Copper T Research Articles

Does Obesity Influence Body Mass Index Changes in Nulliparous Adolescent Users of Long-Acting Reversible Contraceptives?

To compare body mass index (BMI) changes in adolescents using long-acting reversible contraceptives (LARCs), specifically, the etonogestrel subdermal implant (ENG-implant), levonorgestrel intrauterine device (LNG-IUD), and copper IUD (Cu-IUD), by initial BMI category from the time of LARC insertion to within 6-18 months after insertion. This was a single-center retrospective cohort study. We reviewed electronic health records from our large health system to identify and follow a cohort of 196 adolescents aged 14-19 years with LARCs inserted from 2010 to 2016. We excluded adolescents with conditions or medications affecting weight, including childbirth. BMI change from LARC insertion to first BMI documented after 6-18 months RESULTS: Mean age was 17.2 ± 0.2 years; 59% of the cohort was Hispanic and 29% Black. Mean BMI was 26.4 ± 7.1 kg/m2. Of the total cohort of adolescents, 51% were underweight/normal, 24% overweight, and 25% obese. Mean time to first BMI documented after LARC insertion was 10.1 ± 3.2 months. Mean BMI change for the total cohort was +0.73 ± 1.8 kg/m2, indicating weight gain. Mean BMI change for the ENG-implant+LNG-IUD users (n=127) was larger than for Cu-IUD users (n=69) (+0.92 ± 1.9 kg/m2 vs +0.37 ± 1.6 kg/m2, respectively, P < .05). Two-way analysis of variance showed that both initial BMI category (P=.001) and type of LARC (P=.011) had an independent significant main effect on BMI change. A significant interaction effect (P=.017) showed that obese adolescents had a larger increase in BMI when they were using a progestin-releasing LARC, either ENG-implant or LNG-IUD, as compared to a Cu-IUD (P < .05). Adolescents using progestin-releasing LARCs had a larger increase in BMI within 6-18 months after device insertion than those using Cu-IUDs. The disproportionate increase in BMI with progestin-releasing LARCs was primarily contributed by obese users.

Additive-assisted cobalt electrodeposition as surface magnetic coating to enhance the inductance of spiral copper inductors

In this work, the electrochemical experiments and quantum chemical calculations are performed to investigate the possible mechanism of glycine (Gly) and 3-mercapto-1-propane sulfonate (MPS) during cobalt electrodeposition. It is found that the adsorption behavior of Gly on the electrode surface suppresses the electrodeposition of cobalt, whereas the capture of cobalt cations by sulfonic end groups facilitates the electron transfer and contributes to the acceleration of cobalt electrodeposition with the addition of MPS. Moreover, the crystal structure, surface morphology and magnetic performance of cobalt deposits are characterized to investigate the effects of Gly and MPS. Scanning electron micrographs indicate that the suppression of Gly and the acceleration of MPS on the growth of cobalt particles cause the different surface morphologies. X-ray diffraction and electron backscatter diffraction results indicate that the growth of (10¯10), (10¯11) and (11¯20) crystal planes is inhibited in the presence of MPS. Moreover, the synergistic effect of Gly and MPS is advantageous for obtaining the cobalt deposit with desirable magnetic performance. The inductance of copper inductors with cobalt deposits as the surface magnetic coating is improved by 11%.

Initial Contraceptive Choices of Women Enrolled in a Cluster-Randomized Trial in Southwest Trifinio, Guatemala.

The aim of this analysis is to present initial contraceptive choices of women offered postpartum contraception in rural Guatemala. We trained community nurses participating in the delivery of a home-based antepartum and postpartum care program in rural Guatemala in contraceptive implant placement and had them offer condoms, pills, an injection, or an implant at women's home-based 40-day postpartum visit in intervention clusters of a non-blinded, cluster-randomized trial. Women who had already started postpartum contraception or were over the age of 35 were excluded from participation. The primary outcome of the trial was contraceptive use at 3months postpartum, so this initial analysis describes immediate preferences in the population. Of 208 women enrolled in the study, 108 were in intervention clusters and 100 lived in control clusters. In the intervention group, 32 women declined contraception, 36 women received the injectable, 30 women had an implant placed, 5 women started pills, 2 women chose condoms, and data on 3 women were missing. In the control clusters, 43 women were planning on the injectable, 11 planned on the implant, 10 did not want to start a method, 5 planned on sterilization, 2 aimed for natural family planning, 2 wanted a copper IUD, 1 woman wanted condoms, 18 did not know, and data on 8 women were missing. The contraceptive implant, which was not previously available in this community, had high uptake at 27.8% in the intervention group. Clinicaltrials.gov, NCT04005391; Retrospectively Registered 7/2/2019, https://clinicaltrials.gov/ct2/show/NCT04005391 Protocol: https://doi.org/10.1186/s13063-019-3735-3.

Thermal Transfer Characteristics of Flat Plate Micro Heat Pipe with Copper Spiral Woven Mesh and a Copper Foam Composite Wick.

The thermal efficiency limitation of the Flat-plate Micro Heat Pipe (FMHP) is a major challenge in the development of the FMHP, where the effect of wick structure and wettability on its thermal performance is studied to improve the thermal efficiency of the FMHP. In this work, a copper spiral woven mesh and copper foam Composite Wick FMHP (CW-FMHP) is designed based on the conventional Copper Foam Wick FMHP (CFW-FMHP), and its thermal performance is analyzed regarding the wick structure and internal gas–liquid two-phase flow characteristics. An oxidized copper spiral woven mesh and copper foam Composite Wick FMHP (OCW-FMHP) has been further developed through the modification of composite wick wettability. The performance tests are carried out with the thermal transfer characteristics of CW-FMHP, OCW-FMHP, and CFW-FMHP under different filling rates and different thermal powers. The experimental results show that the thermal transfer performance of CW-FMHP reaches the optimal under a liquid filling rate of 150%, where the maximum thermal power is 15.7 W, 35.3% higher than that of the CFW-FMHP under the same filling rate. Moreover, the dynamic response characteristics of the CW-FMHP are significantly improved. The thermal resistance of the CW-FMHP is 0.48 °C/W under the filling rate of 150% at the thermal power of 10 W with a reduction of 9.4% compared to the CFW-FMHP under the same condition. Furthermore, the optimal filling rate for OCW-FMHP is lower compared with the CW-FMHP. The maximum thermal power of OCW-FMHP increases to 17.8 W while the thermal resistance reduces to 0.34 °C/W under the liquid filling rate of 140%. This implies that the composite wick structure designed in this work can improve the thermal transfer performance of the FMHP, and the composite wick with wettability modification is more effective regarding both thermal resistance and maximum thermal power.

ORAL ABSTRACTS: O11 COMPARATIVE STUDY OF TWO DIFFERENT-SIZED COPPER IUDS: 12-MONTH RESULTS OF A SINGLE-BLIND RANDOMIZED TRIAL IN A PREDOMINATELY NULLIPAROUS POPULATION

ORAL ABSTRACTS: O11 COMPARATIVE STUDY OF TWO DIFFERENT-SIZED COPPER IUDS: 12-MONTH RESULTS OF A SINGLE-BLIND RANDOMIZED TRIAL IN A PREDOMINATELY NULLIPAROUS POPULATION

AGE- AND CONTRACEPTIVE-SPECIFIC ANTI-MÜLLERIAN HORMONE REFERENCE VALUES FROM OVER 25,000 REPRODUCTIVE-AGE WOMEN

To determine age-specific median anti-Müllerian hormone (AMH) levels across contraceptive types in healthy women. Women aged 20 to 47 years of age, with no pre-existing comorbidities, who took the Modern Fertility Hormone Test were included in this study. AMH was determined using the Beckman Coulter Access assay, with values 0.1 to 24 ng/mL. Log transformed AMH values were analyzed using fitting generalized additive models (GAMs) accounting for age using quantile regression and assumed as the ratio of medians. For ages 20, 25, 30, 35, 40, and 45, predicted age specific median (95% confidence intervals) levels were assessed. A sensitivity analysis, adjusted for BMI, smoking frequency, CD3, testing lab, and age of menarche, was also performed. 25,763 healthy women reported their use of current contraceptive methods; no birth control: 16499 (64%), copper IUD: 926 (3.6%), hormonal IUD: 2955 (11.5%), implant: 477 (1.9%), progestin-only pill (POP): 260 (1.0%), combined oral contraceptive (OCP): 4059 (15.8%), ring: 587 (2.3%). AMH exhibited age-related declines regardless of the mode of contraception as shown by predicted median values and 95% CI. Median values at age 30 ranged from 3.39 ng/mL to 2.81 ng/mL across contraceptive types. In the adjusted analysis, median values were lower but the relationship was similar.Tabled 1202530354045No contraceptives4.23 (3.64 - 4.92)3.95 (3.78 - 4.11)3.33 (3.24 - 3.41)2.53 (2.46 - 2.60)1.46 (1.39 - 1.52)0.66 (0.59 - 0.74)OCP3.48 (2.76 - 4.40)3.49 (3.27 - 3.72)2.84 (2.72 - 2.97)2.07 (1.94 - 2.20)1.04 (0.90 - 1.19)0.38 (0.26 - 0.57)Hormonal IUD4.77 (3.70 - 6.14)3.97 (3.70 - 4.27)3.33 (3.18 - 3.49)2.51 (2.35 - 2.68)1.48 (1.29 - 1.71)0.73 (0.51 - 1.04)Copper IUD4.60 (3.42 - 6.17)4.12 (3.69 - 4.59)3.39 (3.17- 3.62)2.65 (2.43 - 2.90)1.84 (1.52 - 2.23)1.22 (0.78 - 1.92)Implant3.68 (2.51 - 5.38)3.60 (3.12 - 4.16)3.08 (2.80 - 3.40)2.09 (1.74 - 2.50)1.21 (0.75 - 1.95)0.66 (0.24 - 1.81)POP5.08 (3.06 - 8.43)3.94 (3.18 - 4.88)2.87 (2.53 - 3.25)1.88 (1.62 - 2.19)1.16 (0.85 - 1.59)0.69 (0.35 - 1.36)Ring3.79 (2.48 - 5.80)3.33 (2.77 - 4.02)2.81 (2.58 - 3.06)2.18 (1.97 - 2.41)1.59 (1.26 - 2.01)1.11 (0.66 - 1.89) Open table in a new tab Understanding and interpreting ovarian reserve in contraceptive users has been limited by the lack of comprehensive AMH reference values for various contraceptive methods. These data, the first AMH reference values by age and contraceptive type, may be used to more accurately estimate underlying ovarian reserve among contraceptive users.

COMPARATIVE COPPER PHARMACOKINETIC PROPERTIES OF A NOVEL LOW-DOSE NITINOL FRAME COPPER INTRAUTERINE DEVICE (IUD) AND THE COPPER T380A IUD: A RANDOMIZED CONTROLLED TRIAL

We compared the pharmacokinetics and bioavailability of serum copper in women receiving either a novel low-dose nitinol frame copper IUD or the copper T380A IUD through the first 57 days of use. Two sites participated in this parallel -single-blind study that randomized reproductive age women 1:1 to an investigational low-dose copper IUD (with 175 mm2 of exposed copper) or the approved copper T380A (Paragard, 380 mm2) IUD. Participants provided two baseline total serum copper samples at least 24 hours apart within 28 days prior to IUD placement followed by seven samples following randomization on days 1, 3, 8, 15, 22, 29, and 57. We used a noncompartmental mixed-effects linear analysis of variance (ANOVA) model with treatment as a fixed effect and subject as a random effect to calculate uncorrected PK parameters Cmax, Cmean, and AUC0-56 days. We compared relative bioavailability between the two groups by geometric mean ratios and 90% confidence intervals. We hypothesized that the relative bioavailability of total serum copper for the low-dose device would not exceed established normal (490 to 1840 ng/ml) or levels seen in users of the copper T380A. Of the 41 participants enrolled, 39 had successful IUD placements (20 in the low-dose group and 19 in the T380A group) with 36 of those subjects completing the treatment comparison phase of the study (19 low-dose and 17 T380A). Participants reported a mean age of 28.4 years. The baseline mean serum copper concentrations for the low-dose group were 1220 ng/ml standard deviation (SD) ± 285 ng/ml vs. 1250 ng/ml ± 276 ng/ml for the T380A group. Observed copper concentrations in both groups remained in the normal range; with the relative mean Cmax, Cmean, and AUC 0-56 days of 1210 ng/ml, 1070 ng/ml, and 59,700 for the low-dose IUD group vs. 1300, 1150, and 63,600 for the T380A group. Post IUD placement values for both the low-dose group and the copper T380A group were slightly lower than baseline values over the seven timepoints from 0-56 days. Respective baseline-corrected mean values for the low-dose group were 7.8 to 29.8 ng/ml and for the T380A group were 14.9 to 34.3 ng/ml lower than baseline. Relative bioavailability by geometric mean copper exposure for all parameters ranged from 0.93-0.94 (90% CI for all values 0.85-1.02) with all mean values for the low-dose IUD lower than the T380A. Serum copper concentrations for the two IUDs remained within the normal range and trended toward lower values for participants assigned to the low-dose copper IUD relative to the T380A. Neither IUD generated clinically meaningful changes in total serum copper concentrations during the first 56 days after IUD placement.

Pooled incidence of continuation and pregnancy rates of four contraceptive methods in young women: a meta-analysis

Background Continuation rates of contraceptive methods in young women vary among studies, and there is scarce data regarding the pregnancy rate in this population. Methods Four independently systematic searches were performed in PUBMED, EMBASE, LILACS, and Cochrane databases from inception until January 2021 for oral contraceptive pill (OCP), copper IUD, levonorgestrel intrauterine system (LNG-IUS), and subdermal implant. Inclusion criteria were observational or RCT studies that reported continuation for at least 12 months and/or pregnancy rate of these contraceptives methods in girls aged 22 years old or younger. Two authors extracted data from the study design and the outcomes. Pooled proportions of each method were applied using the inverse variance in all calculations with LOGIT transformation, using the random-effects model. Cochrane collaboration tool and New Castle-Ottawa were used to assess the quality and bias of all included studies. GRADE criteria evaluated the quality of evidence. Results Continuation rate for OCP was 51% (95%CI 34%–68%), while for cooper IUD was 77% (95%CI 74%–80%), LNG-IUS 84% (95%CI 80%–87%), and implant 85% (95%CI 81%–88%). The pooled estimated pregnancy rate for OCP was 11% (95%CI 6%–20%), while for cooper IUD was 5% (95%CI 3%–7%), LNG-IUS 1.6% (95%CI 1.2%–2.3%), and implant 1.8% (95%CI 0.4%–8.4%). Conclusion Long-acting contraceptive methods presented higher continuation rates and lower pregnancy rates when compared to OCPs.

P–742 Medical contraceptive use in the French population: Can we explore it based on the national health insurance data?

Abstract Study question Are French national health insurance data reliable for studying the use of medical contraception? Summary answer Health insurance data produce a measurement of contraceptive use consistent with population-based survey data, which affords new opportunities for studying contraception. What is known already Medical contraception is a major public health issue as most women of reproductive age use it. It is usually studied through population-based surveys. However, such surveys are conducted only every 10 years, and analyses are limited by their sample size. French national health insurance data provide comprehensive and time-continuous information on each reimbursed contraceptive. However, because these data have been collected for a different purpose (reimbursement), their relevance for measuring the use of contraceptives needs to be assessed. Study design, size, duration Two sources were analysed. First, a cross-sectional cohort was extracted from the health insurance database, which includes all health reimbursements (such as those for medical contraceptives) and covers 98% of the French population, including 14 million women aged 15–49. Secondly, we used the last French survey on contraception, a cross-sectional study including 4,508 women aged 15–49 interviewed by phone. Participants/materials, setting, methods From both sources, we selected all women aged 15–49 living in metropolitan France. We identified the last medical contraceptive purchased by each woman between 2014 and 2019. The woman was then classified as currently using this contraceptive if the recommended duration of use for this contraceptive was still ongoing on 31 December 2019. Prevalences were compared to those observed in the population based survey. Main results and the role of chance Among the 14.3 million women aged 15–49 living in metropolitan France covered by the health insurance, 26.0% were using the pill, 17.4% an IUD (7.6% hormonal IUD; 9.9% copper IUD), and 3.1% an etonogestrel implant. These proportions are very close to and not statistically different from those observed in the population-based survey (26.2% for the pill, 18.4% IUD, and 3.1% implant). Contraceptive use varied widely with women’s age. At ages 20–24, the most widely used contraceptive was the pill (42.2%), and very few long-acting contraceptives were used (7.6% IUD; 4.9% implant). At ages 30–34, the pill was less frequently used (21.6%) and IUD more frequently used (copper IUD: 15.79%; hormonal IUD: 7.06%). Limitations, reasons for caution It cannot be ruled out that some contraceptives were purchased but never used and that a few women stopped using the contraceptive before the end of its recommended duration. Wider implications of the findings: To our knowledge, this study is the first to estimate prevalence for Copper IUD and for hormonal IUD in France. Using the national health insurance database, it is now possible to monitor the use of each type of medical contraceptive over time in a reliable population-based approach. Trial registration number Not applicable

Use of Contraceptive Methods among Pakistani Women in Southern Punjab and Perception about their Effectiveness

Objective: To study the general trends about the use of different contraceptive methods among rural and urban women; and ascertain their perception about the effectiveness of contraceptives and associate desire forfertility, parity, and birth control measures among the women of rural and urban areas.Study Design: A cross-sectional descriptive study.Place and Duration of the Study: The study was conducted in the Gynecology department of Mukhtar. A Sheikh Hospital, Multan from 3th of October 2019 to 3th of March 2020.Materials and Methods: A total of 200 women aged between 31-41 years and varying literacy rates wereincluded in the study. The participants belonged to both rural and urban areas and interviewed for theirdesirability for fertility. Negative responses were asked further probed regarding their perspective aboutcontraception and preferred method. Data was analyzed on SPSS software 23.0.Results: Out of 200 female patients, 75% urban and 65.4% rural women expressed no desire for fertility, Thecontraceptive utilization was reported 91.6% among urban and 76.9% among rural women. Among the ruraland urban users of contraceptives, the barrier method was the most frequently used method with thepercentage of 50% and 42.3%, respectively. Among women with parity less than or equal to 3, 61.5% had nodesire for fertility and 56.4% were using the barrier method while all the women (31.4%) with parity greaterthan 3 expressed no desire for fertility and were using copper IUDs for contraception. Although, 30.4% of urbanwomen regarded contraception methods as most effective yet only 18.8% found them completely effective.Conclusion: The prevalence rate of contraception in Pakistan has drastically risen among both rural and urbanwomen but traditional barrier methods remain the frequent method of use. However, majority still believe thatcontraceptive methods are not effective. Therefore, awareness campaigns should be launched to increase theiracceptability and eliminate myths.

Continuation and satisfaction with intrauterine copper device inserted during caesarean delivery

Purpose The objective was to assess the continuation and satisfaction of women who had copper IUDs inserted during caesarean delivery, in addition to possible factors associated with device positioning. Materials and methods A prospective, observational study was carried out involving 158 women who underwent copper IUD insertion during caesarean delivery in Fortaleza, Brazil. The women were followed up 6 weeks and 6 months after insertion of the IUD, at which time they completed a satisfaction questionnaire. We performed speculum and ultrasound examination. Results IUD continuation rates after 6 weeks and 6 months were 92% and 71.5%, respectively. Approximately 85% and 76% of the women were satisfied with the method after 6 weeks and 6 months, respectively. The rate of poor positioning on ultrasound was 5% and the rate of visible thread after 6 weeks was 29.1%, both without association with age, parity, gestational age or active labour. There were 2 cases of infection (1.3%) and no cases of perforation or pregnancy. Conclusions There was a good rate of continuation and satisfaction with the immediate post-caesarean IUD. There was no association between IUD malpositioning and age, parity, gestational age or active labour.

Low-Cost High-Pressure Clinical-Scale 50% Parahydrogen Generator Using Liquid Nitrogen at 77 K.

We report on a robust and low-cost parahydrogen generator design employing liquid nitrogen as a coolant. The core of the generator consists of catalyst-filled spiral copper tubing, which can be pressurized to 35 atm. Parahydrogen fraction >48% was obtained at 77 K with three nearly identical generators using paramagnetic hydrated iron oxide catalysts. Parahydrogen quantification was performed on the fly via benchtop NMR spectroscopy to monitor the signal from residual orthohydrogen-parahydrogen is NMR silent. This real-time quantification approach was also used to evaluate catalyst activation at up to 1.0 standard liter per minute flow rate. The reported inexpensive device can be employed for a wide range of studies employing parahydrogen as a source of nuclear spin hyperpolarization. To this end, we demonstrate the utility of this parahydrogen generator for hyperpolarization of concentrated sodium [1-13C]pyruvate, a metabolic contrast agent under investigation in numerous clinical trials. The reported pilot optimization of SABRE-SHEATH (signal amplification by reversible exchange-shield enables alignment transfer to heteronuclei) hyperpolarization yielded 13C signal enhancement of over 14,000-fold at a clinically relevant magnetic field of 1 T corresponding to approximately 1.2% 13C polarization-if near 100% parahydrogen would have been employed, the reported value would be tripled to 13C polarization of 3.5%.

Risk of precancerous cervical lesions in women using a hormone-containing intrauterine device and other contraceptives: a register-based cohort study from Denmark.

STUDY QUESTIONIs the risk of high-grade precancerous cervical lesions and/or is the risk of lesion progression increased in users of a hormone-containing intrauterine device (HIUD) compared with users of other contraceptive methods.SUMMARY ANSWERWomen starting use of HIUD had the same subsequent risk of cervical intraepithelial neoplasia 3+ (CIN3+) as copper IUD (CIUD) users, and both groups tended to have lower risks than oral contraceptives (OC) users.WHAT IS KNOWN ALREADYHIUDs may cause inflammatory and immunosuppressive changes that may potentially affect the risk of persistent human papillomavirus infection and precancerous cervical lesions.STUDY DESIGN, SIZE, DURATIONA Danish population-based cohort study was conducted using register data from 2008 to 2011 on 26–50-year-old users of HIUD (n = 60 551), CIUD (n = 30 303), or OC (n = 165 627).PARTICIPANTS/MATERIALS, SETTING, METHODSWithin each user group, women were divided into two groups; normal cytology or abnormal diagnosis before start of contraceptive use (baseline). Follow-up histology and cytology diagnoses were registered during the 5 years after baseline. Adjusted relative risks (aRR) and 95% CI were calculated for precancerous cervical lesions in HIUD users compared with CIUD and OC users.MAIN RESULTS AND THE ROLE OF CHANCEWomen with normal cytology at baseline: at follow-up HIUD users had the same risk of CIN3 or higher (3+) as CIUD users; aRR 1.08 (95% CI 0.94–1.22). For the HIUD and CIUD groups compared with OCs, the risks of CIN3+ were lower: aRR 0.63 (95% CI 0.57–0.69) and aRR 0.58 (95% CI 0.52–0.65), respectively. The same was observed for CIN2 risks: aRR 0.86 (95% CI 0.76–0.96) and aRR 0.68 (95% CI 0.58–0.79) for HIUD and CIUD groups, respectively. Women with abnormal diagnosis at baseline: a lower progression risk, except for CIN2+ at baseline, was observed in HIUD users compared with OC users. Similar progression risks were found in HIUD and CIUD users. There were no differences between the three contraceptive groups in persistence or regression of present lesions.LIMITATIONS, REASONS FOR CAUTIONWe adjusted for age, education, and region of residence as a proxy for socio-economic factors. Data on smoking and sexual behavior were not available thus we cannot exclude some differences between the three user groups.WIDER IMPLICATIONS OF THE FINDINGSThese findings suggest that women may safely use HIUDs.STUDY FUNDING/COMPETING INTEREST(S)A.P. Møller Foundation for the Advancement of Medical Science, Else and Mogens Wedell-Wedellborgs Fund, Direktør Emil C. Hertz og Hustru Inger Hertz Fund, and the Fund for Development of Evidence Based Medicine in Private Specialized Practices. EL is principle investigator for a study with HPV-test-kits provided by Roche. The other authors have nothing to declare.TRIAL REGISTRATION NUMBERN/A.

Real-world cost-effectiveness of etonogestrel implants compared to long-term and short term reversible contraceptive methods in France

Background To estimate the cost-effectiveness (CE) of etonogestrel implants compared to other long-term and short-term reversible contraceptive methods available in France. Research design and methods A 6-year Markov model compared effectiveness between the implant and six other contraceptive methods in sexually active, not-pregnancy-seeking French females of reproductive age. Contraception efficacy, switch rates and outcomes were based on French current medical practice. Incremental CE ratios (ICERs) were calculated as incremental cost per unintended pregnancy (UP) avoided. Efficiency frontier was plotted to identify cost-effective methods. Uncertainty was explored through sensitivity analyses. Results The implant was on the efficiency frontier along with combined oral contraceptive pill (COC) and copper IUD. Implant avoids between 0.75% and 3.53% additional UP per person-year compared to copper IUD and second generation COC, respectively, with an ICER of €2,221 per UP avoided compared to copper IUD. For the 240,000 French women currently using the implant, up to 8,475 UPs and up to 1,992 abortions may be prevented annually. Conclusion With more unintended pregnancies avoided and comparable costs to copper IUD, the implant is a cost-effective option among long-term and short-term reversible contraceptive methods.

The intrauterine device versus oral hormonal methods as emergency contraceptives: A systematic review of recent comparative studies

Oral emergency contraceptives do not appear to be as effective as the copper IUD as an emergency contraceptive. There is as yet no estimation of the relative efficacy rates rather than the failure rates. The references for this study were obtained by entering the terms “intrauterine device” “and “emergency contraception” in Medline, PubMed, Popline, Global Health and ClinicalTrials.gov. Chinese references were obtained from the Wanfang database. For the short term study articles with a defined population who were followed up after the index cycle were eligible. Women who were adequately followed for at least 6 months were included in the long term study.There were 13(of 228) studies which met our selection criteria and were conducted between August 2011 and January 2019. There were 960 insertions of four types of copper IUD with a failure rate of 0.104%. There were 22 failures out of 1453 oral emergency contraception users with a failure rate of 1.51%. The relative risk of failure for an intrauterine device versus an oral method was 0.1376(95% CI −0.03–0.58). The 6 month to 12 month pregnancy rate was 0–6% for IUDs and 2.7–12% for oral methods.The copper IUD appears to be more effective than oral methods as an emergency contraceptive. The 6 to 12 month pregnancy rates after using either method is 4–10%. Emergency contraception is not a solution to unintended pregnancy.

The HER Salt Lake media campaign: comparing characteristics and outcomes of clients who make appointments online versus standard scheduling

BackgroundLittle research has examined how media outreach strategies affect the outcomes of contraceptive initiatives. Thus, this paper assesses the potential impact of an online media campaign introduced during the last six months of a contraceptive initiative study based in Salt Lake City, UT (USA).MethodsDuring the last six months of the HER Salt Lake Contraceptive Initiative (September 2016-March 2017), we introduced an online media campaign designed to connect potential clients to information about the initiative and a brief (9-item) appointment request form (via HERsaltlake.org). Using linked data from the online form and electronic medical records, we examine differences in demographics, appointment show rates, and contraceptive choices between “online requester” clients who made clinical appointments through the online form (n = 356) and “standard requester” clients who made appointments using standard scheduling (n = 3,051). We used summary statistics and multivariable regression to compare groups.ResultsThe campaign logged 1.7 million impressions and 15,765 clicks on advertisements leading to the campaign website (HERSaltLake.org). Compared to standard requesters, online requesters less frequently reported a past pregnancy and were more likely to be younger, white, and to enroll in the survey arm of the study. Relative to standard requesters and holding covariates constant, online requesters were more likely to select copper IUDs (RRR: 8.14), hormonal IUDs (RRR: 12.36), and implants (RRR: 10.75) over combined hormonal contraceptives (the contraceptive pill, patch, and ring). Uptake of the contraceptive injectable, condoms, and emergency contraception did not differ between groups.ConclusionClients demonstrating engagement with the media campaign had different demographic characteristics and outcomes than those using standard scheduling to arrange care. Online media campaigns can be useful for connecting clients with advertised contraceptive methods and initiatives. However, depending on design strategy, the use of media campaigns might shift the demographics and characteristics of clients who participate in contraceptive initiatives.Trial RegistrationClinicaltrials.gov identifier NCT02734199, Registered 12 April 2016—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02734199.

Laboratory measurements of the effects of interlaminar slip on vortex-induced vibrations of the unbonded umbilical

Laboratory tests were performed to investigate the influence of interlaminar slip on the vortex-induced vibrations (VIV) of the unbonded umbilicals. Two types of umbilical models with the same size were fabricated by using an acrylic tube enclosing seven-core spiral copper cable, in which the unbonded umbilical contains relative slip between its tube and cable, and the interior structure of the bonded one was fixed as a contrast. Both umbilical models under a same top tension were excited respectively in a flume with current velocity varying from 0.1 m/s to 0.7 m/s. Fiber Bragg Grating (FBG) sensors were employed to measure the VIV response in both cross-flow (CF) and in-line (IL) directions. Experimental results confirm that the unbonded umbilical is more susceptive to the reduced velocity in terms of displacement, frequency and trajectory, which is attributed to the nonlinear variation in bending stiffness resulting from the relative slip. Furthermore, the onset of lock-in region for the unbonded model occurs at a lower velocity than that for the bonded model, but with a similar width of lock-in region. Although VIV displacement in the mode transition is relatively small, the interlaminar slip still works due to the influence of its high frequency.

Expanding Options for Intrauterine Contraception

In the U.S., levonorgestrel IUDs are preferred over copper IUDs for long-term contraception because they reduce menstrual bleeding and cramping. How do

Postplacental Insertion of Levonorgestrel Intrauterine System Versus Copper Intrauterine Device: A Prospective Study.

To compare between postplacental insertion of levonorgestrel intrauterine system versus copper intrauterine device regarding expulsion rates, patient satisfaction, complications, and continuation rates. This prospective observational study was conducted on 1100 participants divided in to two groups: group (1) CU-IUD group and group (2) LNG-IUS group where women were assigned for postplacental insertion of either CU-IUD or LNG-IUS, respectively. Follow-up at 6weeks, 3 and 6months postpartum and data were collected and analyzed to evaluate outcomes. No statistical difference between both groups regarding patients' characteristics, the overall expulsion rate was higher in LNS-IUS group than CU-IUD group; 77 patients (14%) and 50 patients (9%), respectively, (P value < 0.05), odds ratio: 1.63 at CI: (1.12-2.37). No significant difference between the two groups regarding pain intensity, perforation, abnormal uterine bleeding, and clinical endometritis (P > 0.05). Overall satisfaction rate at six months was 478(87%) in the CU-IUD group and 472(85.8%) in the LNS-IUS group (P value > 0.05), odds ratio: 1.1 at CI: (0.78-1.55). Continuation rate at s6 months was comparable between the two groups 485 (88.2%) and 480 (87.3%) in CU-IUD group and LNS-IUS group respectively, (P value < 0.05), odds ratio: 1.09 at CI: (0.76-1.56). The rate of expulsion of LNG-IUS is higher than copper IUD when inserted postplacental, yet the continuation and acceptability rates were comparable between the two groups.

Clinical availability of the copper IUD in rural versus urban settings: A simulated patient study

ObjectiveTo assess the proportion of Washington state clinics that offer the copper IUD in rural vs urban settings. Study designWe employed a simulated patient model to survey clinics in the Human Health Resources and Services Administration 340B database to primarily assess the availability of the copper IUD. ResultsWe successfully surveyed 194/212 (92%) clinics. More urban than rural clinics reported copper IUD availability (76/97 [78%] vs 49/97 [51%]; p < 0.01). ConclusionsRural clinics are less likely than urban clinics to have the copper IUD available. ImplicationsThe frequency of unintended pregnancies is high in the United States. We should focus our attention on decreasing barriers to the copper IUD as a long-acting reversible contraceptive, particularly for women living in rural settings.