p < 0.001), including rates of moderate and severe PPH (p < 0.001). There were no significant differences in the use of additional uterotonics or blood transfusions following the implementation of Carbetocin. There were significant reductions in admissions to the high‐dependence care unit and length of hospital stay. Secondary analyses identified that Carbetocin was associated with reduced odds of PPH for both vaginal and caesarean birth after adjusting for a range of factors that increase the risk of PPH.ConclusionCarbetocin is associated with reduced blood loss and the rate of PPH compared to Oxytocin. Associated reductions in admissions to high dependency care and length of hospital stay are likely to result in reduced maternal morbidity and lower hospital costs
REIMAGING THE PAST: UTILISING AI FOR VISUAL PRESERVATION OF LOST ARCHITECTURAL HERITAGE
No full textREIMAGING THE PAST: UTILISING AI FOR VISUAL PRESERVATION OF LOST ARCHITECTURAL HERITAG
Rethinking liminality in refugee and migration studies
No full textDrawing on anthropological theories, this paper delves into the evolving discourse on liminality within contemporary refugee and migration studies. While refugee scholars have been at the forefront in applying liminality, there has been an increasing trend in employing it to describe the immigrant experience more generally. Thus, liminality has emerged as a significant concept in understanding the migration experience, akin to established notions such as “structure” and “practice”. The paper identifies three key themes in the discourse on liminality within the refugee and migration literature: the adoption of a linear understanding of the rites of passage; a debate on whether positive or negative characteristics accurately reflect the experience of the liminal refugee/migrant subject and finally claims that the refugee and/or migration experience can be conceived as a state of permanent liminality. Through an analysis of each of these themes, I argue that existing refugee and migration scholarship oversimplifies the idea of liminality by downplaying the dialectical and relational view found in the work of anthropologists such as Arnold van Gennep and Victor Turner. By systematically reengaging with these original anthropological sources and reconsidering concepts like van Gennep’s post-liminal via the work of Clay H. Trumbull and drawing on Turner’s concept of the liminoid, the paper advocates for a more multifaceted and nuanced conceptualization of liminality that is currently missing. This rethinking of liminality can enrich our understanding and provide a deeper analysis of the ritualistic and transformative aspects of the refugee and migration experience
Embodied overcrowding and sensory tensions: A carceral autoethnography of Philippine jails
No full textEmbodied overcrowding and sensory tensions: A carceral autoethnography of Philippine jail
A Two-Stage Robust Security-Constrained Unit Commitment Model for Power System Risk under Transmission Line Outages
No full textA Two-Stage Robust Security-Constrained Unit Commitment Model for Power System Risk under Transmission Line Outage
Forming Auxiliary High-confident Instance-level Loss to Promote Learning from Label Proportions
No full textForming Auxiliary High-confident Instance-level Loss to Promote Learning from Label Proportion
Imiquimod (R837), a TLR7-Specific Agonist, Regulates Boar Sperm Motility via PI3K/GSK3α/β/Hexokinase Pathway
No full textMammalian sperm has a high metabolic activity and primarily relies on glycolysis and mitochondrial oxidative phosphorylation for energy supply. It has been reported that imiquimod (R837), a specific ligand of TLR7 protein, reduces the motility of sperm. However, the specific molecular mechanism by which TLR7 modulates boar sperm is unclear. In this study, the effect of R837, a Toll-like receptor 7 (TLR7) agonist, on boar sperm motility was investigated. Sperm samples were incubated with varying concentrations of R837 (0 to 0.8 µM) at different time points (30, 60, and 90 min). Findings reveal for the first time that TLR7 protein, a key component of the immune system’s Toll-like receptors, is predominantly localized in the middle section of the boar sperm tail, with a smaller concentration observed in the neck. Also, immunofluorescence (IF) revealed that approximately half of the boar sperm sample expressed TLR7. Furthermore, the TLR7 agonist influenced glycolytic hexokinase activity and mitochondrial function via the PI3K-GSK3β signaling pathway. It also selectively inhibited motility in the lower-layer sperm, while motility in the upper-layer sperm remained unaffected. Additionally, this study determined that incubation conditions for boar sperm with 0.2 μM R837 at 37 °C for 60 min yielded the most pronounced inhibition of forward motility in the lower layer of sperm, without compromising the integrity of the acrosome or plasma membrane. The present study reveals the crucial role of R837 in boar sperm motility and highlights TLR7 as an important protein that regulates boar sperm energy metabolism
Predicting Responsiveness to a Dialectical Behavioural Therapy Skills Training App for Recurrent Binge Eating: A Machine Learning Approach
No full textPredicting Responsiveness to a Dialectical Behavioural Therapy Skills Training App for Recurrent Binge Eating: A Machine Learning Approac
Understanding larger-bodied women’s experiences of maternity care: A pilot evaluation of the feasibility and acceptability of an online photovoice approach
No full textUnderstanding larger-bodied women’s experiences of maternity care: A pilot evaluation of the feasibility and acceptability of an online photovoice approac
Acceptability and Efficacy of a Web‐Based, Intuitive Eating‐Focused Single Session Intervention for Recurrent Binge Eating: A Randomized Controlled Trial
No full textABSTRACTObjectiveIntuitive eating is a viable intervention target for binge eating, yet current programs designed to cultivate this pattern of eating face challenges with scalability and accessibility. We developed a web‐based, intuitive eating‐focused, single‐session intervention (SSI) and evaluated its acceptability and efficacy among individuals with recurrent binge eating.MethodTwo‐hundred‐forty‐eight participants reporting recurrent binge eating were randomly assigned to the SSI or a waitlist. Study assessments were conducted at baseline, 2‐week post‐test, and 6‐week follow‐up. Analyses were performed under the intention‐to‐treat principle.ResultsEvidence of acceptability was observed among study retainers, with good ratings of perceived usefulness and satisfaction, and two in three stating that they would recommend the program. Issues with attrition were apparent across both groups. The intervention group reported significantly greater pre–post improvements than the control group in intuitive eating, symptoms of eating disorders, body appreciation, and body interoception, with moderate to large effect sizes. Improvements in intervention participants persisted at 6 weeks and were largely stable across sensitivity analyses that handled missing data in different ways, with a few exceptions. Between 30% and 60% of intervention participants reported that the SSI had increased indicators of confidence and motivation to change, and receptivity towards further help options.ConclusionThis study highlights the acceptability and potential efficacy of brief, but concentrated interventions designed to foster intuitive eating for binge eating. Findings add to a growing body of literature highlighting the potential benefits of SSIs for symptoms of eating disorders