Copper T Research Articles

Knowledge, attitude and acceptability for long-acting reversible contraceptive (LARC) methods among women attending contraception counselling sessions: A cross-sectional study

ABSTRACT Aims: To study the knowledge, attitude, and acceptability of Long-acting Reversible Contraceptive (LARC) methods among women attending contraception counselling sessions. Settings and Design: A cross-sectional study conducted in the family planning clinic of a tertiary care hospital. Methods and Material: Women aged 18–45 years attending contraception counselling sessions were included. Baseline knowledge about LARC methods was assessed. They were given information about LARC methods. Acceptability was assessed on a scale of 0–10. Results: Among four LARC methods, awareness about copper intrauterine devices (CuIUD), DMPA injection, subdermal implant and Mirena was 95%, 55.50%, 27% and 3%, respectively. Around 4% were unaware of the LARC method. Of total, 76.50% women procured the LARC methods information from health care workers, whereas 40% attained from friends, family members, neighbors, or colleagues. After counseling, the majority (58%) were willing for subdermal implant. About 27.50% and 13.50% were willing for copper IUD insertion and injection DMPA, respectively. None was willing for Mirena. Acceptability of various LARC methods was scaled on an acceptability score from 0 to 10. For Cu IUD, implanon and DMPA, the acceptability score was 10 in 50%, 40.17% and 25%, respectively. Conclusions: There are still gaps of knowledge about benefits and safety of available LARC methods. To improve wide coverage and more acceptability of LARC methods, involvement of health care workers and addition of subdermal implants to contraceptive counseling should be considered.

Contraception with levonorgestrel-releasing intrauterine system versus copper intrauterine device: a meta-analysis of randomized controlled trials

Globally, approximately 19.4% of women of reproductive age use intrauterine contraception, encompassing both copper intrauterine devices (Cu-IUDs) and levonorgestrel intrauterine devices (LNG-IUDs). Despite current guidelines endorsing intrauterine contraception as a primary method, there remains debate regarding device selection. Notably, the lack of data regarding reasons for discontinuation has limited previous meta-analyses. This study aims to comprehensively evaluate the potential differences between intrauterine devices using available multinational data, thereby providing a basis for global policy and healthcare services. We systematically searched PubMed, EMBASE, Web of Science, and Cochrane Library for primary studies published from inception to January 13, 2024, with no language or geographic restrictions. The study was registered on PROSPERO (CRD42024496400). We included only randomized controlled trials comparing Cu-IUDs and LNG-IUDs. Data extraction was independently conducted by two reviewers, with unresolved discrepancies referred to a third senior reviewer for consultation. The primary outcome was pregnancy, with secondary outcomes encompassing continuation, reasons for discontinuation, expulsion, satisfaction, and other adverse events. Data were synthesized using a random-effects model. Risk of bias was evaluated with the Cochrane Collaboration's tool, and evidence quality was assessed using the GRADE framework. An analysis of 20 trials showed that compared to Cu-IUDs, LNG-IUDs were associated with lower risks of pregnancy (Risk Ratio 0.22, 95% confidence interval 0.12-0.39), ectopic pregnancy (RR 0.12, 95% CI 0.03-0.47), discontinuation due to increased bleeding (RR 0.49, 95% CI 0.28-0.85), increased bleeding (RR 0.42, 95% CI 0.25-0.7), heavy bleeding (RR 0.41, 95% CI 0.22-0.75), and dysmenorrhea (RR 0.41, 95% CI 0.34-0.48), but they carried a higher risk of discontinuation due to amenorrhea (RR 21.05, 95% CI 8.83-50.00). When comparing LNG (52mg) IUD with copper (380mm2) IUD, The LNG-IUD showed a lower risk of discontinuation due to increased bleeding (RR 0.68, 95% CI 0.55-0.58) and dysmenorrhea (RR 0.42, 95% CI 0.34-0.53), but a higher risk of discontinuation due to bleeding issues (RR 2.83, 95% CI 2.47-3.25) and amenorrhea (RR 5.92, 95% CI 2.81-12.49). There were no significant differences between the two terms of continuation, expulsion, non-medical reasons for discontinuation, satisfaction, and other adverse outcomes. LNG-IUDs and Cu-IUDs are both highly effective contraceptive methods. Compared to Cu-IUDs, LNG-IUDs were associated with a lower risk of pregnancy and adverse reactions. However, LNG-IUDs carry a higher risk of amenorrhea. When recommending contraceptive methods, healthcare providers should fully inform patients of these potential risks and consider patient preferences. The research was funded by Hunan Provincial Natural Foundation of China (2021JJ30040), the National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University (2021KFJJ06), and the National Natural Science Foundation of China (No. 81672225).

Unobstructive and safe-to-wear watt-level wireless charger

A wearable microgrid that centralizes and distributes harvested energy across different body regions can optimize power utilization and reduce overall battery weight. This setup underscores the importance of developing cable-free wireless power transfer (WPT) systems for mobile and portable devices to eliminate the risks posed by wired connections, especially in dynamic and hazardous environments. We introduce a thin, stretchable, and safe hand band capable of watt-level wireless charging through the widely adopted Qi protocol operating at 130 kHz. The implementation of non-adhesive fabric encapsulation serves to protect the 50-μm-thin spiral copper antenna from mechanical strain, ensuring an overall hand band stretchability of 50%. We also create a stretchable “Ferrofabric”, characterized by a magnetic permeability of 11.3 and a tensile modulus of 75.3 kPa, that provides magnetic shielding for the antenna without compromising wearability. The “Ferrofabric” improves the coil inductance but induces core loss in AC application. By fully understanding and managing loss mechanisms such as the skin effect, proximity effect, core loss, and joule heating, we achieve a wireless charging efficiency of 71% and power delivery of 3.81 W in the kHz frequency range. Our WPT hand band is unobstructive to hand motion and can charge a handheld smartphone as fast as a desktop charger or power a battery-free chest-laminated e-tattoo sensor, with well-managed thermal and electromagnetic safety. Through a holistic electromagnetic, structural, and thermal design, our device culminates in a safe, rugged, and versatile solution for wearable WPT systems.

Assessing the validity of counter-authority knowledge: the case of Swedish women’s epistemic patchworking around the risks of copper IUD use

ABSTRACT The internet has given rise to an informational landscape that challenges epistemological hierarchies between experts and lay people. Tensions regarding how to address the growing flora of counter-authority claims are pertinent in the context of health, where warnings about misinformation co-exist with notions of patient empowerment. This context accentuates the importance of revitalizing conceptualizations of how to assess the validity of knowledge claims. In this article, we put critical realist discussions on judgemental rationality into conversation with the case of a group of women who claim that the contraceptive copper IUD may lead to side effects of a kind not recognized by medical authorities. Tracing our own path from radical uncertainty to regarding the women’s claims as a plausible hypothesis, we identify what we deem to be strengths and weaknesses of the women’s claims and pinpoint the judgementally rational grounds for this assessment.

Discontinuation of long-acting reversible contraception: a retrospective Dutch study in general practice

Background In the Netherlands, the use of long-acting reversible contraception (LARC) methods increases. Studies show high premature discontinuation rates of LARCs, but comprehensive insights into the Dutch situation remain limited. Aim The aim of this study is to determine (1) the rate and reasons of discontinuation of different types of LARC in the first 2.5 years of use and (2) what patient characteristics are associated with premature discontinuation. Design and setting Retrospective cohort study utilising data from a Dutch primary care research network. Methods We included all women who received a LARC between 2017 and 2019 with a 2.5-year follow-up period. We performed a descriptive analysis, Kaplan Meier and logistic regression analysis to answer the research questions. Results We included 642 women. In total, 166 women (25.9%) discontinued their LARC within 2.5 years. Discontinuation rates were 22% for levonorgestrel intra-uterine systems (LNG-IUS) 52 mg, 25% for LNG-IUS 19.5 mg, 39% for copper IUDs and 47% for subdermal implants. Common reasons for discontinuation were: alterations in bleeding pattern (68%), abdominal pain (32%), headache or mood fluctuation (24%) and a preference for natural contraceptive methods (23%). Factors associated with discontinuation for reasons other than pregnancy wish were: age between 30 and 34 years old (OR 5.1, 95% CI [1.26–20.48]) and a history of sexual, physical and/or psychological abuse (OR 3.16, 95% CI [1.60–6.23]). A high educational level (OR 0.33, 95% CI [0.12–0.89]) was associated with a lower risk of discontinuation. Conclusion The discontinuation rates of LARCs are high. Better counselling might prevent premature discontinuation.

A REVIEW STUDY ON ROLE OF CONTRACEPTIVES AND THEIR VARIOUS TYPES.

Contraception is the process used to stop unwanted pregnancy and control birth rate. Contraceptives reduces the chances of pregnancy after sexual intercourse. Contraceptives prevent pregnancies by interfering with the procedure of fertilization. Contraceptives reduces the chances of abortion by preventing unintended pregnancies on their partners, in which 842 million (44%) are modern using modern methods of Contraceptives are accessible in huge varieties and types . Numerous contraceptives are available, 790 million (42%) are traditional method users according the statistical data of 2019. The most common contraceptive techniques that are use of contraceptives are increasing day by day, 922 million of women of reproductive age used worldwide are female sterilization and male condoms, female sterilization are used in 219 million users (24%), male condoms are used in 189 million users (21%) according the data of 2019. The use of traditional methods and IUDs has reduced worldwide since 1994. According to WHO, The only form of birth control is a condom,that can prevent both unintended pregnancies and sexually transmitted diseases. The need of family planning is increased globally up to 77% from 2015 to 2020.. Over the past 20 years, the number of women using family planning methods has grown, rising from 900 million in 2020 to 2000 million. Use of modern contraceptive methods is also increased from 663 million to 851 million with the prevalence rate of 47.7% to 49.0%. Numerous contraceptive methods exist, including hormonal methods like CHC vaginal ring, CHC transdermal patch, and combination hormonal contraceptives. Progestin-only techniques include hormonal male contraceptives, progestin-only pills, DMPA injections, implants, and progestin-only IUDs. The other approach is non-hormonal and consists of vaginal pH modulators, barrier techniques like condoms, and copper IUDs. Traditional methods, such as the LAM method, the fertile cycle method, and the withdrawal approach, comprise the third type of contraception. Herbal contraceptives, which use a variety of herbs and plant preparations, are the fourth technique of birth control.

Autoimmune Progesterone Dermatitis Following Placement of a Progesterone-eluting IUD

A 26-year-old female with a history of Raynaud’s phenomenon and a family history of autoimmune disease presented with a cyclical facial rash for 10 months following placement of a progesterone-eluting IUD. The rash began 3-4 days before the onset of menses as a crusted, oozing, vesicular rash, and dried out and improved a few days following the onset of menses. The rash began around her eyes and progressively moved to her forehead, cheeks, jaw, and neck as the months on the IUD progressed. Physical exam revealed poorly-demarcated, pink scaly plaques with overlying crust on the mid-forehead, eyes, cheeks, nose, perioral region, and mid-chin. Patch testing and open application testing of personal skincare products at home were negative. ANA was marginally positive 1:40, although the rest of the rheumatologic workup was unrevealing. The patient’s history and exam were suggestive of autoimmune progesterone dermatitis and she planned to have her progesterone-eluting IUD exchanged for a copper IUD the following week. If no improvement, the patient planned to see a gynecologic endocrinologist for contraception with hormonal treatment that suppresses progesterone secretion rather than using progesterone to inhibit ovulation. The patient was lost to follow-up. Autoimmune progesterone dermatitis, also known as progesterone hypersensitivity, is a rare and under-recognized entity that may be triggered by endogenous (menses, pregnancy) or exogenous progesterone/progestin exposure (contraceptives, IVF).1 It may have a variety of clinical presentations and is thought to be IgE-mediated.1 Management may include reduction of exogenous progesterone and symptomatic control.

Female genital tract host factors and tenofovir and lamivudine active metabolites.

We previously reported the effect of contraception on cervical tenofovir concentrations in Ugandan women living with HIV. Here we explored the role of cervicovaginal cytokines and drug metabolizing enzymes and transporters (DMETs) to elucidate FGT drug disposition in a Ugandan cohort. Cervicovaginal fluid and cervical biopsies were collected from Ugandan women living with HIV receiving tenofovir/lamivudine-based therapy and intramuscular depot medroxyprogesterone acetate (DMPA-IM; n=25), copper IUD (cuIUD; n=12), or condoms (n=13) as contraception. Cytokines were measured in cervicovaginal fluid (CVF). Ectocervical tenofovir diphosphate (TFVdp) and lamivudine triphosphate (3TCtp), dATP/dCTP concentrations, and immune marker/DMETs gene expression were measured in cervical biopsies. Cervical 3TCtp was not correlated with any CVF cytokines. Cervical TFVdp was correlated with IL-10, IL-7, and IL-17 in CVF. CCR5 mRNA expression in cervical biopsies was higher in cuIUD-users versus condoms-users. Using multivariable linear regression, CVF IL-17, tissue dATP, plasma estradiol, and plasma tenofovir were all significant predictors of cervical TFVdp. Tissue dCTP and plasma lamivudine were significant predictors of cervical 3TCtp. TFVdp concentrations in cervix appear to be influenced by local inflammation. In contrast, 3TCtp FGT exposure was not affected by genital inflammation or DMETS. CuIUD users have more immune cells present, which may in turn influence local TFVdp disposition.

Cost-effectiveness analysis of levonorgestrel-releasing intrauterine system (LNG-IUS) 52 mg versus other long-acting reversible contraceptives for contraception in Spain

Introduction Condoms and combined oral contraceptive pills are widely used in Spain with high failure rates. Long-Acting Reversible Contraceptive (LARC) methods offer better efficacy and adherence and reduce unintended pregnancies (UP) compared with short-acting reversible contraceptive (SARC) methods. Objective To assess the cost-effectiveness of LNG-IUS 52 mg (Mirena®) versus other LARC for contraception in Spain. Materials and Methods A Markov model with annual cycles and an eight-year time horizon was developed from the Spanish national healthcare system (NHS) perspective, considering costs for contraceptive method acquisition, health care resources (HCR) and UP. Effectiveness was based on failure and discontinuation rates. Sensitivity analyses were performed to test the model’s robustness. Results LNG-IUS 52 mg (Mirena®) resulted in lower costs and fewer UP versus LNG-IUS 13.5 mg (Jaydess®), Implant (Implanon®) and Copper IUD. LNG-IUS 52 mg (Levosert®) prevented the same UP events at a higher cost. LNG-IUS 19.5 mg (Kyleena®) was the most effective option, due to a lower discontinuation rate. Conclusions LNG-IUS 52 mg (Mirena®) is the least costly LARC, driven by lower acquisition costs and reduced HCR utilisation. Increasing LNG-IUS 52 mg (Mirena®) uptake in contraception could generate further cost savings for the Spanish NHS and reduce economic burden of UP.

Contraceptive Counselling and Uptake Among Female Kidney Transplant Recipients in Ethiopia

ABSTRACTBackgroundContraceptive counselling and utilization for kidney transplant patients is a vital component of their kidney transplant care. The use of standardized information on contraceptive methods to prevent unplanned post‐transplant pregnancies in Africa in general is less studied. This study aimed to describe contraceptive counselling and uptake among kidney transplant recipients at a kidney transplant centre in Ethiopia.MethodsA descriptive study on contraceptive counselling and uptake among female Ethiopian kidney transplant recipients was conducted at St. Paul's Hospital Millennium Medical College (Ethiopia) from April 15 to July 15, 2023. Data on women's sociodemographic, renal transplantation and contraceptive counselling and use were collected through interviewing the participants using a structured questionnaire. Data were analyzed on SPSS 23 using simple descriptive analysis. Percentages and frequencies were used to present the results.ResultsA total of 60 participants were included in the final analysis. The mean age of the participants was 33.7 ± 8.4 years. The median duration from the time of renal transplant was 19 months. Most (49/60, 81.7%) of the participants reported that they did not receive family planning counselling on contraceptive methods in the early post‐transplant phase. The rate of contraceptive uptake was 8.3% (5/60) with two patients being copper IUD users, and Implanon, tubal ligation and combined oral contraceptives each utilized by a single kidney transplant patient.ConclusionContraceptive counselling and uptake rates among female kidney transplant recipients in this study were very low, which is consistent with findings from previous studies. Increasing female kidney transplant patients’ awareness on safe and effective contraceptive use through adequate contraceptive counselling is essential.

Pharmacist recommendations for emergency contraception in Belgium: a simulated user study

Background Emergency contraception reduces the risk of unintended pregnancy, after unprotected sexual intercourse or contraceptive failure. In Belgium, emergency contraception is available without a prescription and pharmacists play therefore a crucial role in dispensing emergency contraception. Aim This study assesses the dispensing practices of emergency contraception by pharmacists in two regions of Belgium. Method and design Simulated patient study, using a predefined scenario, evaluating a request for emergency contraception. The scenario involves a 25-year-old woman not using contraception, who had unprotected sexual intercourse 84 h (3.5 days) ago. Her last menstrual period was 10 days ago. Population 260 pharmacies were randomly selected. Principal outcome: proportion of pharmacists who deliver the adequate emergency contraception. We considered the following responses as adequate: Prescribing ulipristal acetate or redirecting to another pharmacy, in case of unavailability, or referring for a copper IUD Results We analysed the data obtained in 216 pharmacies (216/260 = 83.1%). In 64% of cases, adequate dispensing of emergency contraception (dispensing of ulipristal acetate or referral for intrauterine device insertion) occurred. There was an association between correct dispensing and asking appropriate questions, such as the date of the last menstrual period and the date of the risky sexual intercourse. Conclusion More than one-third of visited pharmacies did not distribute appropriate emergency contraception, underlining the need for improvement. We hypothesise that this may be achieved with appropriate training, use a dispensing checklist.

Numerical analysis on heat transfer performance of spiral elastic copper tube heat exchanger with helical defectors

Based on the flow-induced vibration mechanism, three kinds of spiral elastic copper tube heat exchangers were proposed to improve the comprehensive heat transfer performance, involving the spiral elastic copper tube heat exchanger with no defector, the spiral elastic copper tube heat exchanger with forward helical deflector and the spiral elastic copper tube heat exchanger with reverse helical deflector. A both-way fluid–structure coupling method was utilized to investigate the effects of helical defectors and their arrangements on the vibration-enhanced heat transfer performance of the spiral elastic copper tubes at different inlet velocities by numerical simulation. The results indicate that: when the inlet velocity ranges from 0.1 m/s to 0.7 m/s, the heat exchanger with reverse helical deflector possesses better heat transfer performance than the other two heat exchangers. For the heat exchangers with no defector and forward helical deflector, the flow-induced vibration always promotes the comprehensive heat transfer performance. Compared with the heat exchanger with no defector, the comprehensive heat transfer performance of the heat exchanger with reverse helical deflector is higher 4.02 % averagely, while that of the heat exchanger with forward helical deflector is lower 29.34 % averagely. Furthermore, a structural optimization is presented to improve the existing disadvantages of the heat exchanger with reverse helical deflector, after structural optimization, the average amplitude of the heat exchanger with forward helical deflector is decreased by 3.26 % averagely and the heat transfer performance is raised to a maximum of 26.24 %, which are of great significance to extend the service life and improve the energy efficiency of heat exchanger.

Techniques for Enhancing Thermal Conductivity and Heat Transfer in Phase Change Materials in Hybrid Phase Change Material–Water Storage Tanks

In recent years, extensive research has been dedicated to enhancing energy efficiency and promoting environmental sustainability in heating and cooling systems. Among the promising solutions, phase change materials (PCM) technology stands out as a key area of exploration. This study focuses on improving the thermal performance of PCM–water hybrid tanks by investigating methods to enhance thermal conductivity and heat transfer. Through experimental testing using techniques such as copper matrices, steel twisted matrices, and copper spirals, this study demonstrates significant improvements in thermal conductivity, particularly with the use of copper matrices. The integration of a copper matrix placed in the PCM reservoir increased the heat transfer coefficient and thermal conductivity of the PCM, and thus, the total phase transformation time for solidification was reduced by 79.19% and for melting by 54.7%. Our experimental results demonstrate that the integration of a copper matrix can increase latent heat transfer from 55,677.6 J up to 125,274.6 J, marking a 125% enhancement over the experiment with pure PCM. Additionally, comparisons of the energy storage potentials for different PCMs underscore the benefits of integrating PCMs into hybrid storage tanks. These findings highlight the immense potential of PCM technology to increase energy storage efficiency in heating and cooling applications.

Impact of Various Contraceptive Methods on Immunological Profiles in Women: A Serological Analysis in Diyala Governorate

Introduction: Both hormonal and non-hormonal contraception methods are highly effective and used globally. Our study aimed to examine the immune factors in women using contraceptives, providing insights into the complexities involved. Ninety women participated, with 50 using contraceptives (study group) and 40 not using any (control group), all considered healthy individuals. Venous blood samples, drawn using sterile single-use medical syringes, were 5 ml each. Methods: The study used an inclusive approach, employing techniques like Indirect Sandawish ELISA to assess CD4, CD8, IL16, and IL27 levels, and Single Immunodiffusion (SRID) for IgG, IgM, and IgA determination. Results: Analysis revealed significantly higher levels of IgG, IgM, IgA, and IL16 in contraceptive users compared to non-users. However, CD4 and IL27 levels showed a marked reduction in patients compared to healthy controls. Notably, there were no statistically significant differences (P>0.05) in immune variables between different contraceptive types, except for IgA, which was highest in injection users and lowest in oral contraceptive users. Further scrutiny found no significant variations (P>0.05) between immune variable levels and hormonal/non-hormonal contraceptives, except for IL16 (P>0.01). Conclusions: The study concludes that various contraceptive methods (tablets, injections, copper IUDs) lead to increased levels of immunoglobulins (IgG, IgM, IgA). Importantly, changes in contraceptive type (tablets, injections, IUDs) had minimal impact on immune variables, except for increased IgA in injection users. Hormonal or non-hormonal contraceptives showed no noticeable influence on immune indicators, except for IL16, which exhibited a significant increase.

A contracepção como um valor: histórias de jovens sobre desafios no uso e manejo dos métodos

Abstract This study presents the findings of the social anthropological research project “Jovens da era digital: Sexualidade, reprodução, redes sociais e prevenção às IST/HIV/AIDS” [Young people in the digital age: Sexuality, reproduction, social media, and prevention of STI/HIV/AIDS], which was conducted with interlocutors between the ages of 16 and 24 years old from six Brazilian cities. This study focuses on contraceptive management among heterosexual adolescents and young adults, with particular emphasis on women, given their prominent role in family planning within hierarchical gender contexts. We describe the typical script for youth contraception, which involves the use of condoms at the onset of sexual activity, followed by the incorporation of hormonal methods or the withdrawal method. We also find that adolescents frequently resort to the use of emergency contraception. Women frequently report experiencing side effects from hormonal contraceptives, which results in high rates of discontinuation and an increased interest in copper IUDs, which are scarce resources within the Brazilian National Health System. It can be concluded that, despite gender constraints and social, ethnic, and racial inequalities, the interviewees value contraception, offering insights for the review and improvement of public policies concerning young people.

Identifying what contraceptive side effects women are told about during counseling using nationally representative PMA Ethiopia 2019 cross-sectional data.

Despite widespread concerns about contraceptive side effects among contraceptive users, few studies explore the specific side effects women are told about during contraceptive counseling. It is thus unclear whether women receive appropriate and sufficient information on side effects they may experience. The objective of this study is to describe which specific side effects of hormonal contraception or copper IUD users are counseled on and identify relevant user characteristics associated with receipt of counseling, using nationally representative cross-sectional data from Ethiopia. Data were collected from a nationally representative sample of women between October and December 2019. Analyses were restricted to 2,039 current users of hormonal contraception (implant, injectable, pill, or emergency contraception) or the copper IUD. Descriptive analyses identified the types and number of side effects, across all methods and by the injectable, implant, and pill. Multinomial regression identified factors associated with receipt of counseling on bleeding changes only, non-bleeding changes only, or both, relative to no counseling on side effects, adjusting for method type, source, and socio-economic characteristics. Less than 10% of users were told of at least one bleeding and non-bleeding side effect. Relative to implant users, injectable and other method users were less likely to be told about bleeding changes only (aRRR: 0.65, 95% CI: 0.46-0.93 and aRRR: 0.31, 95% CI: 0.16-0.61, respectively) and users of other methods were less likely to be told about both a bleeding and non-bleeding change (aRRR: 0.43, 95% CI: 0.19-0.93). Users who received their method from a non-public source were less likely to receive counseling on any kind of side effect and nulliparous women were less likely to be told about both kinds of side effects. There is need to improve counseling on the method specific side effects on which women are counseled, particularly in the private sector.

A Novel Method of Wireless Micro Energy Transmission Based on MEMS Micro Coil.

Based on current implantable devices, a battery's rigidity and large size makes it prone to immune rejection and wound incisions. Additionally, it is limited by its finite lifespan, which hinders long-term usage. These limitations greatly restrict the development of implantable medical device systems towards miniaturization and minimally invasive approaches. Consequently, obtaining high-fidelity and stable biological signals from the target tissue area of the organism remains challenging. Therefore, there is a need to develop wireless power transmission technology. In this paper, we propose a wireless micro energy transfer method based on MEMS micro coils for charging implantable devices. Through simulation calculations, we first investigate the influence of coaxial distance, horizontal displacement, and rotation angle between the MEMS micro coil and the transmitting coil on power transmission. Subsequently, we utilize micro nanofabrication technology to create a MEMS micro spiral copper coil with a line width, thickness, and spacing of 50 µm and a total of five turns. Finally, we conduct wireless power transmission tests on the coil. The results show that, when the transmitting coil and the receiving coil are 10 mm apart and the operating frequency is 100 kHz, the power of the wireless power transmission system reaches 45 µW. This power level is sufficient to meet the power supply requirements of implantable pacemakers. Therefore, this technology holds great potential for applications in the field of wireless power transmission for implantable medical devices, including pacemakers and brain neurostimulators.

Provider bias and family planning in Upper Egypt: a simulated client approach

BackgroundProvider bias is a main barrier that extensively violates the right of free family planning method choice. Egypt is one of the countries that shows skewness in its method mix. Provider bias and insufficiency of alternative methods are identified as potential factors underlying this phenomenon which contributes to high unmet needs and discontinuation rates. Provider bias may be influenced by cultural beliefs and societal trends and is usually overlooked as a possible cause of this skewed method mix. This study aims to explore the presence of provider bias in rural Upper Egypt and its potential causes, a community with conservative cultural beliefs and least contraceptive prevalence rates.MethodsThis is a qualitative study using the “simulated client’s approach.” The study was conducted in 16 villages in Assiut and Sohag governorates in Egypt. The simulated clients visited 30 clinics, 15 in each governorate, including primary healthcare units and private clinics. Three scenarios were used to explore the physicians-imposed restrictions for contraceptive use with different clients’ eligibility criteria. Data was analyzed using the grounded theory methodology.ResultsRecommending a contraceptive method for the mystery clients was not based on informed choice. Most providers had method or client bias. Copper IUD was the most favorable contraceptive method recommended by providers, with negative attitude towards using hormonal contraception. Nulliparous and young clients were discouraged to use contraception before proving fertility or offered temporary methods as emergency contraception or condoms. Providers have shown misconceptions related to infertility-associated complications of contraceptive use, especially for the young and nulliparous women.ConclusionIn this study, providers had a clear bias towards recommending IUD rather than all other contraceptive methods, which was hindered in some cases by the lack of insertion skills. Interventions to reduce provider bias should go beyond technical training. Moreover, training on reproductive rights should be a main component of routine training. Providers should regularly receive research results and be oriented toward recent medical eligibility criteria of contraceptive methods use. Moreover, the sociocultural beliefs of providers that may affect their practice should be explored and addressed.

Claims in the clinic: A qualitative group interview study on healthcare communication about unestablished side effects of the copper IUD.

Lay online communication about health-related issues has in recent years largely been associated with the spread of misinformation and decreased trust in healthcare. Such communication has included claims about systemic side effects of the copper IUD. In Sweden, a social media group centered on this issue now gathers around 8,700 members. This study aimed to use the case of reported yet unestablished side effects of the copper IUD to investigate experiences of and reasoning about healthcare encounters between caregivers and patients contesting established medical knowledge. We conducted qualitative, semi-structured, digital group interviews with members of the social media group (seven groups, n = 23) and with midwives and gynecologists (six groups, n = 15). We also gathered essays written by social media group members (n = 23). The material was analyzed thematically. The participant accounts pointed towards tensions related to principles of evidence-based medicine, i.e., perceived insufficiency of research on the safety of the copper IUD and lack of clarity in routines for reporting and following up suspected side effects, and of patient-centered care, i.e., listening respectfully to patients. Tension between caregivers' obligation to adhere to evidence-based medicine while also providing patient-centered care was noted. Healthcare providers' efforts to assess and address patient claims contesting established medical knowledge should include ensuring and communicating sufficient research, clarifying procedures for reporting suspected side effects, and improving person-centered care. This can increase the quality of care while contributing to the mitigation of distrust in healthcare and the spreading of health-related misinformation.

Novel experimental technique to evaluate soil thermal conductivity in a transient state

novel experimental technique to evaluate soil thermal conductivity in a transient state